1
|
Wang L, Zhang W, Dai S, Gao Y, Zhu C, Yu Y. Correlation between the gut microbiota characteristics of hosts with severe acute pancreatitis and secondary intra-abdominal infection. Front Med (Lausanne) 2024; 11:1409409. [PMID: 39234039 PMCID: PMC11371553 DOI: 10.3389/fmed.2024.1409409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 08/05/2024] [Indexed: 09/06/2024] Open
Abstract
Objective The objective of the study is to investigate the changes in the composition of intestinal microecology in severe acute pancreatitis (SAP) patients with or without intra-abdominal infection and also to analyze the expression of antibiotic resistance genes to provide evidence for early warning of infectious diseases and the rational use of antibiotics. Methods Twenty patients with SAP were enrolled in the study. According to whether the enrolled patients had a secondary intra-abdominal infection, they were divided into two groups, each consisting of 10 patients. Stool specimens were collected when the patients were admitted to the emergency intensive care unit (EICU), and nucleic acid extraction was performed. Next-generation gene sequencing was used to compare the differences in intestinal microflora diversity and drug resistance gene expression between the two groups. Results The gut microbiota of patients in the infection group exhibited distribution on multiple clustered branches with some intra-group heterogeneity, and their flora diversity was compromised. The infected group showed an enrichment of various opportunistic bacteria in the gut microbiota, along with a high number of metabolic functions, stress functions to external signals, and genes associated with pathogenesis. Drug resistance genes were expressed in the gut microbiota of both groups, but their abundance was significantly lower in the non-infected group. Conclusion The intestinal microbiota of patients in the infection group exhibited distribution on multiple clustered branches with some intra-group heterogeneity, and their flora diversity was compromised. Additionally, drug resistance genes were expressed in the gut microbiota of both groups, although their abundance was significantly lower in the non-infected group.
Collapse
Affiliation(s)
- Lihui Wang
- Department of Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Weijun Zhang
- Department of Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Simin Dai
- Department of Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yuan Gao
- Department of Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Cheng Zhu
- Department of Disease Prevention and Control, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yuetian Yu
- Department of Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
- Key Laboratory of Intelligent Pharmacy and Individualized Therapy, Zhejiang, China
- Key Laboratory of Multiple Organ Failure (Zhejiang University), Ministry of Education, Zhejiang, China
| |
Collapse
|
2
|
Tadros M, Shaw JLV, Chen Y, Wong-Fung M, Koerner T, Ralevski G, Kerr E, Matukas LM. Point-of-Care Testing Biosafety Decisions: An Investigation Summary Illustrating Current Decision-Making Process in Ontario, Canada. J Appl Lab Med 2024:jfae069. [PMID: 39039897 DOI: 10.1093/jalm/jfae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/22/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Point-of-care testing (POCT) is increasingly being used in healthcare, including hospitals, and POCT-style tests are also used within some laboratories. The principles of biosafety, including risk assessment and containment of biohazardous agents, can be utilized as a foundation to establish policies and procedures guiding safe performance of POCT. However, specific biosafety guidelines for POCT are generally lacking, particularly for those performed outside laboratories by healthcare workers. This study aims to explore POCT biosafety program decision-making infrastructure and oversight in Ontario. CONTENT The Institute of Quality Management in Healthcare distributed a survey to 249 laboratories in Ontario. There were 11 questions on POCT biosafety practices. SUMMARY The survey had a high response rate of 88.7%. How POCT biosafety decisions were made was variable among respondents. For POCT-style tests conducted within laboratories, the biosafety officer (BSO) and/or the microbiologist were involved in biosafety decisions in 95% of microbiology labs or 55% of other labs. Only 27% of the respondents reported that biosafety decisions were made by BSOs and/or microbiologists when POCT was conducted outside the laboratory. When POCT is performed outside the laboratory, biosafety decisions were made largely by Infection Prevention and Control (IPAC) and POCT laboratory staff. Similarly, training and auditing of staff who perform POCT were mainly done by IPAC and POCT laboratory staff. The survey showed that a wide variety of POCT was being conducted for COVID-19 patients during the pandemic.
Collapse
Affiliation(s)
- Manal Tadros
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Julie L V Shaw
- Division of Biochemistry, The Ottawa Hospital and Eastern Ontario Regional Laboratories Association, Ottawa, ON, Canada
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Yan Chen
- Department of Laboratory Medicine, Unity Health Toronto, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Matt Wong-Fung
- Microbiology Program, Institute for Quality Management in Healthcare, North York, ON, Canada
| | - Tess Koerner
- Microbiology Program, Institute for Quality Management in Healthcare, North York, ON, Canada
| | - Georgina Ralevski
- Microbiology Program, Institute for Quality Management in Healthcare, North York, ON, Canada
| | - Elaine Kerr
- Microbiology Program, Institute for Quality Management in Healthcare, North York, ON, Canada
| | - Larissa M Matukas
- Department of Laboratory Medicine, Unity Health Toronto, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
3
|
Zhang K, Zhang R, Li S, Liu S, Wang F, Xu J, Kang Q. Influence on emergency digit replantation and outcome assessment after COVID-19 virus nucleic acid testing normalization. Front Surg 2023; 9:1078933. [PMID: 36684330 PMCID: PMC9852734 DOI: 10.3389/fsurg.2022.1078933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/11/2022] [Indexed: 01/09/2023] Open
Abstract
Objective The study aims to compare the implementation and prognosis of emergency digit replantation surgery before and after normalized corona virus disease 2019 (COVID-19) nucleic acid testing for patients taking emergency operation and to explore the influence of normalized COVID-19 nucleic acid testing on replantation surgery. Method Normalized COVID-19 nucleic acid testing for patients taking emergency operation has been carried out since 1 August 2021 at our hospital, which means each patient who needs emergency surgical treatment has to obtain either positive or negative results of COVID-19 nucleic acid before entering the operating room. This research reviewed and compared the prognosis of the injured extremity that had emergency severed digit replantation between June and September 2021, at the Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, and analyzed the impact of normalized COVID-19 nucleic acid testing on the outcome of the replanted fingers of different severity using disability of arm-shoulder-hand (DASH) and hand injury severity scoring (HISS) scoring systems. Results A total of 54 cases with 74 severed replanted phalanges were included replanted by the research group between 1 August and 30 September 2021, without any COVID-19 suspected/confirmed case detected. Compared with previous period (1 June to 31 July, 2021), although the interval between emergency visits and emergency replantation did increase significantly after normalized COVID-19 nucleic acid testing [(3.83 ± 0.94) to (1.77 ± 0.67) h, P < 0.05], we observed no significant difference in the improvement rate of the DASH scoring of the disabled upper extremity 3-month postoperatively (P = 0.538) nor in the complication rate (P = 0.344). Moreover, there was no significant difference in the improvement rate of the DASH scoring of the disabled upper extremity 3-month postoperatively in patients with different traumatic severities before and after normalized COVID-19 nucleic acid testing (moderate P = 0.269, severe P = 0.055, major P = 0.149). Conclusion Despite the preoperative delay, the policy of COVID-19 nucleic acid testing normalization does not have explicit influence on the short-term outcomes of emergency digit replantation surgery. With this evidence, microsurgeons could pay attention to the patients' anxiety and spend more effort in comforting them during the prolonged preoperative wait. These insights may have implications for other emergency department resource management whenever a social crisis occurs.
Collapse
Affiliation(s)
| | | | | | | | | | - Jia Xu
- Correspondence: Xu Jia Kang Qinglin
| | | |
Collapse
|
4
|
Velayudhan BT, Naikare HK. Point-of-care testing in companion and food animal disease diagnostics. Front Vet Sci 2022; 9:1056440. [PMID: 36504865 PMCID: PMC9732271 DOI: 10.3389/fvets.2022.1056440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
Laboratory diagnoses of animal diseases has advanced tremendously in recent decades with the advent of cutting-edge technologies such as real-time polymerase chain reaction, next generation sequencing (NGS), matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and others However, most of these technologies need sophisticated equipment, laboratory space and highly skilled workforce. Therefore, there is an increasing market demand for point-of-care testing (POCT) in animal health and disease diagnostics. A wide variety of assays based on antibodies, antigens, nucleic acid, and nanopore sequencing are currently available. Each one of these tests have their own advantages and disadvantages. However, a number of research and developmental activities are underway in both academia and industry to improve the existing tests and develop newer and better tests in terms of sensitivity, specificity, turnaround time and affordability. In both companion and food animal disease diagnostics, POCT has an increasing role to play, especially in resource-limited settings. It plays a critical role in improving animal health and wellbeing in rural communities in low- and middle-income countries. At the same time, ensuring high standard of quality through proper validation, quality assurance and regulation of these assays are very important for accurate diagnosis, surveillance, control and management of animal diseases. This review addresses the different types of POCTs currently available for companion and food animal disease diagnostics, tests in the pipeline and their advantages and disadvantages.
Collapse
Affiliation(s)
- Binu T. Velayudhan
- Athens Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, GA, United States,*Correspondence: Binu T. Velayudhan
| | - Hemant K. Naikare
- Tifton Veterinary Diagnostic and Investigational Laboratory, College of Veterinary Medicine, University of Georgia, Tifton, GA, United States
| |
Collapse
|
5
|
He Z, Liu C, Li Z, Chu Z, Chen X, Chen X, Guo Y. Advances in the use of nanomaterials for nucleic acid detection in point-of-care testing devices: A review. Front Bioeng Biotechnol 2022; 10:1020444. [DOI: 10.3389/fbioe.2022.1020444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/23/2022] [Indexed: 01/03/2023] Open
Abstract
The outbreak of the coronavirus (COVID-19) has heightened awareness of the importance of quick and easy testing. The convenience, speed, and timely results from point-of-care testing (POCT) in all vitro diagnostic devices has drawn the strong interest of researchers. However, there are still many challenges in the development of POCT devices, such as the pretreatment of samples, detection sensitivity, specificity, and so on. It is anticipated that the unique properties of nanomaterials, e.g., their magnetic, optical, thermal, and electrically conductive features, will address the deficiencies that currently exist in POCT devices. In this review, we mainly analyze the work processes of POCT devices, especially in nucleic acid detection, and summarize how novel nanomaterials used in various aspects of POCT products can improve performance, with the ultimate aims of offering new ideas for the application of nanomaterials and the overall development of POCT devices.
Collapse
|
6
|
Mo C, Lo K, He Y, Peng B, Guo F, Zheng Z, Jiang R, Cai Y, Li Y, Guo D, Zhang B, Ou T, Xiong D, Zhang X. Performance comparison of two nucleic acid amplification systems for SARS-CoV-2 detection: A multi-center study. J Clin Lab Anal 2022; 36:e24727. [PMID: 36196490 DOI: 10.1002/jcla.24727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/07/2022] [Accepted: 09/23/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Many rapid nucleic acid testing systems have emerged to halt the development and spread of COVID-19. However, so far relatively few studies have compared the diagnostic performance between these testing systems and conventional detection systems. Here, we performed a retrospective analysis to evaluate the clinical detection performance between SARS-CoV-2 rapid and conventional nucleic acid detection system. METHODS Clinical detection results of 63,352 oropharyngeal swabs by both systems were finally enrolled in this analysis. Sensitivity (SE), specificity (SP), and positive and negative predictive value (PPV, NPV) of both systems were calculated to evaluate their diagnostic accuracy. Concordance between these two systems were assessed by overall, positive, negative percent agreement (OPA, PPA, NPA) and κ value. Sensitivity of SARS-CoV-2 rapid nucleic acid detection system (Daan Gene) was further analyzed with respect to the viral load of clinical specimens. RESULTS Sensitivity of Daan Gene was slightly lower than that of conventional detection system (0.86 vs. 0.979), but their specificity was equivalent. Daan Gene had ≥98.0% PPV and NPV for SARS-CoV-2. Moreover, Daan Gene demonstrated an excellent test agreement with conventional detection system (κ = 0.893, p = 0.000). Daan Gene was 99.31% sensitivity for specimens with high viral load (Ct < 35) and 50% for low viral load (Ct ≥ 35). CONCLUSIONS While showing an analytical sensitivity slightly below than that of conventional detection system, rapid nucleic acid detection system may be a diagnostic alternative to rapidly identify SARS-CoV-2-infected individuals with high viral loads and a powerful complement to current detection methods.
Collapse
Affiliation(s)
- Chan Mo
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Kamfai Lo
- The University of Hong Kong-Shenzhen hospital, Shenzhen, Guangdong, China
| | - Ying He
- The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Bo Peng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Feifan Guo
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,Anhui University of Science and Technology, Huainan, Anhui, China
| | - Zhou Zheng
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Ruiwei Jiang
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,Anhui University of Science and Technology, Huainan, Anhui, China
| | - Yihua Cai
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Yumin Li
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Dongyue Guo
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Bing Zhang
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Tong Ou
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Dan Xiong
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,Anhui University of Science and Technology, Huainan, Anhui, China
| | - Xiuming Zhang
- Medical Laboratory of the Third Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.,Anhui University of Science and Technology, Huainan, Anhui, China
| |
Collapse
|
7
|
Zhang Y, Li Z, Su W, Zhong G, Zhang X, Wu Y, Situ B, Xiao Y, Yan X, Zheng L. A highly sensitive and versatile fluorescent biosensor for pathogen nucleic acid detection based on toehold-mediated strand displacement initiated primer exchange reaction. Anal Chim Acta 2022; 1221:340125. [DOI: 10.1016/j.aca.2022.340125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/25/2022] [Accepted: 06/23/2022] [Indexed: 01/03/2023]
|
8
|
Lau CS, Aw TC. Disease Prevalence Matters: Challenge for SARS-CoV-2 Testing. Antibodies (Basel) 2021; 10:antib10040050. [PMID: 34940002 PMCID: PMC8698426 DOI: 10.3390/antib10040050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 01/03/2023] Open
Abstract
While sensitivity and specificity are important characteristics for any diagnostic test, the influence of prevalence is equally, if not more, important when such tests are used in community screening. We review the concepts of positive/negative predictive values (PPV/NPV) and how disease prevalence affects false positive/negative rates. In low-prevalence situations, the PPV decreases drastically. We demonstrate how using two tests in an orthogonal fashion can be especially beneficial in low-prevalence settings and greatly improve the PPV of the diagnostic test results.
Collapse
Affiliation(s)
- Chin-Shern Lau
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore;
| | - Tar-Choon Aw
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore;
- Department of Medicine, National University of Singapore, Singapore 119077, Singapore
- Academic Pathology Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Correspondence: ; Tel.: +65-68504927; Fax: +65-64269507
| |
Collapse
|