salmonella isolate recovery project · aomam, th david, us milinda courey dara ullrich, de vectors...
TRANSCRIPT
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National Center for Emerging and Zoonotic Infectious Diseases
Salmonella Isolate Recovery Project
Jo Williams-Newkirk, PhD
Co-lead, Culture-Independent and Metagenomic Subtyping Group
Enteric Diseases Laboratory Branch, CDC
APHL West Coast Regional Meeting
February 7, 2019
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EDLB Project Contributors
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Katie Dillon
Brooke AspinwallJasmine Hensley
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Current Project
Replicated testing of the most promising conditions used in previous studies to identify an improved
Salmonella isolate recovery workflow
STEC recovery testing beginning in spring 2019
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Standard Stool Creation
4
300mL pooled stool
60mL/donor
105 104 103 102
106
SalmonellaStock
(Oranienburgor Newport)
104
Phases 1-2103
Phase 3102
Phases 1-3101
Phase 3
Salmonella spike-in confirmed by plating and qPCR
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Phase 1
Which transport media, holding temperature, and plating media best facilitate Salmonella recovery?
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Phase 1
Serotype
Plating Media
Holding Temperature
Transport Media
Days Since Collection
Spike Level
Oranienburg Newport Unspiked
104 102 US
4 8 14 Hektoen XLD
6
22°C 4°C
Cary-Blair GN Broth
Experimental Design Variables Tested
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100 10000
4 8 14 4 8 14
CB.HEK.Newport.4
GN.HEK.Newport.4
CB.XLD.Newport.4
GN.XLD.Newport.4
CB.HEK.Oranienburg.4
GN.HEK.Oranienburg.4
CB.XLD.Oranienburg.4
GN.XLD.Oranienburg.4
CB.HEK.Newport.22
GN.HEK.Newport.22
CB.XLD.Newport.22
GN.XLD.Newport.22
CB.HEK.Oranienburg.22
GN.HEK.Oranienburg.22
CB.XLD.Oranienburg.22
GN.XLD.Oranienburg.22
Day
0.00
0.33
0.66
1.00
Mean PositiveSweeps
104102100 10000
4 8 14 4 8 14
CB.HEK.Newport.4
GN.HEK.Newport.4
CB.XLD.Newport.4
GN.XLD.Newport.4
CB.HEK.Oranienburg.4
GN.HEK.Oranienburg.4
CB.XLD.Oranienburg.4
GN.XLD.Oranienburg.4
CB.HEK.Newport.22
GN.HEK.Newport.22
CB.XLD.Newport.22
GN.XLD.Newport.22
CB.HEK.Oranienburg.22
GN.HEK.Oranienburg.22
CB.XLD.Oranienburg.22
GN.XLD.Oranienburg.22
Day
0
1
2
3
Mean PositivePicks
104102
Sweeps Picks
22°C 22°C
4°C 4°C
7
Darker is better
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Phase 1 Outcomes
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Recovery best when specimens transported/stored at 22°C
Cary-Blair is more widely used
Hektoen has a longer shelf-life
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Phase 2 “Hot Truck”
Are heat spikes during transport detrimental to Salmonella recovery?
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Phase 2
Serotype Plating Media
Holding Temperature
Transport Media
Days Since Collection
Spike Level
Oranienburg Newport Unspiked
104 102 US
4 7 14
Hektoen
10
Cary-Blair
Experimental Design
Variables Tested
78°C 55°C 55°C 22°C 22°C
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100 10000
4 7 14 4 7 14
Newport.ice.22
Oranienburg.ice.22
Newport.no ice.22
Oranienburg.no ice.22
Newport.ice.55
Oranienburg.ice.55
Newport.no ice.55
Oranienburg.no ice.55
Newport.ice.78
Oranienburg.ice.78
Day
0
1
2
3
Mean PositivePicks
102 104 100 10000
4 7 14 4 7 14
Newport.ice.22
Oranienburg.ice.22
Newport.no ice.22
Oranienburg.no ice.22
Newport.ice.55
Oranienburg.ice.55
Newport.no ice.55
Oranienburg.no ice.55
Newport.ice.78
Oranienburg.ice.78
Day
0.00
0.33
0.66
1.00
Mean PositiveSweeps
102 104
11
Picks Sweeps
Darker is better
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Phase 2 Outcomes
No difference in recovery between specimens on ice vs 22°C
– For Phase 3, hold samples at 22°C
We recommend that during warmer months…
Clinical Lab SPHL Lab
22°C 22°C12
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Phase 3
Which enrichments best facilitate Salmonella recovery?
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Phase 3
Serotype Plating Media
Holding Temperature
Transport Media
Days Since Collection
Spike Level
Oranienburg Newport Unspiked
102 101 US
4 7 14
Hektoen
14
Cary-Blair
Experimental Design
Variables Tested
22°C
Enrichment
MSRV TET42 SELTET37
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100% Recovery!!
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10 100 1000
New
port
Ora
nie
nburg
4 7 14 4 7 14 4 7 14
NEC
MSRV
TET42
TET37
SEL
NEC
MSRV
TET42
TET37
SEL
Day
Enrichm
ent
1.5
2.0
2.5
3.0
avg_density_1
10 100 1000
Ne
wp
ort
Ora
nie
nb
urg
4 7 14 4 7 14 4 7 14
NEC
MSRV
TET42
TET37
SEL
NEC
MSRV
TET42
TET37
SEL
DayE
nrich
me
nt
2.00
2.25
2.50
2.75
3.00
avg_density_2
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Salmonella Density Commensal Density1 2 3
Darker is better
Lighter is better
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Phase 3 Outcomes
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100% recovery across all enrichments
– Tet37 and selenite perform similarly
Selenite chosen based on:
– Cost
– Preparation difficulty/time
– Commensal suppression
– Shelf-life
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The Golden Path
18
HEK
Specimen in Cary-Blair
Confirmatory test 18
Clinical Lab SPHL Lab22°C 22°C
SELHEK SEL
Recover off HEK, if possible
HEK
Recover off SEL -> HEK if possible
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Our Collaborators:
Department of Health and Human Services (HHS)
Centers for Disease Control and Prevention (CDC)
– EDLB: Michele Parsons, Efrain Ribot, Peter Gerner-Smidt, Cheryl Bopp, Michelle Sanders, Samantha Olson, and Christine VanTubbergen
Association of Public Health Laboratories (APHL) Isolate Recovery Subcommittee
Oak Ridge Institute for Science and Education (ORISE)
CO Department of Public Health & Environment, Laboratory Services Division
Los Angeles County Department of Public Health
MN Department of Health, Public Health Laboratory
TN Department of Health
University of IA, State Hygienic Laboratory19
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EDLB Acknowledgments
Katie Dillon
John Besser
Andrew Huang
Heather Carleton
Yang Gao
Jasmine Hensley
Brooke Aspinwall
Nancy Garrett
Susan Van Duyne
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TheNounProject Acknowledgments StoneHub, NZ BomSymbols, TH SBTS, IN Mynamepong, TH Faisalovers, ID Claire Jones, GB Creaticca Creative Agency, GB Edwin Prayogi M, ID Jenna Rabideaux Anna Bearne, GB Orin zuu Javi Ayala, ES Humantech, ID Jae Deasigner Template, TH Eugen Belyakoff, RU Hendra sudibyo
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CombineDesign
Egon Låstad, NO
Gan Khoon Lay
AomAm, TH
David, US
Milinda Courey
Dara Ullrich, DE
Vectors Market
Lee Mette, DE
Eucalyp
Juraj Sedlák, SK
Wireform, US
Strokeicon
Wilson Joseph
Brand Mania
Nikita Kozin
Shastry
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For more information, contact CDC1-800-CDC-INFO (232-4636)TTY: 1-888-232-6348 www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Thank you!
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