Diagnostic Testing Methods Research Articles

THE STATE OF MOTIVATION TO STUDY AND PROFESSIONAL DEVELOPMENT AMONG MEDICAL STUDENTS OF THE MEDICAL FACULTY OF THE STATE INSTITUTION "UZHHOROD NATIONAL UNIVERSITY".

The aim: To determine the level of motivation for learning and professional development among 6th-year students of the medical faculty. Materials and methods: Included a comparative analysis of contemporary scientific psychological-pedagogical works on this issue and questionnaire surveys. The research design involved the use of psychological diagnostic testing methods by A.O. Rean, V.O. Yakunin, and K. Zamfir in the modification by A.O. Rean. Results: When studying the levels of motivation for acquiring knowledge in students from the two investigated groups, differences were found in the inter-pretation and perception of motivation content. For the first group, the main motivation is the possibility of becoming a highly qualified specialist, while for the second group, it is to ensure the success of their future profession. However, both groups of students have high levels of internal motivation. The main reason for the difference in attitudes toward the learning process is the different motivational complexes in students, which determine a different hierarchy of motives in the studied groups in achieving the goal of becoming a doctor, albeit through different means (due to a greater influence of internal negative motivation, especially in the second group). Conclusions: The main motivation for students of the first group to study is the opportunity to become a highly qualified specialist, while for students of the second group, it is to ensure the success of their future professional activity, primarily through high levels of internal motivation. The effectiveness of the educational process and the future development as a doctor are determined by the type of their motivational complex. Taking this into account can serve as the main reserve of motivation for students and be useful in developing measures to attract and retain medical personnel.

373. Development of multiplex loop-mediated isothermal amplification (LAMP) based on a microfluidic chip for detection of HSV-1 and 2 and VZV.

Abstract Background In the era of universal varicella vaccination, point-of-care testing for herpes simplex viruses 1 and 2 (HSV-1, HSV-2) and varicella-zoster virus (VZV) is becoming more important because of the increase in the number of breakthrough varicella cases. The Loop-mediated isothermal amplification (LAMP) method is a reliable method for rapid diagnostic tests for infectious diseases. Meanwhile, microfluidics technology is revolutionary in total system miniaturization, including facile parallelization through multiplexing and process-reduced reagent volumes. It is easy to create miniaturized chips containing multiple chambers according to the needs. In this study, we sought to develop multiplex LAMP for the detection of HSV-1, HSV-2, and VZV DNA using in-house microfluidic chips. Methods The polydimethylsiloxane-based chip consists of microfluidic channels and 5 reaction chambers. The specific primers were pre-spotted and dried in each chamber. The condition of LAMPs and each specific primer were described previously. The sensitivity of microfluidic LAMPs was confirmed using plasmids that contain the target sequences. In order to assess the reliability of clinical use, 35 swab samples (without DNA extraction) collected from patients with vesicular skin lesions were used. The result of microfluidic multiplex LAMP was compared with conventional LAMPs and real-time PCRs. Results Detection limits of HSV-1 and 2 and VZV LAMP-based on a microfluidic chip were 500 copies per reaction. Among 35 swab samples, HSV-1, HSV-2, and VZV DNA were detected in 10 (28.6%), 4 (11.4%), and 12 (34.3%) samples, respectively. The results of microfluidic LAMPs were completely consistent with the results of conventional LAMPs. HSV-1 DNA was detected in one LAMP negative sample by real-time PCR. One HSV-1 LAMP positive sample was negative in real-time PCR. If real-time PCR was used as a standard, sensitivity of HSV-1, HSV-2, and VZV LAMPs based on microfluidic chip were 90%, 100%, and 100%, and the specificity of three methods were 96%, 100% and 100%, respectively. Conclusion Multiplex LAMP, based on a microfluidic chip that detects three alpha herpesviruses, may be useful in laboratory diagnosis of patients with vesicular skin lesions. Disclosures All Authors: No reported disclosures.

Antibody tests for identification of current and past infection with SARS-CoV-2.

Antibody tests for identification of current and past infection with SARS-CoV-2.

ОБЗОР ЛАЗЕРНЫХ СКАНИРУЮЩИХ МЕТОДОВ ИССЛЕДОВАНИЙ МИКРОЭЛЕКТРОННЫХ ПОЛУПРОВОДНИКОВЫХ СТРУКТУР

The development and widespread of high-tech microelectronic products impose increased requirements on the quality and reliability of microcircuits. The most effective methods for reliability improvement of electronic systems include diagnostic non-destructive testing (NDT) methods and selective destructive testing in special cases. Studies using visual inspection and electrical testing, consisting of functional and parametric testing, do not provide enough information to detect latent defects (for example, macro-defects in SiO 2 layers in CMOS chips) and to detect fakes and counterfeits. A fake integrated circuit (IC) may contain an undeclared malicious modification of the circuit, called hardware bugs. The common ICs studying tools are systems based on microfocus X-ray sources, scanning acoustic microscopes, optical and scanning electron microscopes, and X-ray fluorescence spectroscopes. Products destruction avoidance is a fundamental point, for example, for the technological process control in crystal manufacturing. Investigation of ICs using a light microscope is one of the most accessible and widespread method of microchip NDT. Semiconductor ICs structure scanning from the side of the device layer is limited by the shielding effect of metallization, since the metal is opaque for light. This limitation can be overcome by an alternative approach to microchip scanning based on irradiating the IC from the side of the substrate with laser sources in the near-IR range. This paper provides a brief overview of the major methods used in laser scanning microscopy to analyze the structures, responses, and features of the operating modes of semiconductor circuits. The main advantages and limitations in the use of optical methods are described, as well as what information about the product can be obtained as a result of laser scanning.

МЕТОД ОЦІНЮВАННЯ СФОРМОВАНОСТІ ІВЕНТ-МЕНЕДЖМЕНТУ НА ПІДПРИЄМСТВІ

Purpose. The article aims to develop a comprehensive and targeted method for assessing the formation of event management in the enterprise, based on the separation of the four-factor model of such assessment (areas of professional competence, maturity, event activity, and information technology component). Design/methodology/approach. The main research methods are theoretical and methodological analysis (to clarify the content of the concept of event management), structural and logical analysis, and way of data systematization (to reflect the structure and relationships within a four-factor model for assessing the formation of event management in the enterprise), an empirical method of diagnostic testing (to establish the ranges of the level of construction of event management), as well as the method of graphical display (to illustrate the formation of event management). Findings. The article analyzed and developed the content of the concept of event management formation and executed its distribution on the level and main directions. The research developed a model of estimation of event management formation at the enterprise, which formed the basis of the offered complex-target method of assessment of such formation. There are 4 main areas (factors) for assessing the formation of event management at the enterprise, namely: the direction of professional competence of employees involved in event management, the direction of organizational maturity, the direction of event activity of the enterprise, and the direction of information technology component of the enterprise. The article graphically illustrated a level of event management formation at the enterprise in the form of a petal diagram with a circle drawing of the level of such formation. The developed complex-target method for enterprises of various activity spheres is empirically researched and applied, based on which we formed conclusions and recommendations. Practical implications. The method allows for forming a set of appropriate parameters for assessing the formation of event management in the management of the enterprise and ensuring their integration to obtain a generalized assessment. Therefore, a point and dynamic evaluation of the level of such formation is obtained, taking into account each of the directions. In addition, it is possible to identify the strengths and weaknesses of the company in this direction, which is further the basis for management decisions to improve. Originality/value. The scientific novelty of the research lies in the authorial and empirically substantiated complex-targeted method of assessing the formation of event management, which will allow determining the level of this formation in the following areas: professional competence of employees, organizational maturity, event activity, and information technology component and. This approach will give you the possibility to pinpoint which areas of event management need special attention to maximize the positive effect of this type of management in enterprise management.

The Relationship of Renal Resistive Index and Central Venous Pressure As Predictors of Acute Kidney Injury in Critically III Patients of Intensive Care Unit Adam Malik General Hospital Medan

<p><strong>Background:</strong> Changes in the doppler-based renal resistive index (RRI) occur prior to the changes of glomerular filtration rate (GFR) during the development of acute kidney injury (AKI) and during the healing process from AKI. Central venous pressure (CVP) is not only a marker for resuscitation, but also can determine the microcirculatory perfusion pressure as outflow obstruction.</p><p><strong>Objective</strong><strong>: </strong>This study aims to determine the relationship between RRI and CVP as a predictor of AKI in critically ill patients admitted to the intensive care unit (ICU) of Adam Malik General Hospital.<strong></strong></p><p><strong>Methods: </strong>This was an observational study with prospective cohort design and diagnostic test method. This research was conducted at the Adam Malik General Hospital Medan from June to July 2020. Forty patients aging 18-65 years old who met the diagnostic criteria of sepsis and septic shock were examined for RI and CVP when admitted to the ICU.</p><p><strong>Results:</strong> RI had better sensitivity and specificity than CVP in predicting the incidence of AKI (sensitivity 68% vs 59%, specificity 77% vs 55.5%, Receiver operating characteristics (ROC)<strong> </strong>0.870 vs 0.321 (95% confidence interval)).</p><p><strong>Conclusion:</strong> Based on the results of this study, the renal resistive index has better sensitivity and specificity than central venous pressure in predicting the incidence of AKI in critical patients in the ICU.</p>

A beginner’s guide to peripheral nerve ultrasound

Ultrasonography is currently being developed as a tool for evaluating peripheral neuropathy. It is one of the painless and least-invasive methods of medical diagnostic testing that yields anatomic views of the nerves and their surrounding structures. Here I first describe the equipment settings and technique for nerve ultrasound along with typical sonographic findings for normal nerves. I then address frequently used parameters for nerve measurements that facilitate diagnoses of focal and generalized neuropathies.

Diagnostic test of Rapid antigen SARS Cov-2 against RT-PCR on suspected symptomatic COVID-19 patients at Rato Ebu Hospital Bangkalan

COVID-19 is caused by the SARS-CoV-2 virus. Two tests to detect the SARS-CoV-2 virus are the rapid antigen test and RT-PCR. The gold standard for testing for COVID-19 is RT-PCR. The high number of Covid-19 sufferers in Madura plus the RT-PCR examination takes a long time. Rapid antigen examination is one of the Covid-19 screening solutions that should be tested because it offers fast examination times. This study aims to determine the sensitivity and specificity of the SARS COV-2 rapid antigen test to RT PCR for the diagnosis of COVID 19. This type of research is an analytical study with a cross-sectional design. The study was conducted at Rato Ebu Hospital Bangkalan from July-September 2021. The sample of this study was suspected symptomatic COVID-19 patients who were examined using the SARS-CoV-2 rapid antigen and RT-PCR using purposive sampling of as many as 60 people. Diagnostic test method by measuring the sensitivity and specificity of rapid antigen to RT-PCR. Based on the results of the study, it can be concluded that the sensitivity of the SARS Cov-2 Rapid Antigen to RT-PCR is 82.97% and the specificity of the SARS Cov-2 Rapid Antigen to RT-PCR is 100%.

Comparison of clinical, microscopic, and rapid diagnostic test methods in the diagnosis of Plasmodium falciparum malaria in four districts in the Eastern Region, Ghana

Comparison of clinical, microscopic, and rapid diagnostic test methods in the diagnosis of Plasmodium falciparum malaria in four districts in the Eastern Region, Ghana

7. Optical genome mapping for prenatal diagnostic testing

The current standard-of-care (SOC) for diagnostic prenatal testing incorporates a combination of cytogenetic technologies that include karyotyping, FISH, and chromosomal microarray (CMA) using cultured amniocytes or chorionic villi sampling (CVS). However, each technology has certain limitations viz. karyotyping has low resolution (>5Mb), FISH is targeted, and CMA does not detect balanced SVs or decipher complex rearrangements in the genome. The result of these limitations is the requirement to use multiple technologies to reach a genetic diagnosis. The current diagnostic prenatal testing workflow demonstrates the need for an alternative technology that can provide results in a cost and time-effective manner. Optical genome mapping (OGM) is an emerging technology that has demonstrated its ability to detect all classes of structural variants (SVs), including copy number variations (CNVs) and balanced aberrations in a single assay, but has not been evaluated in prenatal setting. Herein, we evaluated 80 prenatal amniocyte cases using OGM that were previously characterized by SOC technologies (Karyotype and FISH/CMA). Three samples were run in triplicate to evaluate inter-run, intra-run and inter-instrument reproducibility. Clinically relevant SVs and CNVs were reported using built-in filtration criteria and phenotype-specific analysis. OGM data was found to be 100% concordant with conventional cytogenetic analyses. In addition to identifying previously characterized SVs, OGM identified additional aberrations and demonstrated a higher resolution and sensitivity to accurately define SVs w.r.t size and location. Furthermore, OGM demonstrated 100% technical and analytical reproducibility across runs and instruments. This study demonstrated that OGM has the potential to identify all classes of SVs, including complex structural rearrangements. OGM has a standardized laboratory workflow and reporting solution that can be easily adopted in routine clinical laboratories. In conclusion, OGM has the potential to replace the current SOC methods for prenatal diagnostic testing and can be used as first-tier genetic test in prenatal setting.

Challenges and Future of Drug-Induced Liver Injury Research—Laboratory Tests

Drug-induced liver injury (DILI) is a rare but potentially severe adverse drug event, which is also a major cause of study cessation and market withdrawal during drug development. Since no acknowledged diagnostic tests are available, DILI diagnosis poses a major challenge both in clinical practice as well as in pharmacovigilance. Differentiation from other liver diseases and the identification of the causative agent in the case of polymedication are the main issues that clinicians and drug developers face in this regard. Thus, efforts have been made to establish diagnostic testing methods and biomarkers in order to safely diagnose DILI and ensure a distinguishment from alternative liver pathologies. This review provides an overview of the diagnostic methods used in differential diagnosis, especially with regards to autoimmune hepatitis (AIH) and drug-induced autoimmune hepatitis (DI-AIH), in vitro causality methods using individual blood samples, biomarkers for diagnosis and severity prediction, as well as experimental predictive models utilized in pre-clinical settings during drug development regimes.

The Effectiveness of ddPCR for Detection of Point Mutations in Poor-Quality Saliva Samples.

Background: The noninvasive collection of saliva samples for DNA analyses is simple, and its potential for research and diagnostic purposes is great. However, DNA isolates from such samples are often of inferior quality to those from blood. Aim: The aim of this study was to investigate the robustness and sensitivity of the ddPCR instrument for genetic analyses from saliva samples of poor quality by comparing their results to those obtained using an established method from blood samples. Methods: Blood and saliva were collected from 47 university students, which was followed by manual isolation of DNA and analysis on droplet digital PCR (ddPCR). Results of analyses were supplemented with values of fractional abundances. Results: ddPCR proved to be highly suitable for analysis of even low-quality saliva samples (concentrations as low as 0.79 ng/µL), especially when augmented by fractional abundance data. This combination yielded 100% agreement with results obtained from blood samples. Conclusion: This study verified the applicability of ddPCR as a sensitive and robust method of genetic diagnostic testing even from low-quality saliva isolates. This makes it potentially suitable for a wide range of applications and facilitates the performance of large epidemiological studies, even if sampling or sample processing is suboptimal.

Patterns Testing for Tick-Borne Diseases and Implications for Surveillance in the Southeastern US

Tick-borne diseases (TBD), including spotted fever group rickettsiosis (SFGR), ehrlichiosis, and, increasingly, Lyme disease, represent a substantial public health concern throughout much of the southeastern United States. Yet, there is uncertainty about the epidemiology of these diseases because of pitfalls in existing diagnostic test methods. To examine patterns of diagnostic testing and incidence of TBD in a large, academic health care system. This cross-sectional study included diagnostic test results for TBD at UNC Health, a large academic health care system with inpatient and outpatient facilities, from January 1, 2017, to November 30, 2020. Participants included all individuals seeking routine care at UNC Health facilities who had testing for SFGR, ehrlichiosis, or Lyme disease performed during the study period. Rates of test positivity, testing completeness, and incidence of TBD. During the 4-year study period, 11 367 individuals (6633 [58.4%] female; 10 793 [95%] non-Hispanic individuals and 8850 [77.9%] White individuals; median [IQR] age, 53 [37-66] years) were tested for TBD. Among the 20 528 diagnostic tests performed, 47 laboratory-confirmed, incident cases of SFGR, 27 cases of ehrlichiosis, and 76 cases of Lyme were confirmed, representing incidence rates of 4.7%, 7.1%, and 0.7%, respectively. However, 3984 of SFGR tests (79.3%) and 3606 of Ehrlichia tests (74.3%) lacked a paired convalescent sample. Of 20 528 tests, there were 11 977 tests (58.3%) for Lyme disease from 10 208 individuals, 5448 tests (26.5%) for SFGR from 4520 individuals, and 3103 tests (15.1%) for ehrlichiosis from 2507 individuals. Most striking, testing for ehrlichiosis was performed in only 55% of patients in whom SFGR was ordered, suggesting that ehrlichiosis remains underrecognized. An estimated 187 incident cases of SFGR and 309 of ehrlichiosis were potentially unidentified because of incomplete testing. In this cross-sectional study, most of the patients suspected of having TBD did not have testing performed in accordance with established guidelines, which substantially limits understanding of TBD epidemiology. Furthermore, the data revealed a large discrepancy between the local burden of disease and the testing performed. These findings underscore the need to pursue more robust, active surveillance strategies to estimate the burden of TBD and distribution of causative pathogens.

Determinants of Malaria Morbidity Among School-Aged Children Living in East Hararghe Zone, Oromia, Ethiopia: A Community-Based Case-Control Study.

BackgroundUnderstanding the determinants of malaria morbidity offers helpful insights toward the changing malaria situation, which might lead to the adjustment of malaria program activities. Even though the determinants of malaria morbidity remain unknown, school-aged children were the highest malaria morbidity contributors in the East Hararghe Zone. Therefore, this study aimed to assess the determinants of malaria morbidity among school-aged children in the study area from February 1 to May 31, 2020.MethodsA case-control study was conducted among school-aged children living in ten randomly selected low, moderate, and high malaria transmission kebeles. Cases were confirmed as positive for malaria, while controls were confirmed as negative for malaria among randomly selected school-aged children. Rapid diagnostic testing (RDT) and blood film (BF) malaria testing methods were used. Multivariable logistic regression was used to identify association between malaria and its determinants.ResultsThe determinants of malaria infection were having no formal education (adjusted odds ratio (AOR)=4.91, 95% CI: 1.20–20.17), low family wealth index (AOR=2.50, 95% CI: 1.22–5.12), being from rural residence (AOR=2.34, 95% CI: 1.87–4.12), living near to stagnant water (AOR=2.01, 95% CI: 1.14–3.54), having a maximum of three family members (AOR=0.37, 95% CI: 0.18–0.78), using indoor residual spraying (IRS) (AOR=0.15, 95% CI: 0.08–0.29) and long-lasting insecticide-treated net (LLITN) over the last night (AOR=0.19, 95% CI: 0.10–0.35), and living in the house surrounded by cultivated land(AOR=0.24, 95%CI: 0.10-0.60) compared with their counterparts.ConclusionThis study revealed that residence, family size, education, wealth index, stagnant water existence, and using LLITN and IRS had significant association with malaria morbidity. Thus, all concerned bodies, including the community should strengthen working on stagnant water elimination around their house to cut the breeding site of the malaria vector mosquito. Moreover, the findings have an important implication for improving interventions targeting the economic status and literacy of the society that may help in the reduction of the risk of malaria in the school-aged children.

Diverticular disease of the colon: diagnosis, treatment, and prevention of complications

Introduction. Diverticular disease of the colon is one of the most common gastrointestinal diseases. During the last 30–40 years, there has been a “rejuvenation” of the disease. Today, the prevalence of the disease in people under 40 years of age is 5–10%, and therefore the costs of diagnostic testing and treatment are gradually increasing, which makes the disease socially significant.Aim. To study the clinical features of diverticular disease, the features of diagnosis and treatment, and prophylactic approaches. The specific objectives of the analysis were to study epidemiology; study the role and a necessary minimum set of laboratory diagnostic test methods for the diagnosis of diverticular disease; study the incidence rate of SIBO and its impact on the clinic presentation and treatment; develop an algorithm for the diagnosis, treatment, prevention, and management of patients with diverticular disease.Materials and methods. A total of 195 patients with different forms of diverticular disease were examined. As diagnostic tests, we used blood tests, stool tests, biochemical tests; inflammatory tests: calprotectin, CRP, fibrinogen, ferritin; ultrasound imaging, irrigoscopy, CT, NMR, colonoscopy (if medically required); clinical manifestations at different stages of the course of diverticular disease. 5-aminosalicylates were used to treat exacerbation with inflammation; alpha-normix and motility regulators were used to treat exacerbation without signs of inflammation.Results. On the basis of the study results, we suggested an algorithm for the diagnosis, management and treatment of patients with diverticular disease. According to the particulars of the management, it is reasonable to divide all patients with diverticular disease into three groups: 1) patients who underwent acute diverticulitis; 2) patients with uncomplicated diverticular disease; 3) patients with complicated diverticular disease.Conclusions. The first two groups should be followed up by a gastroenterologist/general practitioner, the third group should be followed up by a surgeon. The patient tested positive for SIBO should receive drugs to eradicate SIBO. The treatment regimens for exacerbation of diverticular disease are proposed.

DeepSARS: simultaneous diagnostic detection and genomic surveillance of SARS-CoV-2

BackgroundThe continued spread of SARS-CoV-2 and emergence of new variants with higher transmission rates and/or partial resistance to vaccines has further highlighted the need for large-scale testing and genomic surveillance. However, current diagnostic testing (e.g., PCR) and genomic surveillance methods (e.g., whole genome sequencing) are performed separately, thus limiting the detection and tracing of SARS-CoV-2 and emerging variants.ResultsHere, we developed DeepSARS, a high-throughput platform for simultaneous diagnostic detection and genomic surveillance of SARS-CoV-2 by the integration of molecular barcoding, targeted deep sequencing, and computational phylogenetics. DeepSARS enables highly sensitive viral detection, while also capturing genomic diversity and viral evolution. We show that DeepSARS can be rapidly adapted for identification of emerging variants, such as alpha, beta, gamma, and delta strains, and profile mutational changes at the population level.ConclusionsDeepSARS sets the foundation for quantitative diagnostics that capture viral evolution and diversity.Graphical abstractDeepSARS uses molecular barcodes (BCs) and multiplexed targeted deep sequencing (NGS) to enable simultaneous diagnostic detection and genomic surveillance of SARS-CoV-2. Image was created using Biorender.com.

CYTOGENETIC STUDIES IN BAD OBSTETRIC HISTORY (BOH) AND INFERTILITY-A RETROSPECTIVE STUDY FROMA STAND-ALONE LABORATORY

Introduction: Cytogenetic abnormalities are one of the important causes of recurrent pregnancy loss or bad obstetric history and Infertility. Almost 50% of first trimester pregnancy loss and upto 20% of second trimester loss can be due to cytogenetic cause. At the same time, cytogenetic abnormalities are also detected in2-3% of cases with infertility especially in males. Methods: In this paper, wepresent our detailed analysisof13,618 of Bad Obstetric History (BOH) and infertility cases,referred for cytogenetics studies at Metropolis Healthcare Ltd, with an aim to look at chromosomal abnormalities observed in our huge dataset. This is the largest ever reported study of cytogenetic studies in BOH and infertility cases. Results: We detected chromosome abnormalities in 470 (3.45%) of 13,618 cases. Out of the 470 cases, reciprocal translocations were the highest abnormality noted in 136 (28.94%) cases, followed by chromosome 9 inversion seen in 125 (26.6%) cases and three (0.64%) cases of insertion were also observed. Inversions were seen in 76 (16.17%) cases. Robertsonian translocations were seen in 19(4.04%) cases and complex translocations were seen in 3 (0.64%) cases. Numerical abnormalities were detected in 84 (17.87%) cases where as Mosaicism was seen in 17(3.62%) cases. Conclusion:This study reinstates the importance of cytogenetic analysis in BOH and infertility cases in order to provide effective genetic counseling to guide the patients to prevent the birth of cytogenetically affected babies by informing them about the prenatal diagnostic testing options and preimplantation genetic testing methods.

An Update on the Recent Emergence of Candida auris

The incidence of invasive fungal infections (IFI) caused by unusual pathogens is on the rise, partly driven by the increased population of immunocompromised patients. The emerging multidrug-resistant yeast pathogen Candida auris (C. auris) has been a source of concern as an agent of healthcare-associated infections. C. auris is emerging multidrug-resistant yeast that causes serious invasive infections with high mortality. It was first discovered in 2009, and since then, individual cases or outbreaks have been reported from over 20 countries on five continents. Controlling C. auris is challenging for several reasons: (1) it is resistant to multiple classes of antifungals, (2) it can be misidentified as other yeasts by commonly available Identification methods, and (3) because of its ability to colonize patients perhaps indefinitely and persist in the healthcare environment, it can spread between patients in healthcare settings. The transmissibility and high levels of antifungal resistance that are characteristic of C. auris set it apart from most other Candida species. A robust response that involves the laboratory, clinicians, and public health agencies is needed to identify and treat infections and prevent transmission. This review highlights epidemiology, pathogenesis, microbiological characteristics, clinical presentation, diagnostic challenges and treatment options of C. auris infections. Infection prevention measures to prevent spread of C. auris and special measures during an outbreak situation have also been reviewed. Rapid emergence of hospital onset C. auris is worrisome. Early diagnosis of C. auris is essential for better outcomes and the implementation of infection prevention measures. Lack of widespread awareness, absence of general availability of diagnostic testing methods, and limited options for treatment of C. auris infections make it a difficult-to-treat pathogen. Further studies are needed for better understanding of this emerging pathogen. Keywords: Fungal infection, Candida, C. auris, Candidemia, Bloodstream infection

UnsaddlingStreptococcus equiinfection of horses

Infection with Streptococcus equi, which forms abscesses in the lymph nodes of the head and neck in horses, is endemic in almost all countries around the world. The identification and isolation of horses with fever, an early sign of disease, is critical to minimising the number of horses affected and the severity of an outbreak, while the identification and treatment of persistently infected ‘carrier’ horses can reduce the risk of recurrent outbreaks and transmission between equine populations. Rapid diagnostic testing plays a key role in the identification of infected horses, which can then be isolated before the development of acute disease or treated to clear persistent infection. Vaccination can also be used to reduce the number of horses that become infected and the severity of their ensuing disease. This review describes the tools available to veterinarians and the journey towards the development and launch of a multi-component fusion protein vaccine that does not trigger positive diagnoses with any of the available diagnostic tests for strangles. The use of vaccination, alongside conventional methods of biosecurity and diagnostic testing, has the potential to unsaddle S. equi, reducing the number of strangles outbreaks and enhancing the health of horses.

Advances in the Rapid Diagnostic of Viral Respiratory Tract Infections.

Viral infections are a significant public health problem, primarily due to their high transmission rate, various pathological manifestations, ranging from mild to severe symptoms and subclinical onset. Laboratory diagnostic tests for infectious diseases, with a short enough turnaround time, are promising tools to improve patient care, antiviral therapeutic decisions, and infection prevention. Numerous microbiological molecular and serological diagnostic testing devices have been developed and authorised as benchtop systems, and only a few as rapid miniaturised, fully automated, portable digital platforms. Their successful implementation in virology relies on their performance and impact on patient management. This review describes the current progress and perspectives in developing micro- and nanotechnology-based solutions for rapidly detecting human viral respiratory infectious diseases. It provides a nonexhaustive overview of currently commercially available and under-study diagnostic testing methods and discusses the sampling and viral genetic trends as preanalytical components influencing the results. We describe the clinical performance of tests, focusing on alternatives such as microfluidics-, biosensors-, Internet-of-Things (IoT)-based devices for rapid and accurate viral loads and immunological responses detection. The conclusions highlight the potential impact of the newly developed devices on laboratory diagnostic and clinical outcomes.