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Journal of Clinical Microbiology, August 2004, p. 3869-3872, Vol. 42, No. 8
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.8.3869-3872.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Modified Multiplex PCR Method for Detection of Pyrogenic Exotoxin Genes in Staphylococcal Isolates
Astrid Løvseth,* Semir Loncarevic, and Knut G. Berdal
Section of Feed and Food Microbiology, National Veterinary Institute, Ullevålsveien 68, 0033 Oslo, Norway
Received 30 December 2003/
Returned for modification 17 February 2004/
Accepted 28 March 2004

ABSTRACT
A modified multiplex PCR method for detection of nine
Staphylococcus aureus enterotoxin genes (
sea,
seb,
sec,
sed,
see,
seg,
seh,
sei, and
sej) and one form of immunoreactive toxic shock syndrome
toxin based on a previously published method (S. R. Monday and
G. A. Bohach, J. Clin. Microbiol.
37:3411-3414, 1999) has been
developed. The modified PCR protocol seems robust and gives
reliable results.

TEXT
Staphylococcal enterotoxins (SE), toxic shock syndrome toxin
(TSST), and exfoliative toxins A and B belong to a family of
related pyrogenic toxins produced by
Staphylococcus aureus (
4,
10). By virtue of its variety of enterotoxins
S. aureus is an
important food-borne pathogen. In addition to the well-characterized
SEA, SEB, SEC, SED, and SEE, new serological types of SEs (SEG,
SEH, SEI, SEJ, SEK, SEL, SEM, SEN, SEO, SEP, SEQ, SER, and SEU)
have been identified in recent years (
5,
6,
7,
11,
13,
15,
16,
18). Five of the SE genes (
seg,
sei,
sem,
sen, and
seo) belong
to the same enterotoxin gene cluster (
egc), and detection of
one of these genes usually indicates the presence of all five
enterotoxin genes (
5,
11). For routine detection of SEs, commercially
produced kits, such as reverse passive latex agglutination assays
and enzyme-linked immunosorbent assays, are most commonly used.
However, these methods are, to date, designed only to detect
SEA, SEB, SEC, SED, and SEE. As an alternative to these more
traditional methods, the PCR approach can provide detection
of toxin genes and is presently designed to detect at least
nine SE genes (
sea,
seb,
sec,
sed,
see,
seg,
seh,
sei, and
sej)
(
1,
9,
12,
14).
The objective of this study was initially to establish the multiplex PCR method for detection of the toxin genes in staphylococcal isolates published by Monday and Bohach (12). According to their article, any of the nine SE genes (sea, seb, sec, sed, see, seg, seh, sei, and sej), the TSST gene, and the 16S rRNA gene can be amplified in a single multiplex reaction (results were not shown). However, while establishing the described method on two different types of thermocyclers, no detection of seb, sec, and tsst could be observed, and the amplification of sec and sei gave various results. Some modifications and adaptations were therefore considered necessary.
The following modifications were made to Monday and Bohach's method (12): (i) using another DNA isolation method; (ii) redesigning four primers (seb-sec forward, seb reverse, sei forward, and tsst reverse); (iii) splitting the multiplex into two PCRs; (iv) significantly decreasing the amount of 16S rRNA primers; and (v) adding four cycles to the PCR program.
Bacterial isolates and DNA isolation.
The S. aureus isolates used in this study are listed in Table 1. One colony of each isolate was incubated overnight in 3 ml of brain heart infusion broth medium at 37°C with agitation. Overnight culture (1.5 ml) was transferred to an Eppendorf tube and was centrifuged for 2 min at 17,500 x g. The pellet was resuspended in 1x Tris-EDTA buffer, and the cells were then lysed with 10 µl of 10-mg/ml lysostaphin (Sigma-Aldrich). This solution was incubated for 60 min at 37°C. The DNA was extracted by a standard cetyltrimethylammonium bromide procedure using chloroform followed by ethanol precipitation (17). DNA concentration was measured by the SYBR Green I method (2).
Amplification of selected staphylococcal genes.
Monday and Bohach (
12) compared and evaluated the sequences
of the SE genes. Unique primer sequences were identified for
each gene with the exception of
seb and
sec. The
seb-sec primer
pair produces an identical product for both
seb and
sec. As
a solution to the lack of specificity of the
seb-sec primers,
Monday and Bohach (
12) designed a separate
sec forward primer
that works in combination with the
seb-sec primers and that
produces an amplification product unique to
sec. The
sec primers
detect all three subclasses of enterotoxin SEC (C1, C2, and
C3) (
3,
8). All samples were tested for the presence of the
16S rRNA gene in order to ensure correct interpretation of toxin-negative
isolates (
12). However, due to the existence of multiple copies
of the 16S rRNA gene, the concentration of the corresponding
primers was reduced in the modified method to avoid 16S rRNA
amplification products outcompeting other amplification products.
Monday and Bohach used 22 primers in the same PCR (12). Many primer sets in a single reaction may reduce robustness. Furthermore, some of the PCR products are similar in size and the bands were therefore found to be difficult to differentiate, particularly when analyzing unknown isolates. To avoid these problems we investigated several alternative primer combinations before the 11 primer sets were divided into two halves (reaction mixtures 1 and 2). Primers for sed, see, seg, sei, and tsst (Table 2) were combined in reaction mixture 1, and primers for sea, seb-sec, sec, seh, sej, and 16S rRNA (Table 2) were combined in reaction mixture 2. Monday and Bohach (12) used Gibco BRL Taq DNA polymerase (Life Technologies, Inc., Rockville, Md.) and an Amplitron II thermocycler (Barnstead Thermolyne Co., Dubuque, Iowa) for PCR amplification, whereas we used the following protocol: 5 µl of DNA (10 ng/µl) was added to 45 µl of reaction mixture containing final concentrations of 1x AmpliTaq buffer, 4 mM MgCl2, 2 U of AmpliTaq Gold polymerase (all from Applied Biosystems), 400 µM each deoxynucleoside triphosphate (ABgene, Epsom, United Kingdom), 300 nM each SE primer, and 60 nM 16S rRNA primers. DNA was amplified on an MJ Research thermocycler PTC 225 by initial denaturation for 10 min at 95°C followed by 15 cycles of 95°C for 1 min, 68°C for 45 s, 72° for 1 min, 20 cycles of 95°C for 1 min, 64°C for 45 s, 72° for 1 min, and a final extension at 72°C for 10 min. PCR products were separated by electrophoresis of 10 µl of reaction product in a 2.5% agarose gel (0.5x Tris-borate-EDTA buffer at 100 V for 100 min) and visualized on a UV transilluminator (Gel Documentation System; Bio-Rad, Hercules, Calif.). Product size was determined by comparison with a pUC-mix molecular weight ladder (Fermentas, Vilnius, Lithuania). Both the original and the modified protocol were tested on two different thermocyclers: MJ Research PTC 225 and Perkin-Elmer GeneAmp PCR System 9700.
Analysis of S. aureus isolates using both the unmodified and modified multiplex PCR methods.
Figure
1 shows PCR results with the unmodified multiplex PCR
protocol as described by Monday and Bohach (
12) performed on
the MJ Research PTC 225 thermocycler. No detection of
seb-sec and
tsst was observed, and the amplification of
sec and
sei gave various results. The modified multiplex PCR protocol gave
correct identification of all expected toxins (Table
1). Figures
2 and
3 show the PCR results with reaction mixtures 1 and 2
and detection of the SED, SEE, SEG, SEI, and TSST genes and
the SEA, SEB-SEC, SEC, SEH, SEJ, and 16S rRNA genes, respectively.
When DNA from several isolates was combined (R5460 plus R5010
plus FRI913 or FRI472 plus FRI913 plus R5460), the modified
method was able to detect all enterotoxin genes simultaneously
(results not shown). The modified protocol, including redesigned
seb-sec forward and
seb reverse primers (Table
2), resulted
in the expected amplification of the SEB-SEC gene in known isolates
(Table
1, Fig.
3). However, it has been suggested (
9,
10,
14)
that isolates that give both the
seb-sec and
sec products should
be analyzed further with unique primers for
seb to ensure that
there is no
seb hidden in the
seb-sec product. It is well known
that some isolates express SEC
bovine and thereby generate only
the
sec product instead of both the
seb-sec and
sec products
(
12). This was confirmed in this study by isolate 3169 (Table
1, Fig.
3). The TSST gene could not be detected in the isolates
previously reported as TSST producers with the unmodified protocol
(Table
1, Fig.
1). After redesigning the
tsst reverse primer
(Table
2), the expected
tsst amplification product was detectable
by the modified protocol (Table
1, Fig.
2). Similarly, after
redesigning the
sei forward primer (Table
2) we were able to
detect the expected
sei amplification product in two isolates
(R5371/00 and R5460/00) that were negative by the unmodified
protocol (Table
1, Fig.
1 and
2). In a personal communication,
Monday and Bohach suggested we try different brands of thermocyclers,
because they also observed that their original protocol did
not work on an Eppendorf thermocycler while it worked on a Perkin-Elmer
GeneAmp model 2400 (Applied Biosystems), possibly due to differences
in ramping time and block controls. In the present study we
did not observe differences in performance between the MJ Research
PTC 225 and Perkin Elmer GeneAmp 9700 in either the unmodified
or modified method.
Splitting the multiplex PCR into two halves increases the workload.
However, this may be justified by the observation that this
approach yielded more reliable results. Furthermore, the modified
protocol appeared to be more robust, as observed by the absence
of differences in performance on two different brands of thermocyclers.

ACKNOWLEDGMENTS
We are grateful to Jim McLauchlin for the isolates from the
Food Safety Microbiology Laboratory (London, United Kingdom)
and to Claudia Deobald and Greg Bohach for the isolates from
the Department of Microbiology, Molecular Biology and Biochemistry,
University of Idaho (Moscow).

FOOTNOTES
* Corresponding author. Mailing address: National Veterinary Institute, Section of Feed and Food Microbiology, P.O. Box 8156 Dep., 0033 Oslo, Norway. Phone: 47 23 21 62 41. Fax: 47 23 21 62 02. E-mail:
astrid.lovseth{at}vetinst.no.


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Journal of Clinical Microbiology, August 2004, p. 3869-3872, Vol. 42, No. 8
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.8.3869-3872.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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