Il nomenclatore tariffario
contiene le seguenti prestazioni riferibili alla
|
ICD9 |
esame |
tariffa |
cod
reg |
|
91.10.2 |
TREPONEMA
PALLIDUM ANTICORPI (E.I.A.) |
12800 |
37395 |
|
91.10.3 |
TREPONEMA
PALLIDUM ANTICORPI (I.F.) [FTA-ABS] |
15800 |
14786 |
|
91.10.4 |
TREPONEMA
PALLIDUM ANTICORPI (Ricerca qualitat. mediante emoagglutin. passiva) [TPHA] |
6700 |
14770 |
|
91.10.5 |
TREPONEMA
PALLIDUM ANTICORPI (Ricerca quantit. mediante emoagglutin. passiva) [TPHA] |
11200 |
37403 |
|
91.11.1 |
TREPONEMA
PALLIDUM ANTICORPI ANTI CARDIOLIPINA (Flocculazione) [VDRL] [RPR] |
6500 |
14852 |
Abbiamo aggiornato i nostri
metodi in base allo stato dell'arte, richiamato
In pratica, eseguiremo d'ora
in poi un test immunoenzimatico per IgG
Il mantenimento o meno della
ricerca di anticorpi anti-cardiolipina (test
1: Commun Dis Public Health 2000 Sep;3(3):158-62
Serological diagnosis of syphilis. PHLS Syphilis Serology Working Group.
Egglestone SI, Turner AJ
Bristol Public Health Laboratory, Newcastle General Infirmary, Newcastle
upon
Tyne.
The availability of an increasing number of enzyme immunoassays (EIAs)
for
detecting syphilis antibodies makes it appropriate to review approaches
to
syphilis serology and to assess the role of syphilis EIAs in routine
diagnostic
microbiology laboratories. This paper summarises the principles and
practice
of
syphilis serology and provides recommendations on the use of laboratory
tests
for syphilis in UK diagnostic microbiology laboratories. The main
recommendations are summarised in a testing algorithm. Treponemal EIAs
are
an
appropriate alternative to the use of combined Venereal Disease Research
Laboratories/rapid plasma reagin and Treponema pallidum haemagglutination
assay
(TPHA) tests for screening for syphilis. If a treponemal EIA is used for
screening an alternative treponemal test, such as TPHA, should be used
for
confirmatory testing. The fluorescent treponemal antibody-absorbed test
is
probably best reserved for specimens giving discrepant results. Such
specimens
may be referred to the PHLS laboratories that provide confirmatory
treponemal
testing for reference testing and to facilitate collection of
surveillance
data
on what remains an important public health problem.
PMID: 11014025
1: Diagn Microbiol Infect Dis 2000 Jul;37(3):157-60
Evaluation of the Bio-Rad syphilis IgG test performed on the CODA system
for
serologic diagnosis of syphilis.
Tholcken CA, Woods GL
Department of Pathology, University of Texas Medical Branch, Galveston,
Texas,
USA.
The performance of the Bio-Rad Syphilis IgG EIA test as a "screen
for
syphilis"
[testing first by EIA and then by the rapid plasma reagin (RPR) assay if
the
EIA
was positive or equivocal] and as a confirmatory test was evaluated by
comparing
results to those obtained by CAPTIA Syphilis-G. Discrepancies were
resolved
by
repeating both EIAs and/or the SeroDia TP-PA (a particle agglutination
assay
that replaced the microhemagglutination Treponema pallidum test). Both
EIAs
were
totally automated, the Bio-Rad test using the AutoPrep instrument for
pipetting
and the CODA system to perform all of the steps required to complete the
EIA
and
interpret results, and the CAPTIA test using the LabOTech(R) to
accomplish
both
functions. Of 449 unselected sera submitted to "screen for
syphilis," both
EIAs
agreed for 432 (96.2%) specimens: 395 negative, 36 positive, and one
equivocal.
Fifty-four specimens were positive or equivocal by one or both EIAs; 41
of
these
were RPR reactive. Three of these 41 were incorrectly called negative by
Bio-Rad
(sensitivity 92.7%), and there was 1 false-negative result by CAPTIA
(sensitivity, 97.6%) (P, not significant). To further evaluate the
Bio-Rad
assay
as a confirmatory test, 144 known RPR-reactive specimens were tested by
both
EIAs. Results agreed for 134 (93.1%): 123 positive, 11 negative. After
resolving
discrepancies, there were 3 false-negative and no false-positive results
by
Bio-Rad (sensitivity 97.8%, specificity 100%), and with CAPTIA there
were no
false-negative results and 1 false-positive (sensitivity 100%,
specificity
91.7%) (P, not significant). The sensitivity of the Bio-Rad assay could
be
improved, without altering specificity, by lowering the cut-off value for
equivocal results. In summary, the Bio-Rad Syphilis IgG EIA performed
using
the
AutoPrep instrument and CODA system is a reliable, efficient method of
syphilis
testing.
PMID: 10904187
2: J Clin Microbiol 2000 Jul;38(7):2543-5
Comparison of the Serodia Treponema pallidum particle agglutination,
Captia
Syphilis-G, and SpiroTek Reagin II tests with standard test techniques
for
diagnosis of syphilis.
Pope V, Fears MB, Morrill WE, Castro A, Kikkert SE
Division of AIDS, STD, and TB Laboratory Research, National Center for
Infectious Diseases, Centers for Disease Control and Prevention, Atlanta,
Georgia, USA. vxp1@cdc.gov
We compared the microhemagglutination assay for Treponema pallidum
(MHA-TP),
a
treponemal test, with two other treponemal tests, the Serodia Treponema
pallidum
particle agglutination (TP-PA) assay and the Captia Syphilis-G enzyme
immunoassay, using 390 clinical serum samples. We also compared two
nontreponemal tests, the rapid plasma Reagin (RPR) card test and the
SpiroTek
Reagin II test. Agreements of the MHA-TP with the TP-PA test and the
Syphilis-G
test were 97.4 and 97.7%, respectively. There was 89.2% agreement between
the
RPR and Reagin II tests. The Reagin II test was more apt to be reactive
if
the
treponemal test was also reactive. We conclude that either the Serodia
TP-PA
test or the Captia Syphilis-G test is an appropriate substitute for the
MHA-TP
and that the Spirotek Reagin II test could substitute for the RPR test
as a
screening test.
PMID: 10878040
3: Int J STD AIDS 2000 May;11(5):288-91
Enzywell recombinant enzyme immunoassay for the serological diagnosis of
syphilis.
Young H, Aktas G, Moyes A
Department of Medical Microbiology, Edinburgh University Medical School,
UK.
hugh.young@ed.ac.uk
The aim of this study was to evaluate Enzywell TP, a new rapid enzyme
immunoassay (EIA) that uses 2 recombinant Treponema pallidum antigens for
the
serological diagnosis of syphilis. Specificity was evaluated by screening
1055
unselected bloods requesting serological tests for syphilis in parallel
with
Enzywell TP and the Syphilis ICE EIA which is our standard screening test
for
syphilis. Sensitivity was evaluated using a panel of 159 known treponemal
sera
representing various stages of syphilis and 5 treponemal sera detected on
screening. The specificity of Enzywell TP on initial and repeat testing
(99.6%
and 99.7% respectively) was similar to that of the Syphilis ICE test
(99.8%
and
99.9% respectively). The sensitivity of Enzywell TP (100%) was similar to
that
of Syphilis ICE (99.4%): both tests were significantly more sensitive
(P=0.01)
than the fluorescent antibody absorbed test (94.5%) but not the T.
pallidum
particle agglutination (TPPA) assay (99.4%). Both
Enzywell TP and Syphilis
ICE
were positive with sera from 16 known HIV-infected patients who had been
treated
for syphilis many years previously (mean 9.4 years) confirming the value
of
these tests in excluding previous syphilis in HIV-infected individuals.
We
conclude that the Enzywell recombinant EIA is simple, rapid, highly
sensitive
and specific, and is a welcome addition to the range of currently
available
diagnostic tests for syphilis.
PMID: 10824936
4: J Emerg Med 2000 Apr;18(3):361-7
Syphilis testing.
Clyne B, Jerrard DA
Division of Emergency Medicine, Department of Surgery, University of
Maryland
Medical System, Baltimore, MD 21201, USA.
The organism that causes syphilis, Treponema pallidum, is impossible to
culture
in the clinical laboratory. Direct visualization of the pathogen is one
laboratory technique used in the diagnosis of syphilis. Currently,
serologic
testing is the most widely used laboratory technique in diagnosing
syphilis
and
monitoring its course after treatment. Serologic tests are divided into
two
categories, the nontreponemal and treponemal antibody tests. Newer
techniques
such as enzyme immunoassays have shown excellent results.
Publication Types:
Review
Review, tutorial
PMID: 10729677