Early Diagnosis of Tularemia by Flow Cytometry, Czech Republic, 2003-2015

Chrdle, Ales, Tinayska, Pavlina, Dvorackova, Olga, Filipova, Pavlina, Hnetilova, Vera, Zampach, Pavel, Batistova, Kvetoslava, Chmelik, Vaclav, Semper, Amanda E and Beeching, Nick J ORCID: 0000-0002-7019-8791
(2019) Early Diagnosis of Tularemia by Flow Cytometry, Czech Republic, 2003-2015. EMERGING INFECTIOUS DISEASES, 25 (10). pp. 1919-1927.

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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.

Item Type: Article
Uncontrolled Keywords: T-Lymphocytes, Humans, Tularemia, Early Diagnosis, CD4-CD8 Ratio, Serologic Tests, Flow Cytometry, Sensitivity and Specificity, Case-Control Studies, Retrospective Studies, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Child, Czech Republic, Female, Male, Young Adult, CD3 Complex
Depositing User: Symplectic Admin
Date Deposited: 28 Nov 2019 10:14
Last Modified: 19 Jan 2023 00:18
DOI: 10.3201/eid2510.181875
Open Access URL: https://wwwnc.cdc.gov/eid/article/25/10/18-1875_ar...
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3063827