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samenvatting infectieziekten diagnostiek

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samenvatting van diagnostiek infectieziekten

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  • May 9, 2024
  • 9
  • 2023/2024
  • Summary
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DIAGNOSTIEK INFECTIEZIEKTEN
DIAGNOSTIEK INFECTIEZIEKTEN

1) Pre-analystische fase
- Stalen collectie, clinical informatie collectie, preparatie, transport tot
labo
2) Analytische fase
- Technisch proces
3) Post-analystische fase
- Validation, interpretative van resultaten

, DIAGNOSTISCHE TECHNIEK

 Microscopie & kleuring
 Bac cultuur & identificatie
 Susceptibiliteit testen
 Virale cultuur
 Antigen detective
 Moleculaire technieken
 Serologie

MICROSCOPIE

 Voordelen
- Snelle diagnostische informatie (bv: pneumokokken in CSF of TBC bij ZN kleuring)
- Onderzoek van kwaliteit van staal (bv: sputum -> veel epitheelcellen aanwezig)
 Nadelen
- Lage sensitiviteit (25% als < 10^3 CFU/ml & 60-80% als 10^3-10^5 CFU/ml)
- Lage discriminatoire kracht
 gram – kunnen alle enterobacterales zijn
 commensalen VS pathogenen is moeilijk

BACTERIELE CULTUUR & IDENTIFICATIE

 voordelen
- Sensitief
- Detectie van verschillende bac bij = tijd
- Susceptibiliteit testen is mogelijk bij culturen
- Detectie van replicatie duidt op levende bac
 nadelen:
- zeer traag (TBC -> 6-8 w)
- niet toepasbaar op niet cultuurbare bacterie (M.pneumonia, M. leprae)
- sensitief voor transport & omgeving

SUSCEPTIBILITY TESTING

 methodes
- disk diffusion (diameter)
- eplisometer/E-test/gradient diffusie (MIC waarde)
- broth dilution (MIC value)
 interpretatie (EUCAST clinical breakpoints)
- susceptible (S), intermedair (I), resistent (R)

VIRALE CULTUUR

 voordelen
- sensitief
- detective van verschillende virussen op = tijd
- susceptibiliteit mogelijk op culturen
- detectie van replicerende = levende virussen
 nadelen
- zeer arbeidsintensief, expertise nodig
- late diagnose door lange kweektijden

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