Tamara Tuuminen

ISLAB, Mikkeli, Finland and Univerrsity of Helsinki · clinical microbiology

We hypothesized that prolonged or cumulative exposure to indoor air dampness microbiota in moisture-damaged buildings and daily exposure to wireless telecommunication devices would potentiate the risk of electromagnetic hypersensitivity (EHS), which is poorly defined. We performed a nested comparative analysis within an age- and sex-matched study o...

The assessments of malnutrition in adults with MUST or NRS-2002 criteria do not give a detailed insight into the sufficiency of micronutrients. Sufficiency assessment of essential micronutrients on the individual level can be achieved only with laboratory measurements. The aim of this study was to estimate long-term trends in micronutrient sufficie...

We aimed to establish an etiology-based connection between the symptoms experienced by the occupants of a workplace and the presence in the building of toxic dampness microbiota. The occupants (5/6) underwent a medical examination and urine samples (2/6) were analyzed by LC-MS/MS for mycotoxins at two time-points. The magnitude of inhaled water was...

Salt therapy has been used for millennia, but modern salt therapy can be traced to the salt mines and caves in Europe and Russia from the early 19th century. Today, breathing in the microclimate of caves with their stable air temperature and moderate to high humidity in the presence of sodium, potassium, magnesium and calcium and the absence of air...

In Finland, the public health policy regarding the management of patients exposed to dampness microbiota and decay products of construction materials in moisture-damaged buildings remains unacceptable. Most important, it has become practically impossible to hold a true exchange of views on this topic with the Department of Health and Welfare and th...

Background: There is an on-going debate on how best to test toxic indoor air. Toxicological methods based on condensed water samples and cell culture technique are newly introduced research tools which were tested in this study. Methods: Pupils (n=47) from a water-damaged and (n=56) healthy schools were interviewed using a questionnaire. Indoor...

Our original study entitled “Moist and mold exposure is associated with high prevalence of neurological symptoms and MCS in a Finnish hospital workers cohort” has raised a lot of interest. It has been criticised by our Finnish colleagues. [1] In fact, this critic towards our work depicts the current situation in Finland. Opinions different from the...

Background: The terminology of "sick building syndrome" (SBS), meaning that a person may feel sick in a certain building, but when leaving the building, the symptoms will reverse, is imprecise. Many different environmental hazards may cause the feeling of sickness, such as high indoor air velocity, elevated noise, low or high humidity, vapors or d...

Objectives: The aim of the study was to estimate the risks of different symptoms after the exposure to indoor air dampness microbiota (DM). Methods: This cross-sectional retrospective cohort-based study compared morbidity risks in DM exposed (n = 116) vs. unexposed cohort (n = 45). Gender-adjusted log-binomial regression models were used to calcula...

Our Letter to the Editor opposes the one-sided vision that the mold-exposure or indoor air problems is a psychobiological problem. We bring up novel findings, how the earlier methods of analysis have not been sufficient in search of the toxicity.

Background Indoor air dampness microbiota (DM) is a big health hazard. Sufficient evidence exists that exposure to DM causes new asthma or exacerbation, dyspnea, infections of upper airways and allergic alveolitis. Less convincing evidence has yet been published for extrapulmonary manifestations of dampness and mold hypersensitivity syndrome ). Me...

Mold exposure and HPV vaccinations may induce CFS, and this study be studied further. This is respective finding to narcolepsy, but for some reasons not allowed to be studied.

Background and aims Low-grade chronic inflammation is a condition underlying many serious diseases but there is no good single biomarker which can estimate and monitor the severity of the inflammation. C-reactive protein (CRP) is the best validated and most extensively used marker. The aims of the study were to investigate the extent to which CRP l...

Occupational exposure to indoor air moulds and the consequent development of dampness and mould hypersensitivity syndrome (DMHS) may cause lung damage; in most cases, this is not allergic asthma mediated by specific immunoglobulin E-class antibodies. Instead, it is often a hypersensitivity pneumonitis or bronchopneumonitis. In Finland, the current...

Water damage in buildings is a universe problem. Long-lasting or cumulative stay in water damaged buildings is a serious health hazard. Exposure to fungal and bacterial toxins, nanoparticles from dampness microbiota as well as decay products from construction materials together with biocides used for cleaning will first cause irritation of the muco...

The presence of toxic indoor molds with accompanying bacterial growth is clearly detrimental to human health. The pathophysiological and toxicological effects of toxins and structural components of molds and bacteria have been clarified in experiments conducted in tissue culture and animals, and there is convincing epidemiologic evidence; nonethele...

New biomarkers are needed for discriminating active tuberculosis (TB) from latent TB infection (LTBI), especially in vulnerable groups representing the major diagnostic challenge. This pilot study was carried out to explore the diagnostic potential of selected genes, IFN-γ, IL-17, IL-4, and FoxP3, associated with TB immunity and immunopathology. IF...

Tuberculosis is a devastating contagious disease caused by Mycobacterium tuberculosis. This is the first report describing the development of novel capillary electrophoresis methods to detect lipoarabinomannans shed into the blood circulation by replicating bacteria. The novelty of the methods is the detection without derivatization. The lipoarabin...

Childhood cervical lymphadenitis caused by NTM is a diagnostic challenge for the clinician. We present a new promising diagnostic method for childhood NTM lymphadenitis. The modified T-SPOT®.TB test with PPD as an additional antigen is noninvasive with estimated sensitivity and specificity of 1.00 and 0.81, respectively.

Blood-stream recurrent infections have been reported for a variety of opportunistic bacteria. These are often either catheter-related or caused by indwelling devices. A case of relapsing sepsis with two Escherichia coli strains carrying ESBL and derepressed ampC genes is reported. The patient had seven episodes of blood-stream infections within one...

A total of 95 human Campylobacter jejuni isolates acquired from domestic infections and collected from three districts in Finland during the seasonal peak (June to September) in 2012 were analysed by PCR-based multilocus sequence typing (MLST) and by whole-genome sequencing (WGS). Four predominant sequence types (STs) were detected among the isolat...

Factors affecting transmission of contagious diseases There are differences in the transmission rate of infectious diseases. The mathematic estimates of the transmission rate of various contagious diseases are impossible to predict. The Basic reproduction number, the so-called Ro-value tends to extrapolate the number of persons who can get infected...

The first vector-borne Capnocytophaga canimorsus sepsis case is presented. An immunocompetent male who denied any contact with canines and who worked in a sawmill was bitten on his neck by a large pine weevil (Hylobius abietis L.; Coleoptera: Curculionidae). Bacteriological diagnosis was confirmed by 16S rRNA gene sequence analysis.

Actinobaculum schaalii is an emerging uropathogen. So far, its identification has been performed with 16S rRNA gene sequencing or PCR. The diagnosis has often been delayed due to fastidious growth and identification problems. Eleven clinical isolates of A. schaalii from bloodstream infections that were initially identified with 16S rRNA sequencing...

Data exploring the potential use of effector molecules produced by cytotoxic T lymphocytes (CTLs) in the immunodiagnostics of tuberculosis (TB) are scarce. The present study focused a) to gain an insight into the discriminatory power of CTLs in patients with acute pulmonary or extra-pulmonary TB, or latent tuberculosis infection (LTBI); and b) to e...

On a population-based level, the incidence of reactive arthritis (ReA) is 0.6–27/100,000. The definition of ReA varies and its pathogenesis is not yet clear. Attempts in basic immunology to suggest hypotheses for proliferation of forbidden B cell clones, molecular mimicry, and involvement of cross-reactive antibodies are helpful but not sufficient....

The aim of the study was to evaluate the performance of the new mariPOC® method against the direct fluorescent antibody assay (DFA) as the primary reference method for rapid virus detection from nasopharyngeal aspirates and swab samples. The study was an open prospective evaluation during the seasonal winter epidemics in the Mikkeli Central Hospita...

Having experience ever since 2004 and being responsible for interpretations of nearly 2000 clinical samples tested with QuantiFeron®-TB yearly, I want to raise a question whether an FDA approved method does not need to take into account between-run and within-run imprecision around the cut-off zone (1, 2)?…

Diagnosis of active tuberculosis by detection of urinary lipoarabinomannan (uLAM) from Mycobacterium tuberculosis is an attractive approach. Concentrating urine 100-fold allowed quantitation of uLAM at levels equal to picograms/ml of nonconcentrated urine. The approach of concentrating urine 100-fold improved the clinical sensitivity of the Clearvi...

Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) is a zoonotic pathogen for persons in contact with horses. In horses, S. zooepidemicus is an opportunistic pathogen, but human infections associated with S. zooepidemicus are often severe. Within 6 months in 2011, 3 unrelated cases of severe, disseminated S. zooepidemicus infection occu...

Objective: mariPOC® (ArcDia International Oy Ltd, Turku, Finland) is a novel immunoassay platform for rapid (20 minutes) and automated multianalyte detection of respiratory infection pathogens from swab samples. This system allows detection of influenza A and B, respiratory syncytial, human metapneumo-, adeno-, and parainfluenza 1, 2, and 3 viruses...

Background In 1872, in British Medical Journal (BMJ) Dr. David Ferrier published that Sarcina ventriculi (Goodsir) constantly occurred in the blood of man and the lower animals. His observation was based on bleeding experiments, incubation of blood at 100oF (37.8oC) and later examination. He found “immense numbers of beautifully formed sarcinæ”. In...

The prevalence of active tuberculosis (TB) is low in Finland, but outbreaks do occur. Following exposure national guidelines recommend either tuberculosis skin test or interferon-γ-release assay-testing of asymptomatic children. The aim of this study was to compare QuantiFERON-TB Gold In-Tube test (QFT) and interferon-γ-inducible protein (IP-10) re...

Antigen specific release of IP-10 is an established marker for infection with M.tuberculosis. Compared to IFN-γ, IP-10 is released in 100-fold higher concentrations enabling the development of novel assays for detection. Dried blood spots are a convenient sample for high throughput newborn screening. To develop a robust and sensitive ELISA-based as...

Preparation of filter paper for QFT supernatants. Draw 3×2 dots for nil (black), antigen (red) and mitogen (blue/purple) application. Sample preparation for frozen samples (skip if using fresh plasma) 1) Defrost QFT samples. 2) Vortex 20 sec. per sample. 3) Centrifuge to pellet debris (e.g. 2000 RPM for 2 min) A. Adding sample 1) Place the filter p...

Lower Limit of Quantification (LLOQ). LLOQ can be defined as the point at which the coefficient of variation for relevant patient samples is at least 15% [38]. The LLOQ was determined based on pooled nil, TB antigen and PHA mitogen samples from 18 patients with confirmed positive QFT-IT test. Only 2 samples had a CV% >15% and these were both <4 pg/...

Linearity of the standard curve. We performed 48 consecutive IP-10 assays including aliquots of the same plasma sample and aliquots of the same 7-point standard curve. We prepared standard curves by diluting recombinant IP-10 (Peprotec, USA) in the following 7 concentrations: 566 pg/ml, 377 pg/ml, 189 pg/ml, 94 pg/ml, 38 pg/ml, 9.4 pg/ml and 1.9 pg...

Estimates of assay imprecision. Within-run, Between-run and Total imprecision of the assays was determined using 4 representative samples. DBS, DPS and plasma samples (at x33 dilution) were prepared and analyzed in 5-replicates in 5 independent assays performed by the same operator using the same equipment. The experiments describe the random error...

Cross reactivity with similar analytes. We observed no interference with the following analytes at the concentration in parenthesis: TNF-a (1.2 ng/ml), IL-1b (3.19 ng/ml), IL-2 (1.7 ng/ml), IL-4 (16.18 ng/ml), IL-5 (4.14 ng/ml), IL-6 (3.71 ng/ml), IL-8 (11.17 ng/ml), IL-10 (9.2 ng/ml), IL-3 (1.48 ng/ml), IL-7 (7.64 ng/ml), IL-1a (20.5 ng/ml), IL-12...

Typical standard curve (A) and dynamic range (B) of the IP-10 ELISA. Typical standard curve (A) and dynamic range (B) of the IP-10 ELISA A. Recombinant IP-10 (Peprotec, USA) was prepared in 7 concentrations: 1.9 pg/ml, 9.4 pg/ml, 38 pg/ml, 94 pg/ml, 189 pg/ml, 377 pg/ml and 566 pg/ml and analyzed using the IP-10 ELISA, presented is a typical exampl...

Within- and between-run imprecision. A. Dried blood spot (DBS) samples (pg/2 discs). B. Dried plasma spot (DBS) samples (pg/2 discs). C. Plasma samples (ng/ml). (DOCX)

Spike-recovery of IP-10 in plasma samples. Spike recovery was performed by spiking recombinant IP-10 (Peprotec, USA) into ×10 and ×3 diluted plasma samples without detectable IP-10. The average % recovery was calculated as the proportion of spiked standard in the sample (observed) to that of the control spike (expected). (DOCX)

Stability of IP-10 in dried plasma spots. Stability studies determine the longest time IP-10 in a DPS sample can be stored before it deteriorates and produce inaccurate results. Stability was determined by leaving DPS samples at 5°C, 23°C, 37°C and 50°C for 0–4 weeks as listed in the table 7 A–D. Recovery was within our acceptance range of 70–130%,...

Assay Linearity. Linearity was determined in 4 plasma samples serially diluted throughout the assay range. The % recovery was calculated as observed vs. expected concentration. Average linearity was within our acceptance range of 70–130% between x4 and x64 dilution. (DOCX)

Stability of IP-10 in plasma with repeated freeze thaw cycles. The ability of IP-10 in plasma to tolerate freeze-thaw cycles was assessed by freezing and thawing up to 10 times. Samples were thawed at room temperature and left for minimum 2 hours before refreezing. There was at least 24 hours between each freeze-thaw cycle. %Recovery is calculated...

Stability of IP-10 in plasma stored at +5°C for up to 6 weeks. The stability of IP-10 in plasma was determined by leaving samples at 5°C for the weeks listed in the table. Samples were within our acceptance range of 70–130%, indicating that samples can be stored at +5°C for at least 6 weeks with no loss of signal. (DOCX)

Stability of IP-10 in plasma with storage at room temperature +23°C. The stability of IP-10 in a plasma sample stored at room temperature was assessed. %Recovery is calculated by comparing the value of the treated sample to the reference (0 days) sample ×100. Samples were within our acceptance range of 70–130%, indicating samples can be stored at r...

The performance of the interferon gamma release assays (IGRAs) and tuberculin skin test (TST) was reviewed retrospectively in patients with psoriasis, inflammatory musculoskeletal diseases, or miscellaneous inflammatory conditions. The study was carried out over a 22-month period using 109 records of patients with psoriasis (n = 21), musculoskeleta...

Urine as a clinical specimen to diagnose infections has been used since ancient times. Many rapid technologies to assist diagnosis of infections are currently in use. Alongside traditional enzyme immunoassays (EIA), new technologies have emerged. Molecular analysis of transrenal DNA to diagnose infections is also a rapidly growing field. The majori...

Patients with advanced solid tumors refractory to and progressing after conventional therapies were treated with three different regimens of low-dose cyclophosphamide (CP) in combination with oncolytic adenovirus. CP was given with oral metronomic dosing (50 mg/day, N = 21), intravenously (single 1,000 mg dose, N = 7) or both (N = 7). Virus was inj...

Mycoplasmas belong to the smallest micro-organisms that are independent of animal or plant cells. They are classified as bacteria, since their cultivation does not require any cells. Mycoplasma hominis is a commensal of the human urogenital region, but may sometimes cause even life-threatening, slow-healing soft tissue infections. Ureaplasma urealy...

Several infectious agents may cause arthritis or arthropathy. For example, infection with Borrelia burgdorferi, the etiologic agent of Lyme disease, may in the late phase manifest as arthropathy. Infections with Campylobacter, Salmonella, or Yersinia may result in a postinfectious reactive arthritis. Acute infection with parvovirus B19 (B19V) may l...

To compare ex vivo immunological responses upon stimulation of lymphocytes with Mycobacterium tuberculosis-specific antigens in three groups: 1) subjects diagnosed with tuberculosis (TB) in the early 1940s and 1950s but who did not receive anti-tuberculosis chemotherapy (n = 5), 2) subjects treated with anti-tuberculosis agents prior to the rifampi...

New gamma interferon (IFN-gamma) release assays (IGRAs) to detect an exposure to Mycobacterium tuberculosis have recently been launched. The majority of the studies in temperate-climate countries agree that these methods have superior specificity and equal or even superior sensitivity over tuberculin skin tests (TSTs) in the diagnosis of latent tub...

A 55-year-old, HLA-B27-positive Finnish woman presented with migratory, sterile polyarthritis. Physical examination, chest radiography, serologic testing, microscopy, M. tuberculosis-specific interferon gamma enzyme-linked immunospot (ELISPOT) assay, smear and culture of synovial fluid for acid-fast bacilli, and PCR. The patient's assayed blood and...

Two commercial interferon gamma release assays (IGRAs) (QuantiFERON(R)-TB Gold in Tube and T SPOT(R)-TB) to detect a contact with M. tuberculosis have recently become available. The majority of studies agree that the sensitivity and specificity of these methods are superior to the Tuberculin Skin Tests (TSTs) in detecting an exposure to bacteria in...

In recent years T cell based interferon gamma release assays (IGRA) have been developed for immunodiagnosis of M. tuberculosis infection. At present these assays do not discriminate between disease and latency. Therefore, more promising antigens and diagnostic tools are continuously being searched for tuberculosis immunodiagnostics. The heparin bin...

The induction and maintenance of T cell memory is incompletely understood, especially in humans. We have studied the T cell response and the generation of memory during acute infection by the Puumala virus (PUUV), a hantavirus endemic to Europe. It causes a self-limiting infection with no viral persistence, manifesting as hemorrhagic fever with ren...

The performances of the QuantiFERON-TB Gold in Tubes (QFGT), T SPOT-TB (ELISPOT) and the Mantoux test were compared for the diagnosis of latent tuberculosis infection in Finland, a country of low tuberculosis incidence. In Cohort A (16 students), freshly isolated peripheral blood mononuclear cells (PBMCs), and in Cohort B (21 school children), cryo...

We report the first documented case of bacteremia caused by Asaia bogorensis in a young patient with a history of intravenous-drug abuse. A. bogorensis was identified by sequencing the 16S rRNA gene. The isolate was exceptionally resistant to almost all antibiotics that are routinely tested for gram-negative rods but was susceptible to netilmicin,...

Sera from 150 consecutive patients with established asthma and 150 matched controls were examined for Chlamydia pneumoniae IgG and IgA with commercially available enzyme immunoassays (EIAs) detecting immune response solely to surface proteins of elementary bodies. The assays were also modified to measure combined immune response to surface proteins...

A casuistic immunologic response in primary and repeated Chlamydophila pneumoniae infection is described. The primary C pneumoniae infection was documented as laboratory accident in late 1990. The immunologic response was mediated mainly through production of IgM antibodies with only a marginal IgG and IgA increase near the cut-off value. The secon...

The aim of the study was to evaluate new Mycoplasma pneumoniae IgG, IgA and IgM EIA methods based on the enrichment of P1-protein (ThermoLabsystems, Helsinki, Finland) (L) for the detection of acute infection. This evaluation was performed in two independent routine clinical microbiology laboratories. The first laboratory used samples preselected b...

An in-house P1-enriched (168-kDA protein) Mycoplasma pneumoniae antigen preparation was compared in IgG, IgA and IgM enzyme immunoassays (EIAs) to the respective EIAs employing crude antigen lysate, antigen prepared by Triton X-114 partition and two commercial antigens, one of which was an ether-extracted antigen and the other a P1-enriched antigen...

Enzyme immunoassays (EIAs) for the detection of secretory IgA antibody (sIgA) to Chlamydia pneumoniae and Mycoplasma pneumoniae from saliva are described. The presence of salivary sIgA in healthy laboratory personnel (mean age 40, range 25-62 years) was detected using conjugates of antibodies directed against secretory and alpha-chain domains. The...

New enzyme immunoassays (EIAs) for determination of specific IgG, IgA, and IgM antibody titers to Chlamydia pneumoniae were evaluated independently in three research laboratories. Specificity of the EIAs was enhanced by removing LPS from the chlamydial antigen. The performance of these EIAs was evaluated in comparison with the microimmunofluorescen...

Serology is commonly used for the diagnosis of acute Chlamydia pneumoniae infections and also for the diagnosis of complicated Chlamydia trachomatis infections. Furthermore, recent sero-epidemiological studies have linked C. pneumoniae infection with several diseases traditionally considered non-infectious. The objectives of this mini-review are to...

A pilot neonatal screening programme revealed a high (approximately 1 per 4800 live births) prevalence of congenital toxoplasmosis (CT) in the State of Rio Grande do Sul, Brazil. The purpose of this paper was to estimate in a larger prospective study the prevalence of CT in the country. At the beginning of the study, an in-house indirect enzyme imm...

Chlamydia pneumoniae and Mycoplasma pneumoniae immunoglobulin G (IgG) and IgA antibody seroprevalence rates and antibody levels related to age and gender were studied. The samples (n = 742) were collected during a nonepidemic period and analyzed by quantitative enzyme immunoassays (EIAs). Seroprevalence to C. pneumoniae was found to increase sharpl...

In the Toxoplasma gondii immunoglobulin M (IgM) capture fluorometric enzyme immunoassay used as a model, nonspecific responses due to the binding of human IgM to horseradish peroxidase (HRP) conjugates were observed despite the removal of the Fc portion of the immunoglobulin. This interaction may be mediated through the binding of human IgM to the...