Skip to main content

Advertisement

SpringerLink
Log in

Comparison of the BD MAX® Enteric Bacterial Panel assay with conventional diagnostic procedures in diarrheal stool samples

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Although infectious diarrhea is one of the most predominant diseases around the world, the identification of the causative microorganism is still challenging. The aim of this study was the evaluation of the BD MAX® Enteric Bacterial Panel assay in comparison to conventional diagnostic procedures concerning the detection of the enteric pathogens Salmonella spp., Campylobacter spp., Shigella spp., and Shiga toxin-producing Escherichia coli. For this purpose, 971 prospectively collected stool samples were evaluated. Utilization of the BD MAX Enteric Bacterial Panel elevated the overall detection rate from 5.26 % to 8.06 %. The positive percent agreement of the BD MAX Enteric Bacterial Panel assay and stool culture or enzyme immunoassay was 0.97 for Campylobacter spp., 0.75 for Salmonella spp., 1.00 for Shigella spp., and 0.88 for Shiga toxins. Furthermore, a negative percent agreement of 0.98 for Campylobacter spp., 0.99 for Salmonella spp., 0.99 for Shigella spp., and 0.99 for Shiga toxins has been demonstrated. This study highlighted the superior detection rate of molecular assays compared to conventional diagnostic procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Guerrant RL (1998) Why America must care about tropical medicine: threats to global health and security from tropical infectious diseases. Am J Trop Med Hyg 59:3–16

    PubMed  CAS  Google Scholar 

  2. LeDuc J, Hughes J (1999) Surveillance for emerging infectious diseases. In: Guerrant RL, Walker DH, Weller PF (eds) Tropical infectious diseases: principles, pathogens and practice. Churchill Livingstone, Philadelphia, PA, pp 251–260

    Google Scholar 

  3. Imhoff B, Morse D, Shiferaw B, Hawkins M, Vugia D, Lance-Parker S, Hadler J, Medus C, Kennedy M, Moore MR, Van Gilder T; Emerging Infections Program FoodNet Working Group (2004) Burden of self-reported acute diarrheal illness in FoodNet surveillance areas, 1998–1999. Clin Infect Dis 38(Suppl 3):S219–S226

    Article  PubMed  Google Scholar 

  4. Van Cauteren D, De Valk H, Vaux S, Le Strat Y, Vaillant V (2012) Burden of acute gastroenteritis and healthcare-seeking behaviour in France: a population-based study. Epidemiol Infect 140:697–705

    Article  PubMed  Google Scholar 

  5. Herikstad H, Yang S, Van Gilder TJ, Vugia D, Hadler J, Blake P, Deneen V, Shiferaw B, Angulo FJ (2002) A population-based estimate of the burden of diarrhoeal illness in the United States: FoodNet, 1996–7. Epidemiol Infect 129:9–17

    PubMed  CAS  PubMed Central  Google Scholar 

  6. Gordon MA (2008) Salmonella infections in immunocompromised adults. J Infect 56:413–422

    Article  PubMed  Google Scholar 

  7. Boschi-Pinto C, Velebit L, Shibuya K (2008) Estimating child mortality due to diarrhoea in developing countries. Bull World Health Organ 86:710–717

    Article  PubMed  PubMed Central  Google Scholar 

  8. Choi SW, Park CH, Silva TM, Zaenker EI, Guerrant RL (1996) To culture or not to culture: fecal lactoferrin screening for inflammatory bacterial diarrhea. J Clin Microbiol 34:928–932

    PubMed  CAS  PubMed Central  Google Scholar 

  9. de Wit MA, Koopmans MP, Kortbeek LM, van Leeuwen NJ, Vinjé J, van Duynhoven YT (2001) Etiology of gastroenteritis in sentinel general practices in the Netherlands. Clin Infect Dis 33:280–288

    Article  PubMed  Google Scholar 

  10. Green KY (1997) The role of human caliciviruses in epidemic gastroenteritis. Arch Virol Suppl 13:153–165

    PubMed  CAS  Google Scholar 

  11. Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM (2011) Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis 17:7–15

    Article  PubMed  PubMed Central  Google Scholar 

  12. Elliott EJ (2007) Acute gastroenteritis in children. BMJ 334:35–40

    Article  PubMed  PubMed Central  Google Scholar 

  13. Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV, Hennessy T, Griffin PM, DuPont H, Sack RB, Tarr P, Neill M, Nachamkin I, Reller LB, Osterholm MT, Bennish ML, Pickering LK; Infectious Diseases Society of America (2001) Practice guidelines for the management of infectious diarrhea. Clin Infect Dis 32:331–351

    Article  PubMed  CAS  Google Scholar 

  14. Pawlowski SW, Warren CA, Guerrant R (2009) Diagnosis and treatment of acute or persistent diarrhea. Gastroenterology 136:1874–1886

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  15. Guerrant RL, Wanke CA, Barrett LJ, Schwartzman JD (1987) A cost effective and effective approach to the diagnosis and management of acute infectious diarrhea. Bull N Y Acad Med 63:484–499

    PubMed  CAS  PubMed Central  Google Scholar 

  16. Guarino A, Giannattasio A (2011) New molecular approaches in the diagnosis of acute diarrhea: advantages for clinicians and researchers. Curr Opin Gastroenterol 27:24–29

    Article  PubMed  Google Scholar 

  17. Platts-Mills JA, Liu J, Houpt ER (2013) New concepts in diagnostics for infectious diarrhea. Mucosal Immunol 6:876–885

    Article  PubMed  CAS  Google Scholar 

  18. Stellrecht KA, Espino AA, Maceira VP, Nattanmai SM, Butt SA, Wroblewski D, Hannett GE, Musser KA (2014) Premarket evaluations of the IMDx C. difficile for Abbott m2000 Assay and the BD Max Cdiff Assay. J Clin Microbiol 52:1423–1428

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  19. Harrington SM, Buchan BW, Doern C, Fader R, Ferraro MJ, Pillai DR, Rychert J, Doyle L, Lainesse A, Karchmer T, Mortensen JE (2015) Multicenter evaluation of the BD max enteric bacterial panel PCR assay for rapid detection of Salmonella spp., Shigella spp., Campylobacter spp. (C. jejuni and C. coli), and Shiga toxin 1 and 2 genes. J Clin Microbiol 53:1639–1647

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  20. Khot PD, Fisher MA (2013) Novel approach for differentiating Shigella species and Escherichia coli by matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 51:3711–3716

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  21. Thielman NM, Guerrant RL (2004) Clinical practice. Acute infectious diarrhea. N Engl J Med 350:38–47

    Article  PubMed  CAS  Google Scholar 

  22. Guerrant RL, Shields DS, Thorson SM, Schorling JB, Gröschel DH (1985) Evaluation and diagnosis of acute infectious diarrhea. Am J Med 78:91–98

    Article  PubMed  CAS  Google Scholar 

  23. Walterspiel JN, Ashkenazi S, Morrow AL, Cleary TG (1992) Effect of subinhibitory concentrations of antibiotics on extracellular Shiga-like toxin I. Infection 20:25–29

    Article  PubMed  CAS  Google Scholar 

  24. Buss SN, Leber A, Chapin K, Fey PD, Bankowski MJ, Jones MK, Rogatcheva M, Kanack KJ, Bourzac KM (2015) Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. J Clin Microbiol 53:915–925

    Article  PubMed  PubMed Central  Google Scholar 

  25. Saulnier P, Andremont A (1992) Detection of genes in feces by booster polymerase chain reaction. J Clin Microbiol 30:2080–2083

    PubMed  CAS  PubMed Central  Google Scholar 

  26. Fluit AC, Widjojoatmodjo MN, Verhoef J (1995) Detection of Salmonella species in fecal samples by immunomagnetic separation and PCR. J Clin Microbiol 33:1046–1047

    PubMed  CAS  PubMed Central  Google Scholar 

  27. Biswas JS, Al-Ali A, Rajput P, Smith D, Goldenberg SD (2014) A parallel diagnostic accuracy study of three molecular panels for the detection of bacterial gastroenteritis. Eur J Clin Microbiol Infect Dis 33:2075–2081

    Article  PubMed  CAS  Google Scholar 

  28. Anderson NW, Buchan BW, Ledeboer NA (2014) Comparison of the BD MAX enteric bacterial panel to routine culture methods for detection of Campylobacter, enterohemorrhagic Escherichia coli (O157), Salmonella, and Shigella isolates in preserved stool specimens. J Clin Microbiol 52:1222–1224

    Article  PubMed  PubMed Central  Google Scholar 

  29. Buchan BW, Olson WJ, Pezewski M, Marcon MJ, Novicki T, Uphoff TS, Chandramohan L, Revell P, Ledeboer NA (2013) Clinical evaluation of a real-time PCR assay for identification of Salmonella, Shigella, Campylobacter (Campylobacter jejuni and C. coli), and shiga toxin-producing Escherichia coli isolates in stool specimens. J Clin Microbiol 51:4001–4007

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  30. Cunningham SA, Sloan LM, Nyre LM, Vetter EA, Mandrekar J, Patel R (2010) Three-hour molecular detection of Campylobacter, Salmonella, Yersinia, and Shigella species in feces with accuracy as high as that of culture. J Clin Microbiol 48:2929–2933

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  31. McAuliffe GN, Anderson TP, Stevens M, Adams J, Coleman R, Mahagamasekera P, Young S, Henderson T, Hofmann M, Jennings LC, Murdoch DR (2013) Systematic application of multiplex PCR enhances the detection of bacteria, parasites, and viruses in stool samples. J Infect 67:122–129

    Article  PubMed  Google Scholar 

  32. Vidal M, Kruger E, Durán C, Lagos R, Levine M, Prado V, Toro C, Vidal R (2005) Single multiplex PCR assay to identify simultaneously the six categories of diarrheagenic Escherichia coli associated with enteric infections. J Clin Microbiol 43:5362–5365

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  33. Mortensen JE, Ventrola C, Hanna S, Walter A (2015) Comparison of time-motion analysis of conventional stool culture and the BD MAX™ Enteric Bacterial Panel (EBP). BMC Clin Pathol 15:9

    Article  PubMed  PubMed Central  Google Scholar 

  34. Novak SM, Bobenchik A, Cumpio J, Marlowe E (2014) Evaluation of the Verigene EP IUO test for the rapid detection of bacterial and viral causes of gastrointestinal infection. In: Proceedings of the 30th Clinical Virology Symposium and Annual Meeting of the Pan American Society for Clinical Virology, Daytona Beach, FL, April 2014, abstract 1317

  35. Navidad JF, Griswold DJ, Gradus MS, Bhattacharyya S (2013) Evaluation of Luminex xTAG gastrointestinal pathogen analyte-specific reagents for high-throughput, simultaneous detection of bacteria, viruses, and parasites of clinical and public health importance. J Clin Microbiol 51:3018–3024

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  36. Wang J, Xu Z, Niu P, Zhang C, Zhang J, Guan L, Kan B, Duan Z, Ma X (2014) A two-tube multiplex reverse transcription PCR assay for simultaneous detection of viral and bacterial pathogens of infectious diarrhea. Biomed Res Int 2014:648520

    PubMed  PubMed Central  Google Scholar 

  37. Kaufman SS, Green KY, Korba BE (2014) Treatment of norovirus infections: moving antivirals from the bench to the bedside. Antivir Res 105:80–91

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Frezzini Elisa and Wieser Maria for their skillful technical assistance.

Author information

Authors and Affiliations

  1. Division of Hygiene and Medical Microbiology, Medical University Innsbruck, Schöpfstrasse 41, 6020, Innsbruck, Austria

    L. Knabl, I. Grutsch & D. Orth-Höller

Authors
  1. L. Knabl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Grutsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Orth-Höller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to L. Knabl or D. Orth-Höller.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Knabl, L., Grutsch, I. & Orth-Höller, D. Comparison of the BD MAX® Enteric Bacterial Panel assay with conventional diagnostic procedures in diarrheal stool samples. Eur J Clin Microbiol Infect Dis 35, 131–136 (2016). https://doi.org/10.1007/s10096-015-2517-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-015-2517-4

Keywords

Search

Navigation