Rapid, Simultaneous Detection of Clostridium sordellii and Clostridium perfringens in Archived Tissues by a Novel PCR-Based Microsphere Assay: Diagnostic Implications for Pregnancy-Associated Toxic Shock Syndrome Cases. (22nd March 2012)

• Record Type: Journal Article
• Authors: Bhatnagar, Julu; DeLeon-Carnes, Marlene; Kellar, Kathryn L.; Bandyopadhyay, Kakali; Antoniadou, Zoi-Anna; Shieh, Wun-Ju; Paddock, Christopher D.; Zaki, Sherif R.
• Other Names: Spear Gregory T. Academic Editor.
• Is Part Of: Infectious diseases in obstetrics and gynecology. Volume 2012(2012)
• Publication Date: 2012-03-22
• Subjects: Generative organs, Female -- Infections -- Periodicals; Communicable diseases in pregnancy -- Periodicals; 618.142005
• DOI: 10.1155/2012/972845
• Languages: English
• ISSNs: 1064-7449

Abstract

Abstract : Clostridium sordellii and Clostridium perfringens are infrequent human pathogens; however, the case-fatality rates for the infections are very high, particularly in obstetric C. sordellii infections (>90%). Deaths from Clostridium sordellii and Clostridium perfringens toxic shock (CTS) are sudden, and diagnosis is often challenging. Formalin-fixed, paraffin-embedded (FFPE) tissues usually are the only specimens available for sudden fatal cases, and immunohistochemistry (IHC) for Clostridia is generally performed but it cannot identify species. A clear need exists for a rapid, species-specific diagnostic assay for FFPE tissues. We developed a duplex PCR-based microsphere assay for simultaneous detection of C. sordellii and C. perfringens and evaluated DNA extracted from 42 Clostridium isolates and FFPE tissues of 28 patients with toxic shock/endometritis (20 CTS, 8 non-CTS, as confirmed by PCR and sequencing). The microsphere assay correctly identified C. sordellii and C. perfringens in all known isolates and in all CTS patients (10 C. sordellii, 8 C. perfringens, 2 both) and showed 100% concordance with PCR and sequencing results. The microsphere assay is a rapid, specific, and cost-effective method for the diagnosis of CTS and offers the advantage of simultaneous testing for C. sordellii and C. perfringens in FFPE tissues using a limited amount of DNA.