El valor de proteínas de fase aguda y la prueba LightCycler® SeptiFast en el diagnóstico de infecciones bacterianas y virales en niños / The value of acute phase reactants and LightCycler® SeptiFast test in the diagnosis of bacterial and viral infections in pediatric patients

Introducción. Evaluamos el nivel de reactantes de fase aguda y la prueba LightCycler® SeptiFast para diferenciar infecciones bacterianas vs.virales. Métodos. Estudio prospectivo en niños febriles. Se analizaron recuento de leucocitos, proteína C-reactiva y procalcitonina en días 1, 3 y 7 de hospitalización. El día 1 se realizaron hemocultivo y radiografía de tórax. Se evaluaron dos grupos de niños que presentaron infecciones bacterianas o virales. Resultados. Se incluyeron 94 niños febriles. La temperatura media de la fiebre fue significativamente más alta en niños con infecciones bacterianas que con infecciones virales (p < 0,001). En 34 (72,3%) niños con infecciones bacterianas, el hemocultivo fue negativo. De ellos, 12 (35,2%) presentaron prueba SeptiFast positiva. No hubo resultados positivos en hemocultivos de niños con infecciones virales y todos tuvieron resultado negativo para la prueba SeptiFast. La media de proteína C-reactiva el primer día de hospitalización fue significativamente más alta en el grupo con infecciones bacterianas (p < 0,001) y en los días 3 y 7 junto con la procalcitonina fueron significativamente más altas en niños con infecciones bacterianas (p <0,001). La sensibilidad y especificidad de los leucocitos, la proteína C-reactiva y la procalcitonina fueron 63,8%, 44,7%, 74,5% y 78,7%, 68,1% y 100%, respectivamente. Las áreas bajo la curva de los leucocitos, la proteína C-reactiva y la procalcitonina fueron 0,519, 0,764 y 0,835, respectivamente. Conclusiones. Los reactantes de fase aguda, en especial procalcitonina, y la prueba LightCycler® SeptiFast podrían ayudar a diferenciar infecciones bacterianas de virales.

Introduction: This study was performed to investigate the value of acute phase reactants and LightCycler® SeptiFast test to differentiate bacterial and viral infections. Population and methods: Children with fever were enrolled to this prospective study. Peripheral white blood cell (WBC), C-reactive protein (CRP) and procalcitonin (PCT) were studied from all patients on day 1, 3 and 7. Blood culture and chest X-ray were also obtained on day 1. Blood samples for LightCycler® SeptiFast test were obtained in all patients to use them if there was uncertain diagnosis between bacterial or viral infection. The patients were divided into two groups as bacterial and viral infection. Results: A total of 94 children with fever were enrolled. The mean value of fever was significantly higher in bacterial group than viral group (p <0.001). In bacterial infection group, 34 (72.3%) patients had negative blood culture. Of those, 12 (35.2%) had positive SeptiFast test. There were no positive blood culture in patients with viral infection group and all of them had negative SeptiFast test. The mean levels of CRP on the first day of admission were significantly higher in bacterial group than viral group (p <0.001). CRP and PCT levels of day 3 and 7 were significantly higher in bacterial group (p <0.001). The sensitivity and specificity levels of WBC, CRP and PCT were 63.8%, 44.7%, 74.5% and 78.7% ,68.1% and 100%, respectively. Conclusions: We found that acute phase reactants, especially PCT, and LightCycler® SeptiFast test may help to differentiate bacterial and viral infections.

The value of acute phase reactants and LightCycler® SeptiFast test in the diagnosis of bacterial and viral infections in pediatric patients. / El valor de proteínas de fase aguda y la prueba LightCycler® SeptiFast en el diagnóstico de infecciones bacterianas y virales en niños.

INTRODUCTION: This study was performed to investigate the value of acute phase reactants and LightCycler® SeptiFast test to differentiate bacterial and viral infections. POPULATION AND METHODS: Children with fever were enrolled to this prospective study. Peripheral white blood cell (WBC), C-reactive protein (CRP) and procalcitonin (PCT) were studied from all patients on day 1, 3 and 7. Blood culture and chest X-ray were also obtained on day 1. Blood samples for LightCycler® SeptiFast test were obtained in all patients to use them if there was uncertain diagnosis between bacterial or viral infection. The patients were divided into two groups as bacterial and viral infection. RESULTS: A total of 94 children with fever were enrolled. The mean value of fever was significantly higher in bacterial group than viral group (p <0.001). In bacterial infection group, 34 (72.3%) patients had negative blood culture. Of those, 12 (35.2%) had positive SeptiFast test. There were no positive blood culture in patients with viral infection group and all of them had negative SeptiFast test. The mean levels of CRP on the first day of admission were significantly higher in bacterial group than viral group (p <0.001). CRP and PCT levels of day 3 and 7 were significantly higher in bacterial group (p <0.001). The sensitivity and specificity levels of WBC, CRP and PCT were 63.8%, 44.7%, 74.5% and 78.7% ,68.1% and 100%, respectively. CONCLUSIONS: We found that acute phase reactants, especially PCT, and LightCycler® SeptiFast test may help to differentiate bacterial and viral infections.

INTRODUCCIÓN: Evaluamos el nivel de reactantes de fase aguda y la prueba LightCycler® SeptiFast para diferenciar infecciones bacterianas vs. irales. MÉTODOS: Estudio prospectivo en niños febriles. Se analizaron recuento de leucocitos, proteína C-reactiva y procalcitonina en días 1, 3 y 7 de hospitalización. El día 1 se realizaron hemocultivo y radiografía de tórax. Se evaluaron dos grupos de niños que presentaron infecciones bacterianas o virales. RESULTADOS: Se incluyeron 94 niños febriles. La temperatura media de la fiebre fue significativamente más alta en niños con infecciones bacterianas que con infecciones virales (p < 0,001). En 34 (72,3%) niños con infecciones bacterianas, el hemocultivo fue negativo. De ellos, 12 (35,2%) presentaron prueba SeptiFast positiva. No hubo resultados positivos en hemocultivos de niños con infecciones virales y todos tuvieron resultado negativo para la prueba SeptiFast. La media de proteína C-reactiva el primer día de hospitalización fue significativamente más alta en el grupo con infecciones bacterianas (p < 0,001) y en los días 3 y 7 junto con la procalcitonina fueron significativamente más altas en niños con infecciones bacterianas (p <0,001). La sensibilidad y especificidad de los leucocitos, la proteína C-reactiva y la procalcitonina fueron 63,8%, 44,7%, 74,5% y 78,7%, 68,1% y 100%, respectivamente. Las áreas bajo la curva de los leucocitos, la proteína C-reactiva y la procalcitonina fueron 0,519, 0,764 y 0,835, respectivamente. CONCLUSIONES: Los reactantes de fase aguda, en especial procalcitonina, y la prueba LightCycler® SeptiFast podrían ayudar a diferenciar infecciones bacterianas de virales.

Detection of Entamoeba histolytica/Entamoeba dispar in stool specimens by using enzyme-linked immunosorbent assay

Entamoeba histolytica actually comprises two genetically distinct but morphologically indistinguishable species. E. histolytica can cause invasive intestinal and extra intestinal disease, while E. dispar cannot. Identification and differentiation of E. dispar and E. histolytica in stool sample by microscopy is imprecise. Several weeks of culture and isoenzyme analysis are required to differentiate E. histolytica from E. dispar. In this study, we have used an enzyme-linked immunosorbent assay (ELISA) for detection of E. histolytica/E.dispar and compared it with microscopy. Eighty-eight samples were evaluated, trichrome staining was positive in 20.4 percent (18) and ELISA was positive in 29.5 percent (26). Both tests were positive in 14 (15.9 percent) samples, 4 (4.5 percent) only with direct microscopy, and 12 (13.6 percent) only with ELISA. Both tests were negative in 58 (65.9 percent) samples. Microscopy has low sensitivity and high specificity, low negative predictive value and high positive predictive value in comparison with ELISA. E. histolytica/E. dispar antigen detection ELISA tests are inexpensive compared to the specific tests, yield objective results and do not require experienced microscopists and can therefore be recommended for screening of stools worldwide and the results can be taken for treatment that are fitting with its clinic.

Detection of Entamoeba histolytica/Entamoeba dispar in stool specimens by using enzyme-linked immunosorbent assay.

Entamoeba histolytica actually comprises two genetically distinct but morphologically indistinguishable species. E. histolytica can cause invasive intestinal and extra intestinal disease, while E. dispar cannot. Identification and differentiation of E. dispar and E. histolytica in stool sample by microscopy is imprecise. Several weeks of culture and isoenzyme analysis are required to differentiate E. histolytica from E. dispar. In this study, we have used an enzyme-linked immunosorbent assay (ELISA) for detection of E. histolytica/E.dispar and compared it with microscopy. Eighty-eight samples were evaluated, trichrome staining was positive in 20.4% (18) and ELISA was positive in 29.5% (26). Both tests were positive in 14 (15.9%) samples, 4 (4.5%) only with direct microscopy, and 12 (13.6%) only with ELISA. Both tests were negative in 58 (65.9%) samples. Microscopy has low sensitivity and high specificity, low negative predictive value and high positive predictive value in comparison with ELISA. E. histolytica/E. dispar antigen detection ELISA tests are inexpensive compared to the specific tests, yield objective results and do not require experienced microscopists and can therefore be recommended for screening of stools worldwide and the results can be taken for treatment that are fitting with its clinic.

Environmental pollution with soil-transmitted helminths in Sanliurfa, Turkey

Soil transmitted helminth (STH) infection are endemic in developing countries. A study was carried out of sewage farms, streams and vegetables to determine the sources and routes of STH infection in Sanliurfa, Turkey. Stool samples from farmhouse inhabitants as well as soil and vegetable samples from the gardens were collected and examined. In addition, water samples from streams and vegetable samples from the city market were collected and examined. One hundred and eighty-seven (59.5 percent) of a total of 314 samples, including 88.4 percent of the stool samples, 60.8 percent of the water samples, 84.4 percent of the soil samples and 14 percent of the vegetable samples, were found to be positive for STH eggs. These results indicate that the water, soil and vegetables are heavily contaminated, and suggest a vicious circle between humans and the environment. Improving environmental sanitation is imperative for the control of soil-transmitted helminthiasis in Sanliurfa

Diagnostic performance characteristics of rapid dipstick test for Plasmodium vivax malaria

We compared the diagnostic performance characteristics of newly developed method, the rapid dipstick test, which provides colorimetric determination by developing antibody to the lactate dehydrogenase enzyme of parasites, with conventional standard thick-blood film examination. For the rapid test, OptiMAL commercial kits were used. The results were also evaluated with clinical findings from patients. The parasites were determined by microscopic examination of thick-blood films from 81 patients with vivax malaria from southeastern Anatolia, Turkey. The OptiMAL test results were found to be negative in five patients who were diagnosed clinically and through thick-film testing as having vivax malaria. There was no false positivity observed with the OptiMAL test. We concluded that this rapid malaria test has a lower level of sensitivity than the classical thick-blood-film test for malaria, but that these methods have equal specificity