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Volume 25, Number 10—October 2019

Early Diagnosis of Tularemia by Flow Cytometry, Czech Republic, 2003–20151

Aleš ChrdleComments to Author , Pavlína Tinavská, Olga Dvořáčková, Pavlína Filipová, Věra Hnetilová, Pavel Žampach, Květoslava Batistová, Václav Chmelík, Amanda E. Semper, and Nick J. Beeching
Author affiliations: České Budějovice Hospital, České Budějovice, Czech Republic (A. Chrdle, P. Tinavská, P. Filipová, V. Hnetilová, P. Žampach, V. Chmelík); University of South Bohemia Faculty of Health and Social Sciences, České Budějovice, Czech Republic (A. Chrdle, O. Dvořáčková); Royal Liverpool University Hospital, Liverpool, UK (A. Chrdle, N.J. Beeching); Písek Hospital, Písek, Czech Republic (K. Batistová); Public Health England, Porton Down, UK (A.E. Semper); National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK (A.E. Semper; N.J. Beeching); Liverpool School of Tropical Medicine, Liverpool (N.J. Beeching)

Main Article

Table 3

Time to positive diagnostic test result for tularemia, by starting time point, test, and population, Czech Republic, 2003–2015*

Category Time, d
Median 95% CI Interquartile range Range
Time relative to onset of patient symptoms
Diagnostic test type
Flow cytometry, n = 58 18.5 15.5–22.0 9.75–33.25 2–128
Serologic test, n = 58
Time to first positive serologic test result relative to rise in CD3+/CD4–/CD8– T cells
Patient population
All, n = 58 7.0 1.0–12.0 0–18.75 –50 to 62
Delayed seroconverters, n = 34 14.0 8.0–22.0 7.5–22.0 1–62

*A positive flow cytometry test result for tularemia was defined as >8% of peripheral blood CD3+ T cells having the CD4–/CD8– phenotype. A positive serologic test result for tularemia included probable and confirmed diagnoses and was defined for probable cases as an antibody titer of >1:20 in any acute phase blood sample or for confirmed cases as an antibody titer of >1:160 in any blood sample or a seroconversion from negative to positive (any titer) or a 4-fold increase in titer between acute and convalescent patient samples (agglutination test; Tularemia Diagnostic Set, Bioveta a.s.,

Main Article

1Preliminary data from this study were presented at the European Congress of Clinical Microbiology and Infectious Diseases; April 9–12, 2016; Amsterdam, the Netherlands (abstract no. O367).

Page created: September 17, 2019
Page updated: September 17, 2019
Page reviewed: September 17, 2019
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