Document Detail

Swab protocol for rapid laboratory diagnosis of cutaneous anthrax.
MedLine Citation:
PMID:  23035192     Owner:  NLM     Status:  MEDLINE    
The clinical laboratory diagnosis of cutaneous anthrax is generally established by conventional microbiological methods, such as culture and directly straining smears of clinical specimens. However, these methods rely on recovery of viable Bacillus anthracis cells from swabs of cutaneous lesions and often yield negative results. This study developed a rapid protocol for detection of B. anthracis on clinical swabs. Three types of swabs, flocked-nylon, rayon, and polyester, were evaluated by 3 extraction methods, the swab extraction tube system (SETS), sonication, and vortex. Swabs were spiked with virulent B. anthracis cells, and the methods were compared for their efficiency over time by culture and real-time PCR. Viability testing indicated that the SETS yielded greater recovery of B. anthracis from 1-day-old swabs; however, reduced viability was consistent for the 3 extraction methods after 7 days and nonviability was consistent by 28 days. Real-time PCR analysis showed that the PCR amplification was not impacted by time for any swab extraction method and that the SETS method provided the lowest limit of detection. When evaluated using lesion swabs from cutaneous anthrax outbreaks, the SETS yielded culture-negative, PCR-positive results. This study demonstrated that swab extraction methods differ in their efficiency of recovery of viable B. anthracis cells. Furthermore, the results indicated that culture is not reliable for isolation of B. anthracis from swabs at ≥ 7 days. Thus, we recommend the use of the SETS method with subsequent testing by culture and real-time PCR for diagnosis of cutaneous anthrax from clinical swabs of cutaneous lesions.
Leslie A Dauphin; Chung K Marston; Vinod Bhullar; Daniel Baker; Mahmudur Rahman; M Jahangir Hossain; Apurba Chakraborty; Salah Uddin Khan; Alex R Hoffmaster
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2012-10-03
Journal Detail:
Title:  Journal of clinical microbiology     Volume:  50     ISSN:  1098-660X     ISO Abbreviation:  J. Clin. Microbiol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-19     Completed Date:  2013-04-17     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  7505564     Medline TA:  J Clin Microbiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3960-7     Citation Subset:  IM    
Bioterrorism Rapid Response and Advanced Technology (BRRAT) Laboratory, Division of Preparedness and Emerging Infections (DPEI), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
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MeSH Terms
Anthrax / diagnosis*
Bacillus anthracis / genetics,  growth & development,  isolation & purification*
Bacteriological Techniques / methods*
Microbial Viability
Skin / microbiology*
Skin Diseases, Bacterial / diagnosis*
Specimen Handling / methods*

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