Affiliation:
1. Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology
2. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research
3. Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905
Abstract
ABSTRACT
Campylobacter jejuni
and
Salmonella
,
Shigella
, and
Yersinia
species (along with Shiga toxin-producing
Escherichia coli
) are the most common causes of acute bacterial diarrheal disease in the United States. Current detection techniques are time-consuming, limiting usefulness for patient care. We developed and validated a panel of rapid PCR assays for the detection and identification of
C. jejuni
,
C. coli
,
Salmonella
, and
Yersinia
species and
Shigella
and enteroinvasive
E. coli
in stool samples. A total of 392 archived stool specimens, previously cultured for enteric pathogens, were evaluated by PCR. Overall, 104 stool specimens had been culture positive (
C. jejuni
/
coli
[
n
= 51],
Salmonella
species [
n
= 42],
Shigella
species [
n
= 6], and
Yersinia
species [
n
= 5]). Compared to culture, the overall sensitivity and specificity of PCR detection of these organisms were 92 and 98% (96/104 and 283/288), respectively, from fresh or Cary Blair stool (
P
= 0.41); 87 and 98% (41/47 and 242/246), respectively, from fresh stool (
P
= 0.53); and 96 and 98% (55/57 and 41/42), respectively, from Cary Blair stool (
P
= 0.56). For individual genera, PCR was as sensitive as the culture method, with the exception of
Salmonella
culture using selenite enrichment for which PCR was less sensitive than culture from fresh, but not Cary Blair (
P
= 0.03 and 1.00, respectively) stools. This PCR assay panel for the rapid diagnosis of acute infectious bacterial diarrheal pathogens has a sensitivity and specificity equivalent to that of culture for stools in Cary Blair transport medium. Paired with reflexive culture of stools testing positive, this should provide an improvement in care for patients with acute infectious diarrheal disease.
Publisher
American Society for Microbiology
Cited by
90 articles.
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