Healthcare services and institutions are focused on providing the most appropriate medical service in terms of patient safety and satisfaction outcomes. According to Lean methodologies, effectiveness ...and efficiency can be improved by assuring value-added processes. This article presents a joint approach for the development and implementation of Lean techniques combined with Total Laboratory Automation (TLA) for serology diagnosis in a microbiology laboratory in a tertiary-level hospital. The results obtained show an improvement in the process efficiency and its key performance indicators. In particular, for the HIV and COVID tests, the process Turnaround Times (TAT) were decreased by up to 87.3% and 19.3%, having a direct effect in the diagnostic response time. The process added-value for HIV tests increased by 81%. This meant a cost reduction per test, a higher number of diagnostic tests and clinical samples processed and laboratory resource optimisation. The implementation of TLA also enabled the reallocation of skilled labour towards value-added tasks, increased the process quality and reduced sample waiting times. This work opens up new opportunities for their deployment in other laboratory areas and sample types, directly influencing the overall quality of patient diagnosis in the context of tertiary healthcare facilities.
Aim
To evaluate the serological response against SARS-CoV-2 in a multicenter study representative of the Spanish COVID pandemic.
Methods
IgG and IgM + IgA responses were measured on 1466 samples from ...1236 Spanish COVID-19 patients admitted to the hospital, two commercial ELISA kits (Vircell SL, Spain) based on the detection of antibodies against the viral spike protein and nucleoprotein, were used.
Results
Approximately half of the patients presented antibodies (56.8% were IgM + IgA positive and 43.0% were IgG positive) as soon as 2 days after the first positive PCR result. Serological test positivity increased with time from the PCR test, and 10 days after the first PCR result, 91.5% and 88.0% of the patients presented IgM + IgA and IgG antibodies, respectively.
Conclusion
The high values of sensitivity attained in the present study from a relatively early period of time after hospitalization support the use of the evaluated serological assays as supplementary diagnostic tests for the clinical management of COVID-19.
Although most HTLV infections in Spain have been found in native intravenous drug users carrying HTLV-2, the large immigration flows from Latin America and Sub-Saharan Africa in recent years may have ...changed the prevalence and distribution of HTLV-1 and HTLV-2 infections, and hypothetically open the opportunity for introducing HTLV-3 or HTLV-4 in Spain. To assess the current seroprevalence of HTLV infection in Spain a national multicenter, cross-sectional, study was conducted in June 2009.
A total of 6,460 consecutive outpatients attending 16 hospitals were examined. Overall, 12% were immigrants, and their main origin was Latin America (4.9%), Africa (3.6%) and other European countries (2.8%). Nine individuals were seroreactive for HTLV antibodies (overall prevalence, 0.14%). Evidence of HTLV-1 infection was confirmed by Western blot in 4 subjects (prevalence 0.06%) while HTLV-2 infection was found in 5 (prevalence 0.08%). Infection with HTLV types 1, 2, 3 and 4 was discarded by Western blot and specific PCR assays in another two specimens initially reactive in the enzyme immunoassay. All but one HTLV-1 cases were Latin-Americans while all persons with HTLV-2 infection were native Spaniards.
The overall prevalence of HTLV infections in Spain remains low, with no evidence of HTLV-3 or HTLV-4 infections so far.
The 2022 annual meeting of the HTLV & HIV‐2 Spanish Network was held in Madrid on December 14. We summarize here the main information presented and discussed at the workshop and review time trends ...for human retroviral infections in Spain. As transmissible agents, infections by human retroviruses are of obligatory declaration. Until the end of 2022, the Spanish national registry had recorded 451 cases of HTLV‐1, 821 of HTLV‐2, and 416 of HIV‐2. For HIV‐1, estimates are of 150 000 people currently living with HIV‐1 and 60 000 cumulative deaths due to AIDS. During year 2022, new diagnoses in Spain were of 22 for HTLV‐1, 6 for HTLV‐2, and 7 for HIV‐2. The last updated figures for HIV‐1 are from 2021 and counted 2786 new diagnoses. The slowdown in yearly infections for HIV‐1 in Spain points out that new strategies are needed to achieve the United Nations 95‐95‐95 targets by 2025. For the remaining neglected human retroviral infections, their control might be pushed throughout four interventions: (1) expanding testing; (2) improving education and interventions aimed to reduce risk behaviors; (3) facilitating access to antiretrovirals as treatment and prevention, including further development of long‐acting formulations; and (4) increasing vaccine research efforts. Spain is a 47 million population country in South Europe with strong migration flows from HTLV‐1 endemic regions in Latin America and Sub‐Saharan Africa. At this time universal HTLV screening has been implemented only in the transplantation setting, following the report of 5 cases of HTLV‐associated myelopathy shortly after transplantation of organs from HTLV‐1 positive donors. There are four target populations for expanding testing and unveiling asymptomatic carriers responsible for silent HTLV‐1 transmissions: (1) migrants; (2) individuals with sexually transmitted infections; (3) pregnant women; and (4) blood donors.
Early and accurate diagnosis of invasive aspergillosis (IA) is one of the most critical steps needed to efficiently treat the infection and reduce the high mortality rates that can occur. We have ...previously found that the Aspergillus spp. secondary metabolite, bis(methylthio)gliotoxin (bmGT), can be detected in the serum from patients with possible/probable IA. Thus, it could be used as a diagnosis marker of the infection. However, there is no data available concerning the sensitivity, specificity and performance of bmGT to detect the infection. Here, we have performed a prospective study comparing bmGT detection with galactomannan (GM), the most frequently used and adopted approach for IA diagnosis, in 357 sera from 90 episodes of patients at risk of IA. Our results, involving 79 patients that finally met inclusion criteria, suggest that bmGT presents higher sensitivity and positive predictive value (PPV) than GM and similar specificity and negative predictive value (NPV). Importantly, the combination of GM and bmGT increased the PPV (100 %) and NPV (97.5 %) of the individual biomarkers, demonstrating its potential utility in empirical antifungal treatment guidance and withdrawal. These results indicate that bmGT could be a good biomarker candidate for IA diagnosis and, in combination with GM, could result in highly specific diagnosis of IA and management of patients at risk of infection.
Serologic diagnosis of congenital toxoplasmosis Roc, María Lourdes; Palacián, María Pilar; Lomba, Elena ...
Enfermedades infecciosas y microbiologia clinica
28, Številka:
8
Journal Article
Recenzirano
To investigate the serological diagnosis of congenital toxoplasmosis and the prevalence of antibodies against toxoplasma in pregnant women in our area.
Toxoplasmosis seroprevalence was analyzed in 68 ...712 serum samples from 47 635 pregnant women living in the catchment area of Hospital Miguel Servet during the period of 1992 to 2008. Detection of toxoplasma-specific immunoglobulins (IgM, IgA, IgG) and IgG avidity studies were carried out in the microbiology laboratory.
Toxoplasmosis seroprevalence was 31.9%. The incidence of primary infection was 0.01% in susceptible pregnant women. Fifteen women seroconverted during pregnancy, and 9 of them had infants with congenital toxoplasmosis.
The cases of congenital toxoplasmosis were detected by maternal seroconversion during pregnancy. IgA was the most sensitive marker for the detection of congenital infection in neonates.
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