A combination of ELISA and IFA tests would be recommended, in order to detect more patients suspected of infection in clinical practice

A combination of ELISA and IFA tests would be recommended, in order to detect more patients suspected of infection in clinical practice. Notes Gao C\H, Ji B\J, Han C, Wang M\S. ELISA and IFA tests would be recommended, in order to detect more patients suspected of infection in clinical practice. is a common cause of community\acquired pneumonia (CAP) in the children and adolescent population. In China, several studies investigate the prevalence of in CAP. Data have shown that infection accounted for 6.7% of CAP cases in neonates,1 40.8% in children,2 and 18.8% in adults,3 respectively. All these indicated that remains one of the most common causes of CAP. Alarmingly, a Chinese survey of the antibiotic resistance patterns of found that the macrolide resistance rate was as high as to 69%.3 Diagnosis of infection in routine clinical practice included culture, nucleic acid amplification assays, and serology. Culture of is slow and lacks of sensitivity, nucleic acid amplification assays cannot distinguish between asymptomatic and acute infections, 4 serology still has a place of choice in the diagnosis of infection. Serology tools, such as enzyme\linked immunosorbent assay (ELISA) and indirect immunofluorescence assay (IFA), are the most commonly used methodologies. An ELISA is generally preferred over IFA testing because it is less subjective, is thought to be more sensitive than IFA testing, and has the potential for automated performance.5 The availability of commercial IFA kit has resulted in the increasing use in detection of infection, despite the fact that few studies comparing the performance of ELISA and IFA in diagnosis of infection are available. The aim of this work was to compare commercial ELISA (SeroMP; Savyon Diagnostics, Ashdod, Israel) and IFA (PNEUMOSLIDE; Vircell SL, Granada, Spain) assays for the diagnosis of infection. 2.?MATERIALS AND METHODS 2.1. Subjects The study was approved by the Ethics Committee of the Shandong Provincial Chest Hospital. All participants signed the informed consent form before entering into the study. Patients medical histories were obtained from test forms and were de\identified for the analysis. From March 2016 to May 2017, 180 patients suspected with infection were enrolled in the study. 2.2. Commercial assays The SeroMP kit (Savyon Diagnostics) is an ELISA test for the semi\quantitative detection of that contains the P1 membrane protein. PNEUMOSLIDE kit (Vircell) using IFA was employed to detect the MI-2 (Menin-MLL inhibitor 2) IgM antibodies against 9 common respiratory pathogens including M.?pneumoniaeCoxiella burnetiiChlamydia pneumoniaetest was used to compare quantitative variables according to the categories of the group variable. The proportions were compared with 2 test. Cohen’s kappa statistics were used to assess the agreement between the ELISA and IFA assays in detection of infection. Multiple factor analysis was performed using multivariate logistic regression analysis, and regression coefficient, odds ratios (OR), and 95% confidence intervals (CI) were calculated. MI-2 (Menin-MLL inhibitor 2) infection value(4 cases), (3 cases), (1 case), (1 case). Twenty\nine were positive for fungi, including (25 cases), (3 cases), (1 case). Cough was the most frequently reported symptom (76.7%) followed by fever (65.0%), sputum (52.2%), dyspnea (33.9%), and chest pain (11.1%). Several inflammation markers were tested, the mean level of serum CRP was 35.9??52.4?mg/L; WBC was 8.3??4.0 109/L, ESR was 41.6??30.4?mm/h. 3.2. Results of the ELISA and IFA assays Among the 180 subjects, the positivities of ELISA and IFA assays were 15.6% (95% CI: 11.0%, 21.6%) and 10.0% (95% CI: 6.4%, 15.3%), respectively. The total positivity was 19.4% (95% CI: 14.3%, 25.8%). One hundred and fifty\two showed negative ELISA results with a mean level of 2.5??1.5?BU/mL (range 2\9.92?BU/mL), seven of them were IFA positive; 8 (3.7%) showed indeterminate ELISA results with a mean level of 16.4??1.4?BU/mL (range 14.3\18.0?BU/mL), one of them was IFA positive, 20 showed positive ELISA results with a mean level of 52.5??31.2?BU/mL (range 20.1\128.8?BU/mL), 10 were positive IFA results (Table?2). Table 2 detection by ELISA and IFA assays infection, two methods (ELISA and IFA) used for detecting IgM antibodies against were performed in parallel in our study. The positivities of ELISA and IFA assays were 15.6% and 10.0%, respectively. When the two were combined, the positivity increased to 19.4%. Therefore, the combined use of ELISA and IFA tests would allow the maximal number of diagnoses at a very early phase of infection. Using the Cohen’s kappa statistical analysis, statistically significant low agreement was found between the ELISA and IFA assays. Further multivariate analysis was performed to determine factors relevant to the discordance. The results showed sex and age were significant risk factors for the discordance in detection of infection. After infection by infection in adult CAP patients. Similarly, Qu et?al8 reported a low sensitivity (7.4%) of the IgM assay for Icam1 diagnosis of infection, another study conducted by Chang et? al9 found that MI-2 (Menin-MLL inhibitor 2) the assay had a sensitivity of 62.2% and a specificity of 85.5%. Based on the above research, it is easy to conclude.