APHL 2019 POSTER ABSTRACTS
positives were African American, 27.5% were Caucasian, and 7.7%
were identified as unknown. In men, 82.9% of positives were African
American, 14.3% were Caucasian, and 2.8% were unknown.
Conclusions: This study demonstrates that Mycoplasma genitalium
is highly prevalent in our patient population, indeed higher than
that of the other STI’s evaluated in this same study (CT, NG or TV).
Our M.gen prevalence of 13% correlates to recently published
studies that show M.gen prevalence between 11-17%. Risk factors
associated with M.gen infection in our study were African American
race and young age, with more than half of all infections occurring
in patients under 25. The observation of disease burden in the
younger age group, combined with the morbidities of untreated
M.gen infections, demonstrates the need for routine M.gen testing
amongst the symptomatic patient population.
Presenter: Traci Dailey, Alabama Dept. of Public Health,
Montgomery, AL, [email protected]
Application of PCR-based Methods to Assess Optimal
Sample Types for Detection of Sin Nombre Virus (SNV)
Nucleic Acid in Deer Mice
S. Messenger, K. Hsieh, M. Deldari, K. Padgett, B. Jackson, M.
Yoshimizu and M. Novak, California Department of Public Health
Objective: The California Department of Public Health (CDPH)
performs environmental surveillance for SNV to assess potential
risks for human transmission and support human case
investigations. Rodent surveillance focused on detection of SNV-
specific IgG, an indicator of past exposure. Recently, testing was
updated to include detection of SNV RNA in blood by real-time
RT-PCR (RT-PCR) as a better indicator of the prevalence of currently
infectious rodents. It was not known, however, whether blood was
an optimal sample to detect SNV RNA, or if other tissues must be
sampled if our goal was to identify infectious rodents. In this study,
we compared different tissue samples to identify optimal sample
type(s) to detect SNV RNA in rodents.
Study Design and Results: 157 rodents from known SNV hotspots
in California were collected between 2002 to 2017. For 105 rodents,
we collected eight different sample types; heart, lung, spleen,
kidney, bladder, salivary gland, oral swab and fecal material. For the
remaining 52 rodents we collected; heart, lung, spleen, and kidney.
The relative viral load in a sample was estimated by the Ct value of
extracted SNV RNA tested by RT-PCR.
In Phase 1, 20 rodents from site one were selected and all eight
sample types (i.e., six tissues and an oral and fecal sample) were
tested. Results indicated that lung, followed by spleen, was the most
sensitive sample type for detection of SNV RNA. In Phase 2, lung
tissue for the remaining 105 rodents from “site one” was tested;
40 of 105 (38%) rodents were positive. Of interest, among the 40
SNV-positive rodents, 50% had positive oral swabs and 20% positive
fecal samples indicating that less invasive samples can yield SNV
RNA. In Phase 3, lung tissue was tested from 59 rodents which had
blood samples previously tested by RT-PCR. While 20% of rodent
bloods had detectable SNV RNA, 30% of lung tissues were positive.
Conclusion: In field surveillance studies of SNV, seroprevalence in
sampled rodent populations is a primary indicator of Hantavirus
risk. Because serology tests (i.e., IgG EIA) are not specific to SNV
and indicate both current and past infections, seroprevalence
studies identify animals that were previously exposed at an
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undetermined time to either Sin Nombre or another related
Hantavirus. Addition of molecular tests for surveillance of SNV in
California rodent populations may improve our understanding of the
prevalence of infectious mice that may be shedding virus. This study
evaluated a variety of sample types and determined that addition of
extracted lung tissue can improve detection of SNV in rodents, but
less invasive sample types (i.e., blood, oral, and fecal samples) while
slightly less sensitive, can be obtained with minimal handling and
from rodents released after capture. SNV RNA screening could be a
valuable addition to field surveillance and molecular epidemiological
studies.
Presenter: Mojgan Deldari, California Department of Public Health,
Richmond, CA, [email protected]
Extended-Spectrum β-Lactamase-Producing
Enterobacteriaceae Collected Through the Emerging
Infections Program, 2017
D. Campbell 1 , J. Daniels 1 , R. Stanton 1 , V. Albrecht 1 , S. Janelle 2 , K.
Schutz 2 , C. Bower 3 , J. Jacob 3 , 4 , P. Rebolledo 4 , E. Phipps 5 , K. Flores 5 ,
G. Dumyati 6 , R. Tsay 6 , H. Kopin 6 , M. Kainer 7 , D. Muleta 7 , H. Reses 1 ,
N. Duffy 1 , J.K. Rasheed 1 , J. Lutgring 1 , M. Karlsson 1 , 1 Centers for
Disease Control and Prevention, 2 Colorado Department of Public
Health and Environment, 3 Georgia Emerging Infections Program,
4
Emory University School of Medicine, 5 University of New Mexico,
6
University of Rochester Medical Center, 7 Tennessee Department of
Health
Background: Extended-spectrum β-lactamases (ESBLs), named
for their expanded substrate spectrum for hydrolyzing β-lactam
antibiotics (penicillins, third generation cephalosporins and
monobactams), have disseminated globally since their initial report
in 1983. ESBLs are often plasmid-mediated and produced by
Enterobacteriaceae such as Klebsiella pneumoniae and Escherichia
coli. ESBL-producing Enterobacteriaceae are responsible for both
hospital-acquired and community-onset infections. Here we describe
the antimicrobial susceptibility profile and molecular epidemiology
of ESBL-producing isolates collected through the Emerging
Infections Program (EIP) at the Centers for Disease Control and
Prevention (CDC).
Methods: In 2017, 5 EIP sites (Colorado, Georgia, New Mexico,
New York, and Tennessee) submitted a convenience sample of
E. coli, K. oxytoca, and K. pneumoniae clinical isolates meeting
the case definition (resistant to ceftazidime, cefotaxime, or
ceftriaxone and non-resistant to all carbapenems tested) based
on clinical laboratory results to CDC. Isolates underwent reference
antimicrobial susceptibility testing (AST) with broth microdilution,
phenotypic screening for ESBLs using ceftazidime or cefotaxime
alone and in combination with clavulanate, and whole genome
sequencing (WGS) (Illumina, MiSeq).
Results: Among 136 isolates submitted, 122 (89.7%) met the
case definition using reference AST whereas 116 (85.3%) were
ESBL screen-positive. Among the 122 isolates meeting the case
definition, 104 (85.2%) isolates were identified as E. coli, 16 (13.1%)
as K. pneumoniae, and 2 (1.6%) as K. oxytoca. By WGS, 113 of
122 isolates meeting the case definition harbored an ESBL gene
(92.6%). The most commonly identified ESBL gene was blaCTX-M-15
(n=69, 61.1%) followed by blaCTX-M-14 (n=17, 15.0%) and
blaCTX-M-27 (n=14, 12.4%). The most prevalent E. coli sequence
types were ST131 (n=52), ST38 (n=12), and ST10 (n=5); ST45 was
Summer 2019 LAB MATTERS
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