RESUMO
Limited access to diagnostic tests for liver fibrosis remains one of the main reasons for late diagnosis, especially in rural and remote communities. Saliva diagnostics is accessible with excellent patient compliance. The aim of this study was to develop a saliva-based diagnostic tool for liver fibrosis/cirrhosis. Salivary concentrations of hyaluronic acid (HA), tissue inhibitor of metalloproteinase-1 (TIMP-1), and α-2-macroglobulin (A2MG) were significantly increased (p < 0.05) in patients with liver fibrosis/cirrhosis. By combining these biomarkers, we developed the Saliva Liver Fibrosis (SALF) score, which identified patients with liver cirrhosis with an area under the receiver operating characteristic curve (AUROC) of 0.970 and 0.920 in a discovery and validation cohorts, respectively. The SALF score had a performance that was similar to that of the current Fibrosis-4 (AUROC:0.740) and Hepascore (AUROC:0.979). We demonstrated the clinical utility of saliva to diagnose liver fibrosis/cirrhosis with a potential to improve the screening for cirrhosis in asymptomatic populations.
RESUMO
Objective: The study was conducted to determine geneticrelatedness of Salmonella serotypes by pulsed field gel electrophoresis (PFGE). Design and Methodology: A total of 1503 caecal samples of freshly slaughtered poultry were randomly collected from 'pluck shops' across the country. The samples were screened for Salmonella by biochemical, serological and molecular methods. The Salmonella serotypes were analyzed for genetic relatedness for phenotypic antimicrobial resistance, resistance and virulence gene profiles by PFGE generated by digestion with XbaI. Results: Ten different serotypes were detected from all 91 Salmonella isolates. PFGE fingerprinting profiles showed that the Salmonella serotypes in general, were genetically diverse with the detection of a total of 20 PFGE groups. The antibiograms of the isolates were also clearly very variable, which suggest that genotypic antimicrobial resistance may not relate to the phenotypic antibiograms in dendrograms, except for qnrB gene. Results demonstrated a varied spectrum of antimicrobial resistance and PFGE patterns among Salmonella isolates and signify the importance of sustained surveillance of foodborne pathogens in retail poultry pluck shops. Conclusions: The findings provide evidence that poultry from pluck shops are colonized by pathogenic Salmonella harboring antimicrobial resistance genes. The study also reported for the first time in Trinidad, molecular characterization of Salmonella isolates from poultry regarding the relatedness of antibiograms, possession of resistance and virulence genes using their PFGE profiles. The epidemiological surveillance of these serotypes would be necessary to evaluate their possible impact on human health in the country and possibly in the Caribbean region.
