Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
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Data are limited for the performance of enzyme immunoassays for the detection of Chlamydia trachomatis in conjunctival and nasopharyngeal specimens from infants. The only available data are for one assay, Chlamydiazyme (Abbott Diagnostics). The purpose of this study was to compare a new enzyme immunoassay, Pathfinder (Kallestad Diagnostics), with Chlamydiazyme and culture for the diagnosis of chlamydial conjunctivitis and pneumonia in infants. Pathfinder differs from Chlamydiazyme in that it uses a monoclonal antibody directed against the chlamydial lipopolysaccharide in addition to a polyclonal antichlamydial antibody. Triplicate conjunctival and nasopharyngeal specimens were obtained from 97 infants with conjunctivitis, and additional nasopharyngeal specimens were obtained from 14 infants with suspected chlamydial pneumonia (total, 111 nasopharyngeal specimens). Twenty-nine (30%) of the conjunctival specimens from infants with conjunctivitis and four (28.6%) of the nasopharyngeal specimens from the infants with pneumonia were positive for C. trachomatis by cell culture. The sensitivities, specificities, and positive and negative predictive values for Pathfinder for conjunctival specimens were 96.6, 98.5, 96.6, and 98.5%, respectively. The results for Chlamydiazyme were 96.6, 100, 100, and 98.6%, respectively. For nasopharyngeal specimens, the results for Pathfinder were 77.8, 94.6, 73.7, and 95.7%, respectively. The results for Chlamydiazyme were 66.7, 95.7, 75, and 93%, respectively. Pathfinder and Chlamydiazyme appeared to perform equivalently for the detection of C. trachomatis in both eye and nasopharyngeal specimens from infants with chlamydial conjunctivitis and pneumonia.
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PMID:Comparison of two enzyme immunoassays to culture for the diagnosis of chlamydial conjunctivitis and respiratory infections in infants. 220 10

Direct fluorescent antibody assay (DFA) using monoclonal antibody and enzyme-linked immunosorbent assay (ELISA) for rapid detection of Respiratory Syncytial Virus (RSV) in nasopharyngeal secretions (NPS) were compared with conventional virus isolation and identification procedures in cell cultures. When 134 NPS were examined from infants and young children with acute respiratory tract infection, 42 (31%) were culture-positive for RSV and 31 of these were detected by the appearance of a typical cytopathic effect and identified by DFA either before or after its appearance, whereas 11 were identified as RSV-positive by DFA performed blindly on HEp-2 cell cultures 5 or 10 days after inoculation. DFA for RSV on NPS smears was positive in 33 (26%) cases, from seven of which RSV was not isolated. The same group of 134 NPS was tested for RSV detection by three commercial ELISA kits. The sensitivities of the three ELISA kits when compared with a combination of culture and DFA results, were comparable (53%, 51%, and 47% for Ortho, Kallested, and Abbott, respectively), whereas specificity was 100% for all three assays. In the group of 26 NPS detected as positive by both virus isolation and DFA, 20-22 (77-85% according to different kits) were found positive for RSV by the three ELISA assays. These data suggest that virus isolation is still critical for diagnosis of a fair number of cases of RSV infection. Of the two rapid techniques, DFA is a valuable complementary method, whereas ELISA still lacks sensitivity. However, both DFA and ELISA were able to detect RSV in 7 of 8 young patients with severe respiratory infection (pneumonia, bronchiolitis), thus permitting diagnosis of RSV infection at least two days before culturing.
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PMID:Rapid detection of respiratory syncytial virus in nasopharyngeal secretions by immunofluorescence and ELISA does not justify discontinuation of virus isolation. 267 34

Serum specimens from 252 recipients of factor VIII and/or factor IX (237 hemophiliacs and 15 nonhemophiliacs), 99 blood transfusion recipients, 269 chronic diseases, and 366 healthy subjects (included blood donors, hospital personnel and family members of hemophiliacs) were tested for reactivity to lymphadenopathy-associated virus/T-lymphotropic retrovirus type III (LAV/HTLV-III) by ELISA test kit (Abbott), and the presence of the antibodies to LAV/HTLV-III was confirmed by indirect immunofluorescence assay (IFA). Seropositivity rates were 38.4% (91 of 237) in hemophiliacs, 13.3% (2 of 15) in nonhemophiliac recipients of factor VIII and/or factor IX, and 8% (2 of 27) in male homosexuals. None of the other patients and healthy individuals had antibodies to LAV/HTLV-III. In serological follow-up study on 40 seronegative and 10 seropositive hemophiliacs, 4 of the seronegative hemophiliacs converted to seropositive, and 7 of seropositive hemophiliacs had the antibody titers elevated by 2 to 4 fold within the period for 3.5 to 13 months after first blood samplings. Comparative analysis of the absolute numbers of T helper (T4) and T suppressor (T8) lymphocytes between the seropositive and seronegative hemophiliacs revealed that more than 50% of both seropositive and seronegative hemophiliacs had lower T4 lymphocyte numbers and higher T8 lymphocyte numbers than those of normal subjects. Particularly, over 80% of seropositive hemophiliacs had lower T4 lymphocyte numbers. Two Japanese AIDS cases (a hemophiliac B and a male homosexual) were found in the present study. Both died of pneumonia, and were confirmed officially as AIDS cases.
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PMID:Prevalence of antibodies to AIDS-associated retrovirus in in- and out-patients in Japan. 310 40

We compared a rapid respiratory syncytial virus (RSV) antigen enzyme immunoassay (EIA) (Abbott Diagnostics, North Chicago, Ill.) with virus culture and with the indirect fluorescent-antibody test (FAT) by using nasopharyngeal washings from children with suspected RSV pneumonia or bronchiolitis. Fresh washings were used in all three tests. Specimens were inoculated into HEp-2 cells and human embryonic lung fibroblasts and observed for cytopathic effect. Cells in the centrifuged sediments of the nasal washes were examined for typical cytoplasmic fluorescence of RSV by FAT. The EIA cutoff was an optical density (OD) at 492 nm that was greater than the mean OD of the negative controls plus 0.1. An OD within +20% of the cutoff was considered borderline, and these specimens were retested. Of 289 specimens, 118 (41%) were positive by culture, 150 (52%) were positive by FAT, and 154 (53%) were positive by EIA. Eight borderline EIAs were all negative when the specimens were retested after storage at -70 degrees C. Of 17 specimens positive by EIA but negative by culture and FAT, 9 were blocked in a competitive EIA, indicating that they were true-positives and that the culture and FAT were falsely negative. The sensitivity, specificity, and predictive value (positive) of the EIA versus culture, FAT, or blocking assay were 90, 94, and 95%, respectively. We conclude that the Abbott RSV antigen EIA is highly sensitive and specific.
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PMID:Detection of respiratory syncytial virus antigen in nasopharyngeal secretions by Abbott Diagnostics enzyme immunoassay. 329 Feb 43

Respiratory secretions for viral diagnosis are often collected with nasopharyngeal (NP) swabs, although many laboratories recommend NP aspirates or washings. We compared results using NP washings and NP swabs in three diagnostic RSV tests, a rapid RSV EIA antigen test (Abbott Laboratories), an indirect fluorescent antibody test (FAT) with rabbit antiserum, and virus culture (HEp-2 cells). Paired samples were collected from 121 children with suspected RSV bronchiolitis or pneumonia. A minitip swap was passed into the nasopharynx for 10 sec, rotated and withdrawn. The opposite nares was irrigated with approximately 1 ml of saline and aspirated using a syringe and plastic feeding tube. Fifty-one children (42%) grew RSV in culture, 49 from NP washings versus 27 from NP swabs (p less than 0.001). Fifty-three (44%) were positive by FAT, 52 from NP washings versus 12 from NP swabs (p less than 0.001). Fifty-eight children (48%) had positive RSV EIA tests, 57 from NP washings versus 35 from NP swabs (p less than 0.001). Detection by EIA was more sensitive than culture regardless of the method of specimen collection. We conclude that NP washings are superior to NP swabs for RSV culture and rapid diagnosis by EIA or FAT.
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PMID:Comparison of nasopharyngeal washings and swab specimens for diagnosis of respiratory syncytial virus by EIA, FAT, and cell culture. 332 55

The efficacy of Chlamydiazyme (Abbott Laboratories, North Chicago, Ill.) in detecting neonatal conjunctival and respiratory infections caused by Chlamydia trachomatis was determined by comparison of this enzyme immunoassay (EIA) with the method of isolation of chlamydiae in tissue culture. The sensitivity and specificity of Chlamydiazyme for detecting C. trachomatis in conjunctival specimens from infants with conjunctivitis were 98 and 94%, respectively. For nasopharyngeal infection in infants with conjunctivitis, the sensitivity and specificity were 87 and 92%, respectively. There were nine nasopharyngeal specimens that were Chlamydiazyme positive and culture negative. All of these specimens demonstrated the presence of typical fluorescing chlamydial elementary bodies when pellets of the original specimens were examined with a fluorescein-conjugated monoclonal antibody. When the EIA was performed on nasopharyngeal specimens from infants with suspected chlamydial pneumonia, 6 culture-positive and 10 culture-negative specimens were correctly identified.
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PMID:Comparison of enzyme immunoassay and culture for diagnosis of chlamydial conjunctivitis and respiratory infections in infants. 332 26

Chlamydia trachomatis is an organism commonly transmitted through sexual intercourse. In women it is associated with cervicitis, salpingitis, perihepatitis and infertility. Neonates born to infected women may have inclusion conjunctivitis and pneumonia due to this organism. Screening in obstetrics and in gynecology clinics is not usually performed routinely because of the cost and time involved in culturing the organism. A rapid enzyme immunoassay (EIA) kit (Chlamydiazyme, Abbott Laboratories) that can detect C. trachomatis was developed recently. Women belonging to two different cohorts were studied to determine whether multiple endocervical samples increased the likelihood of a positive result from this EIA kit. One cohort consisted of 70 asymptomatic, sexually active female adolescents from a local family planning clinic. The second cohort included 80 women who were seen at a sexually transmitted disease (STD) clinic. Both groups were assayed for Chlamydia infections using the rapid EIA kit. Positive test results were found in 7 of the 70 asymptomatic teenagers (10%) and 12 of the 80 women from the STD clinic (15%). No significant differences were noted in the order of the positive swabs in either group, although more of the earlier swabs tended to be positive.
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PMID:Detection of Chlamydia trachomatis using consecutive endocervical swabs. Prevalence in asymptomatic female adolescents and women attending a sexually transmitted disease clinic. 352 34

Cefmenoxime concentration/effect relationships were retrospectively explored for gram-negative bacteria isolated from 14 critical care patients treated for nosocomial pneumonia. The effects of cefmenoxime concentrations on in vitro growth kinetics of 21 isolated pathogens were studied using the Abbott MS-2 Research System, from which a dynamic response concentration was derived. Serum pharmacokinetic profiles were obtained in each patient. These data were used to calculate the in vivo total area under the curve over dynamic response concentration and the time that cefmenoxime concentrations exceeded the dynamic response concentration for each bacteria. The same determinations were made in 18 patients prospectively treated, except that dosage was optimized on the basis of previous mathematical relations to achieve bacterial eradication in four days. This method of dosage optimization is termed dual individualization. Serial cultures of infected tissues were evaluated to determine the number of days to the eradication of bacteria, and the pharmacokinetic and pharmacodynamic variables were used to describe the bacteriologic response of the original pathogen isolated in pretreatment culture. Bacterial eradication rates could be described from cefmenoxime pharmacokinetics in the patient and from the relation between concentration and bacterial inhibition. Patients who were prospectively treated using these retrospectively derived relationships had a predictable day of bacterial eradication. This, in turn, was associated with a shorter duration of treatment (p less than 0.05). The success of prospective dual individualization is encouraging and suggests that more precise optimization of antibiotic dosage can yield a predictable rate of bacterial eradication from the infection site.
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PMID:Role for dual individualization with cefmenoxime. 609 24

The objective of this study was to verify whether the assay of carcinoembryonic antigen (CEA) in bronchoalveolar lavage fluid (BALF) can increase the sensitivity and specificity of serum CEA for the diagnosis of lung cancer. We examined 72 subjects, 53 males and 19 females, 18 affected with peripheral lung cancer (10 adenocarcinoma, 6 squamous cell carcinoma, 1 small cell lung cancer, 1 adenosquamous carcinoma), 19 with acute pneumonia, 14 with chronic obstructive pulmonary disease (COPD), 6 with interstitial lung disease (ILD), and 15 healthy subjects. CEA was assayed in blood and in BALF using microparticle enzyme immunoassay (MEIA) (IMX Abbott). The mean serum CEA value in the lung cancer group did not differ from that in each group of non-neoplastic subjects, neither was it different from that in healthy subjects. The mean BALF CEA in patients with lung cancer, pneumonia, and COPD was significantly increased compared with that in healthy subjects, whereas there was no difference between the three groups of patients. The ratio of BALF CEA was not significantly different in the three groups of patients. There were no differences according to the histological type of the tumour (adenocarcinoma or squamous cell carcinoma). Based on the results in healthy subjects, the upper limits of normal were defined for serum CEA, BALF CEA, and CEA/albumin ratio. Thus, the sensitivity of BALF CEA in detecting lung cancer (50%) was higher than that of serum CEA (33%), although clinically not useful. In addition, BALF CEA had only 59% specificity compared to 100% of serum CEA. The diagnostic accuracy was 79% for serum CEA and 56% for BALF CEA.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bronchoalveolar lavage fluid level of carcinoembryonic antigen in the diagnosis of peripheral lung cancer. 766 86

Macrolides, such as clarithromycin and azithromycin, having good activity against pathogens such as Legionella, Chlamydia, Campylobacter spp, Branhamella spp, Pasteurella multocida and streptococci, have gained wide acceptance for the treatment of both upper and lower respiratory tracts, as well as cutaneous infections. Emergence of bacterial resistance, particularly in gram-positive bacteria, has been observed. Macrolide-resistant Streptococcus pneumoniae and S. pyogenes are found in France and many other countries, resulting in failure of therapy for pneumonia, pharyngitis, and skin infection. RU 004, HMR 3647, and TE 802 were reported to be active against these resistant strains. Research at Abbott produced several macrolide derivatives in the anhydrolide, tricyclic and tetracyclic ketolides as well as 6-O-alkyl ketolides series having potent activity against macrolide resistant S. pyogenes and S. pneumoniae. Research on streptogramins to overcome bacterial resistance in gram-positive bacteria has produced interesting compounds. Another class of antibacterial agent called quinolones is useful for the treatment of bacterial infections of respiratory tract, urinary tract, skin and soft tissues, as well as sexually transmitted diseases. Ciprofloxacin, the market leader, however, has low potency against anaerobes. Bacterial resistance ( such as Pseudomonas aeruginosa and methicillin- resistant Staphylococcus aureus ) to ciprofloxacin is increasing rapidly. Many quinolone compounds are being synthesized to address these drawbacks. The new quinolones currently under development are characterized by enhanced activities against streptococci, staphylococci, enterococci, and anaerobes. This presentation reviews the current research in the identification of agents to overcome the macrolide and quinolone resistance.
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PMID:Recent progress in novel macrolides, quinolones, and 2-pyridones to overcome bacterial resistance. 1055 67


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