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Matic N, Lawson T, Young M, Jang W, Bilawka J, Gowland L, Ritchie G, Leung V, Payne M, Stefanovic A, Romney MG, Lowe CF. Melting curve analysis reveals false-positive norovirus detection in a molecular syndromic panel. J Clin Virol 2024; 173:105697. [PMID: 38820917 DOI: 10.1016/j.jcv.2024.105697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 05/03/2024] [Accepted: 05/26/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Molecular syndromic panels can improve rapidity of results and ease clinical laboratory workflow, although caution has been raised for potential false-positive results. Upon implementation of a new panel for infectious diarrhea (BioFire® FilmArray® Gastrointestinal [GI] Panel, bioMérieux) in our clinical laboratory, a higher than expected number of stool samples with norovirus were detected. OBJECTIVES The goal of this study was to investigate positive percent agreement and the false-positive rate of norovirus detected by the multiplex BioFire GI panel compared to a singleplex commercial assay. STUDY DESIGN From October 2023 to January 2024, all prospective stool samples with a positive norovirus result by BioFire had melting curves reviewed manually using the BioFire FilmArray Torch System. Stool samples further underwent testing by a supplementary real-time RT-PCR assay (Xpert® Norovirus, Cepheid) for comparative analysis. RESULTS Of the 50 stool samples with norovirus detected by BioFire, 18 (36 %) tested negative by Xpert (deemed "false-positives"). Furthermore, melting curve analysis revealed nearly all of these samples had atypical melting curve morphologies for the "Noro-1" target on BioFire (16/18, 89 %), which was statistically significant (Odds Ratio 173.2, 95 % CI [22.2, 5326.9], p < 0.0001). Stool samples with multiple pathogens detected by BioFire including norovirus were not more likely to produce false-positive norovirus results (Odds Ratio 1, 95 % CI [0.3, 3.3], p = 1). CONCLUSIONS Although not described in the manufacturer's Instructions for Use, we propose routine manual review of melting curves for the BioFire GI panel prior to reporting, to mitigate potential false-positive norovirus results.
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Affiliation(s)
- Nancy Matic
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University British Columbia, Vancouver, Canada.
| | - Tanya Lawson
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Matthew Young
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Willson Jang
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Jennifer Bilawka
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Leah Gowland
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Gordon Ritchie
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University British Columbia, Vancouver, Canada
| | - Victor Leung
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University British Columbia, Vancouver, Canada
| | - Michael Payne
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University British Columbia, Vancouver, Canada
| | - Aleksandra Stefanovic
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University British Columbia, Vancouver, Canada
| | - Marc G Romney
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University British Columbia, Vancouver, Canada
| | - Christopher F Lowe
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University British Columbia, Vancouver, Canada
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Claas ECJ, Rezek Y, Sterk L, Russcher A, Verhees FB, Heijne-Tol A, Smits PHM, Nijhuis RHT. Diagnosing viral gastro-enteritis using the fully automated sample-in, result-out STARlet All in one system (AIOS). J Virol Methods 2024; 329:114985. [PMID: 38878870 DOI: 10.1016/j.jviromet.2024.114985] [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: 04/22/2024] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 06/21/2024]
Abstract
The STARlet All-In-One system is a modular platform that integrates the complete molecular diagnostic workflow from nucleic acid extraction of clinical samples to PCR set-up and amplification. The platform was evaluated in comparison with laboratory developed tests (LDT) on fecal samples from patients with suspected viral gastro-enteritis. In a retrospective study, 72 positive samples were analysed, including all pathogens detected by the Seegene Allplex™ GI-virus assay, adenovirus, astrovirus, norovirus GI and GII, sapovirus, and rotavirus. Concordant results were obtained for 69 samples (96 %). Three discordant results were observed, one norovirus GII positive that gave an invalid result in the AIOS and two samples that were negative in the AIOS. One adenovirus positive that was subtyped as a genotype 2 virus, which is not associated with gastro-enteritis, and a sapovirus. In the prospective part of the study, 661 fecal samples were included. A total of 61 positive samples were detected, of which 60 were also detected by the AIOS. One norovirus GII positive sample (CT 35.2) was tested negative in the AIOS. Two additional sapovirus positive samples, CT 37 and 38, were detected by the AIOS but not by the LDT. The STARlet All-In-One platforms results in an automated molecular workflow with reduced hands-on time and enables running assays during out of office hours. Application of the Seegene Allplex™ GI-virus assay showed excellent concordance to the current diagnostic LDT. In a prospective comparison, only three discordant results were observed, all with CT values over 35 and therefore unlikely of clinical relevance.
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Affiliation(s)
- Eric C J Claas
- Center for Infectious Diseases - Medical Microbiology and Infection Control, Leiden University Medical Center, Leiden, the Netherlands.
| | - Youssef Rezek
- Laboratory for Medical Microbiology and Immunology, Meander Medical Center, Amersfoort, the Netherlands
| | - Luuk Sterk
- Center for Infectious Diseases - Medical Microbiology and Infection Control, Leiden University Medical Center, Leiden, the Netherlands
| | - Anne Russcher
- Laboratory for Medical Microbiology and Immunology, Meander Medical Center, Amersfoort, the Netherlands
| | - Fabienne B Verhees
- Center for Infectious Diseases - Medical Microbiology and Infection Control, Leiden University Medical Center, Leiden, the Netherlands
| | - Anja Heijne-Tol
- Laboratory for Medical Microbiology, Atal-medial, Amsterdam, the Netherlands
| | - Paul H M Smits
- Laboratory for Medical Microbiology, Atal-medial, Amsterdam, the Netherlands
| | - Roel H T Nijhuis
- Laboratory for Medical Microbiology and Immunology, Meander Medical Center, Amersfoort, the Netherlands
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3
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Mangalea MR, Halpin AL, Haile M, Elkins CA, McDonald LC. Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections. Emerg Infect Dis 2024; 30:1069-1076. [PMID: 38781679 PMCID: PMC11138981 DOI: 10.3201/eid3006.231338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Antimicrobial resistance in healthcare-associated bacterial pathogens and the infections they cause are major public health threats affecting nearly all healthcare facilities. Antimicrobial-resistant bacterial infections can occur when colonizing pathogenic bacteria that normally make up a small fraction of the human microbiota increase in number in response to clinical perturbations. Such infections are especially likely when pathogens are resistant to the collateral effects of antimicrobial agents that disrupt the human microbiome, resulting in loss of colonization resistance, a key host defense. Pathogen reduction is an emerging strategy to prevent transmission of, and infection with, antimicrobial-resistant healthcare-associated pathogens. We describe the basis for pathogen reduction as an overall prevention strategy, the evidence for its effectiveness, and the role of the human microbiome in colonization resistance that also reduces the risk for infection once colonized. In addition, we explore ideal attributes of current and future pathogen-reducing approaches.
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Kabue JP, Khumela R, Meader E, Baroni de Moraes MT, Traore AN, Potgieter N. Norovirus-Associated Gastroenteritis Vesikari Score and Pre-Existing Salivary IgA in Young Children from Rural South Africa. Viruses 2023; 15:2185. [PMID: 38005863 PMCID: PMC10674611 DOI: 10.3390/v15112185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Norovirus (NoV) is the leading cause of viral gastroenteritis, mostly affecting young children worldwide. However, limited data are available to determine the severity of norovirus-associated AGE (acute gastroenteritis) and to correlate it with the NoV-specific IgA antibodies' level. Between October 2019 and September 2021, two hundred stool samples were randomly collected from symptomatic cases for the vesikari score and NoV-specific IgA assessment in young children from rural South Africa. Additionally, one hundred saliva specimens were concomitantly sampled within the same cohort to evaluate the NoV-specific salivary IgA levels. In addition, 50 paired saliva and stool samples were simultaneously collected from asymptomatic children to serve as controls. NoV strains in stool samples were detected using real-time RT-PCR, amplified, and genotyped with RT-PCR and Sanger sequencing. ELISA using NoV VLP (virus-like particles) GII.4 as antigens was performed on the saliva specimens. Dehydrated children were predominantly those with NoV infections (65/74, 88%; p < 0.0001). NoV-positive infections were significantly associated with the severe diarrhea cases having a high vesikari score (55%, 33/60) when compared to the non-severe diarrheal score (29.3%, 41/140; p < 0.0308). NoV of the GII genogroup was mainly detected in severe diarrhea cases (50.9%, 30/59; p = 0.0036). The geometric means of the NoV-specific IgA level were higher in the asymptomatic NoV-infected group (0.286) as compared to the symptomatic group (0.174). This finding suggests that mucosal immunity may not protect the children from the NoV infection. However, the findings indicated the contribution of the pre-existing NoV-specific IgA immune response in reducing the severity of diarrheal disease. A high vesikari score of AGE associated with the NoV GII genogroup circulating in the study area underscores the need for an appropriate treatment of AGE based on the severity level of NoV-associated clinical symptoms in young children.
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Affiliation(s)
- Jean-Pierre Kabue
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (R.K.); (A.N.T.); (N.P.)
| | - Ronewa Khumela
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (R.K.); (A.N.T.); (N.P.)
| | - Emma Meader
- Clinical Microbiology, Pathology Department, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 OLZ, UK;
| | - Marcia Terezinha Baroni de Moraes
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Avenida Brazil, 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil;
| | - Afsatou Ndama Traore
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (R.K.); (A.N.T.); (N.P.)
| | - Natasha Potgieter
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Private Bag X5050, Thohoyandou 0950, South Africa; (R.K.); (A.N.T.); (N.P.)
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5
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Johansen RL, Schouw CH, Madsen TV, Nielsen XC, Engberg J. Epidemiology of gastrointestinal infections: lessons learned from syndromic testing, Region Zealand, Denmark. Eur J Clin Microbiol Infect Dis 2023; 42:1091-1101. [PMID: 37468662 PMCID: PMC10427544 DOI: 10.1007/s10096-023-04642-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
The aim of this study was to investigate the value of syndromic diagnostic testing for a better understanding of the epidemiology of gastrointestinal infections in Denmark. Here we evaluated the QIAstat-Dx® Gastrointestinal (GI) Panel 1 assay on 18,610 fecal samples requested for analysis for enteric pathogens in Region Zealand, Denmark, in 1 year (October 1, 2021, to September 30, 2022). In total, 6905 (37%) samples were detected positive for one or more diarrhoeal bacteria, viruses, and protozoa. The most common bacterial, viral, and parasitic pathogens detected with the QIAstat-Dx® Gastrointestinal Panel 1 were EPEC (in patients ≥ 2 years of age) (n = 1420 (20.6%)), rotavirus (n = 948 (13.7%)), and Cryptosporidium spp. (n = 196 (2.84%)). We identified a large diversity in infections likely reflecting substantial differences in the epidemiology including origin of infections, mode of transmission, seasonality, age-dependent susceptibility to disease, severity, and travel history. All pathogens were detected as both single and coinfections. Viral infections peaked in March with a positive rate of 31.6%, and bacterial infections peaked in August with a positive rate of 35.3%. ETEC, Shigella/EIEC, EAEC, and P. shigelloides were most related to travel activity, and coinfections were frequent. The distribution of Ct values varied significantly between the pathogens, with the lowest Ct values (median 17-18) observed in astrovirus, adenovirus, and rotavirus. Our results highlight the value of providing extensive diagnostic testing on fecal samples for sufficient detection of relevant diarrhoeal pathogens for optimal clinical care.
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Affiliation(s)
- Rikke Lykke Johansen
- The Regional Department of Clinical Microbiology, Zealand University Hospital, Koege, Ingemannsvej 46, DK-4200, Slagelse, Denmark
| | - Christian Højte Schouw
- The Regional Department of Clinical Microbiology, Zealand University Hospital, Koege, Ingemannsvej 46, DK-4200, Slagelse, Denmark
| | - Tina Vasehus Madsen
- The Regional Department of Clinical Microbiology, Zealand University Hospital, Koege, Ingemannsvej 46, DK-4200, Slagelse, Denmark
| | - Xiaohui Chen Nielsen
- The Regional Department of Clinical Microbiology, Zealand University Hospital, Koege, Ingemannsvej 46, DK-4200, Slagelse, Denmark
| | - Jørgen Engberg
- The Regional Department of Clinical Microbiology, Zealand University Hospital, Koege, Ingemannsvej 46, DK-4200, Slagelse, Denmark.
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Schuster CJ, Leong C, Kasschau KD, Sharpton TJ, Kent ML. Early detection of Pseudocapillaria tomentosa by qPCR in four lines of zebrafish, Danio rerio (Hamilton 1882). JOURNAL OF FISH DISEASES 2023; 46:619-627. [PMID: 36821594 DOI: 10.1111/jfd.13773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 05/07/2023]
Abstract
The intestinal nematode Pseudocapillaria tomentosa in zebrafish (Danio rerio) causes profound intestinal lesions, emaciation and death and is a promoter of a common intestinal cancer in zebrafish. This nematode has been detected in zebrafish from about 15% of the laboratories. Adult worms are readily detected about 3 weeks after exposure by either histology or wet mount preparations of the intestine, and larval worms are inconsistently observed in fish before this time. A quantitative PCR (qPCR) test was recently developed to detect the worm in fish and water, and here we determined that the test on zebrafish intestines was effective for earlier detection. Four lines of zebrafish (AB, TU, 5D and Casper) were experimentally infected and evaluated by wet mounts and qPCR at 8, 15-, 22-, 31- and 44-day post-exposure (dpe). At the first two time points, only 8% of the wet mounts from exposed fish were identified as infected, while the same intestines screened by qPCR showed 78% positivity, with low and consistent cycle threshold (Ct) values at these times. Wet mounts at later time points showed a high prevalence of infection, but this was still surpassed by qPCR.
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Affiliation(s)
- Corbin J Schuster
- Zebrafish International Resource Center, University of Oregon, Eugene, Oregon, USA
| | - Connor Leong
- Department of Microbiology, Oregon State University, Corvallis, Oregon, USA
| | - Kristin D Kasschau
- Department of Microbiology, Oregon State University, Corvallis, Oregon, USA
| | - Thomas J Sharpton
- Department of Microbiology, Oregon State University, Corvallis, Oregon, USA
- Department of Statistics Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Michael L Kent
- Zebrafish International Resource Center, University of Oregon, Eugene, Oregon, USA
- Department of Microbiology, Oregon State University, Corvallis, Oregon, USA
- Department of Biomedical Sciences, Oregon State University, Corvallis, Oregon, USA
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7
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Masson L, Barbé L, Henaff F, Ahmed T, Le Moullac-Vaidye B, Peltier C, Marchand SS, Scherdel P, Vibet MA, Ruvoën-Clouet N, Elenga N, Imbert-Marcille BM, Gras-Le Guen C, Le Pendu J. Extent of the protection afforded by histo-blood group polymorphism against rotavirus gastroenteritis in metropolitan France and French Guiana. Front Microbiol 2023; 14:1141652. [PMID: 36970669 PMCID: PMC10036354 DOI: 10.3389/fmicb.2023.1141652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
Human rotaviruses attach to histo-blood group antigens glycans and null alleles of the ABO, FUT2 and FUT3 genes seem to confer diminished risk of gastroenteritis. Yet, the true extent of this protection remains poorly quantified. Here, we conducted a prospective study to evaluate the risk of consulting at the hospital in non-vaccinated pediatric patients according to the ABO, FUT2 (secretor) and FUT3 (Lewis) polymorphisms, in Metropolitan France and French Guiana. At both locations, P genotypes were largely dominated by P [8]-3, with P [6] cases exclusively found in French Guiana. The FUT2 null (nonsecretor) and FUT3 null (Lewis negative) phenotypes conferred near full protection against severe gastroenteritis due to P [8]-3 strains (OR 0.03, 95% CI [0.00–0.21] and 0.1, 95% CI [0.01–0.43], respectively in Metropolitan France; OR 0.08, 95% CI [0.01–0.52] and 0.14, 95%CI [0.01–0.99], respectively in French Guiana). Blood group O also appeared protective in Metropolitan France (OR 0.38, 95% CI [0.23–0.62]), but not in French Guiana. The discrepancy between the two locations was explained by a recruitment at the hospital of less severe cases in French Guiana than in Metropolitan France. Considering the frequencies of the null ABO, Secretor and Lewis phenotypes, the data indicate that in a Western European population, 34% (95% CI [29%; 39%]) of infants are genetically protected against rotavirus gastroenteritis of sufficient severity to lead to hospital visit.
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Affiliation(s)
- Lydie Masson
- Department of Pediatrics, University Hospital of Nantes, Nantes, France
| | - Laure Barbé
- Nantes Université, Inserm, CNRS, Immunology and New Concepts in Immunotherapy, INCIT, Nantes, France
| | - Fanny Henaff
- Department of Pediatrics, Centre Hospitalier Andrée Rosemon, Cayenne, France
| | - Tasnuva Ahmed
- Nantes Université, Inserm, CNRS, Immunology and New Concepts in Immunotherapy, INCIT, Nantes, France
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | | | - Cécile Peltier
- Center for Research in Transplantation and Translational Immunology, Inserm, Nantes Université, Nantes, France
| | - Sarah S Marchand
- Virology Department, University Hospital of Nantes, Nantes, France
| | - Pauline Scherdel
- Clinical Investigation Center (CIC004), Inserm, University Hospital of Nantes, Nantes, France
| | - Marie-Anne Vibet
- Clinical Research Department, University Hospital of Nantes, Nantes, France
| | - Nathalie Ruvoën-Clouet
- Nantes Université, Inserm, CNRS, Immunology and New Concepts in Immunotherapy, INCIT, Nantes, France
- Ecole Nationale Vétérinaire, Agroalimentaire et de l'Alimentation, Oniris, Nantes, France
| | - Narcisse Elenga
- Department of Pediatrics, Centre Hospitalier Andrée Rosemon, Cayenne, France
| | - Berthe-Marie Imbert-Marcille
- Center for Research in Transplantation and Translational Immunology, Inserm, Nantes Université, Nantes, France
- Virology Department, University Hospital of Nantes, Nantes, France
| | | | - Jacques Le Pendu
- Nantes Université, Inserm, CNRS, Immunology and New Concepts in Immunotherapy, INCIT, Nantes, France
- *Correspondence: Jacques Le Pendu,
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8
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Sala E, Shah IS, Manissero D, Juanola-Falgarona M, Quirke AM, Rao SN. Systematic Review on the Correlation Between SARS-CoV-2 Real-Time PCR Cycle Threshold Values and Epidemiological Trends. Infect Dis Ther 2023; 12:749-775. [PMID: 36811776 PMCID: PMC9945817 DOI: 10.1007/s40121-023-00772-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The ability to proactively predict the epidemiological dynamics of infectious diseases such as coronavirus disease 2019 (COVID-19) would facilitate efficient public health responses and may help guide patient management. Viral loads of infected people correlate with infectiousness and, therefore, could be used to predict future case rates. AIM In this systematic review, we determine whether there is a correlation between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) real-time reverse-transcription polymerase chain reaction (RT-PCR) cycle threshold (Ct) values (a proxy for viral load) and epidemiological trends in patients diagnosed with COVID-19, and whether Ct values are predictive of future cases. METHODS A PubMed search was conducted on August 22 2022, based on a search strategy of studies reporting correlations between SARS-CoV-2 Ct values and epidemiological trends. RESULTS Data from 16 studies were relevant for inclusion. RT-PCR Ct values were measured from national (n = 3), local (n = 7), single-unit (n = 5), or closed single-unit (n = 1) samples. All studies retrospectively examined the correlation between Ct values and epidemiological trends, and seven evaluated their prediction model prospectively. Five studies used the temporal reproduction number (Rt) as the measure of the population/epidemic growth rate. Eight studies reported a prediction time in the negative cross-correlation between Ct values and new daily cases, with seven reporting a prediction time of ~1-3 weeks, and one reporting 33 days. CONCLUSION Ct values are negatively correlated with epidemiological trends and may be useful in predicting subsequent peaks in variant waves of COVID-19 and other circulating pathogens.
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Affiliation(s)
- Ester Sala
- STAT-Dx Life, S.L. (a QIAGEN Company), Baldiri Reixac, 4-8, 08028, Barcelona, Spain.
| | - Isheeta S Shah
- QIAGEN, Inc, 19300 Germantown Road, Germantown, MD, 20874, USA
| | - Davide Manissero
- QIAGEN Manchester Ltd, Skelton House, Lloyd Street North, Manchester, M15 6SH, UK
| | | | | | - Sonia N Rao
- QIAGEN, Inc, 19300 Germantown Road, Germantown, MD, 20874, USA
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9
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Ligero-López J, García-Rodríguez J, Ruiz-Carrascoso G. Diagnosis of gastrointestinal infections: comparison between traditional microbiology and a commercial syndromic molecular-based panel. FEMS Microbiol Lett 2023; 370:fnad122. [PMID: 37960927 DOI: 10.1093/femsle/fnad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/26/2023] [Accepted: 11/11/2023] [Indexed: 11/15/2023] Open
Abstract
Traditional diagnosis of infectious gastroenteritis is based on culture, microscopy and antigen detection. The development of gastrointestinal syndromic panels based on molecular techniques have allowed rapid and simultaneous identification of multiple pathogens. The objective was to evaluate the implementation of Allplex™ Gastrointestinal Panel Assays (AGPA): Allplex™ GI-Virus, Allplex™ GI-Bacteria (I) and Allplex™ GI-Parasite by comparing with traditional diagnosis. A retrospective comparative study was conducted at Hospital Universitario La Paz, between the first year of implementation of the AGPA (April 1, 2018 to March 31, 2019) and the results obtained during the previous year with traditional methods (April 1, 2017 to March 31, 2018). With the implementation of AGPA we obtained an increase in the detection of rotavirus and adenovirus, being statistically significant for rotavirus ([CI95%:3.60-6.79]; P < 0.05) and an increase in the positivity rates of all the bacteria tested, with the exception of Salmonella spp. ([CI95%:3.60-6.79]; P < 0.05). Comparing the bacteria recovered by culture, we obtained an increase in the case of Shigella spp. cultivation during the AGPA period. Regarding protozoa, we achieved a significant increase in the positivity rates for Cryptosporidium spp. ([CI95%:1.98-3.01] P < 0.05), Giardia intestinalis ([CI95%:3.94-5.25]; P < 0.05) and Blastocystis spp. ([CI95%:9.44-11.36]; P < 0.05). There was an improvement in report turnaround time when comparing molecular diagnosis to bacterial culture and concentration plus microscopy for parasites; but not compared with antigen detection. The molecular diagnosis approach with AGPA were more sensitive and had a faster turnaround time for some targets, and in our setting, enabled an increased diagnostic capacity for viruses and protozoa.
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Affiliation(s)
- Jorge Ligero-López
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, 28046 - Madrid, Spain
| | - Julio García-Rodríguez
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, 28046 - Madrid, Spain
| | - Guillermo Ruiz-Carrascoso
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, 28046 - Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, 28029 -Madrid, Spain
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10
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Saber MM, Nomair AM, Osman AM, Nomeir HM, Farag NM. Endothelial Monocyte-Activating Polypeptide-II Is an Indicator of Severity and Mortality in COVID-19 Patients. Vaccines (Basel) 2022; 10:vaccines10122177. [PMID: 36560587 PMCID: PMC9784120 DOI: 10.3390/vaccines10122177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Data for predicting the severity and mortality of coronavirus disease 2019 (COVID-19) are limited, and investigations are ongoing. Endothelial monocyte-activating protein II (EMAP-II) is a multifunctional polypeptide with pro-inflammatory properties. EMAP-II is a significant pathogenic component in chronic inflammatory lung diseases and lung injury. In this study, we aimed to assess the potential utility of EMAP-II as a predictor of COVID-19 severity and mortality. This study included 20 healthy volunteers and 60 verified COVID-19 patients. Nasopharyngeal samples from COVID-19-positive subjects and normal volunteers were collected at admission. The nasopharyngeal samples were subjected to EMAP-II real-time polymerase chain reaction (RT-PCR). EMAP-II RNA was not detected in nasopharyngeal swabs of normal controls and mild to asymptomatic COVID-19 patients and was only detectable in severe COVID-19 patients. EMAP-II critical threshold (Ct) was positively associated with lymphocyte percentages and oxygen saturation (p < 0.001) while being negatively associated with age (p = 0.041), serum CRP, ferritin, and D-dimer levels (p < 0.001). EMAP-II Ct cutoff ≤34 predicted a worse outcome in COVID-19 illness, with a sensitivity and specificity of 100%. Our study suggests that EMAP-II could be considered a potential biomarker of COVID-19 severity. EMAP-II can predict the fatal outcome in COVID-19 patients.
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Affiliation(s)
- Manal Mohamed Saber
- Department of Clinical Pathology, Faculty of Medicine, Minia University, Minia 61519, Egypt
- Correspondence:
| | - Azhar Mohamed Nomair
- Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria 21561, Egypt
| | - Ashraf M. Osman
- Department of Clinical Pathology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Hanan Mohamed Nomeir
- Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Alexandria 21131, Egypt
| | - Naglaa M. Farag
- Department of Clinical Pathology, Faculty of Medicine, Minia University, Minia 61519, Egypt
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11
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Kralicek SE, Sitaraman LM, Kuprys PV, Harrington AT, Ramakrishna B, Osman M, Hecht GA. Clinical Manifestations and Stool Load of Atypical Enteropathogenic Escherichia coli Infections in United States Children and Adults. Gastroenterology 2022; 163:1321-1333. [PMID: 35948108 PMCID: PMC9613550 DOI: 10.1053/j.gastro.2022.07.064] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS There is debate whether atypical enteropathogenic Escherichia coli (aEPEC) causes disease in adults. aEPEC is commonly detected in symptomatic and asymptomatic individuals. aEPEC, in contrast to typical EPEC, lacks bundle-forming pili, altering its pathogenicity. Here, we define for the first time the clinical manifestations of sporadic aEPEC infection in United States children and adults and determine whether EPEC load correlates with disease. METHODS This is a retrospective case-control study of 380 inpatients/outpatients of all ages. EPEC load in stools was determined by quantitative polymerase chain reaction. RESULTS Diarrhea, vomiting, abdominal pain, and fever were more prevalent in EPEC-positive cases than in EPEC-negative controls. aEPEC infection caused mostly acute, mild diarrhea lasting for 6 to 13 days. However, some had severe diarrhea with 10 to 40 bowel movements per day or had persistent/chronic diarrhea. Fever, vomiting, and abnormal serum sodium levels were more common in children. Adults more often reported abdominal pain and longer duration of diarrhea. Symptomatic aEPEC infection was associated with leukocytosis in 24% of patients. EPEC load >0.1% was associated with symptomatic infection; however, loads varied greatly. Co-infecting pathogens did not alter diarrhea severity or EPEC load. Longitudinal data reveal that some are colonized for months to years or are repeatedly infected. CONCLUSIONS aEPEC is associated with a wide array of symptoms in adults, ranging from asymptomatic carriage to severe diarrhea. Higher EPEC loads are associated with presence of symptoms, but bacterial load does not predict disease or severity. Future studies are needed to understand bacterial and host factors that contribute to aEPEC pathogenicity to improve diagnostic tools and clinical care.
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Affiliation(s)
- Sarah E Kralicek
- Department of Biochemistry and Molecular Biology, Loyola University Chicago, Maywood, Illinois
| | - Lalitha M Sitaraman
- Division of Gastroenterology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Paulius V Kuprys
- Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois
| | - Amanda T Harrington
- Clinical Microbiology Laboratory, Loyola University Medical Center, Maywood, Illinois; Pathology and Laboratory Medicine, Loyola University Chicago, Maywood, Illinois
| | | | | | - Gail A Hecht
- Division of Gastroenterology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois; Department of Microbiology and Immunology, Loyola University Chicago, Maywood, Illinois.
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12
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Halaji M, Pournajaf A, Sadeghi F, Hasanzadeh A, Chehrazi M, Gholinia H, Hejazi Amiri F, Saber Amoli S, Javanian M, Bayani M, Sadeghi Haddad Zavareh M, Shokri M, Babazadeh A, Bazi Broun M, Mohammadi M, Mehdinezhad H, Monadi M, Amri Maleh P, Nouri HR, Daraei A, Yousefnia Pasha M, Tourani M, Ahmadian SR, Esmailzadeh N, Mirtabar SM, Asadi S, Yousefghahary B, Babaei M, Nabipour M, Vakili Sadeghi M, Pourkia R, Jafarypour I, Zieaie Amiri N, Akbary R, Asgharpour M, Oliaei F, Zahedpasha Y, Mahmoodi H, Akbarian Rad Z, Haghshenas Mojaveri M, Seyfi S, Shokri Shirvani J, Alhooee S, Abedi H, Behzad K, Bayani MA, Kheirkhah F, Saadat P, Nasiraie E, Ezami N, Gorjinejad S, Fallhpour K, Fakhraie F, Beheshti Y, Baghershiroodi M, Rasti F, Salehi M, Aleahmad A, Nasrollahian S, Babapour R, Malekzadeh R, Habibzadeh Kashi R, Shams Esmaili MA, Javadian Kotnaei M, Ghanbarpour A, Yahyapour Y. One-year prevalence and the association between SARS-CoV-2 cycle threshold, comorbidity and outcomes in population of Babol, North of Iran (2020-2021). CASPIAN JOURNAL OF INTERNAL MEDICINE 2022; 13:244-253. [PMID: 35872672 PMCID: PMC9272954 DOI: 10.22088/cjim.13.0.244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/23/2022] [Accepted: 03/09/2022] [Indexed: 03/10/2023]
Abstract
BACKGROUND The present study aimed to investigate the one-year prevalence of SARS-CoV-2, common comorbidities and demographic information among negative- and positive rRT-PCR in health care workers (HCW), hospitalized and outpatients. Also, the association between SARS-CoV-2 cycle threshold (Ct) and the outcomes of patients were analyzed in Babol, northern Iran. METHODS This large retrospective cross-sectional study was performed between March 2020 and March 2021. The records of 19232 hospitalized, outpatients and HCW suspected to COVID-19 were collected from teaching hospitals in the North of Iran. RESULTS Out of the 19232 suspected to COVID-19 patients, 7251 (37.7%) had a positive rRT-PCR result; 652 (9%), 4599 (63.4%) and 2000 (27.6%) of those were categorized as HCW, hospitalized and outpatients, respectively. Moreover, between the hospitalized and the outpatient group, 10.2 and 0.8% cases died, whereas no death cases were reported in the HCW. Furthermore, it seems that death rate was significantly different between the three groups of Ct value, the highest mortality in those with Ct between 21 and 30 (group B=7.6%) and the lowest in the group with the highest Ct (between 31 and 40 = 5.5%) (p<0.001). CONCLUSION In summary, 37.7% of cases were positive for SARS-CoV-2; of which, 63.4, 27.6 and 9% were hospitalized, outpatients and HCW, respectively. With regard to the mortality rate in hospitalized patients and the significant association with Ct under 20 and 30, it seems that the early detection and the initial quantification of SARS-CoV-2 in the first week of the conflict and therapeutic considerations to reduce the relative load can reduce the mortality rate.
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Affiliation(s)
- Mehrdad Halaji
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.,These authors contributed equally to this work
| | - Abazar Pournajaf
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.,These authors contributed equally to this work
| | - Farzin Sadeghi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Hasanzadeh
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Hejazi Amiri
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Saghar Saber Amoli
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Masoumeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahmoud Sadeghi Haddad Zavareh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehran Shokri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mana Bazi Broun
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Mohammadi
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Mehdinezhad
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mahmoud Monadi
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Parviz Amri Maleh
- Department of Anesthesiology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hamid Reza Nouri
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Abdolreza Daraei
- Department of Medical Genetics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Mehdi Tourani
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Nadia Esmailzadeh
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Shakiba Asadi
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Behnaz Yousefghahary
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mansour Babaei
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Majid Nabipour
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Vakili Sadeghi
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Roghayeh Pourkia
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Iraj Jafarypour
- Department of Cardiology, School of Medicine , Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Naghmeh Zieaie Amiri
- Department of Cardiology, School of Medicine , Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Roghayeh Akbary
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Masoumeh Asgharpour
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farshid Oliaei
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Yadollah Zahedpasha
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hasan Mahmoodi
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Akbarian Rad
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Haghshenas Mojaveri
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shahram Seyfi
- Department of Anesthesiology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Javad Shokri Shirvani
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Saman Alhooee
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hasan Abedi
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Katrin Behzad
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Ali Bayani
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Payam Saadat
- Part of Infectious Control, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Ebrahim Nasiraie
- Part of Infectious Control, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Nafiseh Ezami
- Part of Medical Records, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Shahrbano Gorjinejad
- Part of Infectious Control, Amirkola Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Kobra Fallhpour
- Part of Infectious Control, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Fakhraie
- Part of Infectious Control, Shahid Yahyanejad Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Yousef Beheshti
- Department of Medical Genetics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mahnaz Baghershiroodi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Faeze Rasti
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Salehi
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Atiyeh Aleahmad
- Department of Clinical Biochemistry, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Sina Nasrollahian
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Rahman Babapour
- Babol Health Center, Babol University of Medical Sciences, Babol, Iran
| | - Rahim Malekzadeh
- Babol Health Center, Babol University of Medical Sciences, Babol, Iran
| | | | | | - Maryam Javadian Kotnaei
- Department of Obstetrics and Gynecology, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Azita Ghanbarpour
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Yousef Yahyapour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
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