Multisite Evaluation of a Point-of-Care Instrument for CD4+ T-Cell Enumeration Using Venous and Finger-Prick Blood

Diaw, Papa Alassane; Daneau, Géraldine; Coly, Abdoul Aziz; Ndiaye, B; Wade, Djibril; Camara, Makhtar; Mboup, Souleymane; Kestens, Luc; Diéye, Tandakha Ndiaye

doi:10.1097/qai.0b013e318235b378

Cited by 72 publications

(103 citation statements)

References 13 publications

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“…Although cellular analyses typically require trained laboratory staff and central equipment such as flow cytometers, recent advances in microfluidics have made the development of accurate and affordable single-use chip devices a realistic option. [42][43][44] This promising technological progress is likely to allow routine monitoring of complex immune fingerprints in infected patients in the near future, suggesting that rapid differential biomarker-based diagnosis and guided management of noninfectious and infectious syndromes at the point of care are feasible.…”

Section: Discussionmentioning

confidence: 99%

Pathogen-Specific Local Immune Fingerprints Diagnose Bacterial Infection in Peritoneal Dialysis Patients

Lin

Roberts

Kift-Morgan

et al. 2013

Journal of the American Society of Nephrology

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Accurate and timely diagnosis of bacterial infection is crucial for effective and targeted treatment, yet routine microbiological identification is inefficient and often delayed to an extent that makes it clinically unhelpful. The immune system is capable of a rapid, sensitive and specific detection of a broad spectrum of microbes, which has been optimized over millions of years of evolution. A patient's early immune response is therefore likely to provide far better insight into the true nature and severity of microbial infections than conventional tests. To assess the diagnostic potential of pathogen-specific immune responses, we characterized the local responses of 52 adult patients during episodes of acute peritoneal dialysis (PD)-associated peritonitis by multicolor flow cytometry and multiplex ELISA, and defined the immunologic signatures in relation to standard microbiological culture results and to clinical outcomes. We provide evidence that unique local "immune fingerprints" characteristic of individual organisms are evident in PD patients on the day of presentation with acute peritonitis and discriminate between culture-negative, Gram-positive, and Gram-negative episodes of infection. Those humoral and cellular parameters with the most promise for defining disease-specific immune fingerprints include the local levels of IL-1b, IL-10, IL-22, TNF-a, and CXCL10, as well as the frequency of local gd T cells and the relative proportion of neutrophils and monocytes/macrophages among total peritoneal cells. Our data provide proof of concept for the feasibility of using immune fingerprints to inform the design of point-of-care tests that will allow rapid and accurate infection identification and facilitate targeted antibiotic prescription and improved patient management.

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Section: Discussionmentioning

confidence: 99%

Pathogen-Specific Local Immune Fingerprints Diagnose Bacterial Infection in Peritoneal Dialysis Patients

Lin

Roberts

Kift-Morgan

et al. 2013

Journal of the American Society of Nephrology

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“…Unfortunately, the price of each cartridge is quite high (approx. 6 USD per single use cartridge) and a high error frequency with aborted analysis of up to 14 % when used on capillary samples make the device less attractive in RSL as it increases cost further and requires higher educated staff (20) . In addition the analyzer cannot measure total lymphocyte counts, thus is not usable for monitoring in children where CD4 % are required.…”

Section: Hiv Diagnosis and Monitoringmentioning

confidence: 99%

“…In addition the analyzer cannot measure total lymphocyte counts, thus is not usable for monitoring in children where CD4 % are required. However, products under development such as the Daktari TM CD4 Counter (Daktari Diagnostics Inc., Cambridge, MA, USA), the MBio ™ Diagnostics CD4 system (MBio Diagnostics, Boulder, CO, USA), Zyomyx CD4 counter (Zyomyx, Hayward, CA, USA), the CD4 counter developed by the Burnet Institute (Melbourne, Australia) and the CD4 Point-of-Care Technology (BD Biosciences, Franklin Lakes, NJ, USA) may be promising alternatives and will also contribute to a competition on the CD4 point-of-care analyzer market with hopefully the effect of further price reductions to make CD4 cell monitoring widely available (20) .…”

Section: Hiv Diagnosis and Monitoringmentioning

confidence: 99%

Experience of Médecins Sans Frontières in laboratory medicine in resource-limited settings

Kosack¹

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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In medical humanitarian assistance, the diagnosis of diseases plays a crucial role. Laboratory investigations are one of the main diagnostic tools utilized in M é decins Sans Fronti è res ' (MSF) programs. Currently MSF supports and/ or operates more than 130 laboratories in approximately 45 countries. The variety of analysis offered depends largely on the context of the program and the availability of context adapted tools and ranges from sophisticated laboratories specializing in tuberculosis culture to small laboratories within a primary health care program or operating as mobile clinics. The largest laboratories in MSF are found in programs with the main objective to diagnose, treat and monitor patients with tuberculosis and/or human immunodefi ciency virus. Other MSF programs are either disease-specifi c (e.g., malaria, Chagas, kala azar or visceral leishmaniasis, sleeping sickness, malnutrition, sexually transmitted infections) or are integrated in primary or secondary health care structures.

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“…For instance, the PointCare NOW TM and the CyFlow ® miniPOC are modified flow cytometers. PIMA TM is based on a dualfluorescence image analysis to count CD3 + /CD4 + cells (Diaw et al, 2011). The Coulter ® CD4Count Kit and the Dynal T4 Quant Kit are manual CD4 tests based on the use of beads for lymphocyte capturing, labeling and counting under light microscope (Lutwama et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Electrochemical magneto-actuated biosensor for CD4 count in AIDS diagnosis and monitoring

Carinelli

Ballesteros

Martı́

et al. 2015

Biosensors and Bioelectronics

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Multisite Evaluation of a Point-of-Care Instrument for CD4+ T-Cell Enumeration Using Venous and Finger-Prick Blood

Abstract: PIMA is a good POC instrument for screening adult HIV-infected patients in resource-limited settings for treatment eligibility. Its performance on finger-prick blood is not as good as on venous blood. Adequate training for correct use of finger-prick blood samples is mandatory.

Cited by 72 publications

References 13 publications

Pathogen-Specific Local Immune Fingerprints Diagnose Bacterial Infection in Peritoneal Dialysis Patients

Pathogen-Specific Local Immune Fingerprints Diagnose Bacterial Infection in Peritoneal Dialysis Patients

Experience of Médecins Sans Frontières in laboratory medicine in resource-limited settings

Electrochemical magneto-actuated biosensor for CD4 count in AIDS diagnosis and monitoring

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