Affiliation:
1. Department of Research & Development
2. Department of Medical Microbiology, Laboratory for Infectious Diseases, Groningen, Netherlands
Abstract
ABSTRACT
The detection of bacterial and parasitic gastrointestinal pathogens through culture and microscopy is laborious and time-consuming. We evaluated a molecular screening approach (MSA) for the detection of five major enteric pathogens:
Salmonella enterica
,
Campylobacter jejuni
,
Giardia lamblia
, Shiga toxin-producing
Escherichia coli
(STEC), and
Shigella
spp./enteroinvasive
E. coli
(EIEC), for use in the daily practice of a clinical microbiology laboratory. The MSA consists of prescreening of stool specimens with two real-time multiplex PCR (mPCR) assays, which give results within a single working day, followed by guided culture/microscopy of the positive or mPCR-inhibited samples. In the present 2-year overview, 28,185 stool specimens were included. The MSA was applied to 13,974 stool samples (49.6%), whereas 14,211 samples were tested by conventional methods only (50.4%). The MSA significantly increased the total detection rate compared to that of conventional methods (19.2% versus 6.4%). The detection of all included pathogens, with the exception of
S. enterica
, significantly improved. MSA detection frequencies were as follows:
C. jejuni
, 8.1%;
G. lamblia
, 4.7%;
S. enterica
, 3.0%; STEC, 1.9%; and
Shigella
spp./EIEC, 1.4%. The guided culture/microscopy was positive in 76.8%, 58.1%, 88.9%, 16.8%, and 18.1% of mPCR-positive specimens, respectively. Of all mPCRs, only 1.8% was inhibited. Other findings were that detection of mixed infections was increased (0.9% versus 0.02%) and threshold cycle (
C
T
) values for MSA guided culture/microscopy-positive samples were significantly lower than those for guided culture/microscopy-negative samples. In conclusion, an MSA for detection of gastrointestinal pathogens resulted in markedly improved detection rates and a substantial decrease in time to reporting of (preliminary) results.
Publisher
American Society for Microbiology
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