The imperative for quality control programs in Monkeypox virus DNA testing by PCR: CIBERINFEC quality control.

To evaluate molecular assays for Mpox diagnosis available in various clinical microbiology services in Spain through a quality control (QC) approach. A total of 14 centers from across Spain participated in the study. The Reference Laboratory dispatched eight serum samples and eight nucleic acid extracts to each participating center. Some samples were spiked with Mpox or Vaccinia virus to mimic positive samples for Mpox or other orthopox viruses. Participating centers provided information on the results obtained, as well as the laboratory methods used. Among the 14 participating centers seven different commercial assays were employed, with the most commonly used kit being LightMix Modular Orthopox/Monkeypox (Mpox) Virus (Roche®). Of the 12 centers conducting Mpox determinations, concordance ranged from 62.5% (n = 1) to 100% (n = 11) for eluates and from 75.0% (n = 1) to 100% (n = 10) for serum. Among the 10 centers performing Orthopoxvirus determinations, a 100% concordance was observed for eluates, while for serum, concordance ranged from 87.5% (n = 6) to 100% (n = 4). Repeatedly, 6 different centers reported a false negative in serum samples for Orthopoxvirus diagnosis, particularly in a sample with borderline Ct = 39. Conversely, one center, using the TaqMan™ Mpox Virus Microbe Detection Assay (Thermo Fisher), reported false positives in Mpox diagnosis for samples spiked with vaccinia virus due to cross-reactions. We observed a positive correlation of various diagnostic assays for Mpox used by the participating centers with the reference values. Our results highlight the significance of standardization, validation, and ongoing QC in the microbiological diagnosis of infectious diseases, which might be particularly relevant for emerging viruses.

Congenital infection of SARS-CoV-2 in live-born neonates: a population-based descriptive study.

OBJECTIVE: To evaluate the evidence of mother-to-child transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: This is a descriptive, multicentre, observational study in nine tertiary care hospitals throughout Spain. The study population was women with coronavirus disease 2019 during pregnancy. Mother-to-child transmission was defined as positive real-time RT-PCR of SARS-CoV-2 in amniotic fluid, cord blood, placenta or neonatal nasopharyngeal swabs taken immediately after birth. RESULTS: We included 43 women with singleton pregnancies and one with a twin pregnancy, as a result we obtained 45 samples of placenta, amniotic fluid and umbilical cord blood. The median gestational age at diagnosis was 34.7 weeks (range 14-41.3 weeks). The median interval between positive RT-PCR and delivery was 21.5 days (range 0-141 days). Fourteen women (31.8%, 95% CI 18.6%-47.6%) were positive at the time of delivery. There was one singleton pregnancy with SARS-CoV-2 RT-PCR positive in the placenta, amniotic fluid and umbilical cord blood (2.2%, 95% CI 0.1%-11.8%). Nasopharyngeal aspiration was performed on 38 neonates at birth, all of which were negative (0%, 95% CI 0%-9.3%). In 11 neonates the nasopharyngeal aspiration was repeated at 24-48 hours, and one returned positive (9.1%, 95% CI 0.2%-41.3%). CONCLUSIONS: The presence of SARS-CoV-2 in placenta, amniotic fluid and cord blood shows that mother-to-child transmission is possible but uncommon.

Detection of Streptococcus pneumoniae antigen in pleural fluid: usefulness of an immunofluorescence-based lateral flow assay for the diagnosis of pneumococcal pneumonia.

The performance of an immunofluorescence-based Streptococcus pneumoniae antigen detection test in pleural fluid (IF-PF) was evaluated. For proven and possible pneumococcal pneumonias global sensitivity and specificity were 92.6 (95 CI 76.6-97.9) and 80 (95 CI 62.7-90.5), respectively, with no significant differences between children and adults. Global diagnostic accuracy of IF-PF was 86% (74.2-93.7), and a substantial k index of concordance with culture/RT-PCR of 0.716 (0.535-0.896). IF-PF might be useful as a rapid complementary test for the etiologic diagnosis of pneumococcal pneumonia.

Caracterización clínica y etiológica de los casos de parotiditis en un servicio de urgencias / Clinical features and origin of cases of parotiditis in an emergency department

No disponible

Diagnóstico microbiológico de las infecciones virales respiratorias en el paciente adulto / Microbiological diagnosis of viral respiratory infections in the adult patient

Las técnicas tradicionales para el diagnóstico de los virus respiratorios siguen estando todavía vigentes, aunque los métodos moleculares aplicados al diagnóstico de la infección viral respiratoria han supuesto una auténtica revolución. Las técnicas moleculares tienen como principales ventajas una excelente sensibilidad, especificidad, capacidad de adaptación a virus emergentes, capacidad para detectar múltiples dianas en un mismo ensayo y posibilidad de automatización. Adicionalmente, estas técnicas han permitido profundizar en el papel de los virus en la infección respiratoria aguda a la vez que han descrito la existencia de nuevos virus no conocidos previamente. Los métodos moleculares y no moleculares de diagnóstico rápido para 1 o más virus respiratorios han permitido la toma de decisiones de forma inmediata en el manejo del paciente mejorando su pronóstico y evitando la transmisión nosocomial. Sin embargo, también hay inconvenientes, la mayor sensibilidad de las técnicas moleculares ha supuesto un incremento significativo de la tasa de codetecciones múltiples de virus respiratorios, cuya implicación clínica resulta difícil de interpretar. Finalmente queda por demostrar todavía si la utilización de las nuevas técnicas, de elevado coste, en el diagnóstico microbiológico de rutina de las infecciones respiratorias agudas de etiología viral, en el paciente hospitalizado, es coste-efectiva

Conventional techniques for the diagnosis of respiratory viruses are still being used, although molecular methods are now considered as a gold standard in this field. Molecular techniques have a great number of advantages such as an excellent sensitivity, specificity, adaptability to emerging viruses, capability for multiplex and for automation. With all the available repertoire of techniques for microbiological diagnosis, the knowledge relative to respiratory viruses is growing up not only for new aetiological agents but also for its epidemiology. The advances in molecular and non-molecular fast diagnostic methods for one or more respiratory viruses allow quick decisions in the management of the patient. However, there are also disadvantages. The great sensitivity of molecular techniques has meant a significant increase in the rate of multiple detections of respiratory viruses, whose clinical involvement is difficult to interpret. Finally, it remains to show whether the use of new techniques, of high cost, in the microbiological routine diagnosis of acute respiratory viral infections in the hospitalized patient, is cost effective

Diagnóstico microbiológico de las infecciones virales respiratorias en el paciente adulto / Microbiological diagnosis of viral respiratory infections in the adult patient

Las técnicas tradicionales para el diagnóstico de los virus respiratorios siguen estando todavía vigentes, aunque los métodos moleculares aplicados al diagnóstico de la infección viral respiratoria han supuesto una auténtica revolución. Las técnicas moleculares tienen como principales ventajas una excelente sensibilidad, especificidad, capacidad de adaptación a virus emergentes, capacidad para detectar múltiples dianas en un mismo ensayo y posibilidad de automatización. Adicionalmente, estas técnicas han permitido profundizar en el papel de los virus en la infección respiratoria aguda a la vez que han descrito la existencia de nuevos virus no conocidos previamente. Los métodos moleculares y no moleculares de diagnóstico rápido para 1 o más virus respiratorios han permitido la toma de decisiones de forma inmediata en el manejo del paciente mejorando su pronóstico y evitando la transmisión nosocomial. Sin embargo, también hay inconvenientes, la mayor sensibilidad de las técnicas moleculares ha supuesto un incremento significativo de la tasa de codetecciones múltiples de virus respiratorios, cuya implicación clínica resulta difícil de interpretar. Finalmente queda por demostrar todavía si la utilización de las nuevas técnicas, de elevado coste, en el diagnóstico microbiológico de rutina de las infecciones respiratorias agudas de etiología viral, en el paciente hospitalizado, es coste-efectiva (AU)

Conventional techniques for the diagnosis of respiratory viruses are still being used, although molecular methods are now considered as a gold standard in this field. Molecular techniques have a great number of advantages such as an excellent sensitivity, specificity, adaptability to emerging viruses, capability for multiplex and for automation. With all the available repertoire of techniques for microbiological diagnosis, the knowledge relative to respiratory viruses is growing up not only for new aetiological agents but also for its epidemiology. The advances in molecular and non-molecular fast diagnostic methods for one or more respiratory viruses allow quick decisions in the management of the patient. However, there are also disadvantages. The great sensitivity of molecular techniques has meant a significant increase in the rate of multiple detections of respiratory viruses, whose clinical involvement is difficult to interpret. Finally, it remains to show whether the use of new techniques, of high cost, in the microbiological routine diagnosis of acute respiratory viral infections in the hospitalized patient, is cost effective (AU)