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Copyright © 2020 Lieberman et al.The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) brought with it rapid development of both molecular and serologic assays for identification of COVID-19 infections. While Food and Drug Administration (FDA) emergency use authorization (EUA) is required for clinical application of SARS-CoV-2 molecular tests, submission for EUA is currently a voluntary process for manufacturers of serologic assays. The absence of FDA oversight of serologic tests is concerning, given that the commercially available serologic assays are highly variable, differing in their format, the antibody class detected, the targeted antigen and the acceptable specimen types. An added complication is the lack of a clear understanding for how such assays should be utilized and what the reported results ultimately indicate, or perhaps more importantly, what they do not indicate. Here, we provide a brief summary of the performance of a number of serologic assays reported in the literature, comment on what we do and do not know regarding our immune response to SARS-CoV-2, and provide a number of scenarios for which serologic testing will play a role in during our global response to this pandemic. Copyright © 2020 Theel et al.Streptococcus suis is an important pathogen of pigs but is also transmissible to humans with potentially fatal consequences. Among 29 serotypes currently recognized, some are clinically and epidemiologically more important than others. This is particularly true for serotypes 2 and 14 having a large impact on pig production and also on human health. Conventional PCR-based serotyping cannot distinguish between serotype 1/2 and serotype 2 and between serotype 1 and serotype 14. Although serotype 1/2 and serotype 2 have a very similar cps locus, they differ in a single nucleotide substitution at 483 nucleotide position of the cpsK gene. Similarly, serotypes 1 and 14 have a very similar cps locus, but also differ in the same nucleotide substitution of the cpsK gene. Fortunately, this cpsK 483G/C,T substitution can be detected by BstNI restriction endonuclease. A PCR-RFLP detection method amplifying a fragment of the cpsK gene digested by BstNI restriction endonuclease was developed and tested in reference strains of these serotypes and also in field isolates. Copyright © 2020 American Society for Microbiology.Lower respiratory tract infections including hospital acquired and ventilator associated pneumonia are common in hospitalized patient populations. Standard methods frequently fail to identify the infectious etiology due to the polymicrobial nature of respiratory specimens and necessity to order specific tests to identify viral agents. The potential severity of these infections combined with a failure to clearly identify the causative pathogen results in administration of empirical antibiotic agents based on clinical presentation and other risk factors. We examined the impact of the multiplexed, semi-quantitative BioFire® FilmArray® Pneumonia (PN) Panel test on laboratory reporting for 259 adult inpatients submitting bronchioalveolar lavage (BAL) specimens for laboratory analysis. The PN Panel demonstrated a combined 96.2% positive percent agreement (PPA) and 98.1% negative percent agreement (NPA) for the qualitative identification of 15 bacterial targets when compared to routine bacterial culture. Semi-quantitative values reported by the PN Panel were frequently higher than values reported by culture, resulting in semi-quantitative agreement (within the same log10 value) of 43.6% between the PN Panel and culture; however, all bacterial targets reported as >105 CFU/mL in culture were reported as ≥105 genomic copies/mL by the PN Panel. Viral targets were identified by the PN Panel in 17.7% of specimens tested, of which 39.1% were detected in conjunction with a bacterial target. A review of patient medical records, including clinically prescribed antibiotics, revealed the potential for antibiotic adjustment in 70.7% of patients based on the PN Panel result, including discontinuation or de-escalation in 48.2% of patients resulting in an average savings of 6.2 antibiotic days/patient. Copyright © 2020 Buchan et al.Sepsis is a complex process defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. It is associated with significant morbidity and mortality in both adults and children, and emphasis has been placed on its early recognition and prompt provision of antimicrobials. Owing to limitations of current diagnostic tests (i.e. poor sensitivity, delayed results), significant research has been conducted to identify sepsis biomarkers. buy BAY 11-7821 Ideally, a biomarker could reliably and rapidly distinguish bacterial infection from other, non-infectious causes of systemic inflammatory illness. In doing so, a sepsis biomarker could be used for earlier identification of sepsis, risk stratification/prognostication, and/or guidance of antibiotic decisions. In this Minireview, we review one of the most commonly clinically used sepsis biomarkers, procalcitonin, and its roles in sepsis management in these three areas. We highlight key findings in the adult literature, but focus the bulk of this review on pediatric sepsis. The challenges and limitations of procalcitonin measurement in sepsis are also discussed. Copyright © 2020 American Society for Microbiology.The ability to provide timely identification of the causative agent of lower respiratory tract infections can promote better patient outcomes and support antimicrobial stewardship efforts. Current diagnostic testing options can include culture, molecular testing, and antigen detection. These methods may require collection of various specimens, involve extensive sample treatment, and can suffer from low sensitivity and long turn-around-times. This study assessed the performance of the BioFire® FilmArray® Pneumonia (PN)/Pneumonia plus (PNplus) Panel, an FDA-cleared sample-to-answer assay that enables the detection of viruses, atypical bacteria, bacteria, and antimicrobial resistance marker genes from lower respiratory tract specimens (sputum and bronchoalveolar lavage (BAL)). Semi-quantitative results are also provided for the bacterial targets. This manuscript describes select analytical and clinical studies that were conducted to evaluate performance of the panel for regulatory clearance. Prospectively collected respiratory specimens (846 BAL, 836 sputum) evaluated with the PN Panel were also tested by quantitative reference culture and molecular methods for comparison.