Laboratory diagnosis of the first cases of HIV-2 infection in Canada.

Until recently the geographic distribution of infection due to human immunodeficiency virus type 2 (HIV-2) had excluded North America. We report the first two cases of such infection in Canada. Both people came from endemic areas of western Africa and were asymptomatic. The results of a commercial enzyme immunoassay specific for HIV-1 antibody were positive in both cases, but those of the Western blot technique were indeterminate. The Western blot technique specific for HIV-2 antibody and the indirect fluorescent antibody test were used to verify the presence of HIV-2 antibody.     

生殖道沙眼衣原体感染的实验室诊断

沙眼衣原体（Chlamydia trachomatis,CT）感染目前已成为许多国家和地区常见的性传播疾病,其发病率呈明显上升趋势,日益引起人们的重视,检测技术也在不断进步,除了改进各种核酸扩增技术外,国外学者在标本取材上也进行了探索。随着检测技术的进展,CT感染的诊断也会不断地发生变化。     

Laboratory diagnosis of urinary tract infection in ambulatory women

We evaluated the accuracy and work load of six different approaches to identifying urinary tract infections in a general microbiology laboratory. Midstream urine (MSU) specimens from 387 ambulatory women were examined for pyuria and were cultured using a dual-plating technique that detects both low (10(2) to 10(4) organisms per milliliter) and high (greater than or equal to 10(5) organisms per milliliter) colony counts. Seventy-four urinary tract infections (defined as greater than or equal to 10(5) organisms per milliliter of MSU or greater than or equal to 10(2) aerobic gram-negative bacilli per milliliter of MSU in symptomatic patients) were identified. Twenty-four (32%) of the infections were characterized by low colony counts and would not have been identified using a 10(5) or greater colony-forming units/mL criterion for infection. Using the presence of pyuria to direct microbiological processing of urine specimens was the most accurate and efficient method of identifying urinary tract infections among voided specimens from ambulatory women, particularly if rapid screening methods for pyuria can be used.     

Laboratory and clinical diagnosis of human cytomegalovirus infection after transplantation

Summary Urine and blood specimens from 32 recipients of allograft organ transplant were investigated for human cytomegalovirus (HCMV) by conventional cell culture, indirect immunofluo.rescent assay subsequent to the rapid cell culture and DNA-DNA hybridization. The results showed that the rapid cell culture technique might be the best method for rapid detection of active HCMV infection after transplantation because it possesses the advantages of simplicity, speediness, sensitiveness, and high reliability of detecting productive HCMV infection. The major symptoms were prolonged or intermittent fever unresponsive to antibiotics, dysfunction or loss of function of the transplanted organ, pulmonary infiltrates and leukopenia. As our results suggested, reactivation of a latent infection appears to be the most probable etiologic factor contributing to HCMV infection after transplantation.     

Untreated gonococcal and chlamydial infection in a probability sample of adults

Context  The prevalence and distribution of gonococcal and chlamydial infections in the general population are poorly understood. Development of nucleic acid amplification tests, such as the ligase chain reaction assay, provides new opportunities to estimate the prevalence of untreated infections in the population. Objective  To estimate the overall prevalence of untreated gonococcal and chlamydial infections and to describe patterns of infection within specific demographic subgroups of the young adult population in Baltimore, Md. Design and Setting  Cross-sectional behavioral survey based on a probability sample of Baltimore households with collection of urine specimens between January 1997 and September 1998. Participants  A total of 728 adults aged 18 to 35 years completed the interview portion of the study, and 579 of these respondents also provided a urine specimen adequate for testing. Main Outcome Measure  Prevalence of untreated infection, as measured by the percentage of specimens testing positive for gonococcal and chlamydial infection by ligase chain reaction, weighted to reflect variations in probabilities of sample selection from the population. Alternate estimates of the prevalence of recent treated infection were derived from clinically diagnosed cases reported to the Baltimore City Health Department and by diagnoses reported by participants in the survey. Results  An estimated 5.3% (SE, 1.4%) of the population aged 18 to 35 years has an untreated gonococcal infection, and 3.0% (SE, 0.8%) is estimated to have an untreated chlamydial infection. While 7.9% (SE, 1.6%) of the population is estimated to have either an untreated gonococcal or chlamydial infection, estimated prevalence is substantially higher among black women (15.0%; SE, 3.7%). Few participants with untreated infections reported dysuria or discharge during the 6 months preceding testing. The estimated number of untreated gonococcal infections in the population (9241; SE, 2441) substantially exceeds both the number of such infections diagnosed among Baltimore adults aged 18 to 35 years and reported to the Baltimore City Health Department during 1998 (4566), and the estimated number of diagnoses derived using participants' reports for the 12 months prior to the survey (4708 [SE, 1918] to 5231 [SE, 2092]). The estimated number of untreated chlamydial infections (5231; SE, 1395) is also greater than the number of cases reported to the health department in 1998 (3664) but is slightly less than the estimated number of diagnoses derived using participants' reports of chlamydial infections diagnosed during the 12 months prior to the survey (5580 [SE, 1918] to 6975 [SE, 2441]). Conclusion  In 1997-1998, the estimated number of undiagnosed gonococcal and chlamydial infections prevalent in the population of Baltimore adults aged 18 to 35 years approached or exceeded the number of infections that were diagnosed and treated annually.      

Laboratory diagnosis and monitoring of rheumatologic diseases.

Improved laboratory investigative techniques now foster an increased clinical interest in and awareness of the rheumatologic disease. This review is a discussion of the relevance of laboratory tests used in the more common rheumatologic disorders and of their role in both the diagnosis and assessment of these diseases from the standpoint of the practising clinician.     

Disseminated gonococcal infection associated with deficiency of the second component of complement

A case of C2 deficiency presenting with disseminated gonococcal infection is described. The predisposition of C2-deficient individuals to infection in addition to the commoner problem of immune complex diseases is noted. Attention is drawn to the absence of documented cases of gonococcal infection associated with C2 deficiency. No other homozygous C2 deficient family members were identified. Lifelong penicillin prophylaxis was recommended for the patient.