LB-14. Rapid screening method for multiple gastro-enteric pathogens also detects novel EHEC O104:H4
Session: Poster Abstract Session: Late Breaker Posters
Saturday, October 22, 2011
Room: Poster Hall B1
Background: 

Since early May 2011 an increasing number of patients presenting with bloody diarrhoea was reported. The outbreak started in northern Germany and was caused by a novel E. coli variant,  EHEC O104:H4.

Patients suspected to be infected with EHEC O104:H4 bear the risk of developing haemolytic-uremic syndrome (HUS) and thus need a rapid differential diagnosis. To avoid misdiagnosis potentially guiding false initial therapy or infection control measures rapid screening diagnostic methods are required and have been developed by specialized laboratories.

Method: The novel xTAG GPP assay from Luminex (Toronto, Canada) was tested detecting 17 viral, bacterial or parasitic pathogens in a single reaction. samples were also investigated using konventional microbiological methods. The test identified Shiga-like Toxin (Stx) 1 and 2, thus we assumed that also the novel variant which is Stx 1 negative but Stx 2 positive could be identified.

Result: 

Until now a total number of 80 patients suffering from bloody diarrhoea or suspected to be infected with the novel EHEC variant were tested. The multiplex testing revealed 5 patients positive for the novel EHC O104:H4 variant of which four were already independently confirmed by an external laboratory. In one case Stx 2 producing E.coli O157 was detected, in another a strain producing Stx 1 and 2 suggesting another EHEC but O104:H4. 9 further patients suffered from severe Campylobacter infections, two patients from toxigenic C.difficile and two from Salmonella spec..

Conclusion: 

We conclude that the assay is useful to pre-screen patients suffering from the novel EHEC variant. Additional beneficiary effects are that only a pre-selected cohort of clinical samples has to be analysed by the specialized laboratories and that those patients that are negative for EHEC but positive for pathogens like Campylobacter spec. or Clostridium difficile can be subjected to the correct antibiotic therapy. The Luminex technology is widely available and the assays procedure is rather simple with a total hands-on time of less than 5 hours and a sample capacity of up to 96 samples per run, the assays is suitable for high throughput analyses and thus will cover the peaks in the epidemiological outbreak situation.


Subject Category: D. Diagnostic microbiology

Frauke Mattner, MD1, Monika Malecki2, Verena Schildgen2, Kamm Matthias2 and Oliver Schildgen2, (1)Institut für Hygiene, Kliniken der Stadt Köln, Cologne, Germany, (2)Kliniken der Stadt Köln, Cologne, Germany

Disclosures:

F. Mattner, Luminex: Investigator, travel grant

M. Malecki, Luminex: Scientific Advisor, travel grant

V. Schildgen, None

K. Matthias, None

O. Schildgen, Luminex: Scientific Advisor, travel grant

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