Rapid Identification and Strain-Typing of Respiratory Pathogens for Epidemic Surveillance

Epidemic respiratory infections are responsible for extensive morbidity and mortality within both military and civilian populations. We describe a methodology to examine respiratory samples that simultaneously identifies broad groups of bacteria. The process uses electrospray ionization mass spectro...

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Bibliographic Details
Main Authors: Ecker, David J, Sampath, Rangarajan, Blyn, Lawrence B, Samant, Vivek, Russell, Kevin, Freed, Nikki, Barrozo, Chris, Wu, Jianguo, Rudnick, Karl, Desai, Anjali
Format: Report
Language:English
Subjects:
6609
AMPLIFICATION
BACTERIA
CIVILIAN POPULATION
EPIDEMIOLOGY
ETIOLOGY
GENES
IDENTIFICATION
INFECTIOUS DISEASES
IONIZATION
LOCUS
MASS SPECTROMETRY
MEDICAL SERVICES
Medicine and Medical Research
Microbiology
MILITARY PERSONNEL
PATHOGENIC MICROORGANISMS
PATIENTS
PNEUMONIA
REAL TIME
RECURSIVE FUNCTIONS
RESPIRATORY DISEASES
RESPIRATORY SYSTEM
SAMPLING
STRAINS(BIOLOGY)
SURVEILLANCE
TEST AND EVALUATION
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Summary:Epidemic respiratory infections are responsible for extensive morbidity and mortality within both military and civilian populations. We describe a methodology to examine respiratory samples that simultaneously identifies broad groups of bacteria. The process uses electrospray ionization mass spectrometry and base composition analysis of broad-range PCK amplification products. The base composition analyses from a small set of broad-range primer pairs are used to triangulate the identity of pathogenic organisms present in the sample. Once a species has been identified, the rapid recursive use of species-specific primers to housekeeping genes allows strain-typing. This strategy was used to examine samples from military recruits sickened in a recent Group A streptococcal (GAS) pneumonia outbreak (MMWK 52, 6, p106-109, 2003). The strain-typing results were essentially identical to those obtained using classic emm typing and Multi Locus Sequence Typing. This method allows real-time evaluation of patient samples and will make possible more rapid and appropriate treatment of patients in an ongoing epidemic, regardless of the etiology, in a time frame not previously achievable. The original document contains color images.