Members of the genus Bartonella (formerly Rochalimaea) were virtually unknown to modern-day clinicians and microbiologists until they were associated with opportunistic infections in AIDS patients about 6 years ago. Since that time, Bartonella species have been associated with cat scratch disease, bacillary angiomatosis, and a variety of other disease syndromes. Clinical presentation of infection with Bartonella ranges from a relatively mild lymphadenopathy with few other symptoms, seen in cat scratch disease, to life-threatening systemic disease in the immunocompromised patient. In some individuals, infection manifests as lesions that exhibit proliferation of endothelial cells and neovascularization, a pathogenic process unique to this genus of bacteria. As the spectrum of disease attributed to Bartonella is further defined, the need for reliable laboratory methods to diagnose infections caused by these unique organisms also increases. A brief summary of the clinical presentations associated with Bartonella infections is presented, and the current status of laboratory diagnosis and identification of these organisms is reviewed.

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The performance of a new rapid lateral-flow chromatographic membrane immunoassay test kit for detection of influenza virus was evaluated and compared to that of viral culture in respiratory secretions collected from 400 adults and children seen at three large university hospitals during the recent 2003 influenza season. The rapid test provided results in 15 min, with excellent overall performance statistics (sensitivity, 94.4%; specificity, 100%; positive predictive value, 100%; negative predictive value, 97.5%). Both influenza A and B type viruses were reliably detected, with no significant difference in performance statistics noted by influenza virus type or by the center performing the test.Influenza virus is a major cause of respiratory infection in both adults and children and is a common cause of hospitalization, especially in young children, elderly adults, and persons with chronic diseases (17,20). Influenza epidemics also account for over 47,000 deaths annually in the United States. Furthermore, three global pandemics during the 20th century caused over 50 million deaths (22). Readily available, rapid, and accurate detection methods for influenza virus allow for prompt administration of appropriate antiviral therapy and judicious use of antibiotics, assist in isolation of patients in hospitals and emergency centers to reduce health care-associated spread of infection, and identify local epidemics of influenza in a timely manner (10, 13-15, 19, 21, 22). Rapid detection of influenza virus also is currently important because of increased concern for pandemic influenza caused by either naturally occurring strains, such as avian H5N1, or altered strains that may be used in an act of bioterrorism (7,8,18). Also, the diagnosis of influenza based on clinical grounds alone may be inaccurate, because the presenting symptoms of influenza are similar to those caused by other infectious agents (13). Furthermore, the rapid and accurate determination that a severe respiratory or flu-like illness is caused by influenza virus rather than severe acute respiratory syndrome-associated coronavirus or a bioterrorism agent, such as smallpox or tularemia, is helpful not only to the individual patient but also from the public health perspective (6).Currently, there are at least seven different test kits approved by the Food and Drug Administration for detection of influenza virus in respiratory samples (2-4, 9, 12, 16, 21, 23). However, not all available methods distinguish the type of influenza virus present in the sample, and those that do distinguish type A and B influenza viruses have not shown consistently reliable performance for both types of virus (3,4,9,12). This recent multicenter study documented promising performance of a new rapid lateral-flow chromatographic immunoassay for both detection and differentiation of influenza A and B type viruses in respiratory samples. . Most (239 of 400, or 59.75%) specimens were nasal washes, 122 of 400 (30.5%) were nasopharyngeal swabs, 30 of 400 (7.5%) were throat swabs, 4 of 400 ...

Decisions as to the disposition of swine carcasses with lesions attributable to a mycobacterial infection are based upon a lesion criterion which is used as a diagnostic test by federal meat inspectors. Using this criterion, a federal meat inspector classified 58 of 100 pigs as "passed for cooking" and the other 42 pigs passed. Of the 58 pigs passed for cooking and the 42 pigs passed, mycobacterial isolations were made from the lymph nodes of 33 and 15 of the animals, respectively. The lesion criterion as a diagnostic test has the following attributes: 70% sensitive; 53% specific; 23% index of performance; 57% positive accuracy; and 67% negative accuracy.