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The Brief Case: Secondary Measles and the Pitfalls of Diagnostic Testing Marwan M. Azar, Joseph Canterino, Marie L. Landry Diagnostic Accuracy of Nucleic Acid Amplification-Based Assays for Clostridium perfringens-Associated Diseases: a Systematic Review and Meta-analysis Timely and accurate methods for detecting Clostridium perfringens-associated diseases (CPAD) are crucial to improve patient care. A number of studies have evaluated the accuracy of nucleic acid amplification tests (NAAT) in detecting CPAD, but decisive results about their effectiveness have not been reported. We conducted a meta-analysis to evaluate the diagnostic... Ke Chen, Sarfraz Ahmed, Yun-Juan Sheng, Changfeng Sun, Cun-Liang Deng, Suvash Chandra Ojha Role of Toxoplasma gondii IgG Avidity Testing in Discriminating between Acute and Chronic Toxoplasmosis in Pregnancy Risk of mother-to-child transmission of Toxoplasma gondii during pregnancy is much greater in women who are exposed to primary T. gondii infection (toxoplasmosis) after conception compared to those who were exposed to the infection before conception. Therefore, laboratory tests that help classify... Aref Teimouri, Sina Mohtasebi, Elham Kazemirad, Hossein Keshavarz Fourth-Generation QuantiFERON-TB Gold Plus: What Is the Evidence? QuantiFERON-TB Gold Plus (QFT-Plus) is the latest generation of interferon gamma release assays (IGRAs) to receive approval from the U.S. FDA, replacing its predecessor, QuantiFERON-TB Gold In-Tube (QFT-GIT). The novelty of QFT-Plus is that it elicits a response from CD8 T cells, in addition to CD4 T cells, thus collecting a broader response from T-cell subsets than QFT-GIT. It was developed with the aim to improve the detection of... Arena Shafeque, Jacob Bigio, Catherine A. Hogan, Madhukar Pai, Niaz Banaei Genomic Surveillance Enables Suitability Assessment of Salmonella Gene Targets Used for Culture-Independent Diagnostic Testing Salmonella is a highly diverse genus consisting of over 2,600 serovars responsible for high-burden food- and waterborne gastroenteritis worldwide. Sensitivity and specificity of PCR-based culture-independent diagnostic testing (CIDT) systems for Salmonella, which depend on a highly conserved gene target, can be affected by single nucleotide polymorphisms (SNPs), indels, and genomic rearrangements within primer and... Rebecca J. Rockett, Alicia Arnott, Qinning Wang, Peter Howard, Vitali Sintchenko A Population-Specific Optimized GeneXpert Pooling Algorithm for Chlamydia trachomatis and Neisseria gonorrhoeae To Reduce Cost of Molecular Sexually Transmitted Infection Screening in Resource-Limited Settings The sexually transmitted infections (STIs) chlamydia (CT) and gonorrhea (NG) are often asymptomatic in women and undetected by syndromic management, leading to complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy. Molecular testing, such as the GeneXpert CT/NG assay, is highly sensitive, but cost restraints preclude implementation of these technologies in resource-limited settings. Pooled testing is one... Sarah Connolly, William Kilembe, Mubiana Inambao, Ana-Maria Visoiu, Tyronza Sharkey, Rachel Parker, Kristin M. Wall, Amanda Tichacek, Eric Hunter, Susan Allen Comparative Analysis of the Euroimmun CXCL13 Enzyme-Linked Immunosorbent Assay and the ReaScan Lateral Flow Immunoassay for Diagnosis of Lyme Neuroborreliosis Diagnosis of Lyme neuroborreliosis (LNB) is challenging, as long as Borrelia-specific intrathecal antibodies are not yet detectable. The chemokine CXCL13 is elevated in the cerebrospinal fluid (CSF) of LNB patients. Here, we compared the performances of the Euroimmun CXCL13 enzyme-linked immunosorbent assay (CXCL13 ELISA) and the ReaScan CXCL13 lateral flow immunoassay (CXCL13 LFA), a rapid point-of-care test, to support the... Katharina Ziegler, Anca Rath, Christoph Schoerner, Renate Meyer, Thomas Bertsch, Frank Erbguth, Christian Bogdan, Jörg Steinmann, Jürgen Held Utilization, Yield, and Accuracy of the FilmArray Meningitis/Encephalitis Panel with Diagnostic Stewardship and Testing Algorithm The impact of diagnostic stewardship and testing algorithms on the utilization and performance of the FilmArray meningitis/encephalitis (ME) panel has received limited investigation. We performed a retrospective single-center cohort study assessing all individuals with suspected ME between February 2017 and April 2019 for whom the ME panel was ordered. Testing was restricted to patients with cerebrospinal fluid (CSF) pleocytosis.... M. Jana Broadhurst, Shefali Dujari, Indre Budvytiene, Benjamin A. Pinsky, Carl A. Gold, Niaz Banaei Impact of Rapid Antimicrobial Susceptibility Testing in Gram-Negative Rod Bacteremia: a Quasi-experimental Study Clinical justification for rapid antimicrobial susceptibility testing (AST) in Gram-negative rod (GNR) bacteremia is compelling; however, evidence supporting its value is sparse. We investigated the impact of rapid AST on clinical and antimicrobial stewardship outcomes in real-world practice. We performed a before-and-after quasi-experimental study from February 2018 to July 2019 at a tertiary hospital of the 24-h/day, 7-day/week... Catherine Anne Hogan, Bertrand Ebunji, Nancy Watz, Kristopher Kapphahn, Joseph Rigdon, Emily Mui, Lina Meng, William Alegria, Marisa Holubar, Stanley Deresinski, Niaz Banaei Gold Standard Cholera Diagnostics Are Tarnished by Lytic Bacteriophage and Antibiotics A fundamental, clinical, and scientific concern is how lytic bacteriophage, as well as antibiotics, impact diagnostic positivity. Cholera was chosen as a model disease to investigate this important question, because cholera outbreaks enable large enrollment, field methods are well established, and the predatory relationship between lytic bacteriophage and the etiologic agent... E. J. Nelson, J. A. Grembi, D. L. Chao, J. R. Andrews, L. Alexandrova, P. H. Rodriguez, V. V. Ramachandran, M. A. Sayeed, J. F. Wamala, A. K. Debes, D. A. Sack, A. J. Hryckowian, F. Haque, S. Khatun, M. Rahman, A. Chien, A. M. Spormann, G. K. Schoolnik Newly Named Klebsiella aerogenes (formerly Enterobacter aerogenes) Is Associated with Poor Clinical Outcomes Relative to Other Enterobacter Species in Patients with Bloodstream Infection Enterobacter aerogenes was recently renamed Klebsiella aerogenes. This study aimed to identify differences in clinical characteristics, outcomes, and bacterial genetics among patients with K. aerogenes versus Enterobacter... Austin Wesevich, Granger Sutton, Felicia Ruffin, Lawrence P. Park, Derrick E. Fouts, Vance G. Fowler, Joshua T. Thaden Multicenter Evaluation of the Xpert Carba-R Assay for Detection and Identification of Carbapenemase Genes in Sputum Specimens Rapid diagnosis of infections caused by carbapenem-resistant Enterobacteriaceae (CRE) is crucial for proper treatment and infection control. The Xpert Carba-R assay is a qualitative multiplex real-time PCR method that qualitatively detects and differentiates five common carbapenemase genes (blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP... Zhen Cai, Jia Tao, Tianye Jia, Hongyu Fu, Xin Zhang, Mei Zhao, Hong Du, Hua Yu, Bin Shan, Bin Huang, Liang Chen, Yi-Wei Tang, Wei Jia, Fen Qu Comparative Genomics and Antimicrobial Resistance Profiling of Elizabethkingia Isolates Reveal Nosocomial Transmission and In Vitro Susceptibility to Fluoroquinolones, Tetracyclines, and Trimethoprim-Sulfamethoxazole The Elizabethkingia genus has gained global attention in recent years as containing sporadic, worldwide, nosocomial pathogens. Elizabethkingia spp. are intrinsically multidrug resistant, primarily infect immunocompromised individuals, and are associated with high mortality (∼20 to 40%). As yet, gaps remain in our understanding of transmission, global strain relatedness, antimicrobial resistance, and effective therapy.... Delaney Burnard, Letitia Gore, Andrew Henderson, Ama Ranasinghe, Haakon Bergh, Kyra Cottrell, Derek S. Sarovich, Erin P. Price, David L. Paterson, Patrick N. A. Harris NitroSpeed-Carba NP Test for Rapid Detection and Differentiation between Different Classes of Carbapenemases in Enterobacterales A biochemical test (NitroSpeed-Carba NP test) was developed to identify carbapenemase production in Enterobacterales and to discriminate between the different types of clinically significant carbapenemases (Ambler classes A, B, and D). It is based on two main features, namely, the hydrolysis by all β-lactamases, including carbapenemases of the nitrocefin substrate, and the capacity of ertapenem to prevent this hydrolysis for... Patrice Nordmann, Mustafa Sadek, Anthony Demord, Laurent Poirel A Selective Culture Medium for Screening Ceftazidime-Avibactam Resistance in Enterobacterales and Pseudomonas aeruginosa The SuperCAZ/AVI medium was developed for screening ceftazidime-avibactam (CZA) resistance among Gram-negative bacteria (Enterobacterales and Pseudomonas aeruginosa). It was evaluated using 50 CZA-susceptible and 42 CZA-resistant Gram-negative isolates. Its sensitivity and specificity of detection were 100%. Excellent performance of the medium was also... Mustafa Sadek, Laurent Poirel, Camille Tinguely, Patrice Nordmann Optimizing a Screening Protocol for Potential Extended-Spectrum β-Lactamase Escherichia coli on MacConkey Agar for Use in a Global Surveillance Program The increasing prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is worrisome. Coordinated efforts to better understand global prevalence and risk factors are needed. Developing lower- and middle-income countries need reliable, readily available, and cost-effective solutions for detecting ESBL... Megan E. Jacob, Shivaramu Keelara, Awa Aidara-Kane, Jorge R. Matheu Alvarez, Paula J. Fedorka-Cray Prevalence of Mycoplasma genitalium and Antibiotic Resistance-Associated Mutations in Patients at a Sexually Transmitted Infection Clinic in Iceland, and Comparison of the S-DiaMGTV and Aptima Mycoplasma genitalium Assays for Diagnosis Mycoplasma genitalium is prevalent among attendees in sexually transmitted infection (STI) clinics, and therapy is hampered by rapidly rising levels of resistance to azithromycin and moxifloxacin. In this study, we evaluated, for the first time in Iceland, the prevalence of M. genitalium and... Ingibjörg Hilmarsdóttir, Eva Mjöll Arnardóttir, Elísabet Reykdal Jóhannesdóttir, Freyja Valsdóttir, Daniel Golparian, Ronza Hadad, Hannes Bjarki Vigfússon, Magnus Unemo Changing from Clinician-Collected to Self-Collected Throat Swabs for Oropharyngeal Gonorrhea and Chlamydia Screening among Men Who Have Sex with Men The coronavirus disease 2019 (COVID-19) pandemic has led many clinics to move from clinician-collected to self-collected oropharyngeal swabs for the detection of sexually transmitted infections (STIs). Before this change, however, self-collection was used primarily for genital and anorectal infections, with only limited studies on the performance of self-collection of oropharyngeal swabs for oropharyngeal STI detection. The Melbourne... Eric P. F. Chow, Catriona S. Bradshaw, Deborah A. Williamson, Shauna Hall, Marcus Y. Chen, Tiffany R. Phillips, Ria Fortune, Kate Maddaford, Christopher K. Fairley Mild or Malign: Clinical Characteristics and Outcomes of Clostridium difficile Infection in Thailand Little is known about the clinical characteristics of Clostridium difficile infection (CDI) in Asia in general, and Thailand specifically, with a few studies suggesting that the disease may be milder than elsewhere. This study aimed to describe CDI in Thailand, evaluate treatment options and their outcomes, and explore possible protective factors responsible for any... Korakrit Imwattana, Papanin Putsathit, Teera Leepattarakit, Pattarachai Kiratisin, Thomas V. Riley The Addition of Anaerobic Blood Cultures for Pediatric Patients with Concerns for Bloodstream Infections: Prevalence and Time to Positive Cultures Anaerobes are an important but uncommon cause of bloodstream infections (BSIs). For pediatric patients, routine inclusion of an anaerobic blood culture alongside the aerobic remains controversial. We implemented automatic anaerobic blood culture alongside aerobic blood cultures in a pediatric emergency department (ED) and sought to determine changes in recovery of obligate and facultative anaerobes. This was a cohort study in a... Jennifer Dien Bard, Todd P. Chang, Rebecca Yee, Keya Manshadi, Nhan Lichtenfeld, Hee Jae Choi, Ara Festekjian Performance of PCR/Electrospray Ionization-Mass Spectrometry on Whole Blood for Detection of Bloodstream Microorganisms in Patients with Suspected Sepsis Blood culture (BC) often fails to detect bloodstream microorganisms in sepsis. However, molecular diagnostics hold great potential. The molecular method PCR/electrospray ionization-mass spectrometry (PCR/ESI-MS) can detect DNA from hundreds of different microorganisms in whole blood. The aim of the present study was to evaluate the performance of this method in a multicenter study including 16 teaching hospitals in the United States (... Kristoffer Strålin, Richard E. Rothman, Volkan Özenci, Kieron Barkataki, David Brealey, Neelam Dhiman, Lara Poling, Michael C. Kurz, Ajit P. Limaye, Frank LoVecchio, Kristin Lowery, Loren G. Miller, Gregory J. Moran, J. Scott Overcash, Amisha Parekh, W. Frank Peacock, Emanuel P. Rivers, Matthew Sims, Amy M. Stubbs, Martin Sundqvist, Måns Ullberg, Karen C. Carroll Optimization and Evaluation of a Multiplex Quantitative PCR Assay for Detection of Nucleic Acids in Human Blood Samples from Patients with Spotted Fever Rickettsiosis, Typhus Rickettsiosis, Scrub Typhus, Monocytic Ehrlichiosis, and Granulocytic Anaplasmosis Spotted fever group rickettsioses (SFGR), typhus group rickettsioses (TGR), scrub typhus (caused by Orientia tsutsugamushi), ehrlichiosis, and anaplasmosis often present as undifferentiated fever but are not treated by agents (penicillins and cephalosporins) typically used for acute febrile illness. Inability to diagnose these infections when the patient is acutely... Megan E. Reller, J. Stephen Dumler Accuracy of Xpert Ultra in Diagnosis of Pulmonary Tuberculosis among Children in Uganda: a Substudy from the SHINE Trial Childhood tuberculosis (TB) presents significant diagnostic challenges associated with paucibacillary disease and requires a more sensitive test. We evaluated the diagnostic accuracy of Xpert MTB/RIF Ultra (Ultra) compared to other microbiological tests using respiratory samples from Ugandan children in the SHINE trial. SHINE is a randomized trial evaluating shorter treatment in 1,204 children with minimal TB disease in Africa and India... Willy Ssengooba, Jean de Dieu Iragena, Lydia Nakiyingi, Serestine Mujumbi, Eric Wobudeya, Robert Mboizi, David Boulware, David B. Meya, Louise Choo, Angela M. Crook, Kristen Lebeau, Moses Joloba, Anne-Marie Demers, Fiona V. Cresswell, Diana M. Gibb Evaluation of Xpert MTB/RIF Ultra Assay for Diagnosis of Childhood Tuberculosis: a Multicenter Accuracy Study A multicenter study was performed to evaluate the value of testing gastric aspirate (GA) with Xpert MTB/RIF Ultra assay (Ultra) for childhood tuberculosis (TB) detection in China. In total, 129 children with active TB and 173 children without TB were enrolled. The sensitivity of Ultra in bacteriologically confirmed TB and probable TB cases was 87.5% (42/48) and 44.4% (36/81), respectively. The specificity of Ultra was high (99.4%, 172/... Lin Sun, Yu Zhu, Min Fang, Yan Shi, Xiaoshan Peng, Qiong Liao, Xingyun Wang, Shuting Quan, Yacui Wang, Li Duan, Xiaomei Shi, Zhipeng Zhao, Lanqin Chen, Yongsheng Xu, Tongqiang Zhang, Xiaojian Cui, Chaomin Wan, Adong Shen Evaluation of a Novel Semiquantitative Cryptococcal Antigen Lateral Flow Assay in Patients with Advanced HIV Disease Higher cryptococcal antigen (CrAg) titers are strongly associated with mortality risk in individuals with HIV-associated cryptococcal disease. Rapid tests to quantify CrAg levels may provide important prognostic information and enable treatment stratification. We performed a laboratory-based validation of the IMMY semiquantitative cryptococcal antigen (CrAgSQ) lateral flow assay (LFA) against the current gold standard CrAg tests. We... Joseph N. Jarvis, Mark W. Tenforde, Kwana Lechiile, Thandi Milton, Amber Boose, Tshepo B. Leeme, Leabaneng Tawe, Charles Muthoga, Ivy Rukasha, Fredah Mulenga, Ikanyeng Rulaganyang, Mooketsi Molefi, Síle F. Molloy, Julia Ngidi, Thomas S. Harrison, Nelesh P. Govender, Madisa Mine Comparison of Serum Hepatitis B Virus RNA Levels and Quasispecies Evolution Patterns between Entecavir and Pegylated-Interferon Mono-treatment in Chronic Hepatitis B Patients Hepatitis B virus (HBV) RNA may independently predict virological and serological response. This study aimed to compare dynamic changes in serum HBV RNA levels and HBV quasispecies evolution patterns between entecavir and pegylated-interferon mono-treatment in chronic hepatitis B patients and to determine the clinical significance during treatment. TaqMan real-time PCR was used for quantitative analysis. HBV RNA levels were... Xiao-qi Yu, Ming-jie Wang, De-min Yu, Pei-zhan Chen, Ming-yu Zhu, Wei Huang, Yue Han, Qi-ming Gong, Xin-xin Zhang Evaluation of the FecalSwab for Stool Specimen Storage and Molecular Detection of Enteropathogens on the BD Max System The FecalSwab system (Copan Italia, Brescia, Italy) is a convenient alternative to bulk stool for the diagnosis of enteric pathogens. Although the U.S. Food and Drug Administration (FDA) approved for transport and culture of enteric bacterial pathogens, the FecalSwab has not been well assessed for its suitability with molecular platforms. In this study, we evaluated the FecalSwab as a specimen type for the BD Max system using the viral... Melissa Richard-Greenblatt, Candy Rutherford, Kathy Luinstra, Ana María Cárdenas, Xiaoli Lilly Pang, Padman Jayaratne, Marek Smieja Biennial Upsurge and Molecular Epidemiology of Enterovirus D68 Infection in New York, USA, 2014 to 2018 Enterovirus D68 (EV-D68) infection has been associated with outbreaks of severe respiratory illness and increased cases of nonpolio acute flaccid myelitis. The patterns of EV-D68 circulation and molecular epidemiology are not fully understood. In this study, nasopharyngeal (NP) specimens collected from patients in the Lower Hudson Valley, New York, from 2014 to 2018 were examined for rhinovirus/enterovirus (RhV/EV) by the FilmArray... Victoria L. Gilrane, Jian Zhuge, Weihua Huang, Sheila M. Nolan, Abhay Dhand, Changhong Yin, Christian Salib, Faariah Shakil, Helen Engel, John T. Fallon, Guiqing Wang A Highly Prevalent Polymorphism in the Core Region Impairs Quantification of Hepatitis B Virus (HBV) by the cobas TaqMan HBV Assay The high genetic variability of hepatitis B virus (HBV) can impair DNA quantification. Here, we investigate a major underquantification of HBV by the cobas TaqMan HBV assay (CTM; Roche). In France, between 2005 and 2017, HBV DNA was detected in 3,102 blood donations by use of the CTM (95% limit of detection [LOD95], 4.8 IU/ml). HBV strains were sequenced in the S region (LOD95, ∼30 IU/ml). Concordant (n = ... Laure Boizeau, Annabelle Servant-Delmas, Alexandra Ducancelle, Stéphane Chevaliez, Vincent Thibault, Syria Laperche, Pierre Cappy Rapid and Sensitive Direct Detection and Identification of Poliovirus from Stool and Environmental Surveillance Samples by Use of Nanopore Sequencing Global poliovirus surveillance involves virus isolation from stool and environmental samples, intratypic differential (ITD) by PCR, and sequencing of the VP1 region to distinguish vaccine (Sabin), vaccine-derived, and wild-type polioviruses and to ensure an appropriate response. This cell culture algorithm takes 2 to 3 weeks on average between sample receipt and sequencing. Direct detection of viral RNA using PCR allows faster detection... Alexander G. Shaw, Manasi Majumdar, Catherine Troman, Áine O’Toole, Blossom Benny, Dilip Abraham, Ira Praharaj, Gagandeep Kang, Salmaan Sharif, Muhammad Masroor Alam, Shahzad Shaukat, Mehar Angez, Adnan Khurshid, Nayab Mahmood, Yasir Arshad, Lubna Rehman, Ghulam Mujtaba, Ribqa Akthar, Muhammad Salman, Dimitra Klapsa, Yara Hajarha, Humayun Asghar, Ananda Bandyopadhyay, Andrew Rambaut, Javier Martin, Nicholas Grassly Diagnostic Accuracy of Pan-Degenerate Amplification and Adaptation Assay for HIV-1 Drug Resistance Mutation Analysis in Low- and Middle-Income Countries HIV drug resistance (HIVDR) is a barrier to sustained virologic suppression in low- and middle-income countries (LMICs). Point mutation assays targeting priority drug resistance mutations (DRMs) are being evaluated to improve access to HIVDR testing. In a cross-sectional study (June 2018 to September 2019), we evaluated the diagnostic accuracy of a simple and rapid HIVDR assay (the pan-degenerate amplification and adaptation [PANDAA]... Vinie Kouamou, Justen Manasa, David Katzenstein, Alan M. McGregor, Chiratidzo E. Ndhlovu, Tariro Makadzange Analytical and Clinical Comparison of Three Nucleic Acid Amplification Tests for SARS-CoV-2 Detection Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in December 2019 and has quickly become a worldwide pandemic. In response, many diagnostic manufacturers have developed molecular assays for SARS-CoV-2 under the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) pathway. This study compared three of these assays, the Hologic Panther Fusion SARS-CoV-2 assay (Fusion), the Hologic Aptima... Elizabeth Smith, Wei Zhen, Ryhana Manji, Deborah Schron, Scott Duong, Gregory J. Berry Utility of Stool PCR for the Diagnosis of COVID-19: Comparison of Two Commercial Platforms The ability to detect SARS-CoV-2 in the upper respiratory tract ceases after 2 to 3 weeks post-symptom-onset in most patients. In contrast, SARS-CoV-2 can be detected in the stool of some patients for greater than 4 weeks, suggesting that stool may hold utility as an additional source for diagnosis. We validated the Cepheid Xpert Xpress SARS-CoV-2 and Hologic Panther Fusion real-time RT-PCR assays for detection of viral RNA in stool... Wendy A. Szymczak, D. Yitzchak Goldstein, Erika P. Orner, Roger A. Fecher, Raquel T. Yokoda, Karin A. Skalina, Momka Narlieva, Inessa Gendlina, Amy S. Fox Clinical Evaluation of Self-Collected Saliva by Quantitative Reverse Transcription-PCR (RT-qPCR), Direct RT-qPCR, Reverse Transcription–Loop-Mediated Isothermal Amplification, and a Rapid Antigen Test To Diagnose COVID-19 The clinical performances of six molecular diagnostic tests and a rapid antigen test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were clinically evaluated for the diagnosis of coronavirus disease 2019 (COVID-19) in self-collected saliva. Saliva samples from 103 patients with laboratory-confirmed COVID-19 (15 asymptomatic and 88 symptomatic) were collected on the day of hospital admission. SARS-CoV-2 RNA in saliva... Mayu Nagura-Ikeda, Kazuo Imai, Sakiko Tabata, Kazuyasu Miyoshi, Nami Murahara, Tsukasa Mizuno, Midori Horiuchi, Kento Kato, Yoshitaka Imoto, Maki Iwata, Satoshi Mimura, Toshimitsu Ito, Kaku Tamura, Yasuyuki Kato Direct Comparison of SARS-CoV-2 Analytical Limits of Detection across Seven Molecular Assays Analytical sensitivity for SARS-CoV-2 detection is a key performance metric for the evaluation of viral detection assays. We determined analytical limits of detection for seven SARS-CoV-2 assays using serial dilutions of pooled patient material quantified with droplet digital PCR. Limits of detection ranged from ≤10 to 74 copies/ml for commercial high-throughput laboratory analyzers (Roche Cobas, Abbott m2000, and Hologic Panther Fusion... Becky Fung, Allan Gopez, Venice Servellita, Shaun Arevalo, Coral Ho, Anne Deucher, Ed Thornborrow, Charles Chiu, Steve Miller Development and Evaluation of a New Triplex Immunoassay That Detects Group A Streptococcus Antibodies for the Diagnosis of Rheumatic Fever Streptococcal serology is a cornerstone in the diagnosis of acute rheumatic fever (ARF), a postinfectious sequela associated with group A Streptococcus infection. Current tests that measure anti-streptolysin O (ASO) and anti-DNaseB (ADB) titers require parallel processing, with their predictive value limited by the low rate of decay in antibody response. Accordingly, our objective was to develop and assess the diagnostic... Alana L. Whitcombe, Paulina Hanson-Manful, Susan Jack, Arlo Upton, Polly Atatoa Carr, Deborah A. Williamson, Michael G. Baker, Thomas Proft, Nicole J. Moreland Evaluation of Serological Tests for Detection of Antibodies against Lumpy Skin Disease Virus Lumpy skin disease (LSD) is an emerging, transboundary viral pox disease affecting cattle of all ages and breeds. The serological assay for monitoring immunity following vaccination is a virus neutralization test (VNT/OIE) that determines the neutralization index (NI). The first validated enzyme-linked immunosorbent assay (ELISA; IDVet) has become commercially available, facilitating large-scale serosurveillance for LSD. Although the... Nina Krešić, Ivana Šimić, Tomislav Bedeković, Žaklin Acinger-Rogić, Ivana Lojkić Comparability of Titers of Antibodies against Seasonal Influenza Virus Strains as Determined by Hemagglutination Inhibition and Microneutralization Assays We compared titers of antibodies against A/H1N1, A/H3N2, and B influenza virus strains collected pre- and postvaccination using hemagglutination inhibition (HI) and microneutralization (MN) assays and data from two vaccine trials: study 1, performed with a cell-grown trivalent influenza vaccine (TIVc) using cell-grown target virus in both assays, and study 2, performed with an egg-grown adjuvanted quadrivalent influenza vaccine (aQIVe)... Marten Heeringa, Brett Leav, Igor Smolenov, Giuseppe Palladino, Leah Isakov, Vincent Matassa Clinical and Analytical Performance of an Automated Serological Test That Identifies S1/S2-Neutralizing IgG in COVID-19 Patients Semiquantitatively In the coronavirus (CoV) disease 2019 (COVID-19) pandemic, highly selective serological testing is essential to define exposure to severe acute respiratory syndrome CoV 2 (SARS-CoV-2). Many tests have been developed, yet with variable speeds to first results, and are of unknown quality, particularly when considering the prediction of neutralizing capacity. The LIAISON SARS-CoV-2 S1/S2 IgG assay was designed to measure antibodies against... Fabrizio Bonelli, Antonella Sarasini, Claudia Zierold, Mariella Calleri, Alice Bonetti, Chiara Vismara, Frank A. Blocki, Luca Pallavicini, Alberto Chinali, Daniela Campisi, Elena Percivalle, Anna Pia DiNapoli, Carlo Federico Perno, Fausto Baldanti Development and Application of a Core Genome Multilocus Sequence Typing Scheme for the Health Care-Associated Pathogen Pseudomonas aeruginosa Pseudomonas aeruginosa is an opportunistic human pathogen that frequently causes health care-associated infections (HAIs). Due to its metabolic diversity and ability to form biofilms, this Gram-negative nonfermenting bacterium can persist in the health care environment, which can lead to prolonged HAI outbreaks. We describe the creation of a core genome multilocus... Richard A. Stanton, Gillian McAllister, Jonathan B. Daniels, Erin Breaker, Nicholas Vlachos, Paige Gable, Heather Moulton-Meissner, Alison Laufer Halpin Clinical and Genomic Epidemiology of Carbapenem-Nonsusceptible Citrobacter spp. at a Tertiary Health Care Center over 2 Decades Carbapenem-nonsusceptible Citrobacter spp. (CNSC) are increasingly recognized as health care-associated pathogens. Information regarding their clinical epidemiology, genetic diversity, and mechanisms of carbapenem resistance is lacking. We examined microbiology records of adult patients at the University of Pittsburgh Medical Center (UMPC) Presbyterian Hospital (PUH) from 2000 to 2018 for CNSC, as defined by ertapenem... Ahmed Babiker, Daniel R. Evans, Marissa P. Griffith, Christi L. McElheny, Mohamed Hassan, Lloyd G. Clarke, Roberta T. Mettus, Lee H. Harrison, Yohei Doi, Ryan K. Shields, Daria Van Tyne Population Genomic Molecular Epidemiological Study of Macrolide-Resistant Streptococcus pyogenes in Iceland, 1995 to 2016: Identification of a Large Clonal Population with a pbp2x Mutation Conferring Reduced In Vitro β-Lactam Susceptibility Resistance to macrolide antibiotics is a global concern in the treatment of Streptococcus pyogenes (group A Streptococcus [GAS]) infections. In Iceland, since the detection of the first macrolide-resistant isolate in 1998, three epidemic waves of macrolide-resistant GAS infections have occurred, with peaks in 1999, 2004, and 2008. We conducted whole-genome... Sara B. Southon, Stephen B. Beres, Priyanka Kachroo, Matthew Ojeda Saavedra, Helga Erlendsdóttir, Gunnsteinn Haraldsson, Prasanti Yerramilli, Layne Pruitt, Luchang Zhu, James M. Musser, Karl G. Kristinsson Performance Evaluation of Culture-Independent SYBR Green Candida auris Quantitative PCR Diagnostics on Anterior Nares Surveillance Swabs Ourania Georgacopoulos, Natalie S. Nunnally, Ngoc Le, Colleen Lysen, Rory M. Welsh, Milena Kordalewska, David S. Perlin, Elizabeth L. Berkow, D. Joseph SextonJournal of Clinical Microbiology (JCM) publishes the most current research related to the laboratory diagnosis of human and animal infections and the role of the laboratory in both the management of infectious diseases and the elucidation of the epidemiology of infections.Editor in Chief: Dr. Alexander J. McAdamFor AuthorsWatch Detection of carbapenemases a discussion with Dr. Patricia Simner. Hosted by Journal of Clinical Microbiology Editor in Chief, Dr. Alexander McAdam. 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