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Rapid identification and strain-typing of respiratory pathogens for epidemic surveillance
Authors:Ecker David J  Sampath Rangarajan  Blyn Lawrence B  Eshoo Mark W  Ivy Cristina  Ecker Joseph A  Libby Brian  Samant Vivek  Sannes-Lowery Kristin A  Melton Rachael E  Russell Kevin  Freed Nikki  Barrozo Chris  Wu Jianguo  Rudnick Karl  Desai Anjali  Moradi Emily  Knize Duane J  Robbins David W  Hannis James C  Harrell Patina M  Massire Christian  Hall Thomas A  Jiang Yun  Ranken Raymond  Drader Jared J  White Neill  McNeil John A  Crooke Stanley T  Hofstadler Steven A
Affiliation:Ibis Division of Isis Pharmaceuticals, 1891 Rutherford Road, Carlsbad, CA 92008, USA. decker@isisph.com
Abstract:Epidemic respiratory infections are responsible for extensive morbidity and mortality within both military and civilian populations. We describe a high-throughput method to simultaneously identify and genotype species of bacteria from complex mixtures in respiratory samples. The process uses electrospray ionization mass spectrometry and base composition analysis of PCR amplification products from highly conserved genomic regions to identify and determine the relative quantity of pathogenic bacteria present in the sample. High-resolution genotyping of specific species is achieved by using additional primers targeted to highly variable regions of specific bacterial genomes. This method was used to examine samples taken from military recruits during respiratory disease outbreaks and for follow up surveillance at several military training facilities. Analysis of respiratory samples revealed high concentrations of pathogenic respiratory species, including Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pyogenes. When S. pyogenes was identified in samples from the epidemic site, the identical genotype was found in almost all recruits. This analysis method will provide information fundamental to understanding the polymicrobial nature of explosive epidemics of respiratory disease.
Keywords:genotyping   group A streptococci   infectious disease   Streptococcus pyogenes   pneumonia
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