Serum samples from 107 dentists, dental assistants, and dental technicians were examined with an indirect immunofluorescence test for antibodies to Legionella pneumophila SG1-SG6, L. micdadei, L. bozemanii, L. dumoffii, L. gormanii, L. jordanis, and L. longbeachae SG1 + 2. Thirty-six (34%) employees from dental personnel from 13 practices showed a positive reaction for antibodies to Legionella pneumophila. Only five samples (5%) from a control group (non-medical workers) were positive. Of the 36 positive serum samples, 13 (36%) reacted with Serogroup 6, 12 with SG 1 (33%), 12 with SG 5 (33%), and three with SG 4 (8%), and eight samples were positive for antibodies to other Legionella species. Dentists had the highest prevalence (50%) of L. pneumophila antibodies, followed by assistants (38%) and technicians (20%). These results indicate that dental personnel are at an increased risk of legionella infection.
In the recent years the number of commercially available immunoassays for the detection of human cytomegalovirus (HCMV)-specific immunoglobulin M (IgM) antibodies has rapidly increased. The aim of the present study was to evaluate five commercial immunoassays for the serological diagnosis of HCMV-infection. These methods, namely the IMx CMV IgM assay, the AxSYM CMV IgM assay (both Abbott), the Gull CMV IgM, the CMV-IgM-ELA test PCS Medac and the Biotest Anti-HCMV recombinant IgM ELISA, were compared for their diagnostic effectiveness and interference with substances eventually producing cross-reactions with HCMV-IgM (Epstein-Barr-virus (EBV)-IgM, rheumatoid factor (RF)). In addition, repeated measurements on samples from kidney and heart transplant recipients with active HCMV infection were examined to compare the temporal development of the HCMV-IgM measured with the five assay systems. Since there is no commercially available gold standard, it was assumed that the true classification, of whether the patient sample is HCMV-IgM positive or negative, was unknown. Hence sensitivity and specificity were assessed based on a maximum likelihood approach using a "latent class" model. The cross-reactions were quantified by a Bayesian statistical model using prior information for the expected prevalences in the EBV-IgM and rheumatoid factor sample groups. The results of the study demonstrated that there are great differences in sensitivity and specificity as well as in cross-reactions with EBV-IgM and RF between the tested ELISAs.
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