Introduction: Commercially available assays were evaluated in order to determine diagnostic accuracy of Chlamydia trachomatis specific tests for screening.
Methods: The study included 225 sexually active men and women, who were tested for genital chlamydial infection in Institute of Public Health Kragujevac. Three screening tests were used: direct immunofluorescence (DIF) and rapid lateral immunochromatographic test (RT) for qualitative detection of chlamydial antigens and immunoenzyme (ELISA) test for detection of serum levels of anti-chlamydial IgA and IgG antibodies. Diagnostic efficiency of these tests were determined in relation to results obtained by RT-PCR method.
Results: Statistical significance between the results obtained by RT-PCR as a gold standard and DIF, RT and ELISA were analyzed using chi-square (χ2) test. Statistical analysis showed a significant difference between RT-PCR and analyzed screening tests: DIF (χ2 = 303; p < 0.001), RT (χ2 = 4.19; p = 0.041), serum IgA (χ2 = 4.19; p = 0.041) and serum IgG (χ2 = 67; p < 0.001) which indicates poor agreement between these tests. Large numbers of false positive (FP) and false negative (FN) results were observed for all tested assays. According to Youden’s index, serum IgG and DIF testing demonstrated the most-balanced sensitivity-specificity rate. RT assay exhibits the highest expanded Youden’s index, as well as the best overall diagnostic accuracy.
Conclusions: None of evaluated screening tests can be recommended as individual method for the diagnosis of acute infection. We suppose that RT-PCR is unlikely to be a cost-effective screening strategy within the Serbian health system.
Introduction/Objective The increasing resistance to macrolides and lincosamides among staphylococci and streptococci is becoming a global problem. The aim of this study was to investigate the prevalence of macrolide-lincosamide-streptogramin (MLS) resistance phenotypes in staphylococcal and streptococcal isolates in southeast Serbia. Methods The MLS phenotypes were determined by the double-disk diffusion method in 2,121 inpatient and outpatient staphylococcal and streptococcal isolates collected during a one-year period at the Center for Microbiology. Results The methicillin-resistant staphylococci isolates were significantly more resistant to penicillin, erythromycin, clindamycin, gentamicin, and ciprofloxacin (100%, 100%, 29.2%, 65.6%, and 53.1%, respectively) than the methicillin-sensitive ones (93.6%, 64.9%, 12%, 28.9%, and 11.7%, respectively). The inducible clindamycin resistance phenotype was dominant in S. aureus and coagulase-negative staphylococci isolates. S. pneumoniae, S. pyogenes, and S. agalactiae isolates showed very high resistance to erythromycin (77.8%, 46.2%, and 32.4%, respectively). All staphylococci and streptococci isolates were sensitive to vancomycin and linezolid, and all beta-hemolytic streptococci isolates to penicillin and ceftriaxone. Conclusion The phenotypic triage of staphylococci is necessary in order to separate inducible resistant and truly clindamycin-sensitive isolates. Macrolides should not be recommended for empirical therapy of streptococcal infections. Penicillins remain the drug of choice for treatment of streptococcal infections in our local area.
Фактор ризика је нешто што утиче на добијање болести, као што je канцер. Неки фактори ризика, као што је пушење, могу да се променe, док се други, као што су године или породичне предиспозиције, не могу мењати. Како се инциденција оболевања и морталитет од карцинома простате повећавају и више истражују, добија се и бољи увид у факторе ризика за тај рак. Епидемиолошка истраживања истичу важност расе, масноћа у исхрани и породичне предиспозиције, док је улога вазектомије, витамина и минерала у исхрани, пушења и физичке активности још увек дискутабилна. Кључне речи: карцином простате, фа ктори ризика.
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