Evaluation of a new tube latex agglutination test for detection of type-specific pneumococcal antigens in urine.

A modified tube agglutination test using type-specific latex reagents for detection of pneumococcal capsular polysaccharide antigens in alkalinized, unconcentrated urine samples was evaluated in reconstituted urine samples and in groups consisting of 26 children with clinical and roentgenographic evidence of acute lower respiratory tract infection, six patients with blood culture-proven infection of nonpneumococcal etiology, and 30 healthy individuals. The sensitivity of the tube latex agglutination method for pneumococcal polysaccharides was 2 to 10 times higher than that of the slide agglutination method. Positive antigen findings were obtained for 42% of urine samples from patients with acute lower respiratory tract infection but in neither patients with nonpneumococcal septicemia nor healthy controls. Fifty-five percent of the antigen-positive patients also showed evidence of pneumococcal involvement by pneumococcal antibody assay or antigen detection in acute-phase serum.     

Evaluation of a commercial latex agglutination test for rapid detection of salmonella in fecal samples

A latex agglutination test for the detection of salmonella in feces was evaluated in comparison to direct culture and enriched culture using both artificially inoculated samples and clinical samples. In the samples inoculated artificially with different concentrations of salmonella (10¹ to 10⁵ per gram) the enriched culture performed better only at the 10² level in 0.4 g samples, whereas the latex test performed as well as the enriched culture at all levels in 4 g samples. In the tests using clinical samples, there was no significant difference between results of the latex test performed in 2283 samples and the enriched culture performed in 2072 samples. The sensitivity, specificity and negative and positive predictive values of the latex test were 88.2 %, 98 %, 97.5 % and 63 % respectively. The test provided results rapidly but yielded a number of false positive results.     

Evaluation of a rapid latex agglutination test for detection of group B streptococci in vaginal specimens

A rapid latex agglutination test (Bactigen Group B Streptococcus Cervical Screen) for detection of group B streptococci in cervical-vaginal specimens was evaluated using two different slide systems, the traditional serologic slide and capilliary action track (Trak) slide. Culture was used as reference method. A total of 344 cervical-vaginal specimens were tested. The group B streptococci carrier rate was found by culture to be 10.8 %, 56.8 % of these specimens being heavily colonized. The sensitivity and specificity of the latex agglutination test in heavily colonized specimens was 95.2 % and 99.3 % for the serologic and track slides respectively. The overall sensitivity, including lightly colonized specimens, was 62.2 %. The positive predictive value was 92 % for both slide systems, and the negative predictive value 95.4 % and 95.6 % for the serologic and track slides respectively. The latex agglutination test, used with either slide, provides a rapid and effective method for identification of specimens heavily colonized with group B streptococci. The track slide may provide a convenient alternative to serologic slides since it does not require rotation.     

Evaluation of a latex test for rotavirus detection.

A latex agglutination (LA) test (Slidex Rota-Kit; bioMérieux, Marcy-l'Etoile, France) was a rapid, easily used method for detecting rotavirus (RV) in pediatric fecal specimens. With 45 RV-positive and 50 RV-negative diarrhea specimens, the sensitivity of the LA test was 82%, and the specificity was 100%. Six other specimens produced indeterminate results. The frequency of positive LA tests appeared to be proportional to the concentration of virions in the stool.     

Evaluation of a rapid latex test for direct detection ofStreptococcus agalactiae in various obstetrical and gynaecological disorders

Cervical samples collected during speculum examination in 413 women were tested for the presence ofStreptococcus agalactiae by Gram staining, a new latex agglutination test and standard cultures. The results of each method are reported in correlation with the clinical circumstances of isolation. Gram stain and the latex agglutination test had a sensitivity of 30 % and 78 %, and a specificity of 89 % and 98 % respectively compared with culture. The sensitivity of the latex agglutination test was higher in cases of premature rupture of membranes (90 %), presumed chorioamnionitis (86 %), presumed post-partum endometritis (86 %) and presumed salpingitis (87 %). This latex agglutination test appears to be useful for identifying patients who are heavily colonized withStreptococcus agalactiae and are at a high risk of infection.     

Coagglutination and counterimmunoelectrophoresis for detection of pneumococcal antigens in the sputum of pneumonia patients.

Coagglutination was compared with counterimmunoelectrophoresis (CIE) for sensitivity and specificity in the detection of pneumococcal antigens in sputum. Initial sputum samples from patients with pneumococcal pneumonia (less than 12 h of antibiotic therapy) were positive for antigens in 37 of 44 cases (84%) by either test. There was a decline in the number of positive results with sputum samples obtained during continuing antibiotic therapy, but the decline was greater with CIE (only 29% of samples were positive at 3 days of therapy) than with coagglutination (61% of samples were positive at 3 days of therapy) (P less than 0.05). Sputum from 3 of 11 patients (27%) and from 2 of 11 patients (18%) with nonpneumococcal pneumonia was positive for pneumococcal antigens by CIE and coagglutination, respectively, indicating a similar degree of non-specificity. Coagglutination produced the same results as CIE with sputum from patients with chronic bronchitis but without pneumonia; 9 of 23 of these patients were positive. Coagglutination was simpler to perform than CIE and required only a fraction (about 1/30) of the antiserum required for CIE. These advantages, plus the greater sensitivity of coagglutination with sputum samples obtained during antibiotic therapy, suggest that coagglutination is preferable to CIE.     

Assessment of rapid methods of pneumococcal antigen detection in routine sputum bacteriology.

Sputum specimens from 480 patients were examined for the presence of pneumococci by Gram film and culture and for pneumococcal antigen by counterimmunoelectrophoresis, coagglutination, and latex agglutination. Ninety six positive specimens were detected. Gram film and culture provided the most reliable techniques in well taken specimens collected early in the illness before antibiotic treatment had started. More than 70% of the specimens examined were submitted after starting antibiotics, however, and in these specimens, methods of antigen detection proved of greater value than either Gram film or culture. Counterimmunoelectrophoresis, coagglutination, and latex agglutination were similar in sensitivity and specificity, but coagglutination and latex agglutination were much easier to perform and to read.     

Evaluation of a rapid latex agglutination test for identification of group D streptococci

The SeroSTAT latex agglutination test (Scott Laboratories, Inc., Fiskesville, R.I.) for identification of group D streptococci was compared with bile-esculin agar and Lancefield grouping by using 110 clinical isolates of group D streptococci (S. faecalis, 74; S. bovis, 24; S. durans, 3; S. faecium, 9) and 65 viridans streptococci (S. anginosus-constellatus, 2; Streptococcus MG, 15; S. sanguis II, 14; S. mitis, 7; S. mutans, 5; S. salivarius, 8; S. sanguis I, 8; S. acidominimus, 1; S. morbillorum, 2; S. pneumoniae, 3). All strains of group D streptococci were bile-esculin positive. SeroSTAT reactions were falsely positive with 2 strains of S. sanguisII and 1 strain of Streptococcus MG (4.6% of all viridans streptococci tested) and falsely negative with 10 S. bovis, 8 S. faecalis, 1 S. durans, and 6 S. faecium strains (22.7% of all group D streptococci tested). When considered with colonial morphology and hemolytic reaction, SeroSTAT is a rapid (60-s) and useful test for recognition of group D streptococci.     

A latex slide agglutination test for rapid detection of antimyeloperoxidase antibody

AIM: To develop and test a new latex slide agglutination test (MPO-LSAT) to detect antimyeloperoxidase (anti-MPO) antibody in serum. METHODS: Latex bead coating was adjusted to give maximum sensitivity by attending to latex size, MPO to latex ratio for coupling, ratio of diluted serum to MPO-latex, reaction time and temperature for coupling, and reaction time for agglutination. Inhibition studies were performed using MPO, proteinase 3, bactericidal/permeability increasing protein, and lactoferrin. RESULTS: There was very good correlation between this test and the conventional anti-MPO enzyme linked immunosorbent assay (ELISA): 81% of sera positive in the ELISA were positive by MPO-LSAT. MPO-LSAT results correlated better with IgM anti-MPO than with IgG anti-MPO. CONCLUSIONS: MPO-LSAT is a simple diagnostic test that is potentially useful in the clinical laboratory as a rapid screening tool for vasculitic diseases.     

Utility of a rapid latex test for the detection of Clostridium difficile in fecal specimens

Currently, the method of choice for the laboratory diagnosis of Clostridium difficile disease is the detection of cytotoxin in stool filtrates by tissue culture. Since many hospital laboratories do not have tissue culture facilities, there is a need for a rapid test which is both sensitive and specific to diagnose C. difficile disease. A commercial latex agglutination was compared with the conventional cytotoxin tissue culture assay for the detection of C. difficile or its toxin(s) in fecal specimens. Of the 574 specimens evaluated, 111 were cytotoxin positive while 97 were positive by the latex agglutination test. There were 17 specimens positive by latex agglutination but negative by tissue culture assay. The overall sensitivity and specificity of the CDT latex test was 86.1 percent and 95.3 percent respectively. This rapid latex test can serve as an excellent screening procedure for the presence of C. difficile. Those specimens positive by the latex test should be further evaluated for the presence of cytotoxin by tissue culture.     

Evaluation of a colour test for rapid detection of Salmonella

The performance of a colour test (Wellcolex) for rapid detection of the most frequently isolated O serogroups of salmonella (A, B, C, D, E/G) and the Vi antigen was evaluated using colonies grown on enteric differential agar media and in selenite broth. The test had excellent sensitivity (100 %) and specificity (100 %) with colonies taken directly from primary culture plates. Initial tests in selenite broth showed limited sensitivity (62.1 %) but by using high quality media and modifying the inoculation procedure, sensitivity was greatly improved (99 %).     

Highly sensitive biotin-avidin sandwich ELISA for the rapid detection of pneumococcal capsular polysaccharide antigens

The immunological detection of soluble pneumococcal polysaccharide antigens in pathological products is of importance in the direct diagnosis of meningitis or pulmonary infections. We have developed a double antibody sandwich ELISA method using a biotin-avidin system using antibodies constituted with a mixture of IgGs from pooled and/or monospecific antipneumococcal sera provided by the Danish Statens Seruminstitut. The sensitivity of this rapid ELISA method was optimized with purified capsular polysaccharides of the 24 main pneumococcal serotypes. With incubation steps of 30 min at 37 degrees C for the antigens and the conjugates, the detection limit was close to 1 ng/ml for 75% of the purified polysaccharides. A retrospective study of 46 CSF samples established the validity of the assay. This type of modified ELISA system represents a specific, sensitive and rapid procedure for the potential detection of capsular soluble antigens of all pneumococcal serotypes.     

Evaluation of a combination rapid immunoassay for detection of Giardia and Cryptosporidium antigens

A combination cassette format nonenzymatic rapid immunoassay for detection of Giardia and Cryptosporidium antigens was evaluated by using 556 patient stool specimens from three clinical laboratories. This assay (Genzyme Diagnostics Contrast Giardia/Cryptosporidium), which can be used with fresh or formalin-fixed specimens, had unadjusted sensitivities and specificities of 96.1 and 98.5% for Giardia and 100 and 98.7% for Cryptosporidium, respectively, in this study.     

Evaluation of a new latex agglutination test for detection of streptolysin O antibodies.

Acute- and convalescent-phase serum specimens were collected from 50 patients with group A streptococcal pharyngitis. The anti-streptolysin O (ASO) titer for each serum specimen was determined by using both the standard neutralization assay and the latex agglutination (LA) test (Rheumagen ASO; Biokit Inc., New Britain, Conn.). When the ASO titers derived by the two methods were compared, the correlation coefficient was 0.93. When the ability of the LA test to demonstrate a significant ASO titer rise (greater than or equal to 2 dilutions) was compared with that of the standard neutralization assay, the LA test had a sensitivity of 91%, a specificity of 86%, a positive predictive value of 83%, and a negative predictive value of 92%. Triplicate LA test determinations were performed on a subset of 31 serum specimens, and for 29 (94%), the repeated ASO titers were all within 1 dilution of each other; the width of the 95% confidence interval for the triplicate measurements of each serum specimen was +/- 32.8 IU. We found the Rheumagen ASO to be a simple, rapid LA procedure for measuring ASO titers that produces results that are highly reproducible, show little lot-to-lot variability, and are comparable to the ASO titers obtained with the standard neutralization assay.     

A rapid latex agglutination test for detection of antibodies in tuberculosis and Hansen's disease.

Antigens of Mycobacterium w, a saprophytic fast growing organism having antigenic epitopes cross-reactive with Mycobacterium leprae and Mycobacterium tuberculosis, were coated on to latex beads (0.33 micron Zn size), and the reactivity tested with sera of tuberculosis and Hansen's disease (HD) patients. Seventy nine percent of lepromatous leprosy (LL) and eighty five percent of pulmonary tuberculosis (TB) patients sera showed an agglutination reaction easily read by naked eye. Specificity of the test was further checked by testing sera of non-mycobacterial infection cases and all of them were found negative. Among apparently healthy controls, 4.3% were found positive from non-endemic and 8.8% from endemic area. The sensitivity of the assay is further enhanced from 78.7% to 90.4% and 85.7% to 91.6% in both LL HD and pulmonary tuberculosis respectively, by using immune complexes extracted from the patients sera. Potential of these antigen coated beads to detect the two major human mycobacterial disease, LL HD and pulmonary TB was also put evidence in a double blind study on coded sera samples obtained from various hospitals in India. The antigen coated beads are stable for upto 6 months at 4 degrees C. The latex slide agglutination test reported here, is simple, rapid, easy to perform and can be used even in rural areas of developing countries.     

Evaluation of the latex agglutination test for detection of Clostridium difficile.

We compared two Clostridium difficile latex agglutination tests, Meritec from Meridian Diagnostic (Cincinnati, Ohio) and CDT from Becton-Dickinson (Cockeysville, Md), on 289 specimens submitted for tissue culture cytotoxicity using MRC-5 cells. When compared with CDT, the Meritec latex agglutination test had a sensitivity of 90% (26/29), a specificity of 97% (251/260), and a correlation of 96%. Meritec was compared with tissue culture cytotoxicity on 357 specimens. Meritec had a sensitivity of 77% (30/39), a specificity of 93% (298/318), and a correlation of 92%. Clinical review of 10 Meritec +/- tissue culture cytotoxicity minus patients revealed one likely, two probable, and seven doubtful cases of C difficile disease. In contrast, review of 10 Meritec +/- tissue culture cytotoxicity plus patients showed seven likely and three probable cases of C difficile disease. The Meritec is comparable with the CDT latex agglutination test, but is not nearly as sensitive as either tissue culture assay or culture for detection of C difficile disease. A positive latex agglutination test should be confirmed by a tissue culture cytotoxicity assay.     

Routine use of counterimmunoelectrophoresis for the detection of pneumococcal antigen in sputum

Sputum samples obtained routinely for culture from patients at a thoracic department were also examined for pneumococcal antigen by means of counterimmunoelectrophoresis (CIE), using a polyvalent antipneumococcal type serum (omniserum). Pneumococci were found in 1.3% of the 880 cultures, whereas pneumococcal antigen was detected with CIE in 6.5%. The validity of these findings was tested by correlating them with the presence of clinical symptoms in those with positive tests and also by antigen detection in ELISA using monoclonal antibodies specific for the C-polysaccharide common to all types of pneumococci. Clinical findings corresponding to confirmed or probable current chest infection were found in 36 of the 48 patients with positive CIE. ELISA was positive in 33 of the 38 patients with positive CIE who were tested.Although the study deals with an unselected material of chest patients, it indicates that CIE is a sensitive method and that it is independent of current antibiotic treatment.Pneumococcal infection is probably of importance in exacerbations of chronic obstructive lung disease, but the clinical usefulness of detecting pneumococcal and other antigens in this patient group needs to be studied further.