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Donoso Mantke O, Corman VM, Taddei F, McCulloch E, Niemeyer D, Grumiro L, Dirani G, Wallace PS, Drosten C, Sambri V, Niesters HGM. Importance of external quality assessment for SARS-CoV-2 antigen detection during the COVID-19 pandemic. J Clin Virol 2022; 154:105222. [PMID: 35797940 PMCID: PMC9235289 DOI: 10.1016/j.jcv.2022.105222] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/21/2022] [Accepted: 06/26/2022] [Indexed: 11/18/2022]
Abstract
Background: Antigen testing has become an essential part of fighting the ongoing COVID-19 pandemic. With the continual increase in available tests, independent and extensive comparative evaluations using data from external quality assessment (EQA) studies to evaluate test performance between different users are required. Objectives: An EQA scheme was established to assess the sensitivity of antigen tests and the potential impact of circulating SARS-CoV-2 strains on their performance. Study design: Panels were prepared for three challenges in 2021 containing inactivated SARS-CoV-2-positive samples of various genetic strains (including variants of concern, VOCs) at different concentrations, and negative samples. Data was analysed based on qualitative testing results in relation to the antigen test used. Results: Participants registered for each individual challenge in any combination. In total, 258 respondents from 27 countries worldwide were counted submitting 472 datasets. All core samples were correctly reported by 76.7 to 83.1% at participant level and by 73.5 to 83.8% at dataset level. Sensitivity differences could be shown in viral loads and SARS-CoV-2 strains/variants including the impact on performance by a B.1.1.7-like mutant strain with a deletion in the nucleoprotein gene. Lateral flow rapid antigen tests showed a higher rate of false negatives in general compared with automated point-of-care tests and laboratory ELISA/immunoassays. Conclusions: EQA schemes can provide valuable data to inform participants about weaknesses in their testing process or methods and support ongoing assay evaluations for regulatory approval or post-market surveillance.
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Affiliation(s)
| | - Victor M Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, and German Center for Infection Research (DZIF), Berlin, Germany; Labor Berlin-Charité Vivantes GmbH, Berlin, Germany
| | - Francesca Taddei
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Elaine McCulloch
- Quality Control for Molecular Diagnostics (QCMD), Glasgow, United Kingdom.
| | - Daniela Niemeyer
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, and German Center for Infection Research (DZIF), Berlin, Germany
| | - Laura Grumiro
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Giorgio Dirani
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Paul S Wallace
- Quality Control for Molecular Diagnostics (QCMD), Glasgow, United Kingdom
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, and German Center for Infection Research (DZIF), Berlin, Germany
| | - Vittorio Sambri
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Hubert G M Niesters
- The University of Groningen, University Medical Center Groningen, Division of Clinical Virology, Department of Medical Microbiology and Infection Prevention, Groningen, the Netherlands
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Mikaty G, Matheus S, Donoso Mantke O, McCulloch E, Zeichhardt H, Manuguerra JC. Evaluation of the diagnostic capacities for emerging arboviral diseases in the international network MediLabSecure from 2014 to 2018 - Importance of external quality assessments. J Infect Public Health 2021; 15:203-209. [PMID: 35038668 PMCID: PMC8656250 DOI: 10.1016/j.jiph.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/16/2021] [Accepted: 12/05/2021] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Emerging infectious diseases pose an increasing threat to all nations around the world, including to developed countries. By definition, because they are rare or unknown, public health systems are not well prepared against these emerging diseases. To be fully prepared, countries must have implemented surveillance systems to monitor rare or unusual sanitary events. METHODS The capacity of diagnostic laboratories is a key component of surveillance systems since they are in charge of identifying the pathogens responsible for outbreaks in a timely manner. The MediLabSecure project aims at implementing a comprehensive surveillance system for vector-borne diseases around the Mediterranean and Black Sea regions. From 2014 to 2018, the human-virology group of MediLabSecure notably supported the implementation of molecular diagnostic capacities for eight arboviruses and one coronavirus in 19 laboratories of its network through sharing of protocols and reagents, and technical training of the scientific staff of beneficiary laboratories. RESULTS We report the results of External Quality Assessments for four of these viruses to assess the efficiency of the diagnostic for these threats emerging in the geographic area. The results for these EQA demonstrate the success of the project in the implementation of diagnostic technics for the identification of Dengue, Chikungunya, Zika, and West Niles viruses in laboratories that did not have the capacity before. However, results also show that some work is still to be done to strengthen the newly acquired capacity. CONCLUSION The MediLabSecure project deployed an effort to build an efficient capacity in identifying and survey the emergence of arboviruses in the Mediterranean area. Diagnostic technics were successfully implemented in many of the laboratories of the network, but the effort must be maintained over time to strengthen these capacities.
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Affiliation(s)
- Guillain Mikaty
- Institut Pasteur, Université de Paris, Environment and Infectious Risk research Unit - Laboratory for Urgent Response to Biological Threats (ERI-CIBU), Paris, France.
| | - Séverine Matheus
- Institut Pasteur, Université de Paris, Environment and Infectious Risk research Unit - Laboratory for Urgent Response to Biological Threats (ERI-CIBU), Paris, France
| | | | - Elaine McCulloch
- Quality Control for Molecular Diagnostics (QCMD), Glasgow, United Kingdom
| | - Heinz Zeichhardt
- INSTAND; Gesellschaft zur Förderung der Qualitätssicherung in medizinischen Laboratorien e.V., Düsseldorf, Germany
| | - Jean-Claude Manuguerra
- Institut Pasteur, Université de Paris, Environment and Infectious Risk research Unit - Laboratory for Urgent Response to Biological Threats (ERI-CIBU), Paris, France
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Matheeussen V, Corman VM, Donoso Mantke O, McCulloch E, Lammens C, Goossens H, Niemeyer D, Wallace PS, Klapper P, Niesters HG, Drosten C, Ieven M. International external quality assessment for SARS-CoV-2 molecular detection and survey on clinical laboratory preparedness during the COVID-19 pandemic, April/May 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32672149 PMCID: PMC7364759 DOI: 10.2807/1560-7917.es.2020.25.27.2001223] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Laboratory preparedness with quality-assured diagnostic assays is essential for controlling the current coronavirus disease (COVID-19) outbreak. We conducted an external quality assessment study with inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) samples to support clinical laboratories with a proficiency testing option for molecular assays. To analyse SARS-CoV-2 testing performance, we used an online questionnaire developed for the European Union project RECOVER to assess molecular testing capacities in clinical diagnostic laboratories.
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Affiliation(s)
- Veerle Matheeussen
- These authors contributed equally to this work and share first authorship.,Department of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Wilrijk, Belgium
| | - Victor M Corman
- These authors contributed equally to this work and share first authorship.,National Consultant Laboratory for Coronaviruses, Institute of Virology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Oliver Donoso Mantke
- These authors contributed equally to this work and share first authorship.,Quality Control for Molecular Diagnostics (QCMD), Glasgow, United Kingdom
| | - Elaine McCulloch
- Quality Control for Molecular Diagnostics (QCMD), Glasgow, United Kingdom
| | - Christine Lammens
- Department of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Wilrijk, Belgium
| | - Herman Goossens
- Department of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Wilrijk, Belgium
| | - Daniela Niemeyer
- National Consultant Laboratory for Coronaviruses, Institute of Virology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paul S Wallace
- Quality Control for Molecular Diagnostics (QCMD), Glasgow, United Kingdom
| | - Paul Klapper
- School of Biological Sciences, Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, United Kingdom
| | - Hubert Gm Niesters
- Division of Clinical Virology, Department of Medical Microbiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Christian Drosten
- National Consultant Laboratory for Coronaviruses, Institute of Virology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Margareta Ieven
- Department of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Wilrijk, Belgium
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- Details on these projects are noted in the Acknowledgements
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Donoso Mantke O, McCulloch E, Wallace PS, Yue C, Baylis SA, Niedrig M. External Quality Assessment (EQA) for Molecular Diagnostics of Zika Virus: Experiences from an International EQA Programme, 2016⁻2018. Viruses 2018; 10:v10090491. [PMID: 30216988 PMCID: PMC6163558 DOI: 10.3390/v10090491] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 11/16/2022] Open
Abstract
Quality Control for Molecular Diagnostics (QCMD), an international provider for External Quality Assessment (EQA) programmes, has introduced a programme for molecular diagnostics of Zika virus (ZIKV) in 2016, which has been continuously offered to interested laboratories since that time. The EQA schemes provided from 2016 to 2018 revealed that 86.7% (92/106), 82.4% (89/108), and 88.2% (90/102) of the participating laboratories reported correct results for all samples, respectively in 2016, 2017, and 2018. The review of results indicated a need for improvement concerning analytical sensitivity and specificity of the test methods. Comparison with the outcomes of other EQA initiatives briefly summarized here show that continuous quality assurance is important to improve laboratory performance and to increase preparedness with reliable diagnostic assays for effective patient management, infection and outbreak control.
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Affiliation(s)
- Oliver Donoso Mantke
- Quality Control for Molecular Diagnostics (QCMD), Unit 5, Technology Terrace, Todd Campus, West of Scotland Science Park, Glasgow G20 0XA, UK.
| | - Elaine McCulloch
- Quality Control for Molecular Diagnostics (QCMD), Unit 5, Technology Terrace, Todd Campus, West of Scotland Science Park, Glasgow G20 0XA, UK.
| | - Paul S Wallace
- Quality Control for Molecular Diagnostics (QCMD), Unit 5, Technology Terrace, Todd Campus, West of Scotland Science Park, Glasgow G20 0XA, UK.
| | - Constanze Yue
- Division of Virology, Paul-Ehrlich-Institut (PEI), Federal Institute for Vaccines and Biomedicines, 63225 Langen, Germany.
| | - Sally A Baylis
- Division of Virology, Paul-Ehrlich-Institut (PEI), Federal Institute for Vaccines and Biomedicines, 63225 Langen, Germany.
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Fontaine SJ, McCulloch E, Eckersall PD, Haining H, Patterson Kane JC, Morris JS. Evaluation of the modified Glasgow Prognostic Score to predict outcome in dogs with newly diagnosed lymphoma. Vet Comp Oncol 2017; 15:1513-1526. [PMID: 28150446 DOI: 10.1111/vco.12296] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/11/2016] [Accepted: 10/27/2016] [Indexed: 12/16/2022]
Abstract
The modified Glasgow Prognostic Score (mGPS) assigns a numerical value (0-2) from pre-treatment serum concentrations of C-reactive protein (CRP) and albumin to predict patient outcome. CRP and albumin were evaluated in 77 untreated dogs with lymphoma to determine the relationship of mGPS to clinicopathological parameters and whether it could predict progression-free (PFS) and overall survival (OS) in treated dogs. mGPS distribution was significantly associated with clinical stage, substage b, weight loss, gastrointestinal disturbances and lethargy at presentation. On univariate analysis, mGPS was significantly associated with OS and PFS, with shorter median survival times for mGPS 2 compared to mGPS 0 and 1 combined. Hypoalbuminaemia significantly reduced OS and PFS, however increased CRP had no effect. Only clinical stage was significantly associated with OS and PFS on both univariate and multivariate analysis. mGPS has potential prognostic value for canine lymphoma , but further studies are needed.
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Affiliation(s)
- S J Fontaine
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - E McCulloch
- ReactivLab Ltd, University of Glasgow, Glasgow, UK
| | - P D Eckersall
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - H Haining
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - J S Morris
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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McCulloch E, Niesters H, Ricketts A, Kazi S, Wallace P. Characterisation and standardisation of material in QCMD EQA programmes in the absence of higher order standards. J Clin Virol 2016. [DOI: 10.1016/j.jcv.2016.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hinds C, McCulloch E, Ricketts A. Multicentre, multiplatform comparative performance analysis using characterised Internal Quality Control (IQC) materials for VZV, HSV1 and HSV2 molecular diagnostic assays. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Migo EM, O'Daly O, Mitterschiffthaler M, Antonova E, Dawson GR, Dourish CT, Craig KJ, Simmons A, Wilcock GK, McCulloch E, Jackson SHD, Kopelman MD, Williams SCR, Morris RG. Investigating virtual reality navigation in amnestic mild cognitive impairment using fMRI. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2015; 23:196-217. [PMID: 26234803 DOI: 10.1080/13825585.2015.1073218] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Spatial navigation requires a well-established network of brain regions, including the hippocampus, caudate nucleus, and retrosplenial cortex. Amnestic Mild Cognitive Impairment (aMCI) is a condition with predominantly memory impairment, conferring a high predictive risk factor for dementia. aMCI is associated with hippocampal atrophy and subtle deficits in spatial navigation. We present the first use of a functional Magnetic Resonance Imaging (fMRI) navigation task in aMCI, using a virtual reality analog of the Radial Arm Maze. Compared with controls, aMCI patients showed reduced activity in the hippocampus bilaterally, retrosplenial cortex, and left dorsolateral prefrontal cortex. Reduced activation in key areas for successful navigation, as well as additional regions, was found alongside relatively normal task performance. Results also revealed increased activity in the right dorsolateral prefrontal cortex in aMCI patients, which may reflect compensation for reduced activations elsewhere. These data support suggestions that fMRI spatial navigation tasks may be useful for staging of progression in MCI.
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Affiliation(s)
- E M Migo
- a King's College London, Institute of Psychiatry , Psychology and Neuroscience , London , UK
| | - O O'Daly
- a King's College London, Institute of Psychiatry , Psychology and Neuroscience , London , UK
| | - M Mitterschiffthaler
- a King's College London, Institute of Psychiatry , Psychology and Neuroscience , London , UK.,b Department for Psychotherapy and Psychosomatics , Campus Innenstadt, Ludwig-Maximilians-University , Munich , Germany
| | - E Antonova
- a King's College London, Institute of Psychiatry , Psychology and Neuroscience , London , UK
| | | | | | | | - A Simmons
- a King's College London, Institute of Psychiatry , Psychology and Neuroscience , London , UK.,d NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London , London , UK.,e NIHR Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London , London , UK
| | - G K Wilcock
- f Nuffield Department of Clinical Neurosciences , University of Oxford , John Radcliffe Hospital, Oxford , UK
| | - E McCulloch
- f Nuffield Department of Clinical Neurosciences , University of Oxford , John Radcliffe Hospital, Oxford , UK
| | - S H D Jackson
- g Clinical Age Research Unit, King's College Hospital , London , UK
| | - M D Kopelman
- a King's College London, Institute of Psychiatry , Psychology and Neuroscience , London , UK
| | - S C R Williams
- a King's College London, Institute of Psychiatry , Psychology and Neuroscience , London , UK
| | - R G Morris
- a King's College London, Institute of Psychiatry , Psychology and Neuroscience , London , UK
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Migo E, Mitterschiffthaler M, O’Daly O, Dawson G, Dourish C, Craig K, Simmons A, Wilcock G, McCulloch E, Jackson S, Kopelman M, Williams S, Morris R. Alterations in working memory networks in amnestic mild cognitive impairment. Aging, Neuropsychology, and Cognition 2014; 22:106-27. [DOI: 10.1080/13825585.2014.894958] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- E.M. Migo
- King’s College London, Department of Neuroimaging, Institute of Psychiatry, London, UK
- King’s College London, Department of Psychological Medicine, Institute of Psychiatry, London, UK
| | - M. Mitterschiffthaler
- King’s College London, Department of Neuroimaging, Institute of Psychiatry, London, UK
- Department for Psychotherapy and Psychosomatics, Campus Innenstadt, Ludwig-Maximilians-University, Munich, Germany
| | - O. O’Daly
- King’s College London, Department of Neuroimaging, Institute of Psychiatry, London, UK
| | | | | | | | - A. Simmons
- King’s College London, Department of Neuroimaging, Institute of Psychiatry, London, UK
| | - G.K. Wilcock
- OPTIMA Project, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - E. McCulloch
- OPTIMA Project, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - S.H.D. Jackson
- Clinical Age Research Unit, King’s College Hospital, London, UK
| | - M.D. Kopelman
- King’s College London, Department of Psychological Medicine, Institute of Psychiatry, London, UK
| | - S.C.R. Williams
- King’s College London, Department of Neuroimaging, Institute of Psychiatry, London, UK
| | - R.G. Morris
- King’s College London, Department of Neuroimaging, Institute of Psychiatry, London, UK
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Crawford K, Warman SM, Marques AI, Yool DA, Eckersall PD, McCulloch E, Lynn K, Mellanby RJ, Gow AG. Serum haptoglobin concentrations in dogs with liver disease. Vet Rec 2013; 173:579. [DOI: 10.1136/vr.101306] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- K. Crawford
- Northwest Surgeons; Delamere House, Ashville Point Sutton Weaver Cheshire WA7 3FW UK
- Department of Clinical Veterinary Science; University of Bristol; Langford House Langford Bristol BS40 5DU UK
| | - S. M. Warman
- Department of Clinical Veterinary Science; University of Bristol; Langford House Langford Bristol BS40 5DU UK
| | - A. I. Marques
- Division of Veterinary Clinical Studies; Royal (Dick) School of Veterinary Studies; The Roslin Institute; The University of Edinburgh; Hospital for Small Animals; Easter Bush Veterinary Centre Roslin Midlothian EH25 9RG UK
| | - D. A. Yool
- Division of Veterinary Clinical Studies; Royal (Dick) School of Veterinary Studies; The Roslin Institute; The University of Edinburgh; Hospital for Small Animals; Easter Bush Veterinary Centre Roslin Midlothian EH25 9RG UK
| | - P. D. Eckersall
- Division of Animal Production & Public Health; Faculty of Veterinary Medicine; Institute of Comparative Medicine; University of Glasgow; Bearsden Road Glasgow G61 1QH UK
| | - E. McCulloch
- ReactivLab Ltd; Garscube Estate, Bearsden Rd Glasgow G61 1QH UK
| | - K. Lynn
- ReactivLab Ltd; Garscube Estate, Bearsden Rd Glasgow G61 1QH UK
| | - R. J. Mellanby
- Division of Veterinary Clinical Studies; Royal (Dick) School of Veterinary Studies; The Roslin Institute; The University of Edinburgh; Hospital for Small Animals; Easter Bush Veterinary Centre Roslin Midlothian EH25 9RG UK
| | - A. G. Gow
- Division of Veterinary Clinical Studies; Royal (Dick) School of Veterinary Studies; The Roslin Institute; The University of Edinburgh; Hospital for Small Animals; Easter Bush Veterinary Centre Roslin Midlothian EH25 9RG UK
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McCulloch E, Ramage G, Rajendran R, Lappin D, Jones B, Warn P, Kirkpatrick W, Patterson T, Williams C. The effect of antifungal treatments on laboratory diagnostic assays for invasive fungal infections. J Infect 2011. [DOI: 10.1016/j.jinf.2011.04.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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McCulloch E, Ramage G, Rajendran R, Lappin DF, Jones B, Warn P, Shrief R, Kirkpatrick WR, Patterson TF, Williams C. Antifungal treatment affects the laboratory diagnosis of invasive aspergillosis. J Clin Pathol 2011; 65:83-6. [PMID: 22049217 DOI: 10.1136/jcp.2011.090464] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS The purpose of this study was to investigate the performance of non-invasive diagnostic tests such as galactomannan enzyme immunoassay and quantitative PCR in the early diagnosis of invasive aspergillosis (IA), and how these tests are impacted upon by the use of different classes of antifungal agents in an in-vivo model of IA. METHODS A standardised rat inhalation model of IA was used to examine the effects of an azole, posaconazole, a polyene, amphotericin B and an echinocandin caspofungin. Daily blood samples were collected for subsequent analysis using a commercially available galactomannan assay and an inhouse qPCR assay. RESULTS No significant differences were observed in the CE/g of Aspergillus fumigatus in the lungs of each group. qPCR was statistically more sensitive than galactomannan for both the early detection of infected controls (p=0.045) and for overall detection (p=0.018). However, antifungal treatment significantly reduced the overall sensitivity of qPCR (p=0.020); these effects were due to posaconazole and caspofungin. In the latter stages of infection (days 4 and 5) there were no significant differences in the numbers of infections detected by galactomannan and qPCR; however, the antifungal class used caused significant qualitative differences (p=0.041). Galactomannan showed improved detection in posaconazole-treated animals. CONCLUSIONS Previous exposure to antifungal therapy must be considered when interpreting either qPCR or galactomannan-based IA diagnostics as this study has shown that individual classes of antifungal agents impact upon the dynamics of antigen and DNA release into the circulation.
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Affiliation(s)
- Elaine McCulloch
- Microbiology Department, Royal Hospital for Sick Children, Glasgow, UK
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Guy C, McCulloch E, Bicknell S, Macgregor G, Ramage G, Lappin D, Williams C. 148 The influence of moulds as an independent risk factor for decreasing lung function in cystic fibrosis. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60164-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Williams C, Lucas C, Davies P, Ramage G, McCulloch E. 147 Utility of Thymus and Activation Regulated Chemokine (TARC) in serodiagnosis of ABPA in a paediatric cystic fibrosis population. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60163-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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McCulloch E, Rajendran R, Williams C, Ramage G. 164 Cystic fibrosis bacterial pathogens and Aspergillus fumigatus biofilm interactions. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60180-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McCulloch E, Lucas C, Ramage G, Williams C. Improved early diagnosis of Pseudomonas aeruginosa by real-time PCR to prevent chronic colonisation in a paediatric cystic fibrosis population. J Cyst Fibros 2011; 10:21-4. [PMID: 20920896 DOI: 10.1016/j.jcf.2010.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 09/03/2010] [Accepted: 09/06/2010] [Indexed: 12/24/2022]
Abstract
Early detection of Pseudomonas aeruginosa in children with cystic fibrosis is hampered by the need to process a sub-optimal specimen type, namely cough swabs, which are known to have a lower positive yield than sputa or more invasive samples. This delay in the detection of low levels of P. aeruginosa could potentially result in the loss of an opportunity to initiate early aggressive antibiotic therapy and result in chronic colonisation, with a poorer overall prognosis. Quantitative real-time PCR (qPCR) offers an opportunity to increase the detection rate of P. aeruginosa compared to traditional culture techniques. This study examined 500 cough swabs and 42 sputum samples from paediatric patients and showed that detection of P. aeruginosa could be increased in both sample types by 100% and 45% respectively. Overall the sensitivity was 100% and specificity of 58% when compared to culture as a gold standard. These results although initially promising require careful consideration both from a treatment and infection control standpoint as the significance of detection of very low levels of P. aeruginosa is unclear.
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Affiliation(s)
- Elaine McCulloch
- Microbiology Department, Royal Hospital for Sick Children, Dalnair Street, Glasgow, G3 8SJ, UK
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Rajendran R, Quinn RF, Murray C, McCulloch E, Williams C, Ramage G. Efflux pumps may play a role in tigecycline resistance in Burkholderia species. Int J Antimicrob Agents 2010; 36:151-4. [PMID: 20399621 DOI: 10.1016/j.ijantimicag.2010.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 03/05/2010] [Accepted: 03/08/2010] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to investigate the role of multidrug resistance efflux pumps in relation to decreased susceptibility to tigecycline in clinical isolates of Burkholderia cepacia complex (BCC). The role of efflux pumps was analysed using the efflux pump inhibitor (EPI) MC-207,110. Minimum inhibitory concentrations (MICs) were determined for each strain against tigecycline alone and in the presence of 64 mg/L MC-207,110. The effect of efflux pump inhibition on the susceptibility of BCC isolates to tigecycline was assessed by a checkerboard titration assay. Ala-Nap uptake assay was performed to determine efflux pump activity in different strains. The checkerboard titration assay showed that the MIC decreased with increasing concentrations of EPI. MICs for tigecycline in the clinical isolates ranged between 8 mg/L and 32 mg/L, whereas in the presence of MC-207,110, MICs decreased significantly (range <0.125-1.0mg/L; 16 to >256 times reduction). Efflux pump activity was shown to be greatest in strains with the highest MIC and vice versa. In conclusion, BCC possess efflux pumps that influence their resistance to tigecycline. Use of an inhibitor of these pumps restored sensitivity to the antibiotic. Therefore, a combination of tigecycline and EPI to augment its efficacy may present an attractive therapeutic option.
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Affiliation(s)
- Ranjith Rajendran
- Section of Infection and Immunity, Glasgow Dental School, Faculty of Medicine, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK
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Mowat E, Rajendran R, Williams C, McCulloch E, Jones B, Lang S, Ramage G. Pseudomonas aeruginosa and their small diffusible extracellular molecules inhibit Aspergillus fumigatus biofilm formation. FEMS Microbiol Lett 2010; 313:96-102. [DOI: 10.1111/j.1574-6968.2010.02130.x] [Citation(s) in RCA: 159] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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McCulloch E, McMillan M, Lucas C, Ramage G, Mowat E, William C. Molecular typing of Ps. aeruginosa direct from clinical specimens. J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60153-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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McCulloch E, Ramage G, Jones B, Warn P, Kirkpatrick WR, Patterson TF, Williams C. Don't throw your blood clots away: use of blood clot may improve sensitivity of PCR diagnosis in invasive aspergillosis. J Clin Pathol 2009; 62:539-41. [PMID: 19190008 DOI: 10.1136/jcp.2008.063321] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The diagnosis of invasive aspergillosis (IA) remains challenging and frequently is not made until after death. Histopathological examination remains central to confirmation of diagnosis but often requires invasive procedures to obtain tissue for the examination. Detection of aspergillus DNA by quantitative PCR (qPCR) offers the potential for earlier diagnosis due to higher sensitivity, but PCR in clinical use is poorly reproducible, with different centres reporting variable results and often using different extraction and analytical methods. AIMS To optimise the performance of aspergillus PCR as a diagnostic modality. METHODS A rat inhalation model of invasive aspergillosis was used to optimise the methodology of diagnostic aspergillus PCR. Infected animals were terminally bled at 4 days post-infection; samples of EDTA blood, serum and the residual clot were pooled for subsequent analysis. DNA was extracted from each fraction using a variety of methods and an optimised qPCR reaction using an Aspergillus fumigatus primer set performed. RESULTS Significantly more aspergillus DNA was detected from the clot than EDTA and serum samples. Enzymatic and mechanical pretreatment reduced the yield of fungal DNA. There was some evidence that the average Ct values were greater for the EZ1 BioRobot than the MagNA Pure automated extractor, but this did not reach statistical significance at the 5% level (p = 0.078). CONCLUSIONS Automated extraction from the clot present in a blood sample will increase DNA yield and improve the diagnostic sensitivity of the test.
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Affiliation(s)
- E McCulloch
- Microbiology Department, Royal Hospital for Sick Children, Glasgow, UK
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Mowat E, Lang S, Williams C, McCulloch E, Jones B, Ramage G. Phase-dependent antifungal activity against Aspergillus fumigatus developing multicellular filamentous biofilms. J Antimicrob Chemother 2008; 62:1281-4. [PMID: 18819968 DOI: 10.1093/jac/dkn402] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Aspergillus fumigatus undergoes morphological transition throughout its growth and development. These changes have direct implications for the effectiveness of antifungal treatment. Here we report the in vitro antifungal activity of voriconazole, amphotericin B and caspofungin against three specific phases of multicellular development of A. fumigatus. METHODS A. fumigatus conidia were propagated for 8, 12 and 24 h prior to antifungal challenge. The resultant activity of the three agents tested was determined using an XTT reduction assay to assess both endpoint and time-kill susceptibility profiles. RESULTS Endpoint susceptibility testing demonstrated a time-dependent decrease in efficacy for all three antifungal agents as the complexity of the A. fumigatus hyphal structure developed. Overall, amphotericin B exhibited the best spectrum of activity at each phase of growth, but was comparable to voriconazole against germinated conidial growth (8 h). Later, both voriconazole and caspofungin were ineffective against complex mycelial structures (12 and 24 h). Time-kill studies demonstrated that amphotericin B was significantly more efficacious at reducing A. fumigatus metabolism than both voriconazole and caspofungin for all three growth phases examined, most notably after 1 h of drug exposure (P < 0.001). CONCLUSIONS Overall, the data presented demonstrate that treatment of actively growing A. fumigatus cells with antifungal agents is more efficacious than treating mature structures in vitro. Amphotericin B was consistently more effective against each phase and displayed rapid effects, and therefore may be a suitable option for managing patient groups at risk from aspergillosis infections.
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Affiliation(s)
- Eilidh Mowat
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK
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McCulloch E, Harvey-Wood K, Jones B, Ramage G, Williams C. R2200 Use of the human albumin gene as an internal control for multiplex real-time PCR in bone marrow transplant patient routine screening. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)72039-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cullen B, Smith R, McCulloch E, Silcock D, Morrison L. Mechanism of action of PROMOGRAN, a protease modulating matrix, for the treatment of diabetic foot ulcers. Wound Repair Regen 2002; 10:16-25. [PMID: 11983003 DOI: 10.1046/j.1524-475x.2002.10703.x] [Citation(s) in RCA: 196] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Proteases play a critical role in many of the physiologic processes of wound repair. However, if their activity becomes uncontrolled proteases can mediate devastating tissue damage and consequently they have been implicated in chronic wound pathophysiology. Previous studies have shown that chronic wound fluid contains elevated protease levels that have deleterious effects, degrading de novo granulation tissue and endogenous biologically active proteins such as growth factors and cytokines. Therefore, we have proposed that an effective therapeutic approach for chronic wounds would be to modify this hostile environment and redress this proteolytic imbalance. Using an ex vivo wound fluid model, we show the ability of a proprietary new wound treatment to bind and inactivate proteases. We have shown that the addition of this test material to human chronic wound fluid obtained from diabetic foot ulcer patients resulted in a significant reduction in the activities of neutrophil-derived elastase, plasmin, and matrix metalloproteinase when compared to wet gauze. This study provides mechanistic evidence to support the hypothesis that this novel treatment modality for chronic wounds physically modifies the wound microenvironment, and thereby promotes granulation tissue formation and stimulates wound repair.
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Affiliation(s)
- Breda Cullen
- R&DDepartment, Johnson & Johnson Advanced Wound Care, A Division of Ethicon, Gargrave, North Yorkshire, United Kingdom
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McCulloch E. McCulloch directs project on nursing assistants. Fla Nurse 1990; 38:16. [PMID: 2332076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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McCulloch E. Quartan Malaria Transmitted by Transfusion. Can Med Assoc J 1937; 37:26-29. [PMID: 20320667 PMCID: PMC1562252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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