scholarly journals Recent Advances and Novel Approaches in Laboratory-Based Diagnostic Mycology

2021 ◽  
Vol 7 (1) ◽  
pp. 41
Author(s):  
Lewis P. White ◽  
Jessica S. Price
Keyword(s):  
Point Of Care ◽  
Serological Tests ◽  
Just Culture ◽  
Diagnostic Strategies ◽  
Phenotypic Resistance ◽  
Molecular Tests ◽  
Lateral Flow Assays ◽  
Improve Patient Management ◽  
Point Of Care Tests ◽  
Improve Patient

What was once just culture and microscopy the field of diagnostic mycology has significantly advanced in recent years and continues to incorporate novel assays and strategies to meet the changes in clinical demand. The emergence of widespread resistance to antifungal therapy has led to the development of a range of molecular tests that target mutations associated with phenotypic resistance, to complement classical susceptibility testing and initial applications of next-generation sequencing are being described. Lateral flow assays provide rapid results, with simplicity allowing the test to be performed outside specialist centres, potentially as point-of-care tests. Mycology has responded positively to an ever-diversifying patient population by rapidly identifying risk and developing diagnostic strategies to improve patient management. Nowadays, the diagnostic repertoire of the mycology laboratory employs classical, molecular and serological tests and should be keen to embrace diagnostic advancements that can improve diagnosis in this notoriously difficult field.

scholarly journals Molecular point-of-care testing for influenza A/B and respiratory syncytial virus: comparison of workflow parameters for the ID Now and cobas Liat systems

2019 ◽  
Author(s):  
Stephen Young ◽  
Jamie Phillips ◽  
Christen Griego-Fullbright ◽  
Aaron Wagner ◽  
Patricia Jim ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Influenza A ◽  
Point Of Care ◽  
Turnaround Time ◽  
Walk Away ◽  
Molecular Tests ◽  
Syncytial Virus ◽  
Improve Patient Management ◽  
Parallel Workflow ◽  
Improve Patient

ABSTRACTAimsPoint-of-care (POC) tests for influenza and respiratory syncytial virus (RSV) offer the potential to improve patient management and antimicrobial stewardship. Studies have focused on performance; however, no workflow assessments have been published comparing POC molecular tests. This study compared the Liat and ID Now systems workflow, to assist end-users in selecting an influenza and/or RSV POC test.MethodsStaffing, walk-away, and turnaround time (TAT) of the Liat and ID Now systems were determined using 40 nasopharyngeal samples, positive for influenza or RSV. The ID Now system requires separate tests for influenza and RSV, so parallel (two instruments) and sequential (one instrument) workflows were evaluated.ResultsThe ID Now ranged 4.1–6.2 minutes for staffing, 1.9–10.9 minutes for walk-away and 6.4–15.8 minutes for TAT per result. The Liat ranged 1.1–1.8 minutes for staffing, 20.0–20.5 minutes for walk-away and 21.3–22.0 minutes for TAT. Mean walk-away time comprised 38.0% (influenza positive) and 68.1% (influenza negative) of TAT for ID Now and 93.7% (influenza/RSV) for Liat. The ID Now parallel workflow resulted in medians of 5.9 minutes for staffing, 9.7 minutes for walk-away, and 15.6 minutes for TAT. Assuming prevalence of 20% influenza and 20% RSV, the ID Now sequential workflow resulted in medians of 9.4 minutes for staffing, 17.4 minutes for walk-away, and 27.1 minutes for TAT.ConclusionsThe ID Now and Liat systems offer different workflow characteristics. Key considerations for implementation include value of both influenza and RSV results, clinical setting, staffing capacity, and instrument(s) placement.

scholarly journals Detection of SARS-CoV-2 antibodies using commercial assays and seroconversion patterns in hospitalized patients

2020 ◽  
Author(s):  
E Tuaillon ◽  
K Bolloré ◽  
A Pisoni ◽  
S Debiesse ◽  
C Renault ◽  
...  
Keyword(s):  
Point Of Care ◽  
Marked Point ◽  
Humoral Response ◽  
Hospitalized Patients ◽  
Antibody Detection ◽  
Serological Tests ◽  
Molecular Tests ◽  
Antibody Assays ◽  
Point Of Care Tests ◽  
Kinetics Of

AbstractSARS-CoV-2 antibody assays are needed for serological surveys and as a complement to molecular tests to confirm COVID-19. However, the kinetics of the humoral response against SARS-CoV-2 remains poorly described and relies on the performance of the different serological tests.In this study, we evaluated the performance of six CE-marked point-of-care tests (POC) and three ELISA assays for the diagnosis of COVID-19 by exploring seroconversions in hospitalized patients who tested positive for SARS-CoV-2 RNA.Both the ELISA and POC tests were able to detect SARS-CoV-2 antibodies in at least half of the samples collected seven days or more after the onset of symptoms. After 15 days, the rate of detection rose to over 80% but without reaching 100%, irrespective of the test used. More than 90% of the samples collected after 15 days tested positive using the iSIA and Accu-Tell® POC tests and the ID.Vet IgG ELISA assay. Seroconversion was observed 5 to 12 days after the onset of symptoms. Three assays suffer from a specificity below 90% (EUROIMMUN IgG and IgA, UNscience, Zhuhai Livzon).The second week of COVID-19 seems to be the best period for assessing the sensitivity of commercial serological assays. To achieve an early diagnosis of COVID-19 based on antibody detection, a dual challenge must be met: the immunodiagnostic window period must be shortened and an optimal specificity must be conserved.

scholarly journals Molecular point-of-care testing for influenza A/B and respiratory syncytial virus: comparison of workflow parameters for the ID Now and cobas Liat systems

2019 ◽  
Vol 73 (6) ◽  
pp. 328-334 ◽  
Author(s):  
Stephen Young ◽  
Jamie Phillips ◽  
Christen Griego-Fullbright ◽  
Aaron Wagner ◽  
Patricia Jim ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Influenza A ◽  
Point Of Care ◽  
Turnaround Time ◽  
Walk Away ◽  
Molecular Tests ◽  
Syncytial Virus ◽  
Improve Patient Management ◽  
Parallel Workflow ◽  
Improve Patient

AimsPoint-of-care (POC) tests for influenza and respiratory syncytial virus (RSV) offer the potential to improve patient management and antimicrobial stewardship. Studies have focused on performance; however, no workflow assessments have been published comparing POC molecular tests. This study compared the Liat and ID Now systems workflow, to assist end-users in selecting an influenza and/or RSV POC test.MethodsStaffing, walk-away and turnaround time (TAT) of the Liat and ID Now systems were determined using 40 nasopharyngeal samples, positive for influenza or RSV. The ID Now system requires separate tests for influenza and RSV, so parallel (two instruments) and sequential (one instrument) workflows were evaluated.ResultsThe ID Now ranged 4.1–6.2 min for staffing, 1.9–10.9 min for walk-away and 6.4–15.8 min for TAT per result. The Liat ranged 1.1–1.8 min for staffing, 20.0–20.5 min for walk-away and 21.3–22.0 min for TAT. Mean walk-away time comprised 38.0% (influenza positive) and 68.1% (influenza negative) of TAT for ID Now and 93.7% (influenza/RSV) for Liat. The ID Now parallel workflow resulted in medians of 5.9 min for staffing, 9.7 min for walk-away and 15.6 min for TAT. Assuming prevalence of 20% influenza and 20% RSV, the ID Now sequential workflow resulted in medians of 9.4 min for staffing, 17.4 min for walk-away, and 27.1 min for TAT.ConclusionsThe ID Now and Liat systems offer different workflow characteristics. Key considerations for implementation include value of both influenza and RSV results, clinical setting, staffing capacity, and instrument(s) placement.

scholarly journals Systemic Inflammatory Index Is a Novel Predictor of Intubation Requirement and Mortality after SARS-CoV-2 Infection

Pathogens ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 58
Author(s):  
Sajjad Muhammad ◽  
Igor Fischer ◽  
Soheil Naderi ◽  
Morteza Faghih Jouibari ◽  
Sheikhrezaei Abdolreza ◽  
...  
Keyword(s):  
Infected Patient ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Laboratory Findings ◽  
Ventilator Support ◽  
Inflammatory Index ◽  
Organ Failures ◽  
Diagnostic Approaches ◽  
Improve Patient Management ◽  
Improve Patient

Coronavirus disease 2019 (COVID-19), with an increasing number of deaths worldwide, has created a tragic global health and economic emergency. The disease, caused by severe acute respiratory syndrome coronavirus 2019 (SARS-CoV-19), is a multi-system inflammatory disease with many of COVID-19-positive patients requiring intensive medical care due to multi-organ failures. Biomarkers to reliably predict the patient’s clinical cause of the virus infection, ideally, to be applied in point of care testing or through routine diagnostic approaches, are highly needed. We aimed to probe if routinely assessed clinical lab values can predict the severity of the COVID-19 course. Therefore, we have retrospectively analyzed on admission laboratory findings in 224 consecutive patients from four hospitals and show that systemic immune inflammation index (SII) is a potent marker for predicting the requirement for invasive ventilator support and for worse clinical outcome of the infected patient. Patients’ survival and severity of SARS-CoV-2 infection could reliably be predicted at admission by calculating the systemic inflammatory index of individual blood values. We advocate this approach to be a feasible and easy-to-implement assay that may be particularly useful to improve patient management during high influx crisis. We believe with this work to contribute to improving infrastructure availability and case management associated with COVID-19 pandemic hurdles.

scholarly journals Evaluation of Serological SARS-CoV-2 Lateral Flow Assays for Rapid Point of Care Testing

2020 ◽  
Author(s):  
Steven E Conklin ◽  
Kathryn Martin ◽  
Yukari C Manabe ◽  
Haley A Schmidt ◽  
Morgan Keruly ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Symptom Onset ◽  
Point Of Care ◽  
Negative Control ◽  
Lateral Flow ◽  
Point Of Care Testing ◽  
Specific Antibodies ◽  
Testing Performance ◽  
Lateral Flow Assays ◽  
Point Of Care Tests

Background. Rapid point-of-care tests (POCTs) for SARS-CoV-2-specific antibodies vary in performance. A critical need exists to perform head-to-head comparison of these assays. Methods. Performance of fifteen different lateral flow POCTs for the detection of SARS-CoV-2-specific antibodies was performed on a well characterized set of 100 samples. Of these, 40 samples from known SARS-CoV-2-infected, convalescent individuals (average of 45 days post symptom onset) were used to assess sensitivity. Sixty samples from the pre-pandemic era (negative control), that were known to have been infected with other respiratory viruses (rhinoviruses A, B, C and/or coronavirus 229E, HKU1, NL63 OC43) were used to assess specificity. The timing of seroconversion was assessed on five POCTs on a panel of 272 longitudinal samples from 47 patients of known time since symptom onset. Results. For the assays that were evaluated, the sensitivity and specificity for any reactive band ranged from 55%-97% and 78%-100%, respectively. When assessing the performance of the IgM and the IgG bands alone, sensitivity and specificity ranged from 0%-88% and 80%-100% for IgM and 25%-95% and 90%-100% for IgG. Longitudinal testing revealed that median time post symptom onset to a positive result was 7 days (IQR 5.4, 9.8) for IgM and 8.2 days (IQR 6.3 to 11.3). Conclusion. The testing performance varied widely among POCTs with most variation related to the sensitivity of the assays. The IgM band was most likely to misclassify pre-pandemic samples. The appearance of IgM and IgG bands occurred almost simultaneously.

Serological antibody testing in the COVID-19 pandemic: their molecular basis and applications

2020 ◽  
Vol 48 (6) ◽  
pp. 2851-2863
Author(s):  
Jiayue-Clara Jiang ◽  
Yan Zhang
Keyword(s):  
Antibody Response ◽  
Molecular Basis ◽  
Molecular Mechanisms ◽  
Vaccine Development ◽  
Point Of Care ◽  
Herd Immunity ◽  
Contact Tracing ◽  
Antibody Testing ◽  
Serological Tests ◽  
Molecular Tests

The ongoing COVID-19 pandemic has placed an overwhelming burden on the healthcare system, and caused major disruption to the world economy. COVID-19 is caused by SARS-CoV-2, a novel coronavirus that leads to a variety of symptoms in humans, including cough, fever and respiratory failure. SARS-CoV-2 infection can trigger extensive immune responses, including the production of antibodies. The detection of antibody response by serological testing provides a supplementary diagnostic tool to molecular tests. We hereby present a succinct yet comprehensive review on the antibody response to SARS-CoV-2 infection, as well as molecular mechanisms behind the strengths and limitations of serological antibody tests. The presence of antibodies can be detected in patient sera within days post symptom onset. Serological tests demonstrate superior sensitivity to molecular tests in some periods of time during disease development. Compared with the molecular tests, serological tests can be used for point-of-care testing, providing faster results at a lower cost. Commercially available serological tests show variable sensitivity and specificity, and the molecular basis of these variabilities are analysed. We discuss assays of different complexities that are used to specifically quantitate neutralising antibodies against SARS-CoV-2, which has important implications for vaccine development and herd immunity. Furthermore, we discuss examples of successful applications of serological tests to contact tracing and community-level sero-surveying, which provide invaluable information for pandemic management and assessment.

scholarly journals Evaluation of Six Commercial Mid- to High-Volume Antibody and Six Point-of-Care Lateral Flow Assays for Detection of SARS-CoV-2 Antibodies

2020 ◽  
Vol 58 (10) ◽  
Author(s):  
Carmen L. Charlton ◽  
Jamil N. Kanji ◽  
Kam Johal ◽  
Ashley Bailey ◽  
Sabrina S. Plitt ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Point Of Care ◽  
Acute Infection ◽  
High Volume ◽  
Respiratory Viruses ◽  
Cross Reactivity ◽  
Lateral Flow ◽  
Serological Tests ◽  
Deep Blue ◽  
Lateral Flow Assays

ABSTRACT Coronavirus disease (COVID) serological tests are essential to determine the overall seroprevalence of a population and to facilitate exposure estimates within that population. We performed a head-to-head assessment of enzyme immunoassays (EIAs) and point-of-care lateral flow assays (POCTs) to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. Demographics, symptoms, comorbidities, treatment, and mortality of patients whose sera were used were also reviewed. Six EIAs (Abbott, Affinity, Bio-Rad, DiaSorin, Euroimmun, and Roche) and six POCTs (BTNX, Biolidics, Deep Blue, Genrui, Getein BioTech, and Innovita) were evaluated for the detection of SARS-CoV-2 antibodies in known COVID-19-infected individuals. Sensitivity of EIAs ranged from 50 to 100%, with only four assays having overall sensitivities of >95% after 21 days after symptom onset. Notably, cross-reactivity with other respiratory viruses (parainfluenza virus [PIV-4] [n = 5], human metapneumovirus [hMPV] [n = 3], rhinovirus/enterovirus [n = 1], CoV-229E [n = 2], CoV-NL63 [n = 2], and CoV-OC43 [n = 2]) was observed; however, overall specificity of EIAs was good (92 to 100%; all but one assay had specificity above 95%). POCTs were 0 to 100% sensitive >21 days after onset, with specificity ranging from 96 to 100%. However, many POCTs had faint banding and were often difficult to interpret. Serology assays can detect SARS-CoV-2 antibodies as early as 10 days after symptom onset. Serology assays vary in their sensitivity based on the marker (IgA/IgM versus IgG versus total) and by manufacturer; however, overall only 4 EIAs and 4 POCTs had sensitivities of >95% >21 days after symptom onset. Cross-reactivity with other seasonal coronaviruses is of concern. Serology assays should not be used for the diagnosis of acute infection but rather in carefully designed serosurveys to facilitate understanding of seroprevalence in a population and to identify previous exposure to SARS-CoV-2.

scholarly journals Evaluation of Serological SARS-CoV-2 Lateral Flow Assays for Rapid Point of Care Testing

2020 ◽  
Author(s):  
Steven E. Conklin ◽  
Kathryn Martin ◽  
Yukari C Manabe ◽  
Haley A Schmidt ◽  
Jernelle Miller ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Symptom Onset ◽  
Point Of Care ◽  
Negative Control ◽  
Lateral Flow ◽  
Point Of Care Testing ◽  
Specific Antibodies ◽  
Testing Performance ◽  
Lateral Flow Assays ◽  
Point Of Care Tests

Background. Rapid point-of-care tests (POCTs) for SARS-CoV-2-specific antibodies vary in performance. A critical need exists to perform head-to-head comparison of these assays. Methods. Performance of fifteen different lateral flow POCTs for the detection of SARS-CoV-2-specific antibodies was performed on a well characterized set of 100 samples. Of these, 40 samples from known SARS-CoV-2-infected, convalescent individuals (average of 45 days post symptom onset) were used to assess sensitivity. Sixty samples from the pre-pandemic era (negative control), that were known to have been infected with other respiratory viruses (rhinoviruses A, B, C and/or coronavirus 229E, HKU1, NL63 OC43) were used to assess specificity. The timing of seroconversion was assessed on five LFAs on a panel of 272 longitudinal samples from 47 patients of known time since symptom onset. Results. For the assays that were evaluated, the sensitivity and specificity for any reactive band ranged from 55%-97% and 78%-100%, respectively. When assessing the performance of the IgM and the IgG bands alone, sensitivity and specificity ranged from 0%-88% and 80%-100% for IgM and 25%-95% and 90%-100% for IgG. Longitudinal testing revealed that median time post symptom onset to a positive result was 7 days (IQR 5.4, 9.8) for IgM and 8.2 days (IQR 6.3 to 11.3) for IgG. Conclusion. The testing performance varied widely among LFAs with most variation related to the sensitivity of the assays. The IgM band was most likely to misclassify pre-pandemic samples. The appearance of IgM and IgG bands occurred almost simultaneously.

scholarly journals Mass Antibody Detection: Can It be An Avenger for Infectivity War against COVID-19

2020 ◽  
Author(s):  
Sarfaraz Ahmad Ejazi ◽  
Sneha Ghosh ◽  
Nahid Ali
Keyword(s):  
Large Scale ◽  
Point Of Care ◽  
Cost Effective ◽  
Antibody Detection ◽  
Serological Tests ◽  
Ongoing Research ◽  
Molecular Tests ◽  
Immunological Assays ◽  
Commercial Kits ◽  
Vaccination Therapy

The ongoing pandemic of COVID-19 has not only commenced a global health emergency but agitated various aspects of humanity. During this period of crisis researchers over the world have ramped their efforts to constrain the disease in all possible ways whether it is vaccination, therapy, or diagnosis. Since the spread of the disease has not yet elapsed sharing the ongoing research findings could be the key to disease control and management. An early and efficient diagnosis could leverage the outcome until a successful vaccine is developed. Molecular tests both in-house and commercial kits are preferably being used worldwide in the COVID-19 diagnosis. However, the limitation of high prices and lengthy procedures impede their use for mass testing. Keeping the constant rise of infection in mind search for an alternative test that should be cost-effective, simple, and suitable for large scale testing and surveillance is a need of an hour. One such alternative could be the immunological tests. Therefore, in the last few months deluge of immunological rapid tests has been developed and validated across the globe. The objective of the present review is to share the diagnostic performance of various immunological assays reported so far in SARS-CoV-2 case detection. The article consolidated the studies (published and preprints) related to the serological tests such as chemiluminescence, enzyme-linked and lateral flow-based point-of-care tests in COVID-19 diagnosis and updated the current scenario. This review will hopefully be an add-on in COVID-19 research and will contribute to congregate the evidence for decision-making.

scholarly journals Laboratory Diagnostics in COVID-19: What We Know So Far

2020 ◽  
Author(s):  
Siti Zulaikha Zakariah ◽  
Tengku Zetty Maztura Tengku Jamaluddin ◽  
Hasni Mahayidin ◽  
Zuraihan Dahari ◽  
Rosni Ibrahim
Keyword(s):  
Point Of Care ◽  
Medical Science ◽  
High Sensitivity ◽  
Contact Tracing ◽  
Laboratory Diagnostics ◽  
Technological Advancement ◽  
Rt Pcr ◽  
Serological Tests ◽  
S 100 ◽  
Point Of Care Tests

COVID-19 took the world by storm in early 2020 which rapidly escalated to a pandemic of unprecedented proportions. Containment of the outbreak requires a robust public health system of surveillance, contact tracing and laboratory preparedness. Technological advancement in molecular diagnosticshas helped identify patients in the initial stages of the outbreak. RT-PCR remains the gold standard in COVID-19 testing. However, as the pandemic continues, there is need for rapid and point of care tests (POCT) for mass screening and rapid decision making. Current serological tests and POCT have high sensitivity but need to be interpreted with caution. This review aims to discuss current laboratory tests available for the diagnosis of COVID-19. Bangladesh Journal of Medical Science Vol.19(0) 2020 p. S 93-S 100

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