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Journal of Clinical Microbiology, October 2001, p. 3452-3460, Vol. 39, No. 10
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.10.3452-3460.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Molecular Analysis of a Hospital Cafeteria-Associated Salmonellosis Outbreak Using Modified Repetitive Element PCR Fingerprinting

James R. Johnson,1,2,* Connie Clabots,1,3 Miguel Azar,4,5 David J. Boxrud,5 John M. Besser,6 and Joseph R. Thurn1,2,3

Medical Service,1 Laboratory Service,4 and Infection Control Department,3 VA Medical Center, Departments of Medicine2 and Laboratory Medicine and Pathology,5 University of Minnesota, and Microbiology Laboratory, Minnesota State Department of Health,6 Minneapolis, Minnesota

Received 27 December 2000/Returned for modification 9 April 2001/Accepted 13 July 2001

A hospital cafeteria-associated outbreak of gastroenteritis due to Salmonella enterica serotype Infantis was retrospectively evaluated using modified repetitive element PCR (rep-PCR) fingerprinting with the ERIC2 and BOXA1R primers and computer-assisted gel analysis and dendrogram construction. Rep-PCR yielded objective between-cycler, same-strain similarity values of from 92% (composite fingerprints) to 96% (ERIC2 fingerprints). The 70 Salmonella isolates (which included 19 serotype Infantis isolates from the hospital outbreak, 10 other serotype Infantis isolates, and 41 isolates representing 14 other serotypes) were resolved well to the serotype level with each of the three fingerprint types (ERIC2, BOXA1R, and composite). Rep-PCR typing uncovered several historical serotyping errors and provided presumptive serotype assignments for other isolates with incomplete or undetermined serotypes. Analysis of replicate fingerprints for each isolate, as generated on two different thermal cyclers, indicated that most of the seeming subserotype discrimination noted in single-cycler dendrograms actually represented assay variability, since it was not reproducible in combined-cycler dendrograms. Rep-PCR typing, which would have been able to identify the presence of the hospital-associated serotype Infantis outbreak after the second outbreak isolate, could be used as a simple surrogate for serotyping by clinical microbiology laboratories that are equipped for diagnostic PCR.

* Corresponding author. Mailing address: Infectious Diseases (111F), VA Medical Center, One Veterans Dr., Minneapolis, MN 55417. Phone: (612) 725-2000, ext. 4185. Fax: (612) 727-5995. E-mail: johns007{at}tc.umn.edu.

Journal of Clinical Microbiology, October 2001, p. 3452-3460, Vol. 39, No. 10
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.10.3452-3460.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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