The two assays evaluated in this study (the Ridascreen rotavirus and the Pathfinder rotavirus) exhibited comparable sensitivities (100%) but highly divergent positive predictive values (93.74 and 57.7%, respectively) when compared on 393 specimens. This difference should be considered when using these tests on collectives with an unknown or low prevalence.Enzyme immunoassays (EIAs) have replaced electron micoscropy (EM) as the standard method for the detection of rotaviruses in stool samples in the 1980s (1, 3-6, 8-13, 15-18). Typically, these assays are applied on stool specimens from children younger than 2 years with diarrheal disease. Since the past few years, however, we have observed an increasing tendency in clinical practice to include antigen detection assays in pretransplantation evaluation protocols. Therefore, in the present study we examined the impact of this strategy on the predictive values of two representative commercial test kits for rotavirus antigen detection in stool samples: the Ridascreen rotavirus (R-Biopharm, Darmstadt, Germany) as an automated test in microtiter plate format and the Pathfinder rotavirus (Kallestadt, Austin, Tex.) as a manually performed test designed for small series or single specimens. EM served as a supportive method for defining a formal "gold standard."As a high-risk collective for our study, 192 stool samples were acquired from the pediatric unit of the university hospital of Münster during the rotavirus season in 1997 to 1998, which were either submitted with the clinical diagnosis of enteritis or macroscopically liquid (mostly both). As a low-prevalence collective, 201 formed stools from healthy adults were randomly selected from a series of routine examinations from the Institute of Public Health, North Rhine-Westfalia. Both EIAs were performed exactly as specified by the manufacturers. Specimens exhibiting borderline results were retested once, and the latter result was used for evaluation. EM was performed by standard methods with negative staining after concentration of virus particles at 100,000 ϫ g (7). Specimens without clearly recognizable virus particles were considered negative after an examination time of 20 min at ϫ50,000 magnification. To define a formal gold standard, all samples which had positive results in at least two of the three methods were regarded as true positive.An overview of the results is shown in Table 1. A total of 15 samples in this study were considered true positive; 14 of these were recognized by EM (sensitivity, 93.9%), and none of the negative samples was wrongly considered positive (specificity, 100% [ Table 1]). The Pathfinder test recognized all positive samples as positive (sensitivity, 100%) but gave 11 false-positive results (specificity, 79.1% [ Table 1]), 1 of which emerged after retesting a primarily borderline specimen (specimen 1302 [ Table 2]). The Ridascreen test also recognized all true-positive specimens, but it gave one false positive result (sensitivity, 100%; specificity, 99.73%). A detailed analysis of the ...

The retrospective analysis of 494 solid-organ transplant recipients revealed that during the follow-up period (mean duration, 3.2 years) 184 (88%) of 209 anti-human cytomegalovirus (HCMV) immunoglobulin A (IgA)-positive patients remained IgA positive, as did 128 (74.85%) of 171 anti-HCMV IgM-positive patients. We conclude that anti-HCMV IgA and IgM testing for management of clinically relevant HCMV infections in solid-organ transplant recipients is dispensable.

During the early manifestation of peripheral facial paralysis, VZV specific IgA antibodies were detected in the serum in a single case. In similar cases, this serological parameter should be tested for causal diagnosis in connection with early Aciclovir therapy.