Affiliation:
1. Present address: Scientific Advice Unit, European Centre for Disease Prevention and Control, Stockholm, Sweden.
Abstract
ABSTRACT
Fast, reliable, and versatile typing tools are essential to differentiate among related bacterial strains for epidemiological investigation and surveillance of health care-associated infection with multidrug-resistant (MDR) pathogens. The DiversiLab (DL) system is a semiautomated repetitive-sequence-based PCR system designed for rapid genotyping. The DL system performance was assessed by comparing its reproducibility, typeability, discriminatory power, and concordance with those of pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) and by assessing its epidemiological concordance on well-characterized MDR bacterial strains (
n
= 165). These included
vanA Enterococcus faecium
, extended-spectrum β-lactamase (ESBL)-producing strains of
Klebsiella pneumoniae
,
Escherichia coli
, and
Acinetobacter baumannii
, and ESBL- or metallo-β-lactamase (MBL)-producing
Pseudomonas aeruginosa
strains. The DL system showed very good performance for
E. faecium
and
K. pneumoniae
and good performance for other species, except for a discrimination index of <95% for
A. baumannii
and
E. coli
(93.9% and 93.5%, respectively) and incomplete concordance with MLST for
P. aeruginosa
(78.6%) and
E. coli
(97.0%). Occasional violations of MLST assignment by DL types were noted for
E. coli
. Complete epidemiological concordance was observed for all pathogens, as all outbreak-associated strains clustered in identical DL types that were distinct from those of unrelated strains. In conclusion, the DL system showed good to excellent performance, making it a reliable typing tool for investigation of outbreaks caused by study pathogens, even though it was generally less discriminating than PFGE analysis. For
E. coli
and
P. aeruginosa
, MLST cannot be reliably inferred from DL type due to phylogenetic group violation or discordance.
Publisher
American Society for Microbiology
Cited by
48 articles.
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