[Microbiological diagnosis of mycoplasma infections]. / Diagnóstico microbiológico de las infecciones por Mycoplasma.

The microbiological diagnosis of mycoplasma and ureaplasma infections has always been limited due to the fastidious growth of these microorganisms, as well as the lack of commercially prepared growth media, absence of rapid diagnostic procedures, and the clinical perception that these organisms are less significant in the infectious diseases setting. During the last few years, this situation has substantially improved due to the commercial availability of culture media, the development of rapid serological techniques, and, in particular, to the introduction of nucleic acid amplification assays, commercially available or "in-house" preparations. Despite the lack of proper standardisation and validation of the molecular and serological techniques, methodological advances have led to an increased detection of these microorganisms and, consequently, a greater appreciation of their clinical relevance.

Evaluation of VIASURE Sexually Transmitted Diseases Real Time PCR Detection kit (CerTest Biotec) for the diagnostic of sexually transmitted infections.

INTRODUCTION: Sexually transmitted infections (STIs) are common in our environment, and trends have been increasing in the last few years. Different methods for STIs diagnosis have been applied by microbiology laboratories over years, but real-time PCR has improved this process. Our objective was to evaluate VIASURE Sexually Transmitted Diseases Real-Time PCR Detection kit (CerTestBiotec, S.L.) comparing with the real-time PCR technique used in our laboratory (Allplex™ STI7 Essential Assay, Seegene) which was considered as reference assay. METHODS: A total of 948 samples from different sites (vaginal, endocervical, urethral, rectal, pharyngeal swabs and urine samples) were analyzed from July to September 2018. RESULTS: A discordant result was obtained in 4.5% (43 samples). These discrepancies were mainly observed in threshold cycle (Ct) value next to the limit of detection. The k coefficient obtained shows a very high agreement between both methods with k values from 0.92 to 0.99. CONCLUSIONS: VIASURE Sexually Transmitted Diseases Real-Time PCR Detection kit provides a very good correlation with Allplex STI7 and therefore, it's a good tool for the diagnostic of STIs. Positive results with Ct value obtained from 35 and low amplification signal should be applied with caution and should be interpreted based on the patient's clinical data.

[Serologic diagnosis of Mycoplasma pneumoniae infections]. / Diagnóstico serológico de las infecciones por Mycoplasma pneumoniae.

Mycoplasma pneumoniae is a human pathogen with worldwide distribution. This microorganism is a common cause (10-30%) of community-acquired pneumonia, also called primary atypical pneumonia because of the spectrum of clinical and radiological findings. The immune response is mainly based on rapid antibody production against peptide and glycolipid antigens derived from this microorganism. During the primary infection, IgM levels generally rise within the first week, and are then followed by an IgG response. Titers of IgG and IgA increase in reinfections. Microbiological diagnosis is based on specific antibody detection. Polymerase chain reaction (PCR) techniques performed on sputum or pharyngeal/nasopharyngeal exudates, as well as the development of multiplex PCR reactions allowing identification of M. pneumoniae and other respiratory pathogens, would by highly useful in routine diagnosis. The most common serological techniques are complement fixation, immunofluorescence, particle agglutination, and enzyme immunoassay. Diagnosis should be performed by selecting the most appropriate test according to functional criteria and population groups. Specific detection of IgM antibodies should not be included in the differential diagnosis in adults and young people. Diagnostic criteria including seroconversion or rising IgG titers may not be clinically useful, because of the time delay and the difficulty of obtaining a second serum specimen for testing, given the mildness of the clinical symptoms.

Evaluation of VIASURE Sexually Transmitted Diseases Real Time PCR Detection kit (CerTest Biotec) for the diagnostic of sexually transmitted infections / Evaluación de VIASURE® Sexually Transmitted Diseases Real-Time PCR Detection kit (CerTest Biotec) para el diagnóstico de las infecciones de transmisión sexual

Introduction: Sexually transmitted infections (STIs) are common in our environment, and trends have been increasing in the last few years. Different methods for STIs diagnosis have been applied by microbiology laboratories over years, but real-time PCR has improved this process. Our objective was to evaluate VIASURE Sexually Transmitted Diseases Real-Time PCR Detection kit (CerTestBiotec, S.L.) comparing with the real-time PCR technique used in our laboratory (Allplex™ STI7 Essential Assay, Seegene) which was considered as reference assay. Methods: A total of 948 samples from different sites (vaginal, endocervical, urethral, rectal, pharyngeal swabs and urine samples) were analyzed from July to September 2018. Results: A discordant result was obtained in 4.5% (43 samples). These discrepancies were mainly observed in threshold cycle (Ct) value next to the limit of detection. The k coefficient obtained shows a very high agreement between both methods with k values from 0.92 to 0.99. Conclusions: VIASURE Sexually Transmitted Diseases Real-Time PCR Detection kit provides a very good correlation with Allplex STI7 and therefore, it's a good tool for the diagnostic of STIs. Positive results with Ct value obtained from 35 and low amplification signal should be applied with caution and should be interpreted based on the patient's clinical data.(AU)

Introducción: Las infecciones de transmisión sexual (ITS) son frecuentes en nuestro entorno y con tendencia a aumentar. Las técnicas moleculares han mejorado su diagnóstico aportando sensibilidad y rapidez de resultados. Nuestro objetivo ha sido evaluar el nuevo kit de PCR a tiempo real VIASURE® Sexually Transmitted Diseases (CerTest Biotec, SL) comparándolo con la técnica de PCR a tiempo real empleada en nuestro laboratorio (AllplexTM STI7 Essential Assay, Seegene). Métodos: Se analizaron prospectivamente un total de 948 muestras de diferente localización (exudado vaginal, endocervical, uretral, rectal, faríngeo y orina) recibidas en nuestro laboratorio desde julio hasta septiembre de 2018. Resultados: En el 4,5% (43 muestras) se obtuvo un resultado discordante entre ambas técnicas. Estas discrepancias se observaron principalmente en ciclos próximos al límite de detección. El valor del coeficiente k osciló entre 0,92 a 0,99, mostrando una muy buena correlación entre técnicas. Conclusiones: VIASURE® Sexually Transmitted Diseases Real-Time PCR Detection kit es una buena herramienta para el diagnóstico de las ITS. Muestras con señal de amplificación en ciclos a partir de 35 y baja señal de fluorescencia, deben ser tratados con precaución e interpretarse en función de los datos clínicos del paciente.(AU)

Posttraumatic arthritis in a 13-year-old male / Artritis postraumática en un paciente de 13 años

No disponible

[Toxoplasmosis and pregnancy. Multicenter study of 16,362 pregnant women in Barcelona]. / Toxoplasmosis y embarazo. Estudio multicéntrico realizado en 16.362 gestantes de Barcelona.

BACKGROUND AND OBJECTIVE: The aim of this study was to know: 1) the prevalence of antibodies against toxoplasma in pregnant women, 2) the incidence of primary infection during pregnancy and 3) the prevalence of congenital toxoplasmosis. SUBJECTS AND METHOD: Seroprevalence was prospectively analyzed in 16,362 pregnant women visited in 8 hospitals and 2 day care centers in Barcelona during 1999. Each participant laboratory included their own assays to detect toxoplasma-specific immunoglobulins IgM, IgA, IgG and IgG avidity antibodies. In case of positive specific IgM, a second serum sample was requested, which was processed in parallel with the first one. Three infection stages were defined: acute, possible and past (latent). Congenital infection was determined prenatally by polymerase chain reaction (PCR) in amniotic fluid or postnatally by serology in the newborn. RESULTS: Seroprevalence was 28.6%. The incidence of primary infection during pregnancy was 1.02/1,000 susceptible pregnant women. Nine women out of 12 with an acute toxoplasma infection became seroconverted during their pregnancies and five of them had infants with congenital toxoplasmosis (vertical transmission: 41.6%). All four children born alive had no symptoms during their follow-up. CONCLUSIONS: In this study, the prevalence of toxoplasmosis was low. Acute toxoplasmosis was detected mainly by seroconversion during pregnancy. The frequency of maternal-fetal transmission was near half of cases.

Diagnóstico microbiológico de las infecciones por Mycoplasma / Microbiological diagnosis of Mycoplasma infections

El diagnóstico microbiológico de las infecciones causadas por micoplasmas y ureaplasmas se ha visto siempre limitado por el crecimiento muy dificultoso de estos microorganismos, la falta de medios de cultivo comercializados, la ausencia de procedimientos diagnósticos rápidos y la percepción clínica extendida de que estos microorganismos tienen una importancia menor en el contexto de las enfermedades infecciosas. Esta situación ha cambiado notablemente en los últimos años gracias a la comercialización de los medios de cultivo, al desarrollo de técnicas rápidas de diagnóstico serológico y, especialmente, por la aplicación de métodos de amplificación de ácidos nucleicos, comercializados o desarrollados en el propio laboratorio. Aunque se acusa la falta de estandarización y validación de las técnicas moleculares y serológicas, el avance en la metodología ha propiciado un aumento en su detección y, en consecuencia, en la apreciación de la importancia clínica de estos microorganismos (AU)

The microbiological diagnosis of mycoplasma and urea plasma infections has always been limited due to the fastidious growth of these microorganisms, as well as the lack of commercially prepared growth media, absence of rapid diagnostic procedures, and the clinical perception that these organisms are less significant in the infectious diseases setting. During the last few years, this situation has substantially improved due to the commercial availability of culture media, the development of rapid serological techniques, and, in particular, to the introduction of nucleic acid amplification assays, commercially available or "in-house" preparations. Despite the lack of proper standardisation and validation of the molecular and serological techniques, methodological advances have led to an increased detection of these microorganisms and, consequently, a greater appreciation of their clinical relevance (AU)

Diagnóstico serológico de las infecciones por Mycoplasma pneumoniae / Serologic diagnosis of Mycoplasma pneumoniae infections

Mycoplasma pneumoniae es un patógeno exclusivamente humano y de distribución universal. Es causa del 10-30% de las neumonías adquiridas en la comunidad que, por su forma de presentación clinicorradiológica, se denomina neumonían atípica primaria. La respuesta inmunitaria se manifiesta por la rápida producción de anticuerpos frente a antígenos proteicos y glucolipídicos del microorganismo. En la primoinfección se produce un incremento en forma de IgM durante la primera semana, seguido de IgG, y en las reinfecciones se genera una respuesta de IgG e IgA. El diagnóstico microbiológico se ha basado en la demostración de anticuerpos específicos. La aplicación de técnicas de reacción en cadena de la polimerasa en muestras de esputo o exudado faríngeo/nasofaríngeo y el desarrollo de técnicas de reacción en cadena de la polimerasa múltiple, que permiten detectar M. pneumoniae y otros patógenos respiratorios, pueden ser de elevada utilidad en laboratorios de diagnóstico clínico. Las técnicas serológicas aplicables más usuales son la fijación del complemento, la inmunofluorescencia, la aglutinación de partículas y el enzimoinmunoanálisis. Para realizar el diagnóstico se deben seleccionar las técnicas por criterios funcionales y, sobre todo, adecuado al grupo poblacional. La detección específica de IgM no se debe aplicar en infecciones en niños mayores ni en adultos. Tampoco el diagnóstico basado en la seroconversión o el incremento del título de IgG resulta práctico, pues es tardío y, además, es difícil obtener una segunda muestra de suero, dada la levedad del cuadro clínico

Mycoplasma pneumoniae is a human pathogen with worldwide distribution. This microorganism is a common cause (10-30%) of community-acquired pneumonia, also called primary atypical pneumonia because of the spectrum of clinical and radiological findings. The immune response is mainly based on rapid antibody production against peptide and glycolipid antigens derived from this microorganism. During the primary infection, IgM levels generally rise within the first week, and are then followed by an IgG response. Titers of IgG and IgA increase in reinfections. Microbiological diagnosis is based on specific antibody detection. Polymerase chain reaction (PCR) techniques performed on sputum or pharyngeal/nasopharyngeal exudates, as well as the development of multiplex PCR reactions allowing identification of M. pneumoniae and other respiratory pathogens, would by highly useful in routine diagnosis. The most common serological techniques are complement fixation, immunofluorescence, particle agglutination, and enzyme immunoassay. Diagnosis should be performed by selecting the most appropriate test according to functional criteria and population groups. Specific detection of IgM antibodies should not be included in the differential diagnosis in adults and young people. Diagnostic criteria including seroconversion or rising IgG titers may not be clinically useful, because of the time delay and the difficulty of obtaining a second serum specimen for testing, given the mildness of the clinical symptoms