H Westh

Publications of H Westh

• The search and destroy strategy prevents spread and long-term carriage of methicillin-resistant Staphylococcus aureus: results from the follow-up screening of a large ST22 (E-MRSA 15) outbreak in Denmark.

  Authors: S Böcher, R L Skov, M A Knudsen, L Guardabassi, K Mølbak, P Schouenborg, M Sørum, H Westh

  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 09/2010; 16(9):1427-34.

  In the aftermath of a methicillin-resistant Staphylococcus aureus (MRSA) ST22 hospital outbreak, we investigated the prevalence of long-term carriage, the efficacy of MRSA decolonization treatmentIn the aftermath of a methicillin-resistant Staphylococcus aureus (MRSA) ST22 hospital outbreak, we investigated the prevalence of long-term carriage, the efficacy of MRSA decolonization treatment (DT) and the spread of MRSA to households of patients and healthcare workers (HCWs). Furthermore, we evaluated the efficacy of repeated DT in long-term MRSA carriers. Of 250 index persons (58 HCWs and 192 patients), 102 persons (19 HCWs and 83 patients) and 67 household members agreed to participate. Samples from all 169 persons were taken from the nose, throat, wounds and devices/catheters, and urine samples were additionally taken from index persons. Samples from companion animals (n = 35) were taken from the nostrils and anus. Environmental sites (n = 490) screened were telephone, television remote control, toilet flush handle, favourite chair and skirting board beside the bed. Sixteen (19%) patients and two household members, but no HCWs, were ST22-positive. The throat was the most frequent site of colonization. In a multivariate analysis, chronic disease (p <0.001) and pharyngeal carriage (p <0.001) were associated with long-term MRSA carriage. MRSA was found in the environments of four long-term carriers. All animals tested were negative. MRSA-positive households were decolonized using nasal mupirocin TID and daily chlorhexidine body and hair wash for 5 days. Pharyngeal MRSA carriers also received fucidic acid (500 mg TID) combined with rifampicin (600 mg BID) or clindamycin (600 mg BID) for 7 days. The home environment was cleaned on days 2 and 5. At the end of follow-up, ten of 16 long-term carriers and the two household contacts were MRSA-negative. In conclusion, decolonization of MRSA carriers is possible, but should include treatment of household members and the environment.

• Semi-selective broth improves screening for methicillin-resistant Staphylococcus aureus.

  Authors: S Böcher, B Middendorf, H Westh, A Mellmann, K Becker, R Skov, A W Friedrich

  The Journal of antimicrobial chemotherapy. 04/2010; 65(4):717-20.

  To evaluate two enrichment broths for methicillin-resistant Staphylococcus aureus (MRSA) detection and compare results with direct plating. Swabs from 1224 patients were re-analysed for MRSA in aTo evaluate two enrichment broths for methicillin-resistant Staphylococcus aureus (MRSA) detection and compare results with direct plating. Swabs from 1224 patients were re-analysed for MRSA in a central laboratory (Münster) using six methods. Swabs were suspended in 0.5 mL of non-selective enrichment broth (NB) and vortexed. Aliquots of 100 microL were inoculated on/into: (I) ChromID MRSA agar; (II) Columbia sheep blood (5%) agar (BA) and ChromID MRSA; (III, IV) NB incubated overnight followed by plating on BA and ChromID MRSA; and (V, VI) a semi-selective broth containing cefoxitin and aztreonam (TSB-SSI) incubated overnight followed by plating on BA and ChromID MRSA. In III-VI, 100 microL of the enriched broth was plated on each agar. The combined MRSA-positive rate was 21.5%. MRSA isolates detected by each method were: TSB-SSI, n = 223; NB, n = 205; BA and ChromID MRSA, n = 203; ChromID MRSA alone, n = 183. TSB-SSI detected more positive throat samples than the comparators and significantly reduced methicillin-susceptible S. aureus (MSSA) growth. The maximum sensitivity obtained was only 85%, possibly due to the study design using pre-used swabs and dilution of swab material. For 997 samples, results from Münster were compared with initial results. Peripheral laboratories identified 172 MRSA compared with Münster where 186, 186 and 204 MRSA were found for direct plating, NB and TSB-SSI broth, respectively. TSB-SSI was superior to both NB and direct plating on ChromID MRSA and BA. Despite re-using swabs for the study, we showed that routine diagnostic screening could be significantly improved, using a semi-selective enrichment broth.

• Rise and subsequent decline of community-associated methicillin resistant Staphylococcus aureus ST30-IVc in Copenhagen, Denmark through an effective search and destroy policy.

  Authors: M D Bartels, K Kristoffersen, K Boye, H Westh

  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 06/2009;

  Clin Microbiol InfectAbstract The number of patients with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has increased rapidly in Copenhagen, Denmark since 2003. PatientsClin Microbiol InfectAbstract The number of patients with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has increased rapidly in Copenhagen, Denmark since 2003. Patients with the typical Panton-Valentine leukocidin-positive CA-MRSA clone ST30-IVc were contacted with the aim of treating MRSA carriers, evaluating the effect of MRSA eradication therapy (ET), and finding links among patients. Twenty-three index patients infected with the ST30-IVc clone from November 2003 to September 2005 were contacted and transmission chains were studied. The majority of ST30-IVc patients had a connection to the Philippines. Household members were screened for MRSA and all members of families with MRSA carriers were offered treatment of the carrier state and were followed for 1 year. MRSA carriers were found in seven of 16 households and transmission occurred among close contacts and in kindergartens. Five days of ET was insufficient and at least one person in each household was treated with systemic antibiotics. All families were MRSA negative at 1-year follow-up. The CA-MRSA clone ST30-IVc has been imported to Copenhagen, Denmark, primarily from the Philippines, and has spread through close contacts and in kindergartens. Treatment of MRSA carriers was difficult and required many resources, but the clone was eventually successfully eliminated. The import of ST30-IVc to Denmark will continue, but the spread of the clone in Denmark can be kept to a minimum by direct intervention in the affected families.

• Environmental meticillin-resistant Staphylococcus aureus (MRSA) disinfection using dry-mist-generated hydrogen peroxide.

  Authors: M D Bartels, K Kristoffersen, T Slotsbjerg, S M Rohde, B Lundgren, H Westh

  The Journal of hospital infection. 08/2008;

  Meticillin-resistant Staphylococcus aureus (MRSA) is a major problem in hospitals worldwide. Hand hygiene is recognised as crucial in limiting the spread of MRSA but less is known about the role ofMeticillin-resistant Staphylococcus aureus (MRSA) is a major problem in hospitals worldwide. Hand hygiene is recognised as crucial in limiting the spread of MRSA but less is known about the role of MRSA reservoirs in the inanimate hospital environment. We evaluated the effect of hydrogen peroxide vapour diffused by Sterinis((R)) against MRSA in two experimental hospital settings and in two field trials. Dipslides were used for MRSA detection and quantification before and after using the Sterinis disinfection process. In the first experimental hospital setting, four epidemic MRSA strains were placed at five locations and left for one week. All strains survived the week but not the disinfection process. In field trial one 14 upholstered chairs from a department with many MRSA positive patients were left for one month in a closed room prior to disinfection. MRSA was found on the upholstery of four of the 14 chairs. Three chairs became MRSA negative immediately after the disinfection, the fourth 24h later. The second field trial in the private home of a MRSA positive family of four individuals. One location was found MRSA positive, remaining so after the Sterinis cycles. We found Sterinis to be effective against MRSA in the experimental hospital setting and upholstered chairs, but not in the private home of heavily colonised MRSA patients.

• A European laboratory network for sequence-based typing of methicillin-resistant Staphylococcus aureus (MRSA) as a communication platform between human and veterinary medicine--an update on SeqNet.org.

  Authors: A W Friedrich, W Witte, H de Lencastre, W Hryniewicz, J Scheres, H Westh

  Euro surveillance : bulletin européen sur les maladies transmissibles = European communicable disease bulletin. 06/2008; 13(19).

• Methicillin-resistant Staphylococcus aureus in hospitals in Tbilisi, the Republic of Georgia, are variants of the Brazilian clone.

  Authors: M Bartels, A Nanuashvili, K Boye, S Rohde, N Jashiashvili, N Faria, M Kereselidze, S Kharebava, H Westh

  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 06/2008;

  The purpose of this study was to characterise methicillin-resistant Staphylococcus aureus (MRSA) isolates from the Republic of Georgia, part of the former Soviet Union. Thirty-two non-duplicate MRSAThe purpose of this study was to characterise methicillin-resistant Staphylococcus aureus (MRSA) isolates from the Republic of Georgia, part of the former Soviet Union. Thirty-two non-duplicate MRSA isolates were collected in the period from May 2006 to February 2007. The patient data were analysed and the isolates were characterised by staphylococcal protein A (spa) typing, staphylococcal chromosome cassette mec (SCCmec) typing, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE) and the detection of Panton-Valentine leukocidin (PVL) genes. Only two closely related spa types were found; 29 isolates were of spa type 459 and three were t030. The spa types belonged to sequence type (ST) 239, clonal complex (CC) 8. All isolates were multiresistant, PVL-negative and harboured SCCmec type IIIA. Based on the molecular findings and PFGE, the isolates most closely resembled the pandemic Brazilian clone (ST239-IIIA).

• A new multiplex PCR for easy screening of methicillin-resistant Staphylococcus aureus SCCmec types I-V.

  Authors: K Boye, M D Bartels, I S Andersen, J A Møller, H Westh

  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 07/2007; 13(7):725-7.

  A multiplex PCR with four primer-pairs was designed to identify the five main known SCCmec types. A clear and easily discriminated band pattern was obtained for all five types. The SCCmec type wasA multiplex PCR with four primer-pairs was designed to identify the five main known SCCmec types. A clear and easily discriminated band pattern was obtained for all five types. The SCCmec type was identified for 98% of 312 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA). SCCmec type IV was by far the most common SCCmec type among both hospital- and community-acquired MRSA isolates in Denmark.

• Increasing incidence but decreasing in-hospital mortality of adult Staphylococcus aureus bacteraemia between 1981 and 2000.

  Authors: T Benfield, F Espersen, N Frimodt-Møller, A G Jensen, A R Larsen, L V Pallesen, R Skov, H Westh, P Skinhøj

  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 03/2007; 13(3):257-63.

  Staphylococcus aureus is a leading cause of bacteraemia. This study analysed temporal trends from 18,702 adult cases of S. aureus bacteraemia in Denmark between 1981 and 2000. After stratificationStaphylococcus aureus is a leading cause of bacteraemia. This study analysed temporal trends from 18,702 adult cases of S. aureus bacteraemia in Denmark between 1981 and 2000. After stratification for mode of acquisition, 57% of cases were hospital-acquired (HA), 28% were community-acquired (CA) and 15% were of undetermined acquisition (UA). Incidence rates increased from 18.2 to 30.5 cases/100,000 population. Annual rates increased by 6.4% for CA, by 2.2% for HA and by 3.6% for UA cases, respectively. Case-mortality associated with HA bacteraemia decreased from 36.2% to 20.7% (43% rate reduction, p 0.0001), compared with a decrease from 34.5% to 26.5% (23% rate reduction, p 0.0001) for CA bacteraemia. Following multivariate analysis, age, pneumonia, endocarditis and chronic illness were associated with increased mortality, regardless of the mode of acquisition. Overall, mortality associated with S. aureus bacteraemia declined significantly between 1981 and 2000, but incidence rates doubled, so that the total number of deaths increased. These data emphasise the public health importance of S. aureus bacteraemia and the need for further preventive measures and improved care in order to reduce incidence rates and improve outcomes.

• Origins and evolution of methicillin-resistant Staphylococcus aureus clonal lineages.

  Authors: A R Gomes, H Westh, H de Lencastre

  Antimicrobial agents and chemotherapy. 11/2006; 50(10):3237-44.

  Most methicillin-resistant Staphylococcus aureus (MRSA) isolates identified among blood isolates collected in Denmark between 1957 and 1970 belonged to either phage group III or the closely relatedMost methicillin-resistant Staphylococcus aureus (MRSA) isolates identified among blood isolates collected in Denmark between 1957 and 1970 belonged to either phage group III or the closely related 83A complex and had a PSTM antibiotype (resistance to penicillin [P], streptomycin [S], tetracycline [T], and methicillin [M]). Recently, some of these isolates were shown to have the same genetic backgrounds as contemporary epidemic MRSA isolates, and Danish methicillin-susceptible S. aureus (MSSA) isolates from the 1960s with a PST antibiotype were proposed to have been the recipients of the mecA gene in those lineages. In this study, we investigated the genetic backgrounds of isolates from the 83A complex that were fully susceptible or resistant to penicillin only in order to try to trace the evolutionary trajectory of contemporary MRSA lineages. We also studied MSSA and MRSA isolates from other phage groups in order to investigate if they had the potential to develop into contemporary MRSA clones. Most susceptible or penicillin-resistant isolates from phage group III or the 83A complex belonged to sequence type 8 (ST8) or ST5, while four isolates were ST254. STs 30, 45 and 25 were represented by MSSA isolates from other phage groups, which also included several singletons. Representatives of most of the current major epidemic MRSA lineages were identified among fully susceptible isolates collected in the 1960s, suggesting that these were MSSA lineages which carried genetic traits important for superior epidemicity before the acquisition of methicillin resistance.

• High interlaboratory reproducibility of DNA sequence-based typing of bacteria in a multicenter study.

  Authors: M Aires de Sousa, K Boye, H de Lencastre, A Deplano, M C Enright, J Etienne, A Friedrich, D Harmsen, A Holmes, X.W. Huijsdens [......] J K Rasheed, E. Spalburg, B Strommenger, M J Struelens, F C Tenover, J Thomas, U Vogel, H Westh, J Xu, W Witte

  Journal of clinical microbiology. 03/2006; 44(2):619-21.

  Current DNA amplification-based typing methods for bacterial pathogens often lack interlaboratory reproducibility. In this international study, DNA sequence-based typing of the Staphylococcus aureusCurrent DNA amplification-based typing methods for bacterial pathogens often lack interlaboratory reproducibility. In this international study, DNA sequence-based typing of the Staphylococcus aureus protein A gene (spa, 110 to 422 bp) showed 100% intra- and interlaboratory reproducibility without extensive harmonization of protocols for 30 blind-coded S. aureus DNA samples sent to 10 laboratories. Specialized software for automated sequence analysis ensured a common typing nomenclature.

• High interlaboratory reproducibility of DNA sequence-based typing of bacteria in a multicenter study

  Authors: M. ires-de-Sousa, K. Boye, Lencastre H. de, A. Deplano, M.C. Enright, J. Etienne, A. Friedrich, D. Harmsen, A. Holmes, X.W. Huijsdens [......] J.K. Rasheed, E. Spalburg, B. Strommenger, M.J. Struelens, F.C. Tenover, J. Thomas, U. Vogel, H. Westh, J. Xu, W. Witte

  J.Clin.Microbiol. 02/2006; 44.

  Current DNA amplification-based typing methods for bacterial pathogens often lack interlaboratory reproducibility. In this international study, DNA sequence-based typing of the Staphylococcus aureusCurrent DNA amplification-based typing methods for bacterial pathogens often lack interlaboratory reproducibility. In this international study, DNA sequence-based typing of the Staphylococcus aureus protein A gene (spa, 110 to 422 bp) showed 100% intra- and interlaboratory reproducibility without extensive harmonization of protocols for 30 blind-coded S. aureus DNA samples sent to 10 laboratories. Specialized software for automated sequence analysis ensured a common typing nomenclature

• SeqNet.org: a European laboratory network for sequence-based typing of microbial pathogens.

  Authors: A W Friedrich, W Witte, D Harmsen, H de Lencastre, W Hryniewicz, J Scheres, H Westh

  Euro surveillance : bulletin européen sur les maladies transmissibles = European communicable disease bulletin. 02/2006; 11(1):E060112.4.

• The evolution of methicillin resistance in Staphylococcus aureus: similarity of genetic backgrounds in historically early methicillin-susceptible and -resistant isolates and contemporary epidemic clones.

  Authors: M I Crisóstomo, H Westh, A Tomasz, M Chung, D C Oliveira, H de Lencastre

  Proceedings of the National Academy of Sciences of the United States of America. 09/2001; 98(17):9865-70.

  The key genetic component of methicillin resistance, the mecA determinant, is not native to Staphylococcus aureus. Thus, the evolution of methicillin-resistant S. aureus (MRSA) must have begun withThe key genetic component of methicillin resistance, the mecA determinant, is not native to Staphylococcus aureus. Thus, the evolution of methicillin-resistant S. aureus (MRSA) must have begun with the acquisition of the mecA determinant from an unknown heterologous source some time before the first reported appearance of MRSA isolates in clinical specimens in the U.K. and Denmark (in the early 1960s). We compared the genetic backgrounds and phenotypes of a group of methicillin-susceptible S. aureus (MSSA) isolates to the properties of MRSA strains isolated in Denmark and the U.K. during the same time period, and also to the genetic profiles of contemporary epidemic clones of MRSA. All early MRSA isolates resembled a large group of the early MSSA blood isolates in phenotypic and genetic properties, including phage group, antibiotype (resistance to penicillin, streptomycin, and tetracycline), pulsed-field gel electrophoresis pattern, and spaA type and multilocus sequence type, strongly suggesting that the early MSSA examined here represented the progeny of a strain that served as one of the first S. aureus recipients of the methicillin-resistance determinant in Europe. The genetic background of this group of early MSSA isolates was also very similar to that of the widely disseminated contemporary "Iberian clone" of MRSA, suggesting that genetic determinants present in early MSSA and essential for some aspects of the epidemicity and/or virulence of these strains may have been retained by this highly successful contemporary MRSA lineage.

• Archaic strains of methicillin-resistant Staphylococcus aureus: molecular and microbiological properties of isolates from the 1960s in Denmark.

  Authors: H de Lencastre, M Chung, H Westh

  Microbial drug resistance (Larchmont, N.Y.). 02/2000; 6(1):1-10.

  Methicillin-resistant Staphylococcus aureus (MRSA) isolated in the 1960s in Denmark are among the historically earliest samples of these bacteria. We determined microbiological and molecularMethicillin-resistant Staphylococcus aureus (MRSA) isolated in the 1960s in Denmark are among the historically earliest samples of these bacteria. We determined microbiological and molecular properties of 46 such isolates. They showed remarkably uniform properties, which included: (i) low methicillin MIC value (6-25 microg/ml); (ii) heterogeneous expression of resistance; (iii) the presence of a single, common, mecA polymorph II; (iv) lack of the regulatory gene mecI; (v) frequent lack of Tn554; and (vi) a common pulsed-field gel electrophoresis (PFGE) type. These properties, together with the chronological dates of isolation, and recovery of the strains from 18 hospitals scattered over Denmark, suggest that they represent a lineage close in time to the evolutionary origin of European strains of MRSA.

• Vancomycin-resistant Enterococcus faecium strains with highly similar pulsed-field gel electrophoresis patterns containing similar Tn1546-like elements isolated from a hospitalized patient and pigs in Denmark.

  Authors: L B Jensen, A M Hammerum, R L Poulsen, H Westh

  Antimicrobial agents and chemotherapy. 04/1999; 43(3):724-5.

• Ulcer bed infection. Report of a case of enlarging venous leg ulcer colonized by Pseudomonas aeruginosa.

  Authors: L Danielsen, E Balslev, G Döring, N Høiby, S M Madsen, M Agren, H K Thomsen, H H Fos, H Westh

  APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. 08/1998; 106(7):721-6.

  We report a case of ulcer bed infection in an enlarging venous leg ulcer without clinical signs of cellulitis in the surrounding tissues. Signs of infection in the leg ulcer were: 1) cocci-likeWe report a case of ulcer bed infection in an enlarging venous leg ulcer without clinical signs of cellulitis in the surrounding tissues. Signs of infection in the leg ulcer were: 1) cocci-like structures and bacteria-like rods around vessel walls in the viable ulcer bed, 2) vasculitis-like inflammation of deeply situated vessels of the viable tissue, 3) Pseudomonas aeruginosa-specific antibodies in the serum (other than against exotoxin A), 4) extensive epidermolysis of normal human skin by the wound exudate in vitro, and 5) P. aeruginosa exotoxin A in the wound exudate (23 ng/ml). In an in vitro cell assay, the wound exudate was cytotoxic and rabbit antibodies to exotoxin A, but not a serine proteinase inhibitor, inhibited this cytotoxicity. P. aeruginosa exotoxin A might contribute to the pathogenesis of the ulcer enlargement. The ulcer improved after the third skin graft, probably mainly due to effective treatment with a long-stretch compression bandage.

• Bacterial colonization and healing of venous leg ulcers.

  Authors: S M Madsen, H Westh, L Danielsen, V T Rosdahl

  APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. 01/1997; 104(12):895-9.

  The aim of the study was to evaluate a possible influence of selected bacterial species on healing of venous leg ulcers. Fifty-nine patients with venous leg ulcers were followed via frequentThe aim of the study was to evaluate a possible influence of selected bacterial species on healing of venous leg ulcers. Fifty-nine patients with venous leg ulcers were followed via frequent semiquantitative culture of bacteria from the ulcer surface and determination of the ulcer area over a period of 180 days. Occurrences of cellulitis were treated with systemic antibiotics. There was a significant difference in relative areas on days 90 and 180 when ulcers with growth of Pseudomonas aeruginosa were compared to those without (p = 0.0080 and 0.0133, respectively). Ulcers with P. aeruginosa were characterized to a great extent by enlargement in contrast to those without. Ulcers with growth of Staphylococcus aureus or haemolytic streptococci healed significantly more slowly than those without when relative areas were compared on day 180 (p = 0.0079 and 0.0492, respectively). Complete healing within the observation period of 180 days was observed in 10.5% of patients with P. aeruginosa and 35% of those without (p = 0.0631), in 21.6% of patients with S. aureus and 62.5% of those without (p = 0.0278), and in 10.5% of patients with haemolytic streptococci and 35% of those without (p = 0.0631). The initial areas of ulcers colonized with P. aeruginosa or S. aureus were significantly larger than those without, but no significant correlation between initial areas and ulcer healing was revealed. CONCLUSION: Our results suggest that P. aeruginosa in venous leg ulcers can induce ulcer enlargement and/or cause a healing delay. The results also suggest a healing delay caused by S. aureus and haemolytic streptococci. However, conclusions have to be treated with caution since P. aeruginosa was found in combination with haemolytic streptococci in 15.3% of the patients.

• Glycopeptide susceptibility among Danish Enterococcus faecium and Enterococcus faecalis isolates of animal and human origin and PCR identification of genes within the VanA cluster.

  Authors: F M Aarestrup, P Ahrens, M Madsen, L V Pallesen, R L Poulsen, H Westh

  Antimicrobial agents and chemotherapy. 08/1996; 40(8):1938-40.

  The MICs of vancomycin and avoparcin were determined for isolates of Enterococcus faecium and isolates of Enterococcus faecalis recovered from the feces of humans and animals in Denmark. Two hundredThe MICs of vancomycin and avoparcin were determined for isolates of Enterococcus faecium and isolates of Enterococcus faecalis recovered from the feces of humans and animals in Denmark. Two hundred twenty-one of 376 (59%) isolates of E. faecium and 2 of 133 (1.5%) isolates of E. faecalis were resistant to vancomycin (MICs, 128 to > or = 256 micrograms/ml), and all vancomycin-resistant isolates were resistant to avoparcin (MICs, 64 to > or = 256 micrograms/ml). All vancomycin-resistant isolates examined carried the vanA, vanX, and vanR genes, suggesting that a gene cluster similar to that of the transposon Tn1546 was responsible for the resistance.

• Hepatitis C virus and sexual transmission.

  Authors: A M Worm, H Westh, B B Kvinesdal, P S Wantzin

  Acta dermato-venereologica. 06/1996; 76(3):249-50.

• Hepatitis B core antibody screening in a high prevalence group: comparison of three enzyme immunoassays using receiver operating characteristic analysis.

  Authors: H Westh, S Hoffmann, E Christiansen, A M Worm

  Journal of virological methods. 02/1996; 56(1):13-8.

  Selected sera from 296 homosexual men were screened by 3 commercially available anti-HBc enzyme immunoassays (EIA). All patients could be classified either as non-immune to hepatitis B, or withSelected sera from 296 homosexual men were screened by 3 commercially available anti-HBc enzyme immunoassays (EIA). All patients could be classified either as non-immune to hepatitis B, or with current or previous hepatitis B infection. Using the cut-off optical density values (O.D. values) recommended by the respective manufacturers, the results from these three assays were identical for 83% of the serum samples. For anti-HBc reactivity, the ratio (percentage) was calculated using O.D. sample x 100 divided by the O.D. cut-off value. Employing these ratios, sensitivities and specificities for the three assays were compared. All assays performed well when analyzed by receiver operating characteristic curves with area under the curves of 96-97%. A higher specificity, with only a marginal loss of sensitivity could be achieved by lowering the cut-off to 55% for the Enzygost EIA, to 85% for the Enzygost-monoclonal EIA and to 60% for the Corzyme EIA. Using the modified cut-off values, the results with the three assays agreed for 93% of the serum samples.