RESUMO
ABSTRACT The study was conducted to compare the specificity of immunological diagnostic methods used for the diagnosis of Cryptosporidium species capable of causing life-threatening infection in both immunosuppressed and immunocompetent patients. For the detection of Cryptosporidium species in 79 animals with diarrhoea, we used three Copro-antigen tests: RIDASCREEN® Cryptosporidium test, Cryptosporidium 2nd Generation (ELISA) and RIDA®QUICK Cryptosporidium. For immunoassays we used positive and negative samples detected by means of polymerase chain reaction and validated by sequencing and nested polymerase chain reaction to confirm the presence six different species of Cryptosporidium species. Prevalence of cryptosporidiosis in the entire group determined by enzyme immunoassay, enzyme linked immunosorbent assay, immuno-chromatographic test and polymerase chain reaction was 34.17%, 27.84%, 6.33% and 27.84%, respectively. Sensitivity of animal samples with enzyme immunoassay, enzyme linked immunosorbent assay, and immuno-chromatographic test was 63.6%, 40.9% and 22.7%, resp., when questionable samples were considered positive, whereas specificity of enzyme immunoassay, enzyme linked immunosorbent assay and immuno-chromatographic test was 75.9%, 78.9% and 100%, respectively. Positive predictive values and negative predictive values were different for all the tests. These differences results are controversial and therefore reliability and reproducibility of immunoassays as the only diagnostic method is questionable. The use of various Cryptosporidium species in diagnosis based on immunological testing and different results obtained by individual tests indicate potential differences in Copro-antigens produced by individual Cryptosporidium species.
Assuntos
Animais , Testes Imunológicos/métodos , Criptosporidiose/microbiologia , Cryptosporidium/isolamento & purificação , Diarreia/veterinária , Testes Imunológicos/economia , Testes Imunológicos/veterinária , Sensibilidade e Especificidade , Criptosporidiose/diagnóstico , Cryptosporidium/genética , Cryptosporidium/imunologia , Diarreia/diagnóstico , Diarreia/microbiologiaRESUMO
The study was conducted to compare the specificity of immunological diagnostic methods used for the diagnosis of Cryptosporidium species capable of causing life-threatening infection in both immunosuppressed and immunocompetent patients. For the detection of Cryptosporidium species in 79 animals with diarrhoea, we used three Copro-antigen tests: RIDASCREEN®Cryptosporidium test, Cryptosporidium 2nd Generation (ELISA) and RIDA®QUICK Cryptosporidium. For immunoassays we used positive and negative samples detected by means of polymerase chain reaction and validated by sequencing and nested polymerase chain reaction to confirm the presence six different species of Cryptosporidium species. Prevalence of cryptosporidiosis in the entire group determined by enzyme immunoassay, enzyme linked immunosorbent assay, immuno-chromatographic test and polymerase chain reaction was 34.17%, 27.84%, 6.33% and 27.84%, respectively. Sensitivity of animal samples with enzyme immunoassay, enzyme linked immunosorbent assay, and immuno-chromatographic test was 63.6%, 40.9% and 22.7%, resp., when questionable samples were considered positive, whereas specificity of enzyme immunoassay, enzyme linked immunosorbent assay and immuno-chromatographic test was 75.9%, 78.9% and 100%, respectively. Positive predictive values and negative predictive values were different for all the tests. These differences results are controversial and therefore reliability and reproducibility of immunoassays as the only diagnostic method is questionable. The use of various Cryptosporidium species in diagnosis based on immunological testing and different results obtained by individual tests indicate potential differences in Copro-antigens produced by individual Cryptosporidium species.
Assuntos
Criptosporidiose/microbiologia , Cryptosporidium/isolamento & purificação , Diarreia/veterinária , Testes Imunológicos/métodos , Animais , Criptosporidiose/diagnóstico , Cryptosporidium/genética , Cryptosporidium/imunologia , Diarreia/diagnóstico , Diarreia/microbiologia , Testes Imunológicos/economia , Testes Imunológicos/veterinária , Sensibilidade e EspecificidadeRESUMO
Se realizó un estudio retrospectivo (1996 a 1999) del costo-beneficio de las pruebas inmunológicas realizadas en el Instituto Superior de Medicina Militar Dr Luis Díaz Soto. Se crearon bases de datos con todas las pruebas realizadas en el Laboratorio de Inmunología de dicho instituto y se trabajó con los totales y variación de porcentajes de pruebas alteradas. El estudio demostró que antes de la intervención de los especialistas en el diagnóstico inmunológico se indicaban demasiadas pruebas por diversas causas. Se proponen estrategias educativas al personal médico y paramédico para disminuir el gasto de materiales y reactivos, y con ello aumentar la calidad del trabajo
Assuntos
Técnicas de Laboratório Clínico , Análise Custo-Eficiência , Análise Custo-Benefício , Testes Imunológicos/economia , Estudos RetrospectivosRESUMO
The goal of this study is to increase the knowledge of the AIDS cost in a hospital. We have studied the HIV patients diagnosed during a year in our hospital and the charges of the serological tests performed to them. 20.8% of the tests were to study antibodies against HIV (only 20% were positive). After patient distribution between extra or intrahospital origin, we highlight that 61% of the charges are attributed to patients who do not belong to the hospital but to its catchment area. We emphasize the problem that AIDS patients are creating to hospital, being necessary that personal select only useful tests honestly.