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Journal of Clinical Microbiology, December 2008, p. 4037-4040, Vol. 46, No. 12
0095-1137/08/$08.00+0 doi:10.1128/JCM.01405-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
Comparison of Classical Serotyping and PremiTest Assay for Routine Identification of Common Salmonella enterica Serovars
,
Pierre Wattiau,*
Mieke Van Hessche,
Christine Schlicker,
Heidi Vander Veken, and
Hein Imberechts
Veterinary and Agrochemical Research Centre, Department of Bacteriology and Immunology, Groeselenberg 99, Brussels B-1180, Belgium
Received 22 July 2008/
Returned for modification 1 September 2008/
Accepted 27 September 2008

ABSTRACT
The commercial PremiTest
Salmonella kit uses a multiplexed DNA
typing test aimed at identifying common serovars of
Salmonella enterica. It was used in assays over a 9-month period in the
Belgian reference laboratory that performs the routine identification
of
Salmonella strains of animal origin. A blind analysis of
754 strains was conducted in parallel by classical serotyping
and the PremiTest assay. Full results were available for 685
strains (90.8%) by serotyping, while the remaining 69 strains
were found to be nontypeable due to either a lack of surface
antigen expression or autoagglutination properties. When the
PremiTest assay (version 4.2) was performed with crude bacterial
extracts, it identified 658 strains (87.3%), including most
strains found to be nontypeable by serotyping. In contrast,
it gave no, wrong, dual, or noninterpretable results for 96
strains, for which 23 were caused by assay failures. When purified
DNA instead of crude extracts were tested, the number of strains
successfully identified to the serovar level increased to 714
(94.7%), while all assay failures were cleared. Our conclusion
is that, in its actual development stage, the application of
the investigated kit to purified DNA samples offers a valuable
alternative to classical serotyping for laboratories performing
the routine identification of
Salmonella strains belonging to
commonly encountered serovars and isolated from a given geographical
area, assuming that the system has been validated beforehand
with a significant number of strains originating from that particular
area.

TEXT
The scoring of antigenic formulae for
Salmonella enterica subsp.
e
nterica strain typing uses the Kaufmann-White scheme, which
is based on the reactivities of specific antisera with the
Salmonella surface antigens and which is considered the reference method
(
3,
16). More than 150 different somatic O and flagellar H antigens
are used for the characterization of over 2,500 serovars (
3,
15). To compensate for the methodological constraints associated
with antigen profiling, alternative strategies aimed at replacing
or complementing the reference method have been proposed over
the last decade. These include PCR and real-time PCR specific
identification and typing methods (
6,
8,
9,
14,
20,
22,
23),
multiplex PCR (
1,
10), DNA sequencing (
13), and DNA microarray
analysis (
5,
11,
12,
17,
18,
27). Antibody-based arrays have
been developed as well (
4,
7,
21,
26).
The PremiTest Salmonella assay (PT; DSM Nutritional Products) was previously evaluated in our laboratory (25). It uses a DNA-based methodology called the multiplex ligation detection reaction (LDR) to generate a collection of ligated probes from the template genome that are further amplified by PCR with a single pair of amplimers (19, 24, 25). The amplified molecules are subsequently hybridized to a low-density DNA microarray spotted with probe-specific complementary oligonucleotides. A biotin label is incorporated into one of the PCR primers, generating biotinylated amplification products that are detected on the microarray by colorimetric detection. Array images are analyzed with a photometric detector and are computed online through the use of customized software. The target genetic markers were selected to give, as far as possible, a unique microarray hybridization profile (i.e., a PT signature) for each S. enterica serovar considered (2). The system was initially evaluated with strains isolated from Belgium and The Netherlands, and the strains were selected to fairly represent the local diversity of Salmonella serovars associated with food-producing animals (25). In the present work, a blind comparison of PT with the classical serotyping method was conducted over a 9-month period (from April to December 2007) with every strain that arrived at the Belgian reference laboratory for routine testing of Salmonella strains of animal origin. A total of 754 strains belonging to 58 different serovars were tested. Each strain was typed in parallel by slide agglutination by the classical serotyping scheme with antisera purchased from the Statens Serum Institute (Copenhagen, Denmark) and Bio-Rad (La Jolla, CA). The antisera were used according to the manufacturers' instructions.
PT is supplied as a kit containing premixed LDR buffers and probes, customized DNA microarrays in a microtube format (Array Tubes; ClonDiag, Jena, Germany), and reagents and buffers for microarray hybridization and staining. The assay requires standard laboratory equipment, such as a minicentrifuge, a PCR thermocycler, and a rotating heating block for hybridization and staining of the array tubes (Eppendorf, Hamburg, Germany). The array images are generated with a dedicated microarray reader (Array Tube reader; ClonDiag) connected to a standard computer running software customized for PT data analysis (version 4.2). The cost of the assay (without DNA extraction and any other laboratory cost allowance) was
31.5 per sample at the time of testing. The analysis time was about 1.5 working days for a 36-sample batch.
According to the instructions of the manufacturer (Check-Points, Wageningen, The Netherlands), the assays were conducted with crude DNA preparations obtained by boiling a small amount of colony material. In our hands, however, such crude extracts yielded correct results for only 87.3% of the samples tested. Testing of the remaining 12.7% of the samples led to assay failures or to wrong, partial, or noninterpretable results. An increase or decrease in the amount of sample and the use of a lysis buffer prior to boiling of the sample improved the results in some instances but did not do so systematically. Using the commercial kit DNeasy blood and tissue kit (Qiagen Inc., Valencia, CA), we therefore extracted the total genomic DNA from those strains with assay failures or suspect results. By the use of purified DNA, PTs were 100% successful and allowed the results to be updated to 714 strains (94.7%) with correct identifications, 16 strains (2.1%) with a PT signature corresponding to two possible serovars, 19 strains (2.5%) with unknown PT signatures (i.e., the strains were not recognized as defined serovars), and 5 strains (0.6%) with incorrect identifications. The serovars determined by classical slide agglutination and PT were found to be significantly associated, as indicated by independency
2 statistical assessment (P < 0.01). The probabilities of obtaining a successful result by PT performed with crude bacterial extracts and DNA were 0.894 and 0.968, respectively. The results are summarized in Table 1. See Table S1 in the supplemental material for detailed strain typing data.
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TABLE 1. Comparison of PT with classical serotyping for serovar identification of Salmonella enterica subsp. enterica
|
Salmonella strains leading to recurrent assay failures with
crude material often belonged to serovar Typhimurium, Infantis,
or Paratyphi B var. Java (Fig.
1A to F). Such crude strain extracts
are thought to contain an unidentified bacterial compound that
interferes with the assay procedure. The relatively high incidence
of these serovars during the assessment period probably accounts
for the observed frequency of assay failures.
PT results yielding a PT signature but no serovar name typically
belonged to uncommon serovars, as estimated by classical serotyping,
suggesting that their associated PT signature either was never
encountered during system validation or was rarely so (Fig.
1L). We also noticed that more than two-thirds of the strains
(37/50) yielding unknown PT signatures when crude extracts were
tested were, in fact, assigned a wrong PT signature by the software.
When purified DNA from these strains was tested, these strains
displayed a different PT signature, suggesting that the software
had misinterpreted the corresponding poor-quality profiles obtained
with the crude extracts (Fig.
1E).
Incorrect serovar identifications issued from strains that up to now displayed PT signatures found to be exclusively associated with another serovar. Therefore, the interpretation of some PT signatures as defined in version 4.2 of the software should be revised (Fig. 1H). Dual results occurred for strains with PT signatures associated with two serovars (Fig. 1I and J).
In summary, we found that PT performs significantly better when purified DNA rather than crude extracts are used. The proportion of Salmonella strains successfully identified to the serovar level was 4% greater than that successfully identified by the classical serotyping method. This value can be increased by another 2% if strains assigned two possible serovars are considered, which leads to a maximum success rate of 96.8%. Our assessment of the method also pointed to some incomplete or questionable PT signatures, and these should be regularly updated on the basis of present and future results. The current version of PT makes use of a microarray profile made up of 13 DNA markers for serovar discrimination. Given the relatively low level of complexity of the microarray profiles generated, on the one hand, and the limited number of serovars recognized by the system, on the other, it is expected that additional DNA markers will be required to identify unequivocally any of the 2,500 Salmonella serovars defined to date. Therefore, future versions of the system should be extended to generate PT signatures that do not overlap different serovars. In our opinion, the present version of PT already offers a valuable alternative to the classical serotyping method for the routine identification of common Salmonella serovars. Future versions that increase the robustness of the test and the number of DNA markers for serovar discrimination will further enhance the value of the system.

ACKNOWLEDGMENTS
We thank Sophie Bertrand and Bernard China (Belgian Institute
of Public Health) for their support with the classical serotyping
of uncommon
Salmonella serovars and with data processing, respectively.
This work was sponsored through a governmental grant from the Dutch Agency for Sustainability and Innovation (Senternovem).
We declare that none of the participating individuals (authors, laboratory staff, and acknowledged people and bodies) has any commercial interest (direct or indirect) in the results presented here.

FOOTNOTES
* Corresponding author. Mailing address: Veterinary and Agrochemical Research Centre, Department of Bacteriology and Immunology, Groeselenberg 99, Brussels B-1180, Belgium. Phone: 32 (0)2 3790426. Fax: 32 (0)2 3790670. E-mail:
Pierre.Wattiau{at}var.fgov.be 
Published ahead of print on 8 October 2008. 
Supplemental material for this article may be found at http://jcm.asm.org/. 

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Journal of Clinical Microbiology, December 2008, p. 4037-4040, Vol. 46, No. 12
0095-1137/08/$08.00+0 doi:10.1128/JCM.01405-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.