Early diagnosis of tularemia by flow cytometry, Czech Republic, 2003-20151

Aleš Chrdle; Pavlína Tinavská; Olga Dvořáčková; Pavlína Filipová; Věra Hnetilová; Pavel Žampach; Květoslava Batistová; Václav Chmelík; Amanda E. Semper; Nicholas Beeching

doi:10.3201/eid2510.181875

Early diagnosis of tularemia by flow cytometry, Czech Republic, 2003-20151

Aleš Chrdle, Pavlína Tinavská, Olga Dvořáčková, Pavlína Filipová, Věra Hnetilová, Pavel Žampach, Květoslava Batistová, Václav Chmelík, Amanda E. Semper, Nicholas Beeching

Clinical Sciences and International Public Health

Research output: Contribution to journal › Review article › peer-review

6 Citations (Scopus)

Abstract

We retrospectively assessed the utility of a flow cytometry-based test quantifying the percentage of CD3+ T cells with the CD4-/CD8- phenotype for predicting tularemia diagnoses in 64 probable and confirmed tularemia patients treated during 2003-2015 and 342 controls with tularemia-like illnesses treated during 2012-2015 in the Czech Republic. The median percentage of CD3+/CD4-/CD8- T cells in peripheral blood was higher in tularemia patients (19%, 95% CI 17%-22%) than in controls (3%, 95% CI 2%-3%). When we used 8% as the cutoff, this test's sensitivity was 0.953 and specificity 0.895 for distinguishing cases from controls. The CD3+/CD4-/CD8- T cells increased a median of 7 days before tularemia serologic test results became positive. This test supports early presumptive diagnosis of tularemia for clinically suspected cases 7-14 days before diagnosis can be confirmed by serologic testing in regions with low prevalences of tularemia-like illnesses.

Original language	English
Pages (from-to)	1919-1927
Number of pages	9
Journal	Emerging Infectious Diseases
Volume	25
Issue number	10
DOIs	https://doi.org/10.3201/eid2510.181875
Publication status	Published - 1 Jan 2019

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@article{3411ca6ed7534de1865268919a85bc3d,

title = "Early diagnosis of tularemia by flow cytometry, Czech Republic, 2003-20151",

abstract = "We retrospectively assessed the utility of a flow cytometry-based test quantifying the percentage of CD3+ T cells with the CD4-/CD8- phenotype for predicting tularemia diagnoses in 64 probable and confirmed tularemia patients treated during 2003-2015 and 342 controls with tularemia-like illnesses treated during 2012-2015 in the Czech Republic. The median percentage of CD3+/CD4-/CD8- T cells in peripheral blood was higher in tularemia patients (19\%, 95\% CI 17\%-22\%) than in controls (3\%, 95\% CI 2\%-3\%). When we used 8\% as the cutoff, this test's sensitivity was 0.953 and specificity 0.895 for distinguishing cases from controls. The CD3+/CD4-/CD8- T cells increased a median of 7 days before tularemia serologic test results became positive. This test supports early presumptive diagnosis of tularemia for clinically suspected cases 7-14 days before diagnosis can be confirmed by serologic testing in regions with low prevalences of tularemia-like illnesses.",

author = "Ale{\v s} Chrdle and Pavl{\'i}na Tinavsk{\'a} and Olga Dvo{\v r}{\'a}{\v c}kov{\'a} and Pavl{\'i}na Filipov{\'a} and V{\v e}ra Hnetilov{\'a} and Pavel {\v Z}ampach and Kv{\v e}toslava Batistov{\'a} and V{\'a}clav Chmel{\'i}k and Semper, \{Amanda E.\} and Nicholas Beeching",

year = "2019",

month = jan,

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doi = "10.3201/eid2510.181875",

language = "English",

volume = "25",

pages = "1919--1927",

journal = "Emerging Infectious Diseases",

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TY - JOUR

T1 - Early diagnosis of tularemia by flow cytometry, Czech Republic, 2003-20151

AU - Chrdle, Aleš

AU - Tinavská, Pavlína

AU - Dvořáčková, Olga

AU - Filipová, Pavlína

AU - Hnetilová, Věra

AU - Žampach, Pavel

AU - Batistová, Květoslava

AU - Chmelík, Václav

AU - Semper, Amanda E.

AU - Beeching, Nicholas

PY - 2019/1/1

Y1 - 2019/1/1

N2 - We retrospectively assessed the utility of a flow cytometry-based test quantifying the percentage of CD3+ T cells with the CD4-/CD8- phenotype for predicting tularemia diagnoses in 64 probable and confirmed tularemia patients treated during 2003-2015 and 342 controls with tularemia-like illnesses treated during 2012-2015 in the Czech Republic. The median percentage of CD3+/CD4-/CD8- T cells in peripheral blood was higher in tularemia patients (19%, 95% CI 17%-22%) than in controls (3%, 95% CI 2%-3%). When we used 8% as the cutoff, this test's sensitivity was 0.953 and specificity 0.895 for distinguishing cases from controls. The CD3+/CD4-/CD8- T cells increased a median of 7 days before tularemia serologic test results became positive. This test supports early presumptive diagnosis of tularemia for clinically suspected cases 7-14 days before diagnosis can be confirmed by serologic testing in regions with low prevalences of tularemia-like illnesses.

AB - We retrospectively assessed the utility of a flow cytometry-based test quantifying the percentage of CD3+ T cells with the CD4-/CD8- phenotype for predicting tularemia diagnoses in 64 probable and confirmed tularemia patients treated during 2003-2015 and 342 controls with tularemia-like illnesses treated during 2012-2015 in the Czech Republic. The median percentage of CD3+/CD4-/CD8- T cells in peripheral blood was higher in tularemia patients (19%, 95% CI 17%-22%) than in controls (3%, 95% CI 2%-3%). When we used 8% as the cutoff, this test's sensitivity was 0.953 and specificity 0.895 for distinguishing cases from controls. The CD3+/CD4-/CD8- T cells increased a median of 7 days before tularemia serologic test results became positive. This test supports early presumptive diagnosis of tularemia for clinically suspected cases 7-14 days before diagnosis can be confirmed by serologic testing in regions with low prevalences of tularemia-like illnesses.

U2 - 10.3201/eid2510.181875

DO - 10.3201/eid2510.181875

M3 - Review article

SN - 1080-6040

VL - 25

SP - 1919

EP - 1927

JO - Emerging Infectious Diseases

JF - Emerging Infectious Diseases

IS - 10

ER -

Early diagnosis of tularemia by flow cytometry, Czech Republic, 2003-20151

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