Detection of diarrheagenic E. coli (DEC) typically depends on identification of virulence genes from stool cultures, not on stool itself. We developed a multiplex PCR assay that detects key DEC virulence genes (stx1, stx2, eae, bfpA, ipaH, LT, STh, aaiC, aatA). The assay involved a multiplex PCR reaction followed by detection of amplicon (s) using Luminex beads. The assay was evaluated on over 100 colony and broth specimens. We then evaluated the assay using DNA extracted from stool, colony pools and gram-negative broths, using stool spiked with known quantities of DEC. Performance of the assay on stool DNA was most quantitative, while stool broth DNA offered the lowest limit of detection. The assay was prospectively evaluated on clinical specimens in Tanzania. Stool DNA yielded higher sensitivity than colony pools compared with broth DNA as the standard. We propose using this assay to screen for DEC directly in stool or stool broths.
Viable cells of Clavibacter michiganensis subsp. michiganensis (CMM), the causal agent of bacterial canker of tomato, were discriminated from the dead cells by quantitative real-time polymerase chain reaction (PCR), after the bacterial solution was treated with the DNA binding dye ethidium monoazide (EMA). The primers and TaqMan probe, based on the 16S-23S rDNA spacer sequences, were highly specific for CMM at the subspecies level. The detection limit of the direct real-time PCR was 10 3 colony forming units per mL (cfu mL -1 ) in samples and with an apparent sensitivity of 2 cfu of target cells in PCR reaction solution. Application of this method allows for selective quantification of viable cells of CMM and facilitates monitoring the pathogen in tomato seeds.
Introduction
The emergence of Zika virus disease (ZVD) in areas of military operations provided a new opportunity for force health protection. ZVD infection had an estimated 4:1 asymptomatic-to-symptomatic ratio and can cause neurologic sequelae.
Materials and Methods
We provide a brief report of a field investigation utilizing laboratory-based surveillance and survey instruments to characterize ZVD risk among personnel deployed to the Dominican Republic in support of Operation NEW HORIZONS (NH). Additionally, we describe a cluster of 3 ZVD cases among 8 aircrew on a short mission to St. Croix (U.S. Virgin Islands).
Results
Following Operation NH, 6 of a total 189 deployed cohort members tested positive for ZVD by immunoglobulin M and confirmatory plaque reduction neutralization test (3.2%). Reverse transcription polymerase chain reaction testing in urine or serum was positive in 4 of those 6 cases. All 6 cases reported at least one symptom, with 5 reporting subjective fever and arthralgia and 4 reporting rash. Cases were less likely to have air-conditioned living quarters (odds ratio = 0.1; 95% confidence interval 0.02–0.77; P < 0.03), but were otherwise similar to non-cases. Likewise, in St. Croix, 3/8 tested positive by immunoglobulin M and plaque reduction neutralization test for an attack rate of 38%. Similar to Operation NH, all three cases were symptomatic with subjective fever (67%), arthralgia (67%), and/or rash (100%).
Conclusions
This field investigation identified differing, mission location-dependent ZVD attack rates and a 0:9 asymptomatic-to-symptomatic case ratio. As this was unexpected based on a previous report of a 4:1 ratio, it emphasizes the need to be cautious before generalizing outbreak characteristics between populations while also offering additional practical experience for force health protection.
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