Medical microbiology is a branch of medical science concerned with the prevention, diagnosis of infectious diseases. Incorrect or delayed diagnosis of infectious diseases results in misdiagnosis or delay in patient treatment. Also, a diagnosed patient who has not been diagnosed at the time may be infected with inappropriate contact with people around him. From this point of view, extremely dangerous results may occur.
The main objective of microbiological laboratories is to detect microorganisms that cause disease and, when necessary, identify sensitivity to antimicrobials by helping the clinician to diagnose and treat infectious diseases. It is important to establish a close cooperation with the physician and the laboratory in order to interpretation of test results properly.
For clinical microbiological laboratories to perform their duties successfully must be taken sufficient amount of the clinical samples, must be properly and timely sent to the laboratory under appropriate conditions. The correct and comprehensive information provided by the clinician can help identify the patient’s diagnosis at the laboratory and ultimately make the treatment successful.
Detection of antigen-antibody reaction is based on direct and indirect methods of antigen-antibodies complexes.
The antigen-antibody reaction is detected by agglutination. An antigen reaction with an antibody is identified by agglutination (clumping). If the antigen is an erythrocyte, the method is called “haemagglutination”. Inci Laboratories use qualitative and quantitative agglutination/haemagglutination tests. For this purpose, are used agllutionation tests such as heterofil antibodies for EBV, Gruber Widal for Salmonella, Wright and “immune capture” for Brucella and for Echinococcus and Trepanoma pallidum hemagllutionation tests.
Rapid tests based on the detection of antigen or antibodies against infection in the patient’s sample. For example, Streptococcus (Group A) Rapid Test, Streptococcus pneumoniae Antigen, Legionella pneumophila Antigen, Helicobacter pylori Antigen (HpSA), E.coli O157: H7 Antigen, Clostridium difficile Toxin A + B, Cryptosporidium Antigen, Respiratory Syncytial Virus Antigen , Norovirus Antigen, Rotavirus Antigen tests.
Enzyme Linked Immunosorbent Assay (ELISA)
Extensive spectrum serology tests of viruses, bacteria, parasites and fungi are used in the serology department of Inci Laboratories. Microorganisms are determined by various methods of IgG, IgM, IgA and total antibacterial levels, IgG avidity tests and antibody specific indexes (ELISA, LIA, ELFA, ECLIA, Western blot, etc.). The Enzyme Linked Immunosorbent Assay (ELISA) is based on the measurement of coloration using the enzyme substrate for immunocomplexes.
The enzyme is bound to the antigen or antibodies. ELISA tests; micro-ELISA methods. In specific diseases; TORCH infections (Toxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex virus), Hepatitis (A, B, C, D and E) infections, syphilis, infectious mononucleosis, AIDS (HIV), borreliosis (Relapsing fever), brucellosis, chlamydia and others. special panels of infections test are investigated.
Autoantibodies are the antibodies that the immune system of the organism creates against its own cells. Symptoms that occur in the patient vary according to the characteristics of the affected cell. There may be general or organ-specific symptoms.
Indirect Immunofluorescence, ELISA, BLOT methods are used for identification of autoantibodies. These tests are only used in automated systems. Indirect microscopic immunofluorescence tests is carried out by two different specialists. In suspicious cases, the results are confirmed by other methods. Laboratory tests:
Avidity tests: Rubella, Toxoplasma, Cytomegalovirus (CMV), Varicella Zoster Virus (VZV)
Antibody Special Index (ASI) Tests: Borrelia burgdorferi, CMV, Herpes Simplex Virus (HSV), Rubeola, Rubella, Mumps (Parotid)
Antibody Tests: Hepatitis Viruses (A, B, C, D, E) (EIA and ELISA), Epstein Barr Virus (EBV) panels (ELISA and Immunblot), Treponema pallidum-Syphilis (Aggression, Indirect Immunofluorescence), Chlamydia (Indirect Immunofluorescence ), Herpes virus type 1,2,6 (ELISA), HIV antibacterial + p24 antigen (EIA and ELFA), Influenza A / B, Parvovirus B19, Borrelia (ELISA and Immunblot), Bartonella henselae / quintana, Brucella, Legionella pneumophila Cytomegalovirus, Chlamydia trachomatis, Chlamydia pneumonia, Chlamydia psittaci, Campylobacter jejuni, Coxiella, Dengue virus, Diphteria, Echinococcus Indirect Immunofluorescence, Enterovirus, Haemophilus influenzae type B, Hantavirus, Mumps (Leptospira, Helicobacter pylori, Rubeola, Rubella, Varicella zoster virus, Parotid), Mycoplasma pneumonia, Neisseria gonorrhoeae / meningitidis, Parainfluenzae, Tetanus, Tularemia, Histoplasma, Saccharomyces cerevisiae, Entamoeba histolytica, Schistosoma, Leishmania, Toxoplasma, Toxocara canis, Morocco ciola hepatica, Filariasis, Trypanosoma, West Nile virus, Yersinia.
The autoantibody tests that used in our laboratory are broad-spectrum. Indirect Immunofluorescence Tests: ANA, dsDNA, ANCA, GBM, Islet, EMA IgA / IgG, ASMA, LCM, AMA, APA, Intrinsic Antibody
Tests with ELISA method: dsDNA, ANCA (pr3, mpo), Gliadin IgA / IgG, Toxug transglutaminase IgA / IgG, Cardiolipin IgM / IgG, Phospholipid IgM / IgG, Phosphotidylserine IgM / IgG, Beta 2 glycoprotein IgM / IgG, GAD, TRAK, CCP
BLOT Tests: ENA profile (Sm, RNP, SSA, SSB, Scl70, Jo1, Pmscl, centromer, histone, nucloesome)
Antigen Tests: Hepatitis Delta Antigen, Candida albicans Antigen (Beta-Glucan), Aspergillus Antigen (Galactomannan), Histoplasma, Cryptococcus neoformance, Entamoeba histolytica, Giardia, Helicobacter pylori, Campylobacter, Influenza A and B, Legionella pneumophila, Streptococcus pneumoniae, Norovirus, Rotavirus, Adenovirus, RSV, Chlamydia trachomatis, Cytomegalovirus pp65.
Cultivation and Antibiotic Susceptibility Testing
Vitek-2 (Biomeriux, France) is a fully automated system for bacterial identification and antibiotic susceptibility testing. Antibiotic susceptibility testing are implemented according to the EUCAST (The European Committee on Antimicrobial Susceptibility Testing) standards and the results are combined with MIC (minimum inhibitory concentration) values.