An evaluation of a novel dual treponemal/nontreponemal point-of-care test for syphilis as a tool to distinguish active from past treated infection.

Background: Most syphilis point-of-care (POC) tests detect treponemal antibodies, which persist after successful treatment. Subsequent POC tests are positive, despite no active infection, and can lead to unnecessary treatment. We evaluated a new POC test, incorporating a nontreponemal component, to distinguish active from past infection.

Prolonged second diagnostic window for human immunodeficiency virus type 1 in a fourth-generation immunoassay: are alternative testing strategies required?

Diagnosis of acute HIV is done by patient history and examination and testing of RNA, proviral DNA, and serology using fourth-generation antigen/antibody detection assays. We describe an HIV-1 primary infection with a second diagnostic window of 18 to 34 days on a fourth-generation immunoassay, which would have been missed using some current algorithms. Caution must be exercised when fourth-generation HIV-1 immunoassays are interpreted in isolation, and additional testing should be considered depending on patient risk assessment.

A laboratory-based evaluation of four rapid point-of-care tests for syphilis.

Background: Syphilis point-of-care tests may reduce morbidity and ongoing transmission by increasing the proportion of people rapidly treated. Syphilis stage and co-infection with HIV may influence test performance. We evaluated four commercially available syphilis point-of-care devices in a head-to-head comparison using sera from laboratories in Australia.

The reliability of HBV core antibody in serological screening for hepatitis B virus.

Introduction: Accurate diagnosis of hepatitis B virus (HBV) infection is essential for infection control, treatment and screening of potential blood, organ and tissue donors. We assessed the sensitivity of the HBsAg and HBcAb as screening assays alone and in combination for detecting HBV infection in a series of Australian patients. The performance of the Architect (Abbott Diagnostics, Germany) and the Elecsys (Roche Diagnostics, Germany) platforms were assessed for detection of HBcAb.

Improving diagnosis of primary cytomegalovirus infection in pregnant women using immunoblots.

Human cytomegalovirus (CMV) is the most common infectious cause of mental disability in newborns of developed countries. Transmission of CMV from mother to baby is more frequent in maternal primary infection, although CMV reactivation causes more congenital infections overall. Current diagnostic tests for distinguishing primary and reactivation CMV have problems with interpretation and immunoblots may assist with diagnosis.

Case report and evaluation of the frequency of the prozone phenomenon in syphilis serology - an infrequent but important laboratory phenomenon.

Background: Treponema pallidum specific serology generally remains reactive for life. Therefore, the diagnosis of syphilis reinfection relies on clinical assessment and nontreponemal (reagin) serologic testing. The prozone phenomenon can lead to a falsely nonreactive rapid plasma reagin (RPR) assay result.

Significance of isolated reactive treponemal chemiluminescence immunoassay results.

Background: Isolated reactive serum treponemal chemiluminescence immunoassay (CIA) specimens cause clinical uncertainty.

Methods: Sera were screened by CIA, and reactive samples underwent reflex testing with rapid plasma reagin (RPR), Treponema pallidum particle agglutination (TPPA), and fluorescent treponemal antibody absorption (FTA Abs) assays. Samples reactive only on the CIA were deemed "isolated" reactive CIA samples.

Congenital cytomegalovirus--time to diagnosis, management and clinical sequelae in Australia: opportunities for earlier identification.

Objectives: To report on the burden of disease in Australian infants with congenital cytomegalovirus (cCMV) infection in the era of neonatal hearing screening and improved diagnostic techniques.

Design, Setting And Participants: National data were collected from across Australia via the Australian Paediatric Surveillance Unit (APSU) with monthly reporting by > 1000 clinicians between January 1999 and February 2009. For each reported case, data on investigations and epidemiological and clinical features were analysed.

Positive Epstein-Barr virus and cytomegalovirus IgM assays in primary HIV infection.

We report three cases with misleading cytomegalovirus (CMV) or Epstein-Barr virus (EBV) immunoglobulin M (IgM) results during primary human immunodeficiency virus (HIV) infection. We determined the rate of positive anti-CMV IgM assays or anti-EBV capsid antigen IgM assays in sera from a group of well-characterized subjects with primary HIV infection as 2.9% (1/35; 95%CI: 0.

Post-streptococcal glomerulonephritis in Sydney: a 16-year retrospective review.

Aim: Post-streptococcal glomerulonephritis (PSGN) is a frequent cause of acute nephritis in children. Numerous studies have described PSGN in high-risk populations yet few data describing PSGN in a low-incidence population exist. This study aimed to describe the epidemiology, clinical manifestations, diagnosis, complications and outcomes of PSGN in an urban Australian population.

Enhanced serological diagnosis of invasive meningococcal disease by determining anti-group C capsule IgM antibody by enzyme immunoassay.

Aims: To describe the development and evaluation of a diagnostic enzyme immunoassay (EIA) for IgM antibody to serogroup C capsular polysaccharide of Neisseria meningitidis (CCPS).

Methods: Purified CCPS was used as the antigen. The optical densities (OD) that determined the cut-off values for the assay were derived using sera from blood bank donors, and the accuracy was evaluated with sera from patients with culture-confirmed serogroup C and non-serogroup C invasive meningococcal disease (IMD), other infectious diseases, culture-confirmed pharyngeal carriage of N.

Concurrent summer influenza and pertussis outbreaks in a nursing home in Sydney, Australia.

Objective: To report on the investigation of a summer outbreak of acute respiratory illness among residents of a Sydney nursing home.

Design: An epidemiologic and microbiological investigation of the resident cohort at the time of the outbreak and medical record review 5 months later.

Setting: A nursing home located in Sydney, Australia, during February to July 1999.

Pox in the docks: varicella outbreak in an Australian prison system.

Objectives: 1. Describe an outbreak of varicella in a prison system. 2.