Performance of four commercial real-time PCR assays for the detection of bacterial enteric pathogens in clinical samples. (January 2022)

• Record Type: Journal Article
• Authors: Berenger, Byron M.; Chui, Linda; Ferrato, Christina; Lloyd, Tracie; Li, Vincent; Pillai, Dylan R.
• Is Part Of: International journal of infectious diseases. Volume 114(2022)
• Page Start: 195
• Page End: 201
• Publication Date: 2022-01
• Subjects: Shiga-toxigenic Escherichia coli -- Yersinia -- Campylobacter -- Salmonella enterica -- Shigella -- Multiplex polymerase chain reaction; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.10.035
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: This study compared four commercial RT-PCR tests for bacterial gastroenteritis to culture There was >90% agreement for C. jejuni, Salmonella, and STEC Agreement for Yersinia enterocolitica ranged from 70-90% compared to culture Only one RT-PCR detected stx2f ; none detected other Yersinia spp. or C. upsaliensis These findings highlight some gaps in diagnosis and surveillance when using RT-PCR Abstract: Objectives: Many laboratories use culture-independent diagnostic tests for bacterial gastroenteritis (i.e. real-time polymerase chain reaction, RT-PCR) instead of culture because of better sensitivity, automation, and faster turnaround times. To address some gaps in initial evaluations and lack of intraassay comparisons for many commercial RT-PCRs, this study compared the ability of four commercially available RT-PCR tests (Ridagene, Fast Track Diagnostics, BD Max, and Prodesse Progastro) to detect five major bacterial enteric pathogens: Campylobacter, Salmonella, Shiga-toxin producing Escherichia coli (STEC), Shigella, and Yersinia. Methods: Clinical stool specimens and contrived samples comprising commonly circulating species, serotypes, biovars, and/or toxin subtypes were used for the comparison. Results: Concordance rates for RT-PCR and culture using culture-positive and culture-negative clinical stools were >90% for Campylobacter (97.5-100%), Salmonella (97.5-100%), Shigella (100%), and STEC (90-100%). However, the agreement between RT-PCR and culture for Y. enteroccolitica ranged from 70-90%. For the contrived sample set, stx2f was detected by one of four assays. Of note, no assay could detect Yersinia non- enterocolitica and Campylobacter upsaliensis. Conclusions: Depending on the prevalence of certain stx sub-types, Yersinia species, and Campylobacter species in a laboratory's jurisdiction, without further improvement in culture-independent tests, culture methods remain critical for the detection of these pathogens.