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Ming Wei,1 Xi Chen,1 Jun Liu,1 Tianmeng Li,1 Peng Wang,1 Shuai Wang,1 Jing Wang,2,3 Li Gu1 1Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Jing Wang, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, People’s Republic of China, Email kycwangjing@mail.ccmu.edu.cn Li Gu, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, People’s Republic of China, Email didcm2006@mail.ccmu.edu.cnPurpose: Carbapenem-resistant Enterobacterales (CRE) infection is an urgent threat to human health. This study aimed to develop and validate a novel multiplex real-time PCR (multi-qPCR) assay for the detection of the blaKPC, blaNDM, blaIMP, blaOXA-48-like, and blaVIM genes in CRE isolates and clinical samples, as well as to compare it with three phenotypic methods.Methods: The reliability and limit of detection (LOD) of the multi-qPCR assay were evaluated. PCR and DNA sequencing were used as the reference methods to identify carbapenemase genes in CRE isolates and clinical samples. The accuracy of the multi-qPCR assay, modified carbapenem inactivation and EDTA-modified carbapenem inactivation method (mCIMandeCIM), carbapenemase inhibitor-based combined disk test (CDT), and colloidal gold-based immunochromatographic test was compared with the reference methods with 182 isolates of CRE. Furthermore, 112 clinical samples were collected to validate the efficacy of this multi-qPCR assay.Results: The standard deviations (CVs) of intra-assay and inter-assay of the multi-qPCR assay were ≤ 0.53% and ≤ 2.04% for detecting the five major carbapenemase genes, respectively; while the LOD ranged from 2× 102 copies/mL to 8× 102 copies/mL. PCR and DNA sequencing confirmed 168 out of 182 CRE isolates producing carbapenemase(s): KPC (n = 93), NDM (n = 46), IMP (n = 8), OXA-48-like (n = 14), VIM (n = 1), KPC&NDM (n = 5), and KPC&NDM&IMP (n = 1). The accuracy of mCIMandeCIM, CDT, Colloidal Gold, and the multi-qPCR assay was 96.2%, 89.6%, 100%, and 100% respectively for detecting carbapenemase(s) producers. Moreover, the sensitivity and specificity of the multi-qPCR assay were all 100% for the detection of each carbapenemase gene in clinical samples, compared with PCR and sequencing.Conclusion: For clinical isolate detection, the multi-qPCR assay is comparable to Colloidal Gold, and superior to mCIMandeCIM and CDT; while for clinical samples detection, it also shows excellent performance. Therefore, the multi-qPCR assay has great potential for clinical diagnosis.Keywords: carbapenem-resistant Enterobacterales, carbapenemases detection, multiplex real-time PCR assay, mCIM/eCIM, combined disk test, immunochromatographic test

Background: Dengue fever is an arthropod-borne disease transmitted to humans by Aedes aegypti mosquitoes and one of the leading causes of arthropod-borne viral disease in the world. Aims and Objectives: The present study aims to analyze any association between platelet count and immunochromatography -based dengue serology tests. Materials and Methods: This was a cross-sectional study conducted in Government Doon Medical College and Hospital. A total of 19,208 clinically suspected cases of dengue who reported in various outpatient departments, emergency services, and inpatient departments of our hospital between June 2023 and November 2023 were included in this study. Samples were tested by rapid immunochromatographic test for dengue non-structural protein 1 (NS1) antigen, immunoglobulin M (IgM), IgG, and platelet count was also obtained and a comparison was made. Results: Out of total 19,208 samples tested, 4876 (25.38%) samples were positive for NS1, 589 (3.06%) samples were positive for IgM. Majority of the patients were in the age group of 21–40 years 9274 (48.28%). 11,753 (61.19%) were males and 7455 (38.80%) were females. A strong correlation was seen between NS1 and thrombocytopenia where a total of 2737/4876 (n=56.13%) patients showed positivity in NS1 with low platelet counts. Conclusion: Detection of NS1 antigen helps in early diagnosis of dengue to avoid complications significantly. In confirmed dengue cases with fever, thrombocytopenia is more consistently found and can be used as a predictor to reduce the morbidity and mortality of dengue disease.

Background: Acute gastroenteritis is one of the major causes of morbidity and mortality in young children worldwide. Among these, rotavirus, norovirus, and adenovirus have been reported as the primary viral pathogens associated with the disease. Rapid diagnosis of viral pathogens is crucial when diarrhea outbreaks occur to ensure the timely administration of appropriate treatment and control measures. Methods: We evaluated three immunochromatographic test kits designed for the detection of norovirus, rotavirus, and adenovirus in 71 stool specimens collected from children with diarrhea who visited clinics in Japan. The first kit is a triplex immunochromatographic test kit designed for simultaneous detections of norovirus, rotavirus, and adenovirus on a single strip (this kit was referred to as IC-A). The other two immunochromatographic test kits are a dual detection kit for rotavirus and adenovirus, and a single detection kit for norovirus (IC-B). The RT-PCR/PCR was used as the gold standard method. Results: The results revealed that both IC-A and IC-B kits exhibited the same level of sensitivity of detection for rotavirus (72.7%) and adenovirus (22.7%), although the detection rate was lower than that of the RT-PCR/PCR method. However, there was a slight difference in the sensitivity of detection for norovirus between IC-A and IC-B, at 86.7% and 93.3%, respectively. The sensitivity of detection for adenovirus of both kits was relatively lower than those of RT-PCR method. This could be due to low viral load of adenovirus in clinical specimens below the detection limit of IC-A and IC-B kits. However, both immunochromatographic test kits (IC-A and IC-B) exhibited 100% specificity for norovirus, rotavirus, and adenovirus. Conclusions: The triplex immunochromatographic test kit (IC-A) designed for simultaneous detection of norovirus, rotavirus, and adenovirus has been proved to be more practical and convenient than the use of single or dual detection kits with more or less the same sensitivity and specificity of detections.

Background: Dengue fever is an arthropod-borne disease transmitted to humans by Aedes aegypti mosquitoes and one of the leading causes of arthropod-borne viral disease in the world. Aims and Objectives: The present study aims to analyze any association between platelet count and immunochromatography -based dengue serology tests. Materials and Methods: This was a cross-sectional study conducted in Government Doon Medical College and Hospital. A total of 19,208 clinically suspected cases of dengue who reported in various outpatient departments, emergency services, and inpatient departments of our hospital between June 2023 and November 2023 were included in this study. Samples were tested by rapid immunochromatographic test for dengue non-structural protein 1 (NS1) antigen, immunoglobulin M (IgM), IgG, and platelet count was also obtained and a comparison was made. Results: Out of total 19,208 samples tested, 4876 (25.38%) samples were positive for NS1, 589 (3.06%) samples were positive for IgM. Majority of the patients were in the age group of 21-40 years 9274 (48.28%). 11,753 (61.19%) were males and 7455 (38.80%) were females. A strong correlation was seen between NS1 and thrombocytopenia where a total of 2737/4876 (n=56.13%) patients showed positivity in NS1 with low platelet counts. Conclusion: Detection of NS1 antigen helps in early diagnosis of dengue to avoid complications significantly. In confirmed dengue cases with fever, thrombocytopenia is more consistently found and can be used as a predictor to reduce the morbidity and mortality of dengue disease. [ABSTRACT FROM AUTHOR]

Acute gastroenteritis is one of the major causes of morbidity and mortality in young children worldwide. Among these, rotavirus, norovirus, and adenovirus have been reported as the primary viral pathogens associated with the disease. Rapid diagnosis of viral pathogens is crucial when diarrhea outbreaks occur to ensure the timely administration of appropriate treatment and control measures. We evaluated three immunochromatographic test kits designed for the detection of norovirus, rotavirus, and adenovirus in 71 stool specimens collected from children with diarrhea who visited clinics in Japan. The first kit is a triplex immunochromatographic test kit designed for simultaneous detections of norovirus, rotavirus, and adenovirus on a single strip (this kit was referred to as IC-A). The other two immunochromatographic test kits are a dual detection kit for rotavirus and adenovirus, and a single detection kit for norovirus (IC-B). The RT-PCR/PCR was used as the gold standard method. The results revealed that both IC-A and IC-B kits exhibited the same level of sensitivity of detection for rotavirus (72.7%) and adenovirus (22.7%), although the detection rate was lower than that of the RT-PCR/PCR method. However, there was a slight difference in the sensitivity of detection for norovirus between IC-A and IC-B, at 86.7% and 93.3%, respectively. The sensitivity of detection for adenovirus of both kits was relatively lower than those of RT-PCR method. This could be due to low viral load of adenovirus in clinical specimens below the detection limit of IC-A and IC-B kits. However, both immunochromatographic test kits (IC-A and IC-B) exhibited 100% specificity for norovirus, rotavirus, and adenovirus. The triplex immunochromatographic test kit (IC-A) designed for simultaneous detection of norovirus, rotavirus, and adenovirus has been proved to be more practical and convenient than the use of single or dual detection kits with more or less the same sensitivity and specificity of detections. [ABSTRACT FROM AUTHOR]

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can stimulate a systemic inflammatory response with severe lung involvement, multisystem dysfunction, and death in some cases. Immunosuppressive treatments have been proposed for management of COVID-19 patients, but these bring the risk of flare-up of pre-existing infections. Strongyloidiasis can become severe or fatal in immunocompromised individuals. This cross-sectional study determined the prevalence of anti-Strongyloides IgG antibody in sera collected from SARS-CoV-2 infected persons in a tertiary-care Thai hospital from January 2021 to January 2022. The survey was conducted using a rapid immunochromatographic test (ICT) kit based on a recombinant antigen of Strongyloides stercoralis known to be IgG-immunoreactive. High prevalence of anti-Strongyloides IgG antibody was found. Out of 297 SARS-CoV-2-infected patients 117 (39.4 %, 95 % CI 33.8–45.2 %) were positive for S. stercoralis according to the ICT kit. In areas where strongyloidiasis is endemic, we suggest using this point-of-care ICT kit for routine rapid screening in seriously ill COVID-19 patients who will be subjected to immunosuppressive treatment. Prompt anthelminthic treatment should be administered to prevent serious systemic strongyloidiasis in at-risk patients.

Abstract Background Equine piroplasmosis is caused by two tick-borne protozoan parasites, Theileria equi and Babesia caballi,, which are clinically relevant in susceptible horses, donkeys, and mules. Moreover, equine piroplasmosis significantly constrains international trading and equestrian events. Rapidly diagnosing both parasites in carrier animals is essential for implementing effective control measures. Here, a rapid immunochromatographic test for the simultaneous detection of antibodies to T. equi and B. caballi was evaluated using samples from horses and donkeys collected in Greece, Israel, and Italy. The results were compared with an improved competitive enzyme-linked immunosorbent assay (cELISA) for detecting antibodies to both parasites using the same panel of samples. Methods Blood samples were collected from 255 horses and donkeys. The panel consisted of 129 horses sampled at four locations in northern Greece, 105 donkeys sampled at four locations in Sicily, and 21 horses sampled at two locations in Israel. The rapid test and the cELISA were performed according to the manufacturer’s instructions, and the results were subjected to a statistical analysis to determine the sensitivity and specificity of both tests and their association. Results The immunochromatographic test provided a result within 15 min and can be performed in the field, detecting both pathogens simultaneously. The overall coincidence rate between the rapid test and the cELISA for detecting antibodies against T. equi was 93% and 92.9% for B. caballi. The rapid test’s sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for T. equi were above 91.5%. Sixteen samples were positive for both parasites in the rapid test and eight in the cELISA. Either test had no significant association between T. equi and B. caballi detection. The detection rates of both parasites were significantly higher in Italy than in Greece or Israel and in donkeys than in horses. The agreement for T. equi between the results of both tests was high in Greece (93.8%) and Italy (95.2%) and moderate in Israel (76.2%). For B. caballi, the specificity and NPV of the rapid test were high (94.2% and 98.3%, respectively), although the sensitivity and PPV were moderate (69.2% and 39.1%, respectively) due to the small sample size. However, for B. caballi, the sensitivity was higher with the rapid test. Conclusions The rapid test detected T. equi and B. caballi simultaneously in the field, potentially replacing laborious cELISA testing and is recommended for import/export purposes. The test can also be helpful for the differential diagnosis of clinical cases, since seropositivity may rule out equine piroplasmosis since it does not indicate current or active infection. Graphical Abstract

Background: Equine piroplasmosis is caused by two tick-borne protozoan parasites, Theileria equi and Babesia caballi,, which are clinically relevant in susceptible horses, donkeys, and mules. Moreover, equine piroplasmosis significantly constrains international trading and equestrian events. Rapidly diagnosing both parasites in carrier animals is essential for implementing effective control measures. Here, a rapid immunochromatographic test for the simultaneous detection of antibodies to T. equi and B. caballi was evaluated using samples from horses and donkeys collected in Greece, Israel, and Italy. The results were compared with an improved competitive enzyme-linked immunosorbent assay (cELISA) for detecting antibodies to both parasites using the same panel of samples. Methods: Blood samples were collected from 255 horses and donkeys. The panel consisted of 129 horses sampled at four locations in northern Greece, 105 donkeys sampled at four locations in Sicily, and 21 horses sampled at two locations in Israel. The rapid test and the cELISA were performed according to the manufacturer's instructions, and the results were subjected to a statistical analysis to determine the sensitivity and specificity of both tests and their association. Results: The immunochromatographic test provided a result within 15 min and can be performed in the field, detecting both pathogens simultaneously. The overall coincidence rate between the rapid test and the cELISA for detecting antibodies against T. equi was 93% and 92.9% for B. caballi. The rapid test's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for T. equi were above 91.5%. Sixteen samples were positive for both parasites in the rapid test and eight in the cELISA. Either test had no significant association between T. equi and B. caballi detection. The detection rates of both parasites were significantly higher in Italy than in Greece or Israel and in donkeys than in horses. The agreement for T. equi between the results of both tests was high in Greece (93.8%) and Italy (95.2%) and moderate in Israel (76.2%). For B. caballi, the specificity and NPV of the rapid test were high (94.2% and 98.3%, respectively), although the sensitivity and PPV were moderate (69.2% and 39.1%, respectively) due to the small sample size. However, for B. caballi, the sensitivity was higher with the rapid test. Conclusions: The rapid test detected T. equi and B. caballi simultaneously in the field, potentially replacing laborious cELISA testing and is recommended for import/export purposes. The test can also be helpful for the differential diagnosis of clinical cases, since seropositivity may rule out equine piroplasmosis since it does not indicate current or active infection. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the diagnostic performance of different brands of immunochromatographic test (ICT) reagents for Chlamydia trachomatis using homogenized samples to provide a reference for reagent quality control. Methods: Eight commercially available ICT reagents were evaluated, of which three used the latex method and five used the colloidal gold method. Analytical performance evaluation using a pure culture broth of C. trachomatis, as well as clinical application validation using cervical epithelial cell samples acquired from the research subjects, were conducted. The concentration of C. trachomatis was quantified using a nucleic acid amplification test. Results: The limit of detection (LOD) of different ICT reagents in the analytical performance evaluation varied from 9.5 × 103 to 1 × 105 IFU/mL, and only one reagent met the LOD specified in the manufacturer's instructions. Likewise, only one reagent in the clinical application validation achieved the analytical LOD, four reagents were 2.1–4.2-fold of the analytical LODs, and three reagents failed to detect positive results in clinical samples. Conclusions: The diagnostic performance of different methods and different brands of ICT reagents in clinical practice was different from the manufacturer's instructions and the results of laboratory evaluation. The diagnostic performance of reagents should be evaluated before they are actually used in clinical practice.

Background: A pay-for-performance plan for rapid antiretroviral therapy (ART) commencement was initiated in 2018, while a modified testing algorithm offers immunochromatographic test (ICT) to replace Western blot (WB), and simultaneous testing with ICT and Nucleic Acid Amplification Test (NAAT) for HIV-positive sera was adopted in 2019 in Taiwan. Methods: Serum specimens collected from 1117 suspected or confirmed HIV infection cases in 2016–2019 were reassessed the performance of WB, ICT, and NAAT. We reviewed the medical records of 10,732 individuals diagnosed with HIV in 2015–2021 to determine the time from screening to confirmatory diagnosis, followed by ART commencement. Results: All 860 WB-positives were also positive by ICT and NAAT. The positive detection percentages were 37.0% by ICT and 51.4% by NAAT for 257 WB-indeterminate and -negative sera. The sensitivity for WB and ICT was 93.8% and 95.5%, respectively. In the people living with HIV (PLHIV) cohort, the median time from initial positive to confirmatory diagnosis decreased from 5 to 6 days before 2019 to 1 day in 2021. The median time from initial positive to ART initiation decreased from 37 days in 2015, 14 days in 2018, to 6 days in 2021. Compared to 2015–2017, the time to ART initiation was 91.48 days lower in 2018 (P

Toxoplasmosis is a ubiquitous parasitic infection caused by Toxoplasma gondii (Tg). In immunocompetent people, the infection may be asymptomatic with the induction of an immune response that may prevent reinfection or transmission to the fetus in immune pregnant woman. In immunocompromised persons or seronegative pregnant woman with a primary infection during pregnancy, the infection may result in the loss of life, sight, cognition, and motor function in the immune-compromised person or immunologically immature fetus. The objective of this study was to evaluate a new immunochromatographic test Toxoplasma ICT IgG-IgM (ICT) that allows detection of specific anti-Tg immunoglobulins G (Ig G) and M (Ig M). We included 1145 prospectively obtained sera and 376 samples selected for specificity or sensitivity studies. The performance of ICT was compared using Vidas® Toxo Competition (TXC) and Toxoscreen®. In case of discrepancy, Vidas® Toxo Ig G or Ig M and LDBIO Toxo II IgG western blot were used to establish definitive results by additional methods. Sensitivity and specificity of ICT were respectively 99.3% and 100%. In comparison, Toxoscreen®'s sensitivity was 100% and the specificity was 99.8%. TXC had a sensitivity of 98.7% with a specificity of 99.1%. ICT has excellent performance even for low Ig G titers, especially in immunocompromised patients, and confirms the specificity of isolated Ig M. This ICT provides reliable results easily and quickly. This screening technique is not designed to differentiate the Ig M from Ig G. When positive, additional tests may be necessary. [ABSTRACT FROM AUTHOR]

Cystic echinococcus (CE) is a parasitic disease in humans and animals. Our study was performed with the aim of identifying the serology of hydatic cyst disease caused by the Echinococcus granulosus vector, causing a significant health problem in Eastern Anatolia and specifically in our province, among people living in rural areas and involved in animal husbandry. The population for this study comprised 75 volunteers living in rural regions of Erzurum practicing animal husbandry. Blood samples were stored at -40 °C until the time of the study. A survey form was completed to be able to identify the demographic data of participants and to reveal risk factors in terms of infectious vectors. After thawing blood samples at the time of the study, the immunochromatographic test procedure was implemented. The age distribution in the study group was 18 to 70 years, with a mean age of 46.8±15.97 years. The group comprised a total of 75 people, including 29 women (38.7%) and 46 men (61.3%). Of these 75 people with immunochromatographic screening performed, 72 were negative (96%) and 3 were weakly positive (0.5) (4%). It is notable that 4% CE seropositivity was found among individuals with no complaints. Linked to this seropositivity result, it is considered that creating a comprehensive CE screening program will be beneficial for individuals involved in animal husbandry. [Med-Science 2023; 12(3.000): 818-22]

Cystic echinococcus (CE) is a parasitic disease in humans and animals. Our study was performed with the aim of identifying the serology of hydatic cyst disease caused by the Echinococcus granulosus vector, causing a significant health problem in Eastern Anatolia and specifically in our province, among people living in rural areas and involved in animal husbandry. The population for this study comprised 75 volunteers living in rural regions of Erzurum practicing animal husbandry. Blood samples were stored at -40 °C until the time of the study. A survey form was completed to be able to identify the demographic data of participants and to reveal risk factors in terms of infectious vectors. After thawing blood samples at the time of the study, the immunochromatographic test procedure was implemented. The age distribution in the study group was 18 to 70 years, with a mean age of 46.8±15.97 years. The group comprised a total of 75 people, including 29 women (38.7%) and 46 men (61.3%). Of these 75 people with immunochromatographic screening performed, 72 were negative (96%) and 3 were weakly positive (0.5) (4%). It is notable that 4% CE seropositivity was found among individuals with no complaints. Linked to this seropositivity result, it is considered that creating a comprehensive CE screening program will be beneficial for individuals involved in animal husbandry. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of immuno-chromatographic false negative HBV and HCV testing among healthy blood donors in city Lahore. Methodology: This was 18 months cross sectional pilot study, conducted in private and public blood banks of city Lahore. After taking formal consent from head of selected Hospital and in charge blood bank/donors, blood bags screened as HBs Ag and Anti HCV negative by immune-chromatographic (ICT) method, 3-5 ml blood was transferred to coded tube and later transferred to ex-PHRC research Centre NHRC Lahore, where plasma was separated through centrifugation and stored at -40/-20C. Collected samples from this Centre sent to ex-PHRC Research Centre Khyber Medical College Peshawar in cold chain for ELISA testing. Results: Study found that among 385 HBs Ag and anti HCV ICT negative Labeled blood bags 0.8 % was positive for HBs Ag and 2.1% blood bags was positive for anti HCV antibody on ELISA testing. Frequency of AB -ive and A-ive blood bags availability were very rare, 1 % for both types. False negative testing rate of blood bags was comparatively high in public sectors hospitals (1 % for HBs Ag and 3.2% for anti HCV) than private sector hospitals (0.5% for HBs Ag and 1% for anti HCV. False negative ICT testing rate was observed high among blood group B +ive (0.8% for HBV and 4.1% for HCV) than all other blood groups. Conclusion: Study found that 0.8% blood bags were screened falsely negative by immuno-chromatographic method (ICT) for HBs Ag and 2.1% for anti HCV. [ABSTRACT FROM AUTHOR]

Angiostrongylus cantonensis is the major etiological nematode parasite causing eosinophilic meningitis and/or eosinophilic meningoencephalitis in humans. The rapid global spread of Angiostrongylus cantonensis and the emerging occurrence of the infection have exposed the shortcomings of traditional/conventional diagnostics. This has spurred efforts to develop faster, simpler and more scalable platforms that can be decentralized for point-of-need laboratory testing. By far, the point-of-care immunoassays such as the lateral flow assay (LFA) are the best-placed. In this work, a LFA in the form of an immunochromatographic test device (designated AcAgQuickDx), based on the detection of a circulating Angiostrongylus cantonensis-derived antigen, was established using anti-31 kDa Angiostrongylus cantonensis antibody as the capture reagent and anti-Angiostrongylus cantonensis polyclonal antibody as the indicator reagent. The AcAgQuickDx was evaluated for its diagnostic potential with a total of 20 cerebrospinal fluids (CSF) and 105 serum samples from patients with angiostrongyliasis and other clinically related parasitic diseases, as well as serum samples from normal healthy subjects. Three of the ten CSF samples from serologically confirmed angiostrongyliasis cases and two of the five suspected cases with negative anti-Angiostrongylus cantonensis antibodies showed a positive AcAgQuickDx reaction. Likewise, the AcAgQuickDx was able to detect Angiostrongylus cantonensis specific antigens in four serum samples of the 27 serologically confirmed angiostrongyliasis cases. No positive reaction by AcAgQuickDx was observed in any of the CSF (n = 5) and serum (n = 43) samples with other parasitic infections, or the normal healthy controls (n = 35). The AcAgQuickDx enabled the rapid detection of active/acute Angiostrongylus cantonensis infection. It is easy to use, can be transported at room temperature and does not require refrigeration for long-term stability over a wide range of climate. It can supplement existing diagnostic tests for neuroangiostrongyliasis under clinical or field environments, particularly in remote and resource-poor areas. [ABSTRACT FROM AUTHOR]

In this study, an immunochromatographic test (using the Charm QUAD2® Test) was used to screen for residual macrolides and lincosamides in raw cow's milk. The validation parameters (selectivity/specificity, detection capability (CCβ), and ruggedness) were in agreement with the requirements of[EC] 2021. The selectivity of the immunochromatographic test was verified by the negative results of microbiological tests. The false-positive rate was 0%. The CCβ values of the immunochromatographic test for various antibiotics in milk were as follows: erythromycin 0.02 mg/kg, spiramycin 0.1 mg/kg, tilmicosin 0.025 mg/kg, tylosin 0.05 mg/kg, lincomycin 0.15 mg/kg, and pirlimycin 0.15 mg/kg. The determined CCβ values were lower than the respective maximum residue limits (MRLs; regulatory limits in Japan) for milk, except for lincomycin (equal to the MRL). The presence of antibiotic groups other than macrolides and lincosamides did not interfere with the specificity of the test. It showed no significant difference in lot-to-lot repeatability. The results obtained by the two researchers showed no significant differences. Finally, the test was applied to milk samples obtained from a tylosin-treated cow. The outcome was positive and in agreement with the results of the chemical analytical and microbiological methods. Therefore, this validated immunochromatographic test is expected to be suitable for routine analysis to ensure milk safety. [ABSTRACT FROM AUTHOR]

Laboratory-based case confirmation is an integral part of measles surveillance programmes; however, logistical constraints can delay response. Use of RDTs during initial patient contact could enhance surveillance by real-time case confirmation and accelerating public health response. Here, we evaluate performance of a novel measles IgM RDT and assess accuracy of visual interpretation using a representative collection of 125 sera from the Brazilian measles surveillance programme. RDT results were interpreted visually by a panel of six independent observers, the consensus of three observers and by relative reflectance measurements using an ESEQuant Reader. Compared to the Siemens anti-measles IgM EIA, sensitivity and specificity of the RDT were 94.9% (74/78, 87.4–98.6%) and 95.7% (45/47, 85.5-99.5%) for consensus visual results, and 93.6% (73/78, 85.7–97.9%) and 95.7% (45/47, 85.5-99.5%), for ESEQuant measurement, respectively. Observer agreement, determined by comparison between individuals and visual consensus results, and between individuals and ESEQuant measurements, achieved average kappa scores of 0.97 and 0.93 respectively. The RDT has the sensitivity and specificity required of a field-based test for measles diagnosis, and high kappa scores indicate this can be accomplished accurately by visual interpretation alone. Detailed studies are needed to establish its role within the global measles control programme. [ABSTRACT FROM AUTHOR]

Abstract Background Strongyloidiasis, a nematode infection which is mainly caused by Strongyloides stercoralis in humans, can lead to a fatal syndrome in immunocompromised individuals. Its diagnosis is challenging due to the absence of a diagnostic gold standard. The infection is highly prevalent in migrants from endemic countries in tropical and subtropical areas, and a rapid diagnostic test would be helpful for screening purposes. The aim of this study was to estimate the accuracy of a novel immunochromatographic test (ICT) for the diagnosis of S. stercoralis infection. Methods A single-centre diagnostic accuracy study was undertaken using well-characterized frozen sera available from the biobank of a referral hospital for parasitic diseases in Italy. The included sera were from migrants from sub-Saharan Africa, and matching results were available for agar plate culture and/or polymerase chain reaction for S. stercoralis; moreover, the results of both a commercial enzyme-linked immunosorbent assay test and an in-house immunofluorescence test for strongyloidiasis were made available. Laboratory staff who read the ICT results were blinded as regards the results of the other tests. Two readers independently read the ICT, and a third one was involved when results were discrepant. The accuracy of the ICT was assessed both against the results of the panel of faecal tests and by latent class analysis (LCA). Results Agreement between the readers was excellent [Cohen’s κ = 92.7%, 95% confidence interval (CI) 88.3–97.1%]. When assessed against the results of the faecal tests, the sensitivity and specificity of the ICT were 82.4% (95% CI 75.7–89.0%) and 73.8% (95% CI 66.8–80.9%), respectively. According to the LCA, the sensitivity and specificity were 86.3% (95% CI 80.1–92.5%) and 73.9% (95% CI 67.0–80.8%), respectively. Conclusions The results of the ICT demonstrated ease of interpretation. The accuracy proved good, though the sensitivity might be further improved for screening purposes. Graphical Abstract

Toxoplasma gondii is a ubiquitous zoonotic parasite, with felines being the only definitive hosts. Cats shed oocysts with their faeces, and seroprevalence studies can be used to indirectly assess the environmental contamination. The current study aimed to evaluate T. gondii seroprevalence in Greek cats and identify possible risk factors. In total, 1554 blood samples were analyzed from different cats across all nine geographic regions of Greece, and a short questionnaire was completed for each cat. A rapid immunochromatographic test was used to detect anti-T. gondii antibodies, IgG type, and 21.8% of cats were seropositive. Regarding risk factors, when chi-square tests were applied, seropositivity was significantly higher (p < 0.05) in rural cats, cats with outdoor access, and hunting cats. Gender, age, ownership, and raw feeding were not significant risk factors, although female, adult, stray, and raw-feeding cats had a higher seroprevalence than their counterparts. Binary logistic regression models were developed to adjust for the confounding effects of the initially recognized risk factors, and only hunting in urban areas remained a significant risk factor. Greek cats had lower seropositivity than the average European value, and the present research highlights the importance of updated seroprevalence and risk factor studies within the context of One-Health. [ABSTRACT FROM AUTHOR]

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can stimulate a systemic inflammatory response with severe lung involvement, multisystem dysfunction, and death in some cases. Immunosuppressive treatments have been proposed for management of COVID-19 patients, but these bring the risk of flare-up of pre-existing infections. Strongyloidiasis can become severe or fatal in immunocompromised individuals. This cross-sectional study determined the prevalence of anti- Strongyloides IgG antibody in sera collected from SARS-CoV-2 infected persons in a tertiary-care Thai hospital from January 2021 to January 2022. The survey was conducted using a rapid immunochromatographic test (ICT) kit based on a recombinant antigen of Strongyloides stercoralis known to be IgG-immunoreactive. High prevalence of anti- Strongyloides IgG antibody was found. Out of 297 SARS-CoV-2-infected patients 117 (39.4 %, 95 % CI 33.8–45.2 %) were positive for S. stercoralis according to the ICT kit. In areas where strongyloidiasis is endemic, we suggest using this point-of-care ICT kit for routine rapid screening in seriously ill COVID-19 patients who will be subjected to immunosuppressive treatment. Prompt anthelminthic treatment should be administered to prevent serious systemic strongyloidiasis in at-risk patients. [ABSTRACT FROM AUTHOR]

Objective: Trichinellosis is a globally distributed food-borne parasitic disease. Initially, diagnosis is usually made based on clinical signs, symptoms, and history of eating raw or undercooked meat. In the present study, an immunochromatographic test (ICT) kit was developed to diagnose trichinellosis by detecting IgG antibodies in sera of infected humans.Methods: Somatic extract from Trichinella spiralis larvae was used as the antigen for the ICT kit development. Diagnostic efficacy was evaluated using human serum samples from proven trichinellosis patients, healthy persons, and those with other parasitic infections.Results: The diagnostic sensitivity, specificity, positive and negative predictive values and accuracy of the ICT kit were 100.0% (95%; CI 88.8 to 100.0%), 92.5% (95% CI; 86.9 to 96.2%), 73.8% (95% CI; 58.0 to 86.1%), 100.0% (95% CI; 97.3 to 100.0%) and 93.8% (95% CI; 89.2 to 96.9%), respectively.Conclusions: This ICT diagnostic kit can be used as a testing tool for human trichinellosis. This test should permit rapid detection of infection to enable prompt anthelminthic treatment. It can also be used for retrospective diagnoses and field surveys based at laboratories where sophisticated equipment is lacking.

Background: Leptospirosis, a common zoonotic infection in developing countries, usually progresses to severe conditions and poor outcomes when not detected early. Microscopic agglutination test (MAT) and culture are available but are not accessible in all areas and are usually confined to specialized laboratories. There are several available immunochromatographic test kits (ICT) that offer ease of use, access, and affordability, but diagnostic accuracy is not yet well established. In this paper, we aim to review published literature on the use of ICTs for the detection of leptospirosis and evaluate their diagnostic efficiency. Materials and methods: We systematically searched multiple databases (PubMed, Cochrane Library, and Google Scholar), including gray literature sources for published research articles as of April 13, 2022, on the diagnosis of acute leptospirosis using ICT. We assessed the methodological quality of each article using the revised QUADAS-2. Results: From a total of 41 articles, 30 (73.2%) were identified as potentially relevant after reviewing the title and abstract and eliminating duplicate articles; then, 22 (53.7%) articles were included after scrutinizing and applying the inclusion/exclusion criteria to the full text. Almost all test kits detect IgM antibodies against the Leptospira species except for one which used IgG as a marker for diagnosis of acute leptospirosis. A wide range of sensitivity (15.8%–100.0%) and specificity (37.3%–100.0%) were recorded. Lipopolysaccharide (LPS)-specific Immunochromatographic Lateral Flow Assay presented the highest sensitivity (∼93–100%) and specificity (∼99.19–100%). Conclusion: Rapid diagnosis of acute leptospirosis is highly warranted; however, available test kits present a wide range of diagnostic accuracy. We found that LPS-specific ICT kit has the highest diagnostic efficiency; however, our analysis was limited by the included studies’ heterogeneity in design and reporting; thus, we recommend standardization in the conduct and reporting of diagnostic accuracy of test kits as it is vital to evaluate the reliability of the test kit.

Introduction: Incidence of dengue fever has significantly increased in the last few years in developing countries. Its clinical presentation may be variable in paediatrics with high- risk of complications. Dengue fever causes high mortality and morbidity in the paediatric age group. Aim: To evaluate the clinical features and haematological parameters of dengue in paediatric cases in a tertiary care hospital. Materials and Methods: A cross-sectional observational study was conducted in the Department of Paediatrics, FH Medical College, Agra, Uttar Pradesh, India, on patients diagnosed with dengue fever from August 2021 to November 2021. All cases were subjected to detailed clinical history, examination and relevant investigations (laboratory parameters and clinical features). Data was collected in predesigned proforma, entered in Microsoft Excel sheet and analysed. Results: Out of 801 patients, 486 (60.67%) were males and 315 (39.33%) were females. The commonest symptoms were fever (n=779, 97.25%) followed by body pain/ arthralgia (n=700, 87.39%), flushing (n=622, 77.65%), abdominal pain (n=437, 54.55%), and vomiting (n=428, 53.43%). Highest number of cases (n=399, 49.82%), were from dengue with warning signs. Of total, 759 (94.75%) cases had thrombocytopaenia. Common complications were pleural effusion (26.8%) and ascites (11.88%). Of total, 611 (76.27%) cases got cured while 81 (10.11%) patients expired. Conclusion: Dengue fever is more common in paediatric age group with high rate of complications and disease severity, which has high mortality rate. High clinical suspicion and early fluid management are the only measures to reduce the mortality and morbidity.

Simple Summary: Toxoplasmosis is one of the most common parasitic zoonoses in the world. It not only threatens human health and safety but also causes considerable losses to the global animal husbandry industry. Swine, as an intermediate host of Toxoplasma gondii, has important economic and public health significance, and the global prevalence of T. gondii in swine varies between 10% and 60%. Therefore, it is important to establish simple, effective, sensitive and specific diagnostic methods for the detection and prevention of T. gondii infection in swine. In the present study, we developed a colloidal gold immunochromatographic strip based on rTgROP14, recombinant protein A and monoclonal antibody TgROP14-5D5 for serological detection of T. gondii in swine populations. This new ICT achieved good specificity and sensitivity and has potential for routine serological detection of T. gondii in swine. Toxoplasma gondii, a worldwide distributed apicomplexan protozoan, can infect almost all warm-blooded animals and may cause toxoplasmosis. In order to provide a point-of-care detection method for T. gondii infection, an immunochromatographic test (ICT) was established. The proposed test uses recombinant T. gondii rhoptry protein 14 (ROP14) conjugated with 20 nm gold particles, recombinant protein A as the detection line and monoclonal antibody TgROP14-5D5 as the control line. The specificity, sensitivity, positive predictive value, negative predictive value and stability of this new ICT were evaluated. rTgROP14 was specifically recognized by positive serum of T. gondii but not negative serum. mAb TgROP14-5D5 showed higher specific recognition of T. gondii antigens and was therefore selected for subsequent colloidal gold strip construction. The new ICT based on TgROP14 exhibited good diagnostic performance with high specificity (86.9%) and sensitivity (90.9%) using IHA as a "reference standard". Among 436 field porcine sera, ICT and IHA detected 134 (30.7%) and 99 (22.7%) positive samples, respectively. The relative agreement was 87.8%. These data indicate that this new ICT based on TgROP14 is a suitable candidate for routine testing of T. gondii in the field. [ABSTRACT FROM AUTHOR]

A variety of methods have been reported using polymerase chain reaction (PCR)-based nucleic acid testing (NAT) because of its potential to be used in highly sensitive inspection systems. Among these NATs, fusion-PCR (also called as overlap-extension-PCR) has been focused on this study and adopted to generate the fused amplicon composed of plural marker gene fragments for detection. Generally, conventional agarose gel electrophoresis followed by gel staining is employed to check the PCR results. However, these are time-consuming processes that use specific equipment. To overcome these disadvantages, the immunochromatographic test (ICT) for the detection of PCR amplicons with hapten-labels that were generated by PCR using hapten-labeled primers was also adopted in this study. Based on these concepts, we constructed the systems of hapten-labeled fusion-PCR (HL-FuPCR) followed by ICT (HL-FuPCR-ICT) for the two and three marker genes derived from pathogenic microbe. As a result, we successfully developed a two marker genes system for the pathogenic influenza A virus and a three marker genes system for the penicillin-resistant Streptococcus pneumoniae. These detection systems of HL-FuPCR-ICT are characterized by simple handling and rapid detection within few minutes, and also showed the results as clear lines. Thus, the HL-FuPCR-ICT system introduced in this study has potential for use as a user-friendly inspection tool with the advantages especially in the detection of specific strains or groups expressing the characteristic phenotype(s) such as antibiotic resistance and/or high pathogenicity even in the same species. [Display omitted] • This study is on the construction and the evaluation for the hapten-labeled fusion-PCR followed by immunochromatographic test. • Hapten-labeled amplicons were specifically generated from the multiple marker gene fragments by fusion-PCR. • Detection of fusion product by immunochromatographic test is a useful with simplicity, rapidity, and well-defined results. • Hapten-labeled fusion-PCR is superior to versatility and its sole requirement is the specific primer sets for target. • Hapten-labeled fusion-PCR followed by immunochromatographic test has the potential for user-friendly inspection tool. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate the prevalence of Cryptosporidium species detected in humans and calves in the Van region of Turkey. Methods: A total of 150 patients, comprising 60 who were immunosuppressed, 50 who were immunosuppressed and had diarrhea, and 40 who had only diarrhea, were enrolled in this study in the Department of Medical Parasitology, Van Yuzuncu Yıl University Faculty of Medicine, Turkey. Stool samples were taken from the rectums of a total of 50 calves that had 30 diarrhea and 20 that did not have diarrhea, from the stables and farms of 10 central villages of Van, Turkey. All samples were analyzed using modified acid-fast staining, immunochromatographic test, and PCR. Cryptosporidium positive samples were also subtyped. Results: Only C. parvum subtypes were detected in all positive samples. C. parvum was detected in 30 (20%) of the 150 human stool samples, while it was detected in 5 (10%) of the 50 samples from the calves. The GP60 gene region was amplified and sent for sequence analysis to identify the C. parvum subtypes. Conclusion: As a result, C. parvum is found to be an active species that caused cryptosporidiosis is in the Van region. IIdA24G1 subtype of C. parvum were found in both human and calf. Therefore, due to the zoonotic feature of the C. parvum IIdA24G1 subtype, it has been shown that the calves in the region are a significant risk for humans. [ABSTRACT FROM AUTHOR]

Bovine tuberculosis is still a serious problem with major economic impact in many countries. The aim of study was to evaluate the diagnostic capabilities of the classical and some modern, rapid methods for isolation and identification of Mycobacterium bovis. In the period 20152018 from 29 outbreaks in 10 different regions of Bulgaria, 1193 lymph nodes from slaughtered cattle were examined by pathoanatomical, bacteriological, PCR and immunochromatographic methods. Of the 283 bacterial isolates, 263 were identified as M. bovis  member of the M. tuberculosis complex.

Background: We aimed to investigate the prevalence of Cryptosporidium species detected in humans and calves in the Van region of Turkey. Methods: A total of 150 patients, comprising 60 who were immunosuppressed, 50 who were immunosuppressed and had diarrhea, and 40 who had only diarrhea, were enrolled in this study in the Department of Medical Parasitology, Van Yuzuncu Yıl University Faculty of Medicine, Turkey. Stool samples were taken from the rectums of a total of 50 calves that had 30 diarrhea and 20 that did not have diarrhea, from the stables and farms of 10 central villages of Van, Turkey. All samples were analyzed using modified acid-fast staining, immunochromatographic test, and PCR. Cryptosporidium positive samples were also subtyped. Results: Only C. parvum subtypes were detected in all positive samples. C. parvum was detected in 30 (20%) of the 150 human stool samples, while it was detected in 5 (10%) of the 50 samples from the calves. The GP60 gene region was amplified and sent for sequence analysis to identify the C. parvum subtypes. Conclusion: As a result, C. parvum is found to be an active species that caused cryptosporidiosis is in the Van region. IIdA24G1 subtype of C. parvum were found in both human and calf. Therefore, due to the zoonotic feature of the C. parvum IIdA24G1 subtype, it has been shown that the calves in the region are a significant risk for humans.

Angiostrongylus cantonensis is the major etiological nematode parasite causing eosinophilic meningitis and/or eosinophilic meningoencephalitis in humans. The rapid global spread of Angiostrongylus cantonensis and the emerging occurrence of the infection have exposed the shortcomings of traditional/conventional diagnostics. This has spurred efforts to develop faster, simpler and more scalable platforms that can be decentralized for point-of-need laboratory testing. By far, the point-of-care immunoassays such as the lateral flow assay (LFA) are the best-placed. In this work, a LFA in the form of an immunochromatographic test device (designated AcAgQuickDx), based on the detection of a circulating Angiostrongylus cantonensis-derived antigen, was established using anti-31 kDa Angiostrongylus cantonensis antibody as the capture reagent and anti-Angiostrongylus cantonensis polyclonal antibody as the indicator reagent. The AcAgQuickDx was evaluated for its diagnostic potential with a total of 20 cerebrospinal fluids (CSF) and 105 serum samples from patients with angiostrongyliasis and other clinically related parasitic diseases, as well as serum samples from normal healthy subjects. Three of the ten CSF samples from serologically confirmed angiostrongyliasis cases and two of the five suspected cases with negative anti-Angiostrongylus cantonensis antibodies showed a positive AcAgQuickDx reaction. Likewise, the AcAgQuickDx was able to detect Angiostrongylus cantonensis specific antigens in four serum samples of the 27 serologically confirmed angiostrongyliasis cases. No positive reaction by AcAgQuickDx was observed in any of the CSF (n = 5) and serum (n = 43) samples with other parasitic infections, or the normal healthy controls (n = 35). The AcAgQuickDx enabled the rapid detection of active/acute Angiostrongylus cantonensis infection. It is easy to use, can be transported at room temperature and does not require refrigeration for long-term stability over a wide range of climate. It can supplement existing diagnostic tests for neuroangiostrongyliasis under clinical or field environments, particularly in remote and resource-poor areas.

Background and Objectives: RESİST-4 O.K.N.V. assay is a lateral immunochromatocraphic test for the identification of oxacillinase (OXA)-48-like, Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), and Verona integron-encoded metallo-β-lactamase (VIM) producing strains. It was aimed to evaluate the performance of the RESIST-4 O.K.N.V. test and to compare it with the reference method polymerase chain reaction (PCR). Also, the objective was to determine the distribution of carbapenemase types of CRE strains isolated in our hospital. Materials and Methods: Between January 2016-October 2019, 187 strains isolated from clinical samples were included in this study. Bacterial identification was done using MALDI-TOF MS. Antibiotic susceptibility tests were studied with the VITEK-2 automated system. Meropenem minimum inhibitory concentrations (MICs) were determined by the gradient test. All strains were studied with the RESIST-4 O.K.N.V. test and then the strains were selected for the PCR test. blaOXA-48, blaNDM, blaKPC, and bla were investigated with PCR. K. pneumoniae NCTC® 13438 (KWIKSTIKTM, Microbiologics®,USA) was used as the positive control, E. coli ATTC® 25922 TM (Microbiologics®,USA) and three carbapenem-sensitive clinical isolates were also used as the negative control. Results: Meropenem MIC and MIC values were determined to be >32 mg/L. With PCR blaOXA-48, blaNDM, blaKPC and blaVIM were detected in 79, 63, 20, and 4 strains, respectively. bla and blaNDM were found together in 51 of the isolates. blaOXA-48, blaNDM, blaKPC, and bla were not detected in two strains with carbapenem resistance in susceptibility tests. The sensitivity of the immunochromatographic test was 100% for OXA-48, KPC, and VIM but 84.1% for NDM. Specificity was determined as 100% for OXA-48, NDM, KPC, and VIM. Conclusion: RESIST-4 O.K.N.V. test showed high sensitivity and specificity in detecting OXA-48, KPC, NDM, and VIM type carbapenemases. However, it should be kept in mind that there may be false-negative results related to NDM. [ABSTRACT FROM AUTHOR]

Aim: We aimed to retrospectively investigate the viral, bacterial, and parasitic etiological agents detected in patients to present with gastrointestinal complaints and examine their distribution in our region. Materials and Methods: Patients who presented to the XXX Hospital due to gastrointestinal symptoms between January 2017 and December 2019 were included in the study. The results obtained using conventional culture and immunochromatographic (IC) methods from the stool samples of the patients for etiological diagnosis in the microbiology laboratory were retrospectively evaluated. The infectious etiological agents were analyzed according to the age groups. Clinical and epidemiologic characteristics of the agents have been described. Results: The positivity rates were 6.6%, 2.2%, and 0.4% for Rotavirus (RV), Adenovirus (AV), and Norovirus (NV); 0.8%, 2.8%, and 0.4% for Salmonella spp., Helicobacter pylori, and Clostridium difficile; and 2.1% and 1.1% for Entamoeba histolytica and Cryptosporidium spp., respectively. Shigella spp. and Giardia intestinalis were not detected in any of the samples. The highest positivity rates in the 0-2, 3-10 and 11-20 age groups were found for RV, whereas in the 21-40, 41-60 and > 60 age groups were determined for H. pylori. RV infections were observed predominantly in the spring. Conclusion: IC methods are a helpful tool for the routine diagnosis of gastrointestinal infections at hospitals. The agent with the highest positivity rate was RV. Still, the overall positivity rates were low due to the good infrastructure of our city and the successful execution of sanitation measures. [ABSTRACT FROM AUTHOR]

There is an increased use of immunochromatographic test strips to presumptively identify bodily fluids of forensic interest, such as blood, semen, and saliva. Commonly, forensic samples are of low quantities. In the practice of conserving limited samples, it would be ideal to be able to recover the genetic material deposited on these testing membranes. This research aimed to determine whether DNA could be extracted from semen and saliva test strips, which part of the test strip is best to use, and to assess the quality of the DNA recovered. Semen and saliva samples were deposited on SERATEC® PSA Semiquant and Amylase Tests and analyzed. The testing membrane was then removed from the cassette and DNA extraction methods (forensicGEM Universal, forensicGEM Sperm, QIAamp® DNA Mini kit, Monarch® Nucleic Acid Purification kit, and organic extraction) were performed. Quality was evaluated by qPCR and STR analysis. DNA from semen was best extracted using the Monarch® Nucleic Acid Purification kit, while saliva was best extracted using the forensicGEM or QIAamp kits. No significant differences were observed between collection of the sample well pad and testing strip, thus use of the entire strip is encouraged. DNA from semen and saliva was quantifiable with a 1:1000 dilution. DNA quality analysis by qPCR showed that there is no difference in the DNA quality following elution from the test strip. However, degradation was noted in saliva samples and some semen samples by STR analysis. Scientists are encouraged to consider processed test strips for DNA profiling to preserve evidence. [ABSTRACT FROM AUTHOR]

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Background: Strongyloidiasis, a nematode infection which is mainly caused by Strongyloides stercoralis in humans, can lead to a fatal syndrome in immunocompromised individuals. Its diagnosis is challenging due to the absence of a diagnostic gold standard. The infection is highly prevalent in migrants from endemic countries in tropical and subtropical areas, and a rapid diagnostic test would be helpful for screening purposes. The aim of this study was to estimate the accuracy of a novel immunochromatographic test (ICT) for the diagnosis of S. stercoralis infection. Methods: A single-centre diagnostic accuracy study was undertaken using well-characterized frozen sera available from the biobank of a referral hospital for parasitic diseases in Italy. The included sera were from migrants from sub-Saharan Africa, and matching results were available for agar plate culture and/or polymerase chain reaction for S. stercoralis; moreover, the results of both a commercial enzyme-linked immunosorbent assay test and an in-house immunofluorescence test for strongyloidiasis were made available. Laboratory staff who read the ICT results were blinded as regards the results of the other tests. Two readers independently read the ICT, and a third one was involved when results were discrepant. The accuracy of the ICT was assessed both against the results of the panel of faecal tests and by latent class analysis (LCA). Results: Agreement between the readers was excellent [Cohen's κ = 92.7%, 95% confidence interval (CI) 88.3–97.1%]. When assessed against the results of the faecal tests, the sensitivity and specificity of the ICT were 82.4% (95% CI 75.7–89.0%) and 73.8% (95% CI 66.8–80.9%), respectively. According to the LCA, the sensitivity and specificity were 86.3% (95% CI 80.1–92.5%) and 73.9% (95% CI 67.0–80.8%), respectively. Conclusions: The results of the ICT demonstrated ease of interpretation. The accuracy proved good, though the sensitivity might be further improved for screening purposes. [ABSTRACT FROM AUTHOR]

Background and Objectives: RESİST-4 O.K.N.V. assay is a lateral immunochromatocraphic test for the identification of oxacillinase (OXA)-48-like, Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), and Verona integron-encoded metallo-β-lactamase (VIM) producing strains. It was aimed to evaluate the performance of the RESIST-4 O.K.N.V. test and to compare it with the reference method polymerase chain reaction (PCR). Also, the objective was to determine the distribution of carbapenemase types of CRE strains isolated in our hospital. Materials and Methods: Between January 2016-October 2019, 187 strains isolated from clinical samples were included in this study. Bacterial identification was done using MALDI-TOF MS. Antibiotic susceptibility tests were studied with the VITEK-2 automated system. Meropenem minimum inhibitory concentrations (MICs) were determined by the gradient test. All strains were studied with the RESIST-4 O.K.N.V. test and then the strains were selected for the PCR test. blaOXA-48, blaNDM, blaKPC, and blaVIM were investigated with PCR. K. pneumoniae NCTC® 13438 (KWIKSTIKTM, Microbiologics®,USA) was used as the positive control, E. coli ATTC® 25922 TM (Microbiologics®,USA) and three carbapenem-sensitive clinical isolates were also used as the negative control. Results: Meropenem MIC50 and MIC90 values were determined to be >32 mg/L. With PCR blaOXA-48, blaNDM, blaKPC, and blaVIM were detected in 79, 63, 20, and 4 strains, respectively. blaOXA-48 and blaNDM were found together in 51 of the isolates. blaOXA-48, blaNDM, blaKPC, and blaVIM were not detected in two strains with carbapenem resistance in susceptibility tests. The sensitivity of the immunochromatographic test was 100% for OXA-48, KPC, and VIM but 84.1% for NDM. Specificity was determined as 100% for OXA-48, NDM, KPC, and VIM. Conclusion: RESIST-4 O.K.N.V. test showed high sensitivity and specificity in detecting OXA-48, KPC, NDM, and VIM type carbapenemases. However, it should be kept in mind that there may be false-negative results related to NDM.

Schistosoma mekongi infection is endemic in countries along the Mekong River and certain of its tributaries in the lower Mekong basin, especially in Lao People's Democratic Republic and Cambodia. Diagnosis of schistosomiasis is crucial before treatment and epidemiological surveys before and/or after an intervention, such as a mass drug administration. A newly developed immunochromatographic test (ICT) for the diagnosis of schistosomiasis mekongi, based on antiparasite antibody detection in human sera, was evaluated. The schistosomiasis mekongi-ICT (Smk-ICT) strip was developed using somatic antigen from adult S. mekongi. In total, 209 serum samples were examined, including 14 from parasitologically proven schistosomiasis mekongi patients, 30 from schistosomiasis japonica patients, other parasitosis (n = 135), and healthy volunteers (n = 30) from areas not endemic for S. mekongi. Eleven schistosomiasis mekongi samples were positive according to the Smk-ICT, whereas all healthy control samples were negative. Cross-reactions with paragonimiasis heterotremus, sparganosis, trichinellosis, and taeniasis saginata samples were observed at 2.4% (4/165). The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 78.6% (95% confidence interval [CI] 49.2–95.3), 97.6% (95% CI 93.9–99.3), 73.3% (95% CI 44.9–92.2), 98.2% (95% CI 94.7–99.6), and 96.1% (95% CI 92.1–98.4), respectively. The Smk-ICT kit might be useful to assess the prevalence of disease before establishing transmission control and mass deworming campaigns in countries in the Mekong River subregion. [ABSTRACT FROM AUTHOR]

• ∙ Development of an immunochromatographic test for serodiagnosis of human trichinellosis. • ∙ Using Trichinella spiralis larval somatic antigen. • ∙ Valuable for a rapid, uncomplicated point-of-care testing tool. • ∙ A sensitive and specific tool for screening and detection of infection. • ∙ Useful in laboratories where sophisticated equipment is lacking. Objective: Trichinellosis is a globally distributed food-borne parasitic disease. Initially, diagnosis is usually made based on clinical signs, symptoms, and history of eating raw or undercooked meat. In the present study, an immunochromatographic test (ICT) kit was developed to diagnose trichinellosis by detecting IgG antibodies in sera of infected humans. Methods: Somatic extract from Trichinella spiralis larvae was used as the antigen for the ICT kit development. Diagnostic efficacy was evaluated using human serum samples from proven trichinellosis patients, healthy persons, and those with other parasitic infections. Results: The diagnostic sensitivity, specificity, positive and negative predictive values and accuracy of the ICT kit were 100.0% (95%; CI 88.8 to 100.0%), 92.5% (95% CI; 86.9 to 96.2%), 73.8% (95% CI; 58.0 to 86.1%), 100.0% (95% CI; 97.3 to 100.0%) and 93.8% (95% CI; 89.2 to 96.9%), respectively. Conclusions: This ICT diagnostic kit can be used as a testing tool for human trichinellosis. This test should permit rapid detection of infection to enable prompt anthelminthic treatment. It can also be used for retrospective diagnoses and field surveys based at laboratories where sophisticated equipment is lacking. [ABSTRACT FROM AUTHOR]

In this study we developed a rapid and simple assay to detect RFP in fish using an immunochromatographic assay. We produced a sensitive and selective monoclonal antibody against RFP with a half-maximal inhibitory concentration (IC50) of 10.7 ng/mL. Fish samples were extracted with ethyl acetate, then centrifuged at 8000 rpm for 10 min, and concentrated by drying over nitrogen. We found under optimal conditions, that the RFP cut-off limits for the test strip was 10 µg/mL in both 0.01 M phosphate buffered saline and fish samples, and each test could be completed within 5 min. Therefore, immunochromatographic test can be used as a reliable, rapid, and sensitive method for the detection of RFP in fish.

Objectives: To evaluate the diagnostic performance of different brands of immunochromatographic test (ICT) reagents for Chlamydia trachomatis using homogenized samples to provide a reference for reagent quality control., Methods: Eight commercially available ICT reagents were evaluated, of which three used the latex method and five used the colloidal gold method. Analytical performance evaluation using a pure culture broth of C. trachomatis , as well as clinical application validation using cervical epithelial cell samples acquired from the research subjects, were conducted. The concentration of C. trachomatis was quantified using a nucleic acid amplification test., Results: The limit of detection (LOD) of different ICT reagents in the analytical performance evaluation varied from 9.5 × 10 3 to 1 × 10 5 IFU/mL, and only one reagent met the LOD specified in the manufacturer's instructions. Likewise, only one reagent in the clinical application validation achieved the analytical LOD, four reagents were 2.1-4.2-fold of the analytical LODs, and three reagents failed to detect positive results in clinical samples., Conclusions: The diagnostic performance of different methods and different brands of ICT reagents in clinical practice was different from the manufacturer's instructions and the results of laboratory evaluation. The diagnostic performance of reagents should be evaluated before they are actually used in clinical practice., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V.)

Urinary tract infections (UTIs) are a common health concern. Urine culture is the "gold standard" for UTI diagnosis but takes 48h. Rapid methods like dipstick tests are used as point-of-care tests. However, their sensitivity and specificity are variable. In this work, a rapid immunochromatographic test (IT) for detecting Escherichia coli in urine was developed, and its performance was evaluated in urine samples from patients with suspected UTI. The "universal lateral flow assay kit" was employed using an E. coli capture antibody. One hundred and five (105) urine samples were analyzed using the IT, dipstick test, and urine culture. The sensitivity of the IT was 74.5%, specificity 88.9%, positive predictive value (PPV) 86.3%, and negative predictive value (NPV) 78.7%. The combination of the IT with the dipstick test increases sensitivity to 94.1%, specificity to 66.7%, PPV to 72.7%, and NPV to 92.3%. Using the IT for detecting E. coli in urine could be a valuable technique for UTI screening, showing better specificity and diagnostic precision but lower sensitivity than the dipstick test. Based on these results, we propose that the combined use of both screening techniques would allow a rapid and more precise diagnosis of UTI, rationalizing the indication for empirical antibiotics., (Copyright © 2023 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Bovine tuberculosis is still a serious problem with major economic impact in many countries. The aim of study was to evaluate the diagnostic capabilities of the classical and some modern, rapid methods for isolation and identification of Mycobacterium bovis. In the period 2015-2018 from 29 outbreaks in 10 different regions of Bulgaria, 1193 lymph nodes from slaughtered cattle were examined by pathoanatomical, bacteriological, PCR and immunochromatographic methods. Of the 283 bacterial isolates, 263 were identified as M. bovis - member of the M. tuberculosis complex. [ABSTRACT FROM AUTHOR]

Cryptosporidium is a parasite responsible for diarrhea in humans. Practitioners rarely routinely request Cryptosporidium diagnostic tests; thus, its prevalence is likely underrated. The prevalence of cryptosporidiosis among children brought to the hospital with the complaint of diarrhea was investigated using 3 different methods, comprising nested PCR, immunochromatographic testing, and microscopic examination with modified acid-fast staining. Cryptosporidium sp. was detected in 42/150 children with diarrhea (28%) and in 1/50 children in the control group (2%). The main complaint by children admitted to hospital with Cryptosporidium was diarrhea. Additionally, some clinical symptoms/signs like abdominal pain, nausea, vomiting, stool mucus, weakness, weight loss, and anorexia were correlated with cryptosporidiosis. Results from the 3 methods were compared and nested PCR and immunochromatographic testing were the most reliable. Among other pathogens and parasites found in stool samples, Cryptosporidium is a significant cause of hospitalization due to gastrointestinal disease in children in Van, Turkey. [ABSTRACT FROM AUTHOR]

Toxoplasma gondii, a worldwide distributed apicomplexan protozoan, can infect almost all warm-blooded animals and may cause toxoplasmosis. In order to provide a point-of-care detection method for T. gondii infection, an immunochromatographic test (ICT) was established. The proposed test uses recombinant T. gondii rhoptry protein 14 (ROP14) conjugated with 20 nm gold particles, recombinant protein A as the detection line and monoclonal antibody TgROP14-5D5 as the control line. The specificity, sensitivity, positive predictive value, negative predictive value and stability of this new ICT were evaluated. rTgROP14 was specifically recognized by positive serum of T. gondii but not negative serum. mAb TgROP14-5D5 showed higher specific recognition of T. gondii antigens and was therefore selected for subsequent colloidal gold strip construction. The new ICT based on TgROP14 exhibited good diagnostic performance with high specificity (86.9%) and sensitivity (90.9%) using IHA as a “reference standard”. Among 436 field porcine sera, ICT and IHA detected 134 (30.7%) and 99 (22.7%) positive samples, respectively. The relative agreement was 87.8%. These data indicate that this new ICT based on TgROP14 is a suitable candidate for routine testing of T. gondii in the field.

Clostridioides difficile infection is a public health problem because of it is easily spread; with harmful consequences, it is essential to reduce hospital costs and prevent its dissemination by having a precise diagnosis. The gold standard for its diagnosis is polymerase chain reaction (PCR); however, the technique is not available for all laboratories due to the high cost. New approaches using non-molecular tests to detect C. difficile and toxin A/B production has been proposed to improve cost benefits. The objective of this study is to compare molecular methods (PCR) and rapid methods (immunochromatographic test and enzymatic immunoassay). A series of tests comprising these diagnostic techniques was performed with 50 patients with a clinical diagnosis for Clostridioides difficile on GeneXpert® devices test; a calculation of the sensitivity was executed, followed by a comparison of the efficiency of all techniques. Greater sensitivity was observed in the PCR-based methods (BD MAX™ and BioFire FilmArray®) and the GDH-based assays (RIDASCREEN® and Alere Techlab®). The proposed algorithm represents minor monetary disadvantages but a significant temporal optimization of 10%. Future studies concerning both positive and negative results could be advantageous because of the possibility of calculating more method concordance indexes, such as the specificity and Kappa index, in addition to being able to indicate a monetary profit if the proposed algorithm was applied due to the nonproceeding PCR cases. [ABSTRACT FROM AUTHOR]

Abstract Background Leishmaniasis caused by different species of Leishmania affect 98 countries worldwide. Visceral Leishmaniasis (VL) is the mortal clinical presentation of the disease that causes the dead to more than 90% of the patients who suffer it. The diagnosis of VL is made by the direct observation of the parasite in bone marrow, spleen and/or liver aspirates that requires complex proceedings. Therefore, serum samples are submitted to Indirect Immunofluorescence to identify the presence of anti-Leishmania antibodies. Despite the variability in the diagnostic performance of the Immunochromatographic Tests (ICTs), there are many evidences that suggest that ICTs can be used for epidemiological screening. However, in Colombia there are not any evidence about the performance of the ICTs for VL diagnosis, both for human and canine serum samples. Therefore, this study evaluated the diagnostic performance of 4 ICTs for VL (2 ICTs in human sera and 2 ICTs in canine sera) in samples from endemic areas of Colombia. Methods We selected a total of 156 human serum samples (82 positive and 74 negative for VL) and 126 canine serum samples (71 positive and 54 negative) diagnosed by in house Indirect Immunofluorescence (IIF). The samples were submitted to the ICTs following the manufacturers’ instructions. Statistical analysis was performed to evaluate the diagnostic performance of each ICT in comparison with the IIF. PCR for HSP70 gene and sanger sequencing was performed in samples with negative results for both ICTs. Results The sensitivity (S) of both ICTs for human samples (Ad-bio Leishmania IgG/IgM Combo Rapid Test and Kalazar Detect™) was 91.5% and specificity (E) were 93.2 and 89.2% respectively, while for the ICTs tested on canine samples (Kalazar Detect™ Rapid Test, Canine and DPP® CVL rapid test) we found S values between 82.9 and 85.7% and E values between 79.6 and 92.6%. We found L. infantum by PCR and sequencing in 2 human samples, and L. braziliensis and L. amazonensis in canine serum samples that were negative by both ICTs. Conclusions We conclude that both tests evaluated on human samples have a similar diagnostic performance, while the Kalazar Detect™ Rapid Test, Canine showed a better diagnostic performance than the DPP® CVL rapid test evaluated on canine samples. Also, we suggest that it is necessary to design tests with antigens of the circulating strains to increase its diagnostic utility.

Background and Aim: Helicobacter pylori infection has been identified as a major cause of peptic ulcer diseases, including gastric and duodenal ulcers, gastritis, chronic and gastric carcinoma, and even gastric lymphoma. In vitro studies using Western blotting analysis, hemagglutination test, adherence inhibition assays, and immunocytochemical staining revealed that the 49.6-kDa subunit pili protein of H. pylori was considered an immunogenic protein. This study aimed to develop a serological diagnostic test using 49.6 kDa for detecting antibodies against H. pylori proteins in an early phase of the infection. Materials and Methods: An in-house immunochromatographic test (ICT) kit was developed and used to test a panel of sera sample obtained from a randomly selected symptomatic patient, in which 40 sera were H. pylori positive and 40 sera were H. pylori negative. Results: The results showed that ICT with 49.6 kDa as an antigen was highly sensitive and specific for detecting anti-H. pylori immunoglobulin G antibodies in human serum, with a high negative predictive value. Conclusion: The developed test could be used to exclude H. pylori infection in symptomatic patients.

ABSTRACTVisceral Leishmaniasis (VL) causes high morbidity and mortality in low-to-middle-income countries worldwide. In this study, we used Laser Direct-Write (LDW) technology to develop a new Lateral Flow Device (LFD) with double-channel geometry on a low-cost paper platform as a rapid and accurate serodiagnostic assay for human VL. This Duplex VL-LFD was based on a laser-patterned microfluidic device using two recombinant Leishmania proteins, β-tubulin and LiHyp1, as novel diagnostic antigens. The VL-LFD assay was tested with blood/serum samples from patients diagnosed with VL, Tegumentary Leishmaniasis, Leishmaniasis of unknown identity, other parasitic diseases with similar clinical symptoms, i.e. Leprosy Disease and Chagas Disease, and blood from healthy donors, and compared in parallel with commercial rK39 IT-LEISH® Kit. Clinical diagnosis and real-time Polymerase Chain Reaction assay were used as reference standards. VL-LFD Sensitivity (S ± 95% Confidence Intervals (CI)) of 90.9 (78.9-100) and Specificity (Sp ± 95% CI) of 98.7 (96.1-100) outperformed the IT-LEISH® Kit [S = 77.3 (59.8-94.8), Sp = 94.7 (89.6-99.8)]. This is the first study reporting successful development of an LFD assay using the LDW technology and the VL-LFD warrants comparative testing in larger patient cohorts and in areas with endemic VL in order to improve diagnosis and disease management.

Several immunodiagnostic assays have been commercially presented over the last years as easy diagnostic methods for schistosomiasis using serum or urine samples. The performance of immunochromatographic test (ICT) and indirect hemagglutination assay (IHA) was validated in the identification of active schistosomiasis infection. Detection of circulating cathodic antigen (CCA) of the parasite in urine samples and anti-Schistosoma antibodies in serum using ICT (Urine-CCA Cassette test) and IHA respectively. Proved diagnosis of Schistosoma mansoni infection was defined by the sum of positive results from microscopic examination (Gold standard) and Kato–Katz method. Out of 173 (mean age, 45 ± 10 years; 70 from Giza, 103 from different Egyptian governorates), 9 4 adult patients were infected. Urine-CCA cassette test despite showing high specificity (91.14%) it was of low sensitivity (23.40%). PPVs was 75.86% and NPV was 50.00% and diagnostic accuracy of 54.34%. The IHA showed a sensitivity of 57.45% and specificity of 48.10%. PPVs was 56.84% whereas NPVs was 48.72%. As for diagnostic accuracy, it was 53.18%. Urine-CCA Cassette test had lower sensitivity than expected for detection of circulating antigen and the IHA kit is generally more expensive than microscopic examination and Urine-CCA cassette test with low sensitivity and specificity. On the basis of this diagnostic performance none of the two tested immune-assays can be a sole tool in the principal diagnosis of active schistosomiasis infections. [ABSTRACT FROM AUTHOR]