Quantitative assessment of multiple pathogen exposure and immune dynamics at scale.

IMPORTANCE: Serology reveals exposure to pathogens, as well as the state of autoimmune and other clinical conditions. It is used to evaluate individuals and their histories and as a public health tool to track epidemics. Employing a variety of formats, studies nearly always perform serology by testing response to only one or a few antigens. However, clinical outcomes of new infections also depend on which previous infections may have occurred. We developed a high-throughput serology method that evaluates responses to hundreds of antigens simultaneously. It can be used to evaluate thousands of samples at a time and provide a quantitative readout. This tool will enable doctors to monitor which pathogens an individual has been exposed to and how that changes in the future. Moreover, public health officials could track populations and look for infectious trends among large populations. Testing many potential antigens at a time may also aid in vaccine development.

Boletim epidemiológico: perfil sorológico de doadores de sangue da Rede Estadual de Serviços de Hemoterapia - Rede HEMO / Epidemiological bulletin: serological profile of blood donors from the State Network of Hemotherapy Services - Rede HEMO

Esse boletim descreve o perfil sorológico dos doadores de sangue da Rede Estadual de Serviços de Hemoterapia Rede - HEMO. Estudo descritivo elaborado com base nos dados da planilha de registro das Sorologias Positivas, que são extraídos do sistema Hemovida no HEMOGO e na Rede HEMO através dos dados de resultado de exames encaminhados pelo setor de Análises Clínicas do HEMOGO

This bulletin describes the serological profile of blood donors from the Rede Estadual de Serviços de Hemoterapia Rede - HEMO. Descriptive study prepared based on data from the Positive Serology registration spreadsheet, which is extracted from the Hemovida system at HEMOGO and the HEMO Network through test result data sent by the HEMOGO Clinical Analysis sector

Perfil sociodemográfico e laboratorial dos pacientes submetidos à hemodiálise em um centro de referência do Estado do Ceará / Sociodemographic and laboratory profile of patients undergoing hemodialysis in a reference center in the State of Ceará / Perfil sociodemográfico y de laboratorio de dos pacientes sometidos a hemodiálisis en un centro de referencia del Estado de Ceará

A Doença Renal Crônica (DRC) é uma importante redução da função renal que causa alterações no metabolismo dos indivíduos. Para acompanhar a progressão da DRC e prevenir possíveis complicações, foi realizada uma pesquisa para avaliar o perfil sociodemográfico, bioquímico e hematológico de pacientes com Insuficiência Renal Crônica (IRC) submetidos a hemodiálise. Esta pesquisa foi quantitativa, descritiva e transversal de caráter retrospectivo, realizada por meio da análise de dados secundários contidos nos prontuários dos pacientes. A coleta de dados ocorreu no Centro de Hemodiálise da cidade de Russas, no Ceará. A amostra foi constituída por 161 pacientes com DRC, sendo 63,35% do sexo masculino e 85,71% pardos, com uma idade média de 54,39 anos. Desses, 63,97% tinham entre 2 e 10 anos de tratamento e 57,76% possuíam ensino fundamental incompleto. 19,25% residiam em Russas. Resultados: Após a hemodiálise, os resultados mostraram 44 mg/dL de Ureia, 48,44% dos pacientes com valores normais. A hemoglobina e hematócrito médios foram 11,8 g/dL e 33,7%, respectivamente, sendo que 63,35% tiveram valores reduzidos. 85,10% dos pacientes tiveram contagem de plaquetas normal, 72,04% níveis adequados de ferro e albumina, 52,79% tiveram níveis elevados de ferritina, 23,61% redução de transferrina e níveis lipídicos satisfatórios. 79,50% apresentaram níveis séricos de potássio dentro da normalidade, 12,42% de fósforo acima do normal, 85,09% de cálcio dentro dos valores normais, 39,13% de PTHi normais e 86,33% de glicose dentro dos valores considerados normais. Com base nos resultados, concluiu-se que todos os pacientes em tratamento hemodialítico apresentam diversas alterações em decorrência da DRC e do próprio processo de tratamento. Portanto, a realização de exames para avaliar ou monitorar possíveis complicações da IRC é essencial para criar estratégias e intervenções mais eficazes, que melhorem a assistência prestada a esses pacientes e, consequentemente, da qualidade e expectativa de vida dos mesmos.

Chronic Kidney Disease (CKD) is an important reduction in kidney function that causes changes in the metabolism of individuals. To monitor the progression of CKD and prevent possible complications, a survey was carried out to assess the sociodemographic, biochemical and hematological profile of patients with Chronic Renal Failure (CRF) undergoing hemodialysis. This research was quantitative, descriptive and cross-sectional with a retrospective character, carried out through the analysis of secondary data contained in the patients' medical records. Data collection took place at the Hemodialysis Center in the city of Russas, Ceará. The sample consisted of 161 patients with CKD, 63.35% male and 85.71% brown, with an average age of 54.39 years. Of these, 63.97% had between 2 and 10 years of treatment and 57.76% had incomplete primary education. 19.25% resided in Russas. Results: After hemodialysis, the results showed 44 mg/dL of Urea, 48.44% of patients with normal values. Average hemoglobin and hematocrit were 11.8 g/dL and 33.7%, respectively, with 63.35% having reduced values. 85.10% of the patients had normal platelet counts, 72.04% had adequate levels of iron and albumin, 52.79% had high levels of ferritin, 23.61% had reduced transferrin and satisfactory lipid levels. 79.50% had serum levels of potassium within the normal range, 12.42% of phosphorus above normal, 85.09% of calcium within normal values, 39.13% of PTHi normal and 86.33% of glucose within the values considered normal. Based on the results, it was concluded that all patients on hemodialysis have several changes due to CKD and the treatment process itself. Therefore, carrying out tests to assess or monitor possible complications of CRF is essential to create more effective strategies and interventions that improve the care provided to these patients and, consequently, their quality and life expectancy.

La Enfermedad Renal Crónica (ERC) es una reducción importante de la función renal que provoca cambios en el metabolismo de los individuos. Para monitorizar la evolución de la ERC y prevenir posibles complicaciones, se realizó una encuesta para evaluar el perfil sociodemográfico, bioquímico y hematológico de los pacientes con Insuficiencia Renal Crónica (IRC) en hemodiálisis. Esta investigación fue cuantitativa, descriptiva y transversal con carácter retrospectivo, realizada a través del análisis de datos secundarios contenidos en las historias clínicas de los pacientes. La recolección de datos ocurrió en el Centro de Hemodiálisis de la ciudad de Russas, Ceará. La muestra estuvo constituida por 161 pacientes con ERC, 63,35% del sexo masculino y 85,71% pardos, con una edad media de 54,39 años. De estos, 63,97% tenían entre 2 y 10 años de tratamiento y 57,76% tenían primaria incompleta. El 19,25% residía en Russas. Resultados: Posterior a la hemodiálisis los resultados arrojaron 44 mg/dL de Urea, 48,44% de los pacientes con valores normales. La hemoglobina y el hematocrito medios fueron 11,8 g/dl y 33,7 %, respectivamente, con un 63,35 % con valores reducidos. El 85,10% de los pacientes presentaba plaquetas normales, el 72,04% presentaba niveles adecuados de hierro y albúmina, el 52,79% presentaba niveles elevados de ferritina, el 23,61% presentaba transferrina reducida y niveles satisfactorios de lípidos. El 79,50% presentaba niveles séricos de potasio dentro de la normalidad, el 12,42% de fósforo por encima de lo normal, el 85,09% de calcio dentro de los valores normales, el 39,13% de PTHi normal y el 86,33% de glucosa dentro de los valores considerados normales. Con base en los resultados, se concluyó que todos los pacientes en hemodiálisis tienen varios cambios debido a la ERC y al propio proceso de tratamiento. Por tanto, la realización de pruebas para evaluar o monitorizar las posibles complicaciones de la IRC es fundamental para crear estrategias e intervenciones más eficaces que mejoren la atención a estos pacientes y, en consecuencia, su calidad y esperanza de vida.

Enfermedad asociada a anticuerpos contra la glicoproteína de mielina de oligodendrocitos / Myelin oligodendrocyte glycoprotein antibody disease

Introducción: La enfermedad asociada a anticuerpos contra la glicoproteína de mielina del oligodendrocito (MOGAD, por sus siglas en inglés) es una entidad clínica recientemente identificada. La frecuencia de presentación del MOGAD es desconocida, pero se considera baja con respecto a otras enfermedades inflamatorias desmielinizantes. Materiales y métodos: Revisión narrativa de la literatura. Resultados: Las manifestaciones clínicas de esta condición son heterogéneas e incluyen neuritis óptica, mielitis, desmielinización multifocal del sistema nervioso central y encefalitis cortical. Se han descrito algunos hallazgos radiológicos que aumentan la sospecha diagnóstica, como el realce perineural del nervio óptico, el signo de la H en el cordón espinal y la resolución de lesiones T2 con el tiempo. El diagnóstico se basa en la detección de inmunoglobulinas G específicas contra MOG, en el contexto clínico adecuado. El tratamiento consiste en manejo de los ataques agudos con dosis altas de corticoides y en algunos casos se deberá considerar la inmunosupresión crónica, considerar la inmunosupresión crónica en pacientes con recurrencia o con discapacidad severa residual tras el primer evento. Conclusiones: En esta revisión narrativa se resumen los aspectos clave con respecto a la fisiopatología, las manifestaciones, el diagnóstico y el tratamiento de la MOGAD.

Introduction: The disease associated with antibodies against the myelin oligodendrocyte glycoprotein (MOGAD) is a recently identified clinical entity, with unknown frequency, but is considered low compared to other demyelinating inflammatory diseases. Materials And Methods: Narrative review. Results: The clinical manifestations are heterogeneous, ranging from optic neuritis or myelitis to multi-focal CNS demyelination or cortical encephalitis. There have been described characteristic MRI features that increase the diagnostic suspicion, such as perineural optic nerve enhancement, spinal cord H-sign or T2-lesion resolution over time. The diagnosis is based on the detection of specific G- immunoglobulins against MOG, in the suggestive clinical context. Acute treatment is based on high dose steroids and maintenance treatment is generally reserved for relapsing cases or patients with severe residual disability after the first attack. Conclusions: In this narrative review, fundamental aspects of pathophysiology, clinical and radiological manifestations, diagnosis and treatment of MOGAD are discussed.

Serological characteristics of Lewis antibodies and their clinical significance - A case series

Abstract Introduction Lewis antibodies have been thought to play a small role in clinical transfusion practice, but recent reports suggest that they have gained more importance in the context of transfusion and transplantation. Data regarding the prevalence of Lewis antibodies and their clinical significance in the Indian context is very limited. Hence, this study was aimed at analyzing the serological characteristics and clinical significance of Lewis antibodies encountered in our patient and donor populations. Methods The retrospective data analyzed the records of red cell antibody screening results and the additional serological evaluation performed on the donor and patient samples included in the study. Results A total of 26 study subjects were noted to have Lewis antibodies (including 6 healthy donors and 20 patients). Of them, 13 individuals had anti-Leb, 10 had anti-Lea and the remaining three had an anti-Lea/Leb mixture. IgG Lewis antibodies were detected in 7 individuals. All cases of IgM Lewis antibodies detected were reacting at 37°C. Two patients were suspected of having hemolytic transfusion reactions due to Lewis antibodies. Antigen-negative cross-match compatible units were provided for transfusion in the recipients. Conclusion Lewis antibodies of the IgM class reacting at 37°C should be regarded as clinically important. The present study findings urge that the lab personnel look for the thermal amplitude of Lewis antibodies, irrespective of the fact that the antibody class and antigen-negative crossmatch compatible units should be provided to avoid hemolytic transfusion reactions.

High prevalence of serological weak D phenotype and preponderance of weak D type 4.0.1. genetic variant in a Nigerian population: implications for transfusion practice in a resource-limited setting

ABSTRACT Introduction: Prevalence of RhD negative phenotype in Nigeria is low; this leads to scarcity of RhD negative red cells for transfusion. Serological and molecular genotyping of RhD negative individuals for weak D types could reduce this scarcity. The aim of this study was to determine the serological prevalence and molecular types of weak D phenotypes among blood donors and pregnant women in Kano, Nigeria. Methods: A total of 4482 blood donors and pregnant women from three hospitals in Kano were recruited. An indirect antiglobulin test was used to determine weak D phenotypes. Molecular genotyping was performed on genomic DNA from whole blood amplified by polymerase chain reaction sequence-specific primers (PCR-SSP) with agarose gel electrophoresis. Results: The mean age of the participants was 26.50 ±5.79 years. The prevalence of the RhD negative phenotype was 4.2% (189/4482). Of the 189 RhD negative phenotypes, 20 (10.6%) were weak D positive. Molecular genotyping of the 20 Weak D positive phenotypes revealed 15 (75%) weak D type 4, of which 11 were due to the RHD*09.03 and RHD*DAR3 (T201R, F223V) polymorphisms and 4, due to RHD* 08.01 and RHD* DFV polymorphisms; 2 (10%) were due to the 602 C>G polymorphism, while the remaining 3 (15%) constituted partial D or other rare weak D types. Conclusion: The prevalence of weak D positive phenotypes is high in this study; weak D type 4 is the most common RhD genetic variant. Routine serologic weak D testing of RhD negative blood and molecular genotyping should be encouraged in resource-limited settings.

A systematic review of maternal TORCH serology as a screen for suspected fetal infection.

BACKGROUND: The acronym 'TORCH' refers to well-recognised causes of perinatal infections: toxoplasmosis, rubella, cytomegalovirus (CMV) and herpes simplex virus (HSV). A TORCH serology panel is often used to test for maternal primary infection following detection of ultrasound abnormalities in pregnancy. AIM: This review aims to estimate the diagnostic yield of maternal TORCH serology in pregnancy following fetal ultrasound abnormalities. MATERIALS AND METHODS: Primary studies published since 2000 that assessed maternal TORCH serology for suspected fetal infection and included information on indications for testing, definition of positive TORCH serology results, and perinatal outcomes were included. RESULTS: Eight studies with a total of 2538 pregnancies were included. The main indications for testing were polyhydramnios, fetal growth restriction and hyperechogenic bowel. There were 26 confirmed cases of congenital CMV, of which 15 had multiple ultrasound abnormalities. There were no cases of congenital toxoplasmosis, rubella or HSV confirmed in any of the eight studies. CONCLUSIONS: The clinical utility of TORCH serology for non-specific ultrasound abnormalities such as isolated fetal growth restriction or isolated polyhydramnios is low. It is time to retire the TORCH acronym and the reflex ordering of 'TORCH' panels, as their continued use obscures, rather than illuminates, appropriate investigation for fetal ultrasound abnormalities.

Avaliação soroepidemiológica de cães expostos a Rickettsia parkeri e correlação com a estrutura da paisagem no litoral do estado de São Paulo / Serosurvey on dogs for Rickettsia parkeri and correlation with landscape structure in São Paulo state coast (Brazil)

A febre maculosa causada por Rickettsia parkeri é a segunda riquetsiose de maior importância no Brasil. No estado de São Paulo, o agente é transmitido pelo carrapato Amblyomma ovale, que ocorre em número elevado em regiões costeiras de Mata Atlântica. Até o presente momento, não foi estabelecido como a estrutura da paisagem pode afetar a dispersão de carrapatos infectados por R. parkeri e, portanto, dinâmica de transmissão da doença. Propõe-se avaliar a relação entre a sorologia de cães domésticos expostos a R. parkeri e a estrutura da paisagem em áreas de comunidades adjacentes à Mata Atlântica no litoral paulista. Em um estudo transversal, foram selecionadas cinco áreas localizadas nos municípios de Cubatão, Peruíbe, São Sebastião, Cananéia e Ilhabela e, em cada área, amostras de soro de 30 cães foram colhidas e submetidas a reação de imunofluorescência indireta para detecção do título máximo de anticorpos anti-R. parkeri. Spearman foi usado como teste de correlação entre a sorologia e os componentes principais extraídos das métricas de paisagem em cada área de estudo. A análise da estrutura da paisagem evidenciou dois componentes principais não correlacionados que, somados, explicam 94,77% da variabilidade entre as áreas, em que o primeiro componente está relacionado à conectividade e o segundo componente está relacionado à quantidade de borda. A soroprevalência das áreas variou de 16,7% a 83,3%. A exposição de cães domésticos a R. parkeri está associada positivamente com a conectividade de habitat para A. ovale em áreas estudadas do litoral do estado de São Paulo. Não foi evidenciada associação entre a sorologia e a quantidade de borda na paisagem. É recomendado que as ações de vigilância epidemiológica para febre maculosa por R. parkeri sejam priorizadas em áreas com maior conectividade florestal, juntamente com a conscientização da posse responsável de cães.

Spotted fever caused by Rickettsia parkeri is the second most important rickettsiosis in Brazil. In São Paulo state, this agent is transmitted by the Amblyomma ovale tick, highly prevalent in coastal Atlantic Rainforest. Until the present moment, it is not known how landscape structure could affect A. ovale dispersion, and therefore, R. parkeri transmission dynamics. It is proposed to evaluate the seroepidemiology from R. parkeri exposed dogs and its correlation with landscape structure in São Paulo state coast. A transversal study was conducted to evaluate five different areas from communities nearby Atlantic Rainforest (municipalities of Cubatão, Peruíbe, São Sebastião, Cananéia and Ilhabela). Within each area, blood samples from 30 dogs were collected for serologic testing by indirect immunofluorescence assay. Correlation test Spearman was used between serology data and principal components extracted from landscape structure metrics in each area. Principal components analysis pointed two principal uncorrelated components which, together, explain 94,77% of the variability between landscape metrics. First component is related to landscape connectivity, and the second is related to edge abundance. It was found a seroprevalence from 16,7% to 83,3% in the different areas. A positive association between antibodies anti-R. parkeri found in dogs and landscape connectivity (p=0) was demonstrated. There was no association between serologic testing and edge abundance in the study areas. It is recommended that R. parkeri rickettsiosis surveillance to be priorized in connected forest areas, and responsible dog ownership must be encouraged.

Programa alternativo de evaluación externa de calidad para serología de SARS-CoV-2: calidad en tiempos de pandemia / Alternative external quality assessment programme for SARS-CoV-2 serology: quality in pandemic times

Resumen Para el control de la pandemia por COVID-19 es indispensable contar con ensayos confiables para la detección de anticuerpos anti-síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2). Por este motivo el Laboratorio de Serología y la Residencia de Bioquímica Clínica del Hospital Garrahan desarrollaron el primer Programa Piloto Alternativo de evaluación externa de la calidad para serología de SARS-CoV-2 en la Argentina, destinado a evaluar comparativamente el desempeño de los métodos disponibles de los participantes con el fin de asegurar resultados confiables y clínicamente útiles. El esquema constó de 4 envíos con 5 muestras cada uno, con reactividad variable contra SARS-CoV-2 en las que se evaluaron anticuerpos totales, IgG e IgM. Participaron 21 laboratorios, tanto públicos como privados, de la Provincia y de la Ciudad de Buenos Aires de forma gratuita. Informaron metodología utilizada y resultados. Al finalizar cada entrega se enviaron los reportes individuales y se realizó un informe final global con los resultados totales del ciclo. El mismo se llevó a cabo a lo largo del segundo semestre de 2020. Se informó un total de 643 resultados, 239 de anti- SARS-CoV-2 IgM, 365 de IgG y 39 de anticuerpos totales. Se observó mayor concordancia en las metodologías anti-SARS-CoV-2 IgG que en las IgM. ELISA/ COVIDAR fue la metodología más utilizada para IgG y ELFA/bioMérieux para IgM. El espectro de metodologías fue amplio. El programa fue útil para asegurar la calidad de los resultados y brindó a los participantes el marco necesario para emitir resultados confiables y armonizados.

Abstract For the control of COVID-19 pandemic it is essential to have reliable tests for the detection of antibodies against severe acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2). For this reason, the Serology Laboratory and the Residence of Clinical Biochemistry of Hospital Garrahan developed the first Alternative Pilot Programme for external quality assessment for SARS-CoV-2 serology in Argentina, aimed at comparatively evaluating the actuaperformance of the available methods of the participants using different anti-SARS-CoV tests in order to ensure reliable and clinically useful results. The scheme consisted of 4 deliveries with 5 samples each throughout the second semester of 2020, with variable reactivity against SARS-CoV-2 in which total antibodies, IgG and IgM were evaluated. Twenty one public and private laboratories participated in the Province and the City of Buenos Aires for free. The methodology applied and the results were informed. At the end of each delivery, individual reports were sent and a final global report was made with the total results of the cycle. A total of 643 results were reported, 239 for anti-SARS-CoV-2 IgM, 365 for IgG and 39 for total antibodies. There was greater agreement in the anti-SARS-CoV-2 IgG methodologies than in IgM. ELISA/COVIDAR was the most frequently used methodology for IgG and ELFA/bioMérieux for IgM. The spectrum of methodologies was wide. The programme was useful to ensure the quality of the results, providing the participants with the necessary framework to issue reliable and harmonised results.

Resumo Para o controle da pandemia de COVID-19, é imprescindível a existência de testes confiáveis para a detecção de anticorpos anti síndrome respiratória aguda grave por coronavírus 2 (SARS-CoV-2). Por esse motivo o Laboratório de Sorologia e a Residência de Bioquímica Clínica do Hospital Garrahan desenvolveram o primeiro Programa Piloto Alternativo de avaliação externa da qualidade para sorologia de SARS-CoV-2 na Argentina, com o objetivo de avaliar comparativamente o desempenho dos métodos disponíveis dos participantes para garantir resultados confiáveis e clinicamente úteis. O esquema consistiu em 4 remessas com 5 amostras cada uma, com reatividade variável contra SARS-CoV-2 em que foram avaliados anticorpos totais, IgG e IgM. Participaram 21 laboratórios públicos e privados da Província e da Cidade de Buenos Aires que participaram em forma gratuita. Eles relataram a metodologia utilizada e os resultados. Ao final de cada entrega, foram enviados relatórios individuais e foi feito um relatório final global com os resultados totais do ciclo. Ele foi realizado ao longo do segundo semestre de 2020. Um total de 643 resultados foram relatados, 239 de anti-SARS-CoV-2 IgM, 365 de IgG e 39 de anticorpos totais. Foi observada maior concordância nas metodologias anti-SARS-CoV-2 IgG do que nas IgM. ELISA/COVIDAR foi a metodologia mais utilizada para IgG e ELFA/bioMérieux para IgM. O espectro de metodologias foi amplo. O programa foi útil para garantir a qualidade dos resultados, proporcionando aos participantes o enquadramento necessário para a emissão de resultados confiáveis e harmonizados.

Prevalence of syphilis and associated factors in the adult population treated at healthcare facilities in Vitória (ES), Brazil / Prevalência e fatores associados à sífilis em adultos atendidos em unidades de saúde de Vitória (ES), Brasil

Introduction: There are few population-sampling studies on the prevalence of syphilis in Brazil. Objectives: We aim to determine the seroprevalence of syphilis and identify factors associated with the infection in adult patients observed at six regional healthcare facilities in Vitória city, state of Espírito Santo, Brazil. Methods: A cross-sectional study was conducted between September 2010 and December 2011. For individuals included in the study, a Venereal Disease Research Laboratory (VDRL) test and two treponemal tests (immunochromatographic and IgG ELISA assays) were performed. Demographic data, history of sexually transmitted infections, and behavioral data were collected. Results: Of the 1,502 subjects included in the study, 47% were men and 53% were women. The mean age was 41.63±14.57 years. The prevalence of syphilis was (0.9%; 95%CI 0.4­1.3) when a diagnosis of syphilis was considered with VDRL titers equal to or greater than 1:8. However, the prevalence was higher (2.8%) when a positive VDRL test, regardless of the titer, was considered. A multivariate analysis showed a significant association between syphilis and homosexual or bisexual behavior [OR=6.80; 95%CI 1.00­46.20], prior history of sexually transmitted infection [OR=16.30; 95%CI 3.61­73.41], the presence of a tattoo [OR=6.21; 95%CI 1.49­ 25.84], and cocaine use [OR=6.80; 95%CI 1.15­40.30]. The prevalence of positive treponemal test was 10.4%. Conclusion: The seroprevalence of active syphilis in this population was similar to that observed in other populational studies in Brazil. The high prevalence of positive treponemal tests may be due to the positive serological memory of a cured infection, but the results may also be due to cases of early or late syphilis that were not detected by the VDRL test.

Introdução: Existem poucos estudos em amostras populacionais sobre a prevalência da sífilis no Brasil. Objetivos: Determinar a soroprevalência de sífilis e identificar fatores associados à infecção em pacientes adultos atendidos nas unidades das seis regiões de saúde do Município de Vitória, Estado do Espírito Santo. Métodos: Foi realizado um estudo transversal entre setembro de 2010 e dezembro de 2011. Para os indivíduos incluídos no estudo, foram realizados o teste Venereal Disease Research Laboratory (VDRL) e dois testes treponêmicos (imunocromatográfico e IgG ELISA). Foram coletados dados demográficos, histórico de infecções sexualmente transmissíveis e dados comportamentais. Resultados: Dos 1.502 indivíduos incluídos no estudo, 47% eram homens e 53% eram mulheres. A média de idade foi de 41,63±14,57 anos. A prevalência de sífilis foi de 0,9% (IC95% 0,4­1,3) quando considerado diagnóstico de sífilis com títulos de VDRL iguais ou superiores a 1:8. Porém, a prevalência foi maior (2,8%) quando considerado VDRL positivo, independente do título. Análise multivariada mostrou associação significativa da sífilis com comportamento homo ou bissexual [OR=6,80; IC95% 1,00­46,20], história prévia de infecções sexualmente transmissíveis [OR=16,30; IC95% 3,61­73,41], tatuagem [OR=6,21; IC95% 1,49­25,84] e uso de cocaína [OR=6,80; IC95% 1,15­40,30]. A prevalência de teste treponêmico positivo foi de 10,4%. Conclusão: A soroprevalência de sífilis ativa nesta população foi semelhante à observada em outros estudos populacionais no Brasil. A alta prevalência nos testes treponêmicos positivos pode ser devida a cicatriz sorológica de infecção curada, mas pode também estar associada a casos de sífilis primária ou tardia, que não foram detectados pelo teste de VDRL.

Why current quantitative serology is not quantitative and how systems immunology could provide solutions.

Determination of the presence of antibodies against infectious agents, self-antigens, allogeneic antigens and environmental antigens is the goal of medical serology. Along with the standardization of these tests the community also started to use the expression "quantitative serology," referring to the fact that arbitrary units are used for the expression of results. In this review I will argue against the use of the term quantitative serology for current tests. Because each test and each antibody isotype determination uses its own references, the term semiquantitative better describes these methods. The introduction of really quantitative serology could both benefit from and drive forward systems immunological approach to immunity.

Serological investigation and genotyping of Mycobacterium avium subsp. paratuberculosis in sheep and goats in Inner Mongolia, China.

Paratuberculosis a contagious and chronic disease in domestic and wild ruminants, is caused by Mycobacterium avium subspecies paratuberculosis (MAP). Typical clinical signs include intractable diarrhea, progressive emaciation, proliferative enteropathy, and mesenteric lymphadenitis. Paratuberculosis is endemic to many parts of the world and responsible for considerable economic losses. In this study, different types of paratuberculosis and MAP in sheep and goats were investigated in Inner Mongolia, a northern province in China contiguous with two countries and eight other provinces. A total of 4434 serum samples were collected from six cities in the western, central, and eastern regions of Inner Mongolia and analyzed using the ELISA test. In addition, tissue samples were collected from seven animals that were suspected to be infected with MAP. Finally, these tissues samples were analyzed by histopathological examination followed by polymerase chain reaction (PCR), IS1311 PCR-restriction enzyme analysis (PCR-REA), and a sequence analysis of five genes. Among all 4434 ruminant serum samples collected from the six cities in the western, central, and eastern regions of Inner Mongolia, 7.60% (337/4434) measured positive for the MAP antibody. The proportions of positive MAP antibody results for serum samples collected in the western, central, and eastern regions were 5.10% (105/2058), 6.63% (85/1282), and 13.44% (147/1094), respectively. For the seven suspected infected animals selected from the herd with the highest rate of positivity, the gross pathology and histopathology of the necropsied animals were found to be consistent with the pathological features of paratuberculosis. The PCR analysis further confirmed the diagnosis of paratuberculosis. The rest of the results demonstrated that herds of sheep and goats in Inner Mongolia were infected with both MAP type II and type III. To the best of our knowledge, this is the first study of the two subtypes of MAP strains in sheep and goats in Inner Mongolia.

What Can Serology Tell Us About the Burden of Infertility in Women Caused by Chlamydia?

Chlamydia trachomatis (CT) causes pelvic inflammatory disease, which may result in tubal factor infertility (TFI) in women. Serologic assays may be used to determine the proportion of women with and without TFI who have had previous CT infection and to generate estimates of infertility attributable to chlamydia. Unfortunately, most existing CT serologic assays are challenged by low sensitivity and, sometimes, specificity for prior CT infection; however, they are currently the only available tests available to detect prior CT infection. Modeling methods such as finite mixture modeling may be a useful adjunct to quantitative serologic data to obtain better estimates of CT-related infertility. In this article, we review CT serological assays, including the use of antigens preferentially expressed during upper genital tract infection, and suggest future research directions. These methodologic improvements, coupled with creation of new biomarkers for previous CT infection, should improve our understanding of chlamydia's contribution to female infertility.

SARS-CoV-2 Infection in Spondyloarthritis Patients Treated With Biotechnological Drugs: A Study on Serology.

Objective: Serology could help to define the real extent of SARS-CoV-2 diffusion, especially in individuals considered at higher risk of COVID-19, such as spondyloarthritis (SpA) patients undergoing immunosuppressant. Our aim was to detect, by serology, previous SARS-CoV-2 contact in SpA, compared to health care workers (HCW), and healthy controls. Methods: Sera from consecutive patients affected by SpA undergoing cytokine-targeted therapy, HCW and healthy controls from 2015 were analysed through chemiluminescent analytical system for the presence of IgG and IgM anti-SARS-CoV-2. Positive patients (IgM or IgG, or both) additionally underwent real-time Polymerase-Chain-Reaction (RT-PCR) to test for active infection. Serology was repeated at 3-months in SpA. Data across 3 groups were compared by Kruskal Wallis/Chi-square, and between 2 groups by Wilcoxon rank test/Chi-Square. P ≤ 0.05 were considered significant. Results: 200 SpA, 95 HCW and 101 controls were recruited. Positive serology was found in 25(12.5%) SpA, 8(8.4%) HCW, 0(0%) controls (p=0.001). SpA patients with positive serology more frequently reported COVID-19-like symptoms than those with negative serology (20% vs. 4%, p=0.009) and 2 had COVID-19 as confirmed by RT-PCR, non severe. No HCW reported symptoms or had positive RT-PCR. In SpA patients, at 3 months, mean IgM titres decreased from 2.76 ± 2.93 to 2.38 ± 2.95 (p=0.001), while IgG titres from 0.89 ± 3.25 to 0.31 ± 0.87 (p=ns). Conclusions: Serology revealed that exposure to SARS-CoV-2 in SpA patients and HCW was higher than expected based on reported symptoms. In SpA, anti-cytokine therapy could act as a protective factor for a severe disease course. However, a seroconversion was not observed at 3-months.

Epitope profiling reveals binding signatures of SARS-CoV-2 immune response in natural infection and cross-reactivity with endemic human CoVs.

A major goal of current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine efforts is to elicit antibody responses that confer protection. Mapping the epitope targets of the SARS-CoV-2 antibody response is critical for vaccine design, diagnostics, and development of therapeutics. Here, we develop a pan-coronavirus phage display library to map antibody binding sites at high resolution within the complete viral proteomes of all known human-infecting coronaviruses in patients with mild or moderate/severe coronavirus disease 2019 (COVID-19). We find that the majority of immune responses to SARS-CoV-2 are targeted to the spike protein, nucleocapsid, and ORF1ab and include sites of mutation in current variants of concern. Some epitopes are identified in the majority of samples, while others are rare, and we find variation in the number of epitopes targeted between individuals. We find low levels of SARS-CoV-2 cross-reactivity in individuals with no exposure to the virus and significant cross-reactivity with endemic human coronaviruses (CoVs) in convalescent sera from patients with COVID-19.

Disagreement between PCR and serological diagnosis of Trypanosoma cruzi infection in blood donors from a Colombian endemic region / Desacuerdo entre la PCR y la serología en el diagnóstico de la infección por Trypanosoma cruzi en donantes de una región endémica de Colombia

Abstract | Introduction: Chagas' disease is the leading cause of infectious myocarditis worldwide. This infection caused by Trypanosoma cruzi is usually life-long and asymptomatic; however, the third part of infected people can develop severe or even fatal cardiomyopathy. As the parasitemia in the chronic phase is both low-grade and intermittent, T. cruzi infection is principally detected by serology, although this method has sensitivity and specificity limitations. Objective: To determine the level of agreement between serologicand molecular tests in 658 voluntary blood donors from six provinces in the Colombian department of Santander. Materials and methods: We evaluated an array of diagnostic technologies by cross-section sampling performing a serological double diagnostic test for T. cruzi antibody detection (Chagas III ELISA™, BiosChile Group, and ARCHITECT Chagas CMIA™, Abbott) , and DNA detection by polymerase chain reaction (PCR). We collected the demographic, clinical, and epidemiological information of participants. The sample size was calculated using Epidat™ and the statistical analysis was done with Stata 12.1™. Results: PCR was six times more sensitive in detecting T. cruzi infection than ELISA/CMIA with prevalence values of 1.8% (12/658) and 0.3% (2/658), respectively, and kappa=0.28 (95%CI: -0.03 - 0.59). In contrast, serology showed a sensitivity of 16.7% (95%CI: 2.09 - 48.4) and a specificity of 100% (95%CI: 99.4 - 100). All seropositive samples were found to be positive by PCR. Conclusions: The implementation of PCR as a complementary method for screening donors could reduce the probability of false negative and the consequent risk of transfusional-transmission of Chagas' disease, especially in endemic regions.

Resumen | Introducción. La enfermedad de Chagas constituye la principal causa de miocarditis infecciosa en el mundo. Causada por Trypanosoma cruzi,la infección puede persistir toda la vida de manera asintomática y silenciosa, pero un tercio de los infectados desarrolla cardiomiopatía grave. Debido a que la parasitemia en la fase crónica es baja e intermitente, el diagnóstico se hace principalmente mediante la detección de anticuerpos (serología), método que tiene limitaciones de sensibilidad y especificidad. Objetivo. Determinar la concordancia entre el diagnóstico serológico y molecular de T. cruzien 658 donantes voluntarios de sangre del departamento de Santander, Colombia. Materiales y métodos. Se hizo un estudio de evaluación de tecnologías diagnósticas con muestreo transversal, utilizando un doble diagnóstico serológico para la detección de anticuerpos anti-T. cruzi (Chagas III ELISA™, BiosChile Group, y ARCHITECT ChagasCMIA™, Abbott) y la de ADN por PCR. Se recolectó la información demográfica, clínica y epidemiológica de los participantes. El tamaño de la muestra se estimó utilizando Epidat™ y el análisis estadístico se hizo mediante Stata 12.1™. Resultados. La sensibilidad de la PCR fue seis veces mayor que la de las pruebas de ELISA/CMIA, con prevalencias de 1,8 % (12/658) y 0,3 % (2/658), respectivamente, y kappa de 0,28 (IC95% -0,03 - 0,59). La sensibilidad serológica fue de 16,7 % (IC95% 2,09 - 48,4) y la especificidad de 100 % (IC95% 99,4 - 100). Todas las muestras seropositivas fueron positivas también en la PCR. Conclusiones. El uso de la PCR como método complementario para la tamización de donantes podría reducir el riesgo de falsos negativos y disminuir los casos de transmisión transfusional de la enfermedad de Chagas, especialmente en regiones endémicas.

Prevalência sorológica do vírus da Hepatite C na região carbonífera do Rio Grande do Sul / Sorological prevalence of Hepatitis C virus in carboniferous region of Rio Grande do Sul

Objetivo: Estimar a prevalência sorológica de pacientes portadores do HCV na Região Carbonífera do Rio Grande do Sul. Métodos: Foram coletados 1.136 dados de pacien- tes que realizaram exame sorológico para HCV em um laboratório localizado na Região Carbonífera do Rio Grande do Sul durante o período de janeiro de 2017 a julho de 2018. Resultados: Identificaram-se 29 (2,6%) pacientes com o HCV, sendo que o maior número de infectados são do sexo masculino, com uma prevalência maior na cidade de Arroio dos Ratos. Conclusão: Os resultados podem servir de base para se desenvolverem ações de promoção da saúde, prevenção e assistência aos pacientes com HCV, reforçando a vigilância epidemiológica e sanitária.

Perfil epidemiológico da sífilis adquirida em pacientes de um laboratório clínico universitário em Goiânia-GO, no período de 2017 a 2019 / Epidemiological profile of syphilis acquired in patients of a university clinical laboratory in Goiânia-GO from 2017 to 2019

Objetivo: A sífilis é uma doença infectocontagiosa, transmitida pela via sexual e verticalmente durante a gestação. Quando não tratada adequadamente, a doença pode permanecer no organismo por grandes períodos sem sintomas clínicos, pode evoluir atingindo múltiplos sistemas do organismo. O objetivo deste estudo foi determinar o perfil epidemiológico de usuários do Laboratório Clínico da PUC Goiás, com casos confirmados de sífilis adquirida, no período de 2017 a 2019. Métodos: Trata-se de uma pesquisa retrospectiva, a partir da análise dos resultados dos exames de VDRL e FTA-Abs no banco de dados eletrônico do laboratório. Resultados: Um total de 8.884 exames de rastreamento para sífilis adquirida foi solicitado neste período. Deste total, 11,1%, 17,2% e 10,9% apresentaram resultados reagentes no VDRL, respectivamente, nos anos de 2017, 2018 e 2019. Um percentual de 78,7% dos exames positivos para sífilis (VDRL) foi confirmado pelo teste treponêmico FTA-Abs (IgG). Em 2017, 32,45% dos exames foram reagentes para FTA-abs; 7,95% em 2018, e 9,3% em 2019. Os resultados desta pesquisa evidenciam uma maior prevalência de casos de sífilis adquirida em adultos jovens do sexo masculino (47,9%/2017; 72,9%/2018; 63,0%/2019) com baixa escolaridade. Conclusão: Nos últimos anos, a sífilis tem se tornado um grande problema de saúde pública, visto o seu aumento a cada ano, mesmo com tratamento simples e diagnóstico rápido. Medidas de controle, principalmente voltadas para o tratamento adequado do paciente e parceiro, uso de preservativo, informação à população devem ser fortalecidas pelos programas de saúde para controle da sífilis na população estudada.

Objective: Syphilis is an infectious disease, transmitted sexually and vertically during pregnancy. When not treated properly, the disease can remain in the organism for long periods without clinical symptoms, it can evolve reaching multiple systems. The objective of this study was to determine the epidemiological profile of users of the Clinical Laboratory of PUC Goiás, with confirmed cases of acquired syphilis, in the period from 2017 to 2019. Methods: This is a retrospective research, based on the analysis of the results of the VDRL exams and FTA-Abs in the laboratory's electronic database. Results: A total of 8,884 screening tests for acquired syphilis were ordered during this period. Of this total, 11.1%, 17.2% and 10.9% had positive results in the VDRL, respectively, in the years 2017, 2018 and 2019. A percentage of 78.7% of the positive tests for syphilis (VDRL) were confirmed by the FTA-Abs (IgG) treponemic test. In 2017, 32.45% of the tests were reactive for FTA-abs; 7.95% in 2018, and 9.3% in 2019. The results of this research show a higher prevalence of cases of acquired syphilis in young male adults (47.9% / 2017; 72.9% / 2018; 63,0% / 2019) with low education. Conclusion: In recent years, syphilis has become a major public health problem, as it increases every year, even with simple treatment and rapid diagnosis. Control measures, mainly aimed at the adequate treatment of the patient and partner, use of condoms, information to the population must be strengthened by health programs for syphilis control in the studied population.

Comparação de resultados de exames sorológicos para sífilis realizados em um hospital público da região oeste do Paraná / Comparison of results from syphilis serological tests performed in a public hospital from the western region of Paraná

Objetivo: O objetivo desta pesquisa foi estimar a prevalência da positividade de testes sorológicos para sífilis nos pacientes atendidos pelo Hospital Universitário do Oeste do Paraná (HUOP) e descrever parte de suas características socioepidemiológicas. Métodos: Estudo transversal que utilizou como fonte de dados informações do prontuário eletrônico Tasy®, referentes aos resultados de exames de VDRL e FTA-Abs realizados no HUOP, entre janeiro de 2015 e dezembro de 2019. Resultados: Durante este período foram liberados laudos de 26.968 testes de VDRL, realizados no Laboratório do HUOP e o nú- mero de resultados reagentes foi de 1.014. Em relação ao FTA-Abs, foram liberados 383 resultados e destes 116 foram reagentes. O estudo evidenciou um aumento de resultados reagentes do teste não treponêmico VDRL de 2017 a 2019. Conclusão: Neste estudo foi observado um aumento progressivo no diagnóstico de sífilis, e isto reflete a situação da doença em todo o Brasil que, mesmo com protocolos de diagnóstico e tratamento, persiste numa posição de grande destaque na saúde pública. Os dados apresentados demonstram a importância do serviço do HUOP para o diagnóstico desta doença para grande parte do oeste paranaense.

Objective: The objective of this research was to estimate the positivity prevalence of syphilis serological tests, in the patients attended in the State Universitary Hospital from Western of Paraná (HUOP), and to describe part of their socioepidemiological characteristics. Methods: Transversal study, which made use of the informations contained in the electronic medical reports software Tasy®, regarding the results of exams of VDRL and FTA-Abs, performed in the HUOP between january of 2015 and december of 2019. Results: During the studied period, reports on 26,968 VDRL tests were performed in the HUOP laboratory and the number of reagent results is 1,104. Towards the FTA-Abs test, 383 tests were performed and 116 of these were positive. The study showed an increasing number of reagent results for VDRL between 2017 and 2019. Conclusion: In this study, a progressive increase in the diagnosis of syphilis was observed, this reflects the situation of the disease all around the brazillian country, in which, even with well defined diagnostic and treating protocols, the infection persists in a prominent position for the public health. The presented data shows the importance of the HUOP's service to the population, in regards to the syphilis diagnose.

Diagnostic role of CXCL13 and CSF serology in patients with neurosyphilis.

BACKGROUND: Considering the unknown prevalence of neurosyphilis in West China, and the confusing diagnosis of neurosyphilis, the role of CSF_CXCL13 and syphilis serology was studied to provide a more accurate reference for the clinical detection and diagnosis of neurosyphilis. METHODS: A retrospective data set I was used to investigate the prevalence of neurosyphilis, as well as the laboratory characteristics of 244 patients. Besides, to explore the diagnostic value of CSF_CXCL13 and syphilis serology for neurosyphilis, another 116 CSF_serum paired samples (data set II) were collected from 44 neurosyphilis and 72 non-neurosyphilis/syphilis patients. RESULTS: About 6.25% (156 out of 2494) syphilis was neurosyphilis. When Treponema pallidum infection occurs, syphilis serology (sero_TRUST ≥1:16 and sero_TPPA titre ≥1:10240) can be good predictors of neurosyphilis, as well as syphilis CSF serology (CSF_TPPA ≥1:320, CSF_TRUST and venereal disease research laboratory). The sensitivity of serology in neurosyphilis can be complemented by CSF_CXCL13, which could be the therapy monitor of neurosyphilis. CONCLUSION: Due to the lack of ideal biomarkers for neurosyphilis, the importance of syphilis serology cannot be ignored, and their combination with CSF_CXCL13 or other biomarkers should be further investigated.