Comparison of the Carba NP test with the Rapid CARB Screen Kit for the detection of carbapenemase-producing Enterobacteriaceae and Pseudomonas aeruginosa.

The purpose of this investigation was to compare the performance and cost of the Carba NP test with the Rapid CARB Screen Kit in detecting the presence of carbapenemase in Enterobacteriaceae and Pseudomonas aeruginosa. Ninety-two Enterobacteriaceae and 19 P. aeruginosa strains were used in this study. Multiplex polymerase chain reaction (PCR) was performed to determine whether these microorganisms harboured bla VIM, bla IMP, bla NDM, bla KPC and bla OXA-48. The Carba NP test and Rapid CARB Screen Kit were used on the strains according to the standardised protocols. The sensitivity, specificity and positive and negative predictive values of the tests were calculated. The cost of performing one test was also calculated. Forty-five Enterobacteriaceae and six P. aeruginosa were found to harbour carbapenemase-encoding genes. The Carba NP test had sensitivities of 91.1 % and 100 % for Enterobacteriaceae and P. aeruginosa, respectively. The Rapid CARB Screen Kit had sensitivities of 73.3 % and 66.7 % for Enterobacteriaceae and P. aeruginosa, respectively. The specificity of both tests was 100 %. The approximated price for performing one Carba NP test was 0.31 Euros and for CARB Screen Kit, it was 1.25 Euros. The Carba NP test performed better than the Rapid CARB Screen Kit in detecting carbapenemase production in Enterobacteriaceae and P. aeruginosa. The cost to perform both tests is reasonable.

Bordetella pertussis seroprevalence in Belgian adults aged 20-39 years, 2012.

SUMMARY The last report on pertussis seroprevalence in Belgium concerned samples collected during 1993-1994. In the context of the Eupert-Labnet WP6 seroprevalence study (comparing sera from 16 European member states), 1500 anonymized leftover diagnostic samples were collected randomly during the second semester of 2012 by the clinical chemistry laboratories of six participating Belgian centres, distributed equally between Flanders, Wallonia and Brussels Capital Region. As suggested by the WP6 organizers, a total of 750 samples (125/centre) were selected from subjects in the 20-29 years age group and 750 samples (125/centre) from subjects in the 30-39 years age group. Anti-PT IgG levels were measured using Virion-Serion ELISA and analysed using predefined cut-off levels. Sixty-one (4%) sera were indicative of an infection in the past 2 years (between 50 and 100 IU/ml) and another 61 (4%) sera had anti-PT IgG antibodies reflecting acute infection (>100 IU/ml). These results highlight the presence of a Bordetella pertussis reservoir in the adult 'healthy' Belgian population.

Predictive power of screening for antibodies against insulinoma-associated protein 2 beta (IA-2beta) and zinc transporter-8 to select first-degree relatives of type 1 diabetic patients with risk of rapid progression to clinical onset of the disease: implications for prevention trials.

AIMS/HYPOTHESIS: We investigated whether screening for insulinoma-associated protein (IA-2) beta (IA-2beta) autoantibodies (IA-2betaA) and zinc transporter-8 (ZnT8) autoantibodies (ZnT8A) improves identification of first-degree relatives of type 1 diabetic patients with a high 5-year disease risk, which to date has been based on assays for insulin autoantibodies (IAA), GAD autoantibodies (GADA) and IA-2 autoantibodies (IA-2A). METHODS: IA-2betaA and ZnT8A (using a ZnT8 carboxy-terminal hybrid construct, CW-CR, carrying 325Arg and 325Trp) were determined by radiobinding assay in 409 IAA(+), GADA(+) and/or IA-2A(+) siblings or offspring (<40 years) of type 1 diabetic patients consecutively recruited by the Belgian Diabetes Registry. The median (interquartile range) age of the first-degree relatives was 12 (6-19) years. RESULTS: Of the first-degree relatives, 24% were IA-2A(+) (n = 97), 14% (n = 59) IA-2betaA(+) and 20% (n = 80) ZnT8A(+). IA-2betaA and ZnT8A were significantly (p < 0.001) associated with IA-2A and prediabetes (n = 86); in IA-2A(-) first-degree relatives (n = 312) the presence of IA-2betaA and ZnT8A was associated with an increased progression rate to diabetes (p < 0.001). Positivity for IA-2A and/or ZnT8A emerged as the most sensitive combination of two markers to identify first-degree relatives with a 5-year progression rate to diabetes of 45% (survival analysis) and as strongest predictor of diabetes (Cox regression analysis). Omission of first-degree relatives protected by HLA-DQ genotypes or maternal diabetes reduced the group to be followed from n = 409 to n = 246 (40%) with minor loss in the number of prediabetic IA-2A(+) or ZnT8A(+) first-degree relatives identified (n = 3). CONCLUSIONS/INTERPRETATION: IA-2A(+) and/or ZnT8A(+) first-degree relatives may be the participants of choice in future secondary prevention trials with immunointervention in relatives of type 1 diabetic patients.