• Title/Summary/Keyword: Clinical samples

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Validation of Synovial Fluid Clinical Samples for Molecular Detection of Pathogens Causing Prosthetic Joint Infection Using GAPDH Housekeeping Gene as Internal Control

  • Jiyoung Lee;Eunyoung Baek;Hyesun Ahn;Youngnam Park;Geehyuk Kim;Sua Lim;Suchan Lee;Sunghyun Kim
    • Biomedical Science Letters
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    • v.29 no.4
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    • pp.220-230
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    • 2023
  • Identification of the pathogens causing infection is important in terms of patient's health management and infection control. Synovial fluids could be used as clinical samples to detect causative pathogens of prosthetic joint infections (PJIs) using molecular diagnostic assays, therefore, normalization and validation of clinical samples are necessary. Microbial culture is considered the gold standard for all infections, including PJIs. Recently, molecular diagnostic methods have been developed to overcome the limitation of microbial culture. Therefore, guideline for validating clinical samples to provide reliable results of molecular diagnostic assays for infectious diseases is required in clinical field. The present study aimed to develop an accurate validating method of synovial fluid clinical samples using GAPDH gene as an internal control to perform the quantitative PCR TaqMan probe assay to detect pathogens causing PJIs.

Effects of Storage Buffer and Temperature on the Integrity of Human DNA

  • Kim, Yun-Tae;Choi, Eun-Hee;Son, Bo-Kyoung;Seo, Eun-Hee;Lee, Eun-Kyoung;Ryu, Je-Kwon;Ha, Gi-Won;Kim, Jin-Seon;Kwon, Mi-Ran;Nam, Jae-Hoon;Kim, Young-Jin;Lee, Kyoung-Ryul
    • Korean Journal of Clinical Laboratory Science
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    • v.44 no.1
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    • pp.24-30
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    • 2012
  • In this study, we have examined the effects of the storage time and temperature on DNA quality and have also studied the effects of the hydration buffer in which DNA is dissolved. This study was performed using 160 human blood samples collected with informed consent from 2007 to 2008 in the hospital where this cohort study was performed. The DNA extracted was dissolved using distilled water (DW) or Tris-EDTA (TE) buffer, and stored in the deep freezer or refrigerator for up to 10 weeks at $-70^{\circ}C$, $-20^{\circ}C$, $4^{\circ}C$, and $25^{\circ}C$, respectively. DNA integrity was determined by the degree of smearing of DNA on the gel. After four weeks, all of the 20 DNA samples dissolved in DW and stored at $25^{\circ}C$ were entirely degraded. After 10 weeks, 6 of the 20 DNA samples dissolved in TE buffer and stored at $25^{\circ}C$ were fairly degraded, and 4 of the 20 DNA samples dissolved in DW and stored at $4^{\circ}C$ were fairly degraded. The 20 DNA samples dissolved in TE buffer and stored at $4^{\circ}C$ were stable for 10 weeks. DNA samples stored at $-20^{\circ}C$ and $-70^{\circ}C$ did not appear to degrade in either DW or TE buffer, even at the 10-week point. We suggest that TE buffer should use for DNA elution, in order to protect against degradation and to preserve DNA for a long period of time, and the samples should be stored at $-20^{\circ}C$ or $-70^{\circ}C$.

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Evaluation of Interfering Substances in Routine Chemistry Tests Using Toshiba TBA-C8000 Chemistry Analyzer

  • Park, Jum Gi;Joo, Kyeng Woong
    • Korean Journal of Clinical Laboratory Science
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    • v.43 no.1
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    • pp.6-11
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    • 2011
  • In clinical chemistry tests, the interfering substances such as hemoglobin, lipid, bilirubin, and drugs, etc. can cause the changes of test results performed by spectrophotometrical methods. We evaluated the effects of interfering substances on the test results by adding interfering substances on the samples in the 19 kinds of clinical chemistry tests such as aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, gamma-glutamyltransferase, total protein, albumin, glucose, total cholesterol, total bilirubin, triglyceride, uric acid, calcium, inorganic phosphours, high density lipoprotein cholesterol, low density lipoprotein cholesterol, creatinine, blood urea nitrogen, and C-reactive protein using newly implemented automatic chemical analyzer Toshiba TBA-C8000 under the direction of CLSI EP07-A guideline. Hemolytic samples show increased concentration of total protein, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase and reduced concentration of total bilirubin, alkaline phosphatase by interfering effect. Hyperlipemic samples show increased concentration of total protein and alkaline phosphatase and reduced concentration of low density lipoprotein cholesterol. The samples with conjugated bilirubinemia show increased concentration of inorganic phosphours, otherwise the samples with unconjugated bilirubinemia show no interference or allowable range in the test result.

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Multiplex PCR for differential diagnosis of Mycobacterium species from bovine clinical samples (소의 임상병리 가검물에서 Mycobacterium species 감별진단을 위한 multiplex PCR 기법)

  • Kim, Yong-hwan;Al-Haddawi, MH;Cho, Ho-seong;Kang, Sung-kwi;Cho, Kyoung-oh;Park, Hyung-seon;Lee, Bong-joo;Park, Nam-yong
    • Korean Journal of Veterinary Research
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    • v.41 no.4
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    • pp.535-542
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    • 2001
  • A multiplex PCR technique was developed for detecting specifically each Mycobacterium bovis, M. tuberculosis, M. avium and M. avium subsp, paratuberculosis, respectively, using clinical samples of field cattle. To apply this novel technique to clinical specimens, blood sample was obtained from live cows comprising 11 intradermal tuberculin test (ITT)-positive and 17 ITT-negative and tested by multiplex PCR. Positive results were obtained from 15 cows by the multiplex PCR, showing that 4 (23.5%) of the 17 ITT-negative cows were multiplex PCR positive. The multiplex PCR results also showed that among the 15 positive cows, 7 (46.7%) were infected with M. bovis, 1 (6.7%) with M. tuberculosis and 7 (46.7%) with M. avium. The sensitivity and specificity of multiplex PCR in comparison with those of ITT were 100% and 76.5%. The correlation between the multiplex PCR and ITT assays with blood samples was considered excellent, 85.7% agreement and ${\kappa}=0.72$. The results obtained, using reference mycobacterial strains and typed clinical samples, show that the multiplex PCR method may be a rapid, sensitive, and specific tool for the differential identification of various mycobacterial strains in a single-step assay. Therefore, multiplex PCR assay is a useful tool for early diagnosis of tuberculosis in live cattle and to identify the species or complex of mycobacterium from clinical samples.

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Analysis of HPV Prevalence in Pairs of Cervical and Urine Samples from the Same Woman

  • Kim, Dong Hyeok;Jin, Hyunwoo;Lee, Kyung Eun
    • Biomedical Science Letters
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    • v.27 no.1
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    • pp.28-34
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    • 2021
  • The main cause of cervical cancer is a persistent infection with high-risk human papillomavirus (HR-HPV). Cervical cancer is reported as a preventable cancer in more than 80% of cases with early diagnosis and appropriate treatment. Papanicolaou test (Pap test) has been a global strategy to prevent cervical cancer, and recently, HPV test has been reported to be effective against cervical cancer and precancerous lesions. However, pelvic examinations give patients anxiety, discomfort, pain, distress, and psychological stress. HPV test via a urine sample caused less physical and psychological stress and more advantage than the Pap test. Therefore, it is necessary to study the usefulness of the HPV test for easy-to-collect urine samples. A total of 220 samples were collected from a pair of cervical and urine samples from 110 women and only 108 pairs of samples out of 110 were used because 2 cases were not amplified by β-globin. Among 108 pairs of cervical and urine samples, the prevalence of HPV was 37.0% (40/108) in cervical samples, 34.3% (37/108) in urine samples and HR-HPV was 22.2% (24/108) in cervical samples, 18.5% (20/108) in urine samples. In this study, urine samples showed a lower positive rate of HPV than cervical samples. There were many variables that could affect the condition of the urine sample. However, the HR-HPV agreement rate of the cervix and urine samples was 94.44% and the Kappa value was 0.823, which was "almost perfect". Through these results showed the significance of cervical cancer screening using a urine sample. Cervical screening is crucial, as cervical cancer can be prevented in more than 90% of cases. Urine samples collected by non-invasive methods may have the potential advantage of increasing acceptance of cervical cancer screening. Therefore, it is necessary to develop a new cervical cancer screening strategy using urine samples through further study based on the results of this study.

Staphylococcus saprophyticus and Escherichia coli: Tracking from sperm fertility potential to assisted reproductive outcomes

  • Ghasemian, Fatemeh;Esmaeilnezhad, Shahin;Moghaddam, Mohammad Javad Mehdipour
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.2
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    • pp.142-149
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    • 2021
  • Objective: Bacteriospermia and urogenital infections are common problems in male infertility. This study aimed to evaluate the effects of bacteriospermia on sperm parameters and clinical outcomes in semen samples infected with two common bacteria (Staphylococcus saprophyticus and Escherichia coli) in northern Iran. Methods: Microbiological tests were performed to isolate and identify organisms from 435 semen samples from infertile couples. Semen samples were assessed according to the World Health Organization criteria. The protamine status, chromatin structure, chromatin condensation, and acrosome reaction of sperm and assisted reproductive outcomes were determined in couples with different male infertility factors. Results: Among the total cases, the two most prevalent pathogens were considered: S. saprophyticus (38.2%) and E. coli (52.9%). In the semen samples infected with E. coli, the spontaneous acrosome reaction and abnormal chromatin condensation were more common (p<0.05). Significant increases in abnormal chromatin condensation and deprotamination were seen in the presence of S. saprophyticus. In washed semen, tight adhesion between the sperm midpiece and S. saprophyticus was observed. There was also a significant decrease in the fertilization rate using semen samples infected with S. saprophyticus and E. coli during in vitro fertilization cycles (p<0.001). In addition, the presence of S. saprophyticus and E. coli in semen samples was associated with a lower likelihood of clinical pregnancy in couples with various factors of male infertility. Conclusion: Poor results of assisted reproductive techniques may be correlated with semen samples infected with two common bacteria in northern Iran.

Evaluation of Clinical Utility and Biologic False Positive (BFP) Rates in Automated Syphilis Test Kits for Syphilis Screening (자동화 매독검사 키트의 임상적 유용성 및 생물학적 위양성률의 평가)

  • Kim, Sung-Man;Lee, Jehoon
    • Korean Journal of Clinical Laboratory Science
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    • v.41 no.1
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    • pp.42-46
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    • 2009
  • Unlike most bacteria, Treponema pallidum subspecies cannot be readily isolated or sustained in cell culture for numerous generations. In korea, two non treponemal tests are currently considered as standard; the VDRL slide test and RPR card test. These tests are based on an antigen composed of an alcoholic solution containing measured amount of cardiolipin, cholesterol, and sufficient purified lecithin to produce reactivity. The nontreponemal reagin tests measure immunoglobulin M (IgM) and IgG to lipoidal material released from damaged host cells as well as to lipoprotein-like material and possibly by cardiolipin released from the treponemes. The object of the evaluation was to evaluate the performance of the Mediace RPR kit on the automated biochemistry analyzer system as a method for screen method of syphilis as well as to identify BFP possibility. For evaluation of routine screening test, a total 2,380 specimens tested by Mediace RPR from 28th Oct, 2007 to 22th Feb, 2008. For evaluation of BFP possiblility, we measured samples which have potential BFP reaction in Syphilis test such as ANA (anti-nuclear antibody) positive (135 samples), CRP (C-reactive protein) positive (100 samples), RF (Rheumatoid factor) positive (26 samples), and other potential BFP cases (17 samples) including total 278 samples. These samples were tested quantitative test Mediace RPR with Hitachi 7600 P module. For comparison with current manual test, VDRL slide test were performed. Of these 2380 specimens, 2350 were negative, 30 were positive, and one were positive with TPHA. Both methods agreed for 2356 (98.9%) samples. Of the 30 samples showed positive results over 1.0 R.U, 6 samples showed positive results with VDRL test. Of these 6 samples, 1 samples showed positive with TPHA test. The combination of the Automated Biochemistry analyzer and VDRL test for retest can be increase efficiency of syphilis screening test.

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Detection of Viral Antigens in Stool Using EIA in Hospitalized Children and Clinical Implication (간접 효소 면역측정법을 이용한 입원 환아의 대변에서 바이러스 항원의 검출과 임상적 의의)

  • Min, Jung Hye;Seo, Jeong Wan;Park, Hye Kyung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.143-152
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    • 2004
  • Purpose: The purpose of this study is to detect viral coproantigens in children who were hospitalized with acute diarrhea and to compare its association with clinical symptoms. Methods: Seventy-four stool samples were collected from children admitted to Ewha Mokdong Hospital from March 1996 to December 1999. The samples were frozen and analyzed for rotavirus, adenovirus, enterovirus, astrovirus, and calicivirus by enzyme immunoassay (EIA) with monoclonal antibody. 53 stool samples were collected from patients with diarrhea (diarrheal group) and 21 stool samples from patients hospitalized for reasons other than diarrhea (control group). Clinical features and laboratory findings were reviewed in both groups. Results: Among 74 stool samples, virus antigens were detected in 60 samples. Of the 60 virus-positive stool samples, 47 enterovirus, 26 rotavirus, 16 adenovirus, 11 astrovirus, and 11 calicivirus antigens were detected by EIA. Of the 60 virus-positive stool samples, 28 samples have one viral antigen, 30 samples have 2 or more viral antigens, and 2 samples showed a simultaneous infection of Salmonella group B and enterovirus. There was no relationship between the detected virus and clinical features. Conclusion: In this study, viral coproantigen and clinical symptoms were not associated. In the future, further larger scale studies are necessary.

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A Simple, Single Triplex PCR of IS6110, IS1081, and 23S Ribosomal DNA Targets, Developed for Rapid Detection and Discrimination of Mycobacterium from Clinical Samples

  • Nghiem, Minh Ngoc;Nguyen, Bac Van;Nguyen, Son Thai;Vo, Thuy Thi Bich;Nong, Hai Van
    • Journal of Microbiology and Biotechnology
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    • v.25 no.5
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    • pp.745-752
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    • 2015
  • Tuberculosis (TB) is the most common mycobacterial infection in developing countries, requiring a rapid, accurate, and well-differentiated detection/diagnosis. For the rapid detection and discrimination of Mycobacterium tuberculosis complex (MTC) from non-tuberculous mycobacteria (NTM), a novel, simple, and primer-combined single-step multiplex PCR using three primer pairs (6110F-6110R, 1081F-1081R, and 23SF-23SR; annealing on each of IS6110, IS1081, and 23S rDNA targets), hereafter referred to as a triplex PCR, has been developed and evaluated. The expected product for IS6110 is 416 bp, for IS1081 is 300 bp, and for 23S rDNA is 206 bp by single PCR, which was used to verify the specificity of primers and the identity of MTC using DNA extracted from the M. tuberculosis H37Rv reference strain (ATCC, USA) and other mycobacteria other than tuberculosis (MOTT) templates. The triplex PCR assay showed 100% specificity and 96% sensitivity; the limit of detection for mycobacteria was ~100 fg; and it failed to amplify any target from DNA of MOTT (50 samples tested). Of 307 blinded clinical samples, overall 205 positive M. tuberculosis samples were detected by single PCR, 142 by conventional culture, and 90 by AFB smear methods. Remarkably, the triplex PCR could subsequently detect 55 positive M. tuberculosis from 165 culture-negative and 115 from 217 AFB smear-negative samples. The triplex PCR, targeting three regions in the M. tuberculosis genome, has proved to be an efficient tool for increasing positive detection/discrimination of this bacterium from clinical samples.

An Improvement Plan with Assessment of Therapeutic Drug Monitoring Service for Vancomycin (Vancomycin Therapeutic Drug Monitoring 운영 실태 조사와 업무 개선 방안)

  • Kim, Hae-Sook;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.120-130
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    • 2009
  • The objective of this study was to analyze and to improve therapeutic drug monitoring(TDM) service of vancomycin in a local hospital. Patients with TDM service between September 2005 and December 2008 were included and the data were collected for vancomycin use and components of TDM. During that period, 421 cases of TDM service of vancomycin in 236 patients were retrospectively reviewed. The first dosages of vancomycin were appropriate in 135(57.2%) patients and administration of vancomycin was discontinued in 126(53.4%) patients due to therapeutic failure or adverse drug reaction. MRSA was identified in 191(80.9%) patients and 135(70.7%) samples for the identification were sputum. According to the TDM reports, 232(55.1%) serum samples were obtained at the steady-state conditions and 55.5% of the samples that were drawn before the steady-state was due to the physician's inappropriate knowledge about the steady-state. Based on the time of vancomycin administration, 35.8% of the samples were not obtained at the recommended sampling time. For the patients in general wards, the most common reason for the incorrect samples was routine serum sampling by the laboratory medicine phlebotomists between 6 and 8 a.m. except sunday. In contrast, samples drawn by nurses or physicians at inappropriate time were the most common reason for the incorrect samples with patients in the intensive care units. Physicians accepted 68.5% of the recommendations for vancomycin dosage and administration. In conclusion, TDM service of vancomycin needs to be improved in inappropriate sampling time and vancomycin dosage. For solving these problems, current team made of TDM pharmacists and physicians of laboratory medicine can be expanded to include a physician of infectious diseases, nurses and laboratory medicine phlebotomists as new members. Through the TDM service of vancomycin by the new team, we can settle the problems and make the guideline for the scientific controversies associated with therapeutic monitoring of vancomycin.

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