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Yersinia enterocolitica and Y. enterocolitica-like species in clinical stool specimens of humans: identification and prevalence of bio/serotypes in Finland

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Abstract

This study investigated the prevalence of Yersinia enterocolitica (YE) bio/serotypes and YE-like species in clinical stool specimens. The special aim was to find the best methods for accurate identification of YE species and, further, pathogenic strains among YE isolates. Of the 41,848 specimens cultured in ten laboratories during a 12-month period, 473 Yersinia strains were isolated from 462 patients. The strains were identified by 21 biochemical tests, serotyping, colony morphology, as well as by 16S rRNA and gyrB gene sequencing. The most prevalent Yersinia findings were YE biotype 1A (64% of the strains) and pathogenic bio/serotype 4/O:3 (16%). The cold-enrichment increased the number of all isolates, and 25% of the bio/serotype 4/O:3 and 2/O:9 strains were only found by cold-enrichment. In routine diagnostic laboratories, 50% of the YE-like species were identified as YE and in 26% the identification differed from that of the reference laboratory. The microscopic colony identification on CIN agar with positive CR-MOX test, combined with several biochemical tests, identified reliably the pathogenic YE bioserotypes and most YE BT 1A strains, but some strains of the YE-like species were so heterogenic that gene sequencing was the only way to identify them.

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Acknowledgments

We thank Heini Flinck, Tarja Heiskanen, Sari Jaakola, and Joonas Iivonen for skilful technical assistance. Elisa Huovinen is acknowledged for her useful comments. This work was funded by grant 4850/501/2004 from the Finnish Ministry of Agriculture and Forestry.

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Authors and Affiliations

  1. National Institute for Health and Welfare, P.O. box 30, FI-00271, Helsinki, Finland

    L. M. Sihvonen, K. Haukka, M. Kuusi, M. J. Virtanen & A. Siitonen

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  1. L. M. Sihvonen
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  2. K. Haukka
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  3. M. Kuusi
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  4. M. J. Virtanen
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  5. A. Siitonen
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YE study group*

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Correspondence to A. Siitonen.

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*Finnish clinical microbiology laboratories’ YE study group: Martti Vaara, Eveliina Tarkka (Hospital District of Helsinki and Uusimaa), Antti Nissinen, Jaakko Uksila (Central Hospital of Central Finland, Microbiology Laboratory), Erkki Eerola (Turku University, Department of Medical Microbiology), Hannu Sarkkinen, Pauliina Kärpänoja (Päijät-Häme Social and Health Care Group, Clinical Microbiology), Päivi Strandén (Microbiological laboratory, Central Hospital of Seinäjoki), Pekka Ruuska (Joint Authority of Kainuu Region, Clinical Laboratory, Kainuu Central Hospital), Markku Koskela (Oulu University Hospital, Microbiology laboratory), Ulla Larinkari, Vesa Kirjavainen (Laboratory of Clinical Microbiology, Kymenlaakso Central Hospital, Kotka), Anja Kostiala-Thompson, Tiina Muuronen (VITA Terveyspalvelut Oy), Anna Muotiala (Medix Laboratories Ltd).

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Sihvonen, L.M., Haukka, K., Kuusi, M. et al. Yersinia enterocolitica and Y. enterocolitica-like species in clinical stool specimens of humans: identification and prevalence of bio/serotypes in Finland. Eur J Clin Microbiol Infect Dis 28, 757–765 (2009). https://doi.org/10.1007/s10096-008-0696-y

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