APHL 2019 POSTER ABSTRACTS
tests (CIDTs), specifically GI Panels, have changed the way in which
clinical laboratories diagnose patients with foodborne illness.
The utilization of GI panels by clinical laboratories has led to
increased submissions of stools in Cary-Blair or GN broth to public
health laboratories. This has subsequently, required public health
laboratories to spend more time recovering isolates from positive
stools.
Objective: Currently, our laboratory utilizes the Alere Quik Chek
EIA (enzyme-linked immunosorbent assays) to detect Shiga toxins.
Previous experience in our laboratory has shown that rare Shiga toxin
variants may not be detected by commercial EIA kits. This can lead to
discrepancies when confirming CIDT submitted stools. To improve our
detection of known Shiga toxin variants and streamline our processes
related to the handling of CIDT positive stools for (STEC), we sought
to evaluate the feasibility of using a modified commercial Shiga toxin
PCR assay that could eventually be incorporated into a new screening
algorithm utilizing both EIA and PCR.
Methods: Two commercially available real-time PCR kits from Thermo
Fisher Scientific, currently sold and marketed for food testing were
evaluated. The TaqMan™ Verotoxin-producing Escherichia coli VT1/
VT2 Multiplex Assay Beads (Kit 1) and Custom TaqMan™ STX1/
STX2 Assay Beads (Kit 2) both utilized lyophilized reagents. Each
kit was evaluated for the ability to detect a characterized panel
of 15 Shiga toxin producing E. coli isolates enriched in GN broth
which included rare Shiga toxin variants. DNA extraction methods
evaluated with each kit included the recommended PrepSEQ kit, as
well the modification of using a boil prep. Boil prep was performed
using the Biorad T100 Thermal Cycler followed by centrifugation and
dilution. PCR was performed using the ABI 7500 Fast real-time PCR
instrument.
Results: Evaluation results revealed discrepancies in the performance
among the two kits. Kit 1 was not able to detect the following Shiga
toxin variants (1d, 2e, 2f, and 2g). In comparison, Kit 2 accurately
detected all 15 characterized isolates within the panel. Both DNA
extraction methods performed equally and did not affect the
performance of either kit.
Conclusions: Based on the ability of Kit 2 to detect all of the Shiga
toxin variants within the panel, it appears as the best candidate to
integrate within the proposed screening algorithm for STEC positive
CIDT stools. Successful validation of this assay has the potential to
streamline our screening of CIDT stools, improve our detection of
Shiga toxin variants, and reduce discrepancies when confirming STEC
positive CIDT stools.
Presenter: Kimberly Starr, CPEP Fellow, University of Washington
Medical Center, Seattle, WA, [email protected]
Trends in Products and Countries Refused from Import into
the United States
T. Dickerson, K. Yeh and J. Lucas, MRIGlobal
The United States imported $2.4 trillion in goods over the course
of 2017, with 58% of the imports coming from China, Mexico,
Canada, the European Union and Japan. Of this $2.4 trillion, capital
goods such as semiconductors and computers contributed $641
billion to the US economy, while consumer goods like food, cell
phones, TVs and apparel accounted for $602 billion. Of this $602
billion, $138 billion was attributed to food imports, with the most
imported foods being fish and shellfish, meat, dairy, vegetables,
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fruits, nuts, coffee, tea, spices, grains, candy, sugar, chocolate,
cocoa, beverages and liquor. Unfortunately, some of these products
come from countries with food regulations different from the United
States which in turn increases the risk of foodborne illnesses.
Moreover, foodborne illnesses seem to occur more frequently in
food categories (eg., meat, fish, fruits and vegetables) that are in
higher demand and have a wide range of countries of origin. In fact,
the FDA is responsible for monitoring imports from over 300 ports of
entry in approximately 150 different countries. However, due to the
tremendous volume of imported products and limitations in time, as
well as human and financial resources, the FDA physically examines
less than 1% of the products awaiting entry; although all imported
foods are electronically examined. Thus, the FDA prioritizes whether
a food shipment should be imported upon a risk-based prediction
algorithm that determines whether the products in question should
be inspected in the field or a laboratory.
Violations that are most commonly cited for refusal of products
into the United States include the detection of pathogens (eg.,
Salmonella and Listeria) and toxins such as aflatoxins, chemical
contamination (eg., pesticides, drug residues or unsafe additives)
and other sanitary violations like “filth” or a “decomposed
appearance.” Thus, the objective of this study was to assess the
literature for trends in products and their exporting countries that
have been refused entry into the United States due to the detection
of foodborne pathogens. Of the literature reviewed, the greatest
number of refusals were associated with Salmonella. Mexico had
the greatest number of Salmonella violations for vegetables, fruits,
non-chocolate candy and gum, while violations for India were more
commonly found in spices, flavors and salts. China, on the other
hand, had the greatest number of refusals for fishery and seafood
products, vegetables and fruits. Hence, this literature review
indicates rigorous international standards should be developed and
regularly monitored for.
Presenter: Tamar Dickerson, MRIGlobal, Kansas City, MO,
[email protected]
Global Health
Evaluation of Laboratory Management Training: A Case
Study from Ethiopia
K. Lewis 1 , A. Kebede 2 , S. Young 1 , S. Liska-Mills 1 , K. Wainwright 1 ,
T. Kanter 3 , S. Staley 1 ; 1 Association of Public Health Laboratories,
2
Ethiopian Public Health Institute, 3 Centers for Disease and Control
and Prevention-Ethiopia
Background: In many developing countries, there is a gap among
laboratory managers in their knowledge and capabilities to
successfully carry out managerial tasks. Recognizing this, the
Association of Public Health Laboratories (APHL) developed and
implemented a comprehensive basic training curriculum in 2005
for laboratory managers, the Foundations of Laboratory Leadership
and Management (FLLM). In 2018 the FLLM curriculum content
was updated. Although a significant increase in training scores
from pre- and post-tests implies an acquisition of knowledge and
understanding, this does not measure subsequent laboratory
improvement, and it can be a challenge to show measurable
outcomes of laboratory management training.
To address this, mandatory post-training activities for the
Summer 2019 LAB MATTERS
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