Comparison of Three Different Methods for Detection of Shiga Toxin-Producing Escherichia coli in a Tertiary Pediatric Care Center
Open Access
- 1 February 2013
- journal article
- research article
- Published by American Society for Microbiology in Journal of Clinical Microbiology
- Vol. 51 (2), 481-486
- https://doi.org/10.1128/jcm.02219-12
Abstract
Shiga toxin-producing Escherichia coli (STEC) is a well-known cause of sporadic and epidemic food-borne gastroenteritis. A low infectious dose, approximately 10 microorganisms, is sufficient to cause disease that may lead to hemolytic-uremic syndrome. The objective of this study was to compare the performances of an in-house real-time PCR, a commercial enzyme immunoassay (EIA) (Premier EHEC; Meridian Bioscience), and culture on sorbitol MacConkey agar for the detection of STEC in a tertiary care pediatric hospital. Of 632 stool samples tested, 21 were positive for STEC. All were detected by PCR, 6 were detected by EIA, and only 5 O157 STEC isolates were identified by culture. Among the 15 specimens falsely negative by EIA, there were 9 Stx1, 2 Stx2, and 4 Stx1 and Stx2 STEC isolates. The latter group included 2 O157 STEC isolates that would have been missed if only EIA had been performed. To our knowledge, this is the first prospective study performed in a pediatric hospital which demonstrates the superiority of PCR over EIA for the detection of STEC. We conclude that PCR is specific and more sensitive than EIA. PCR should be considered for routine use in clinical settings where molecular detection facilities are available. Its lower limit of detection, equivalent to the infectious dose, is an obvious advantage for patient care and public health surveillance.Keywords
This publication has 39 references indexed in Scilit:
- Laboratory Practices and Incidence of Non-O157 Shiga toxin–producingEscherichia coliInfectionsEmerging Infectious Diseases, 2012
- Epidemiology of Shiga toxin producing Escherichia coli in Australia, 2000-2010BMC Public Health, 2012
- Prevalence of Shiga Toxin-Producing Escherichia coli as Detected by Enzyme-Linked Immunoassays and Real-Time PCR during the Summer Months in Northern Alberta, CanadaJournal of Clinical Microbiology, 2011
- Origins of theE. coliStrain Causing an Outbreak of Hemolytic–Uremic Syndrome in GermanyNew England Journal of Medicine, 2011
- Comparison of Shiga Toxin-Producing Escherichia coli Detection Methods Using Clinical Stool SamplesThe Journal of Molecular Diagnostics, 2010
- Association of Diarrheagenic Escherichia coli Pathotypes with Infection and Diarrhea among Mexican Children and Association of Atypical Enteropathogenic E. coli with Acute DiarrheaJournal of Clinical Microbiology, 2009
- Isolation and Genetic Characterization of a Coinfection of Non-O157 Shiga Toxin-Producing Escherichia coliJournal of Clinical Microbiology, 2007
- Subtyping Method for Escherichia coli Shiga Toxin (Verocytotoxin) 2 Variants and Correlations to Clinical ManifestationsJournal of Clinical Microbiology, 2007
- Food-Related Illness and Death in the United StatesEmerging Infectious Diseases, 1999
- Gapped BLAST and PSI-BLAST: a new generation of protein database search programsNucleic Acids Research, 1997