Implementation of multiplex PCR diagnostics for gastrointestinal pathogens linked to increase of notified Shiga toxin-producing Escherichia coli cases in Norway, 2007–2017

Collection Location Koleksi E-book & E-Journal Perpustakaan Pusat Unila
Edition Vol. 38, Issue 4
Call Number
ISBN/ISSN 1435-4373
Author(s) Jenssen, Gaute Reier...[et al.]
Subject(s) Biomedicine
Classification NONE
Series Title
GMD E-Journal
Language English
Publisher Springer
Publishing Year 2019
Publishing Place Switzerland
Abstract/Notes Abstract
The aim of this study was to investigate implementation of multiplex PCR assays (broad screening PCR) on the distribution and
characteristics of notified Shiga toxin-producing Escherichia coli (STEC) cases in Norway, 2007–2017. We described STEC cases
notified to the Norwegian Surveillance System for CommunicableDiseases (MSIS), 2007–2017 and categorised cases as high-virulent,
low-virulent or unclassifiable STEC infections based on guidelines for follow-up of STEC cases. We conducted descriptive analysis
and time series analysis allowing for trends and seasonality, and calculated adjusted incidence rate ratios (aIRR) using negative
binomial regression for laboratories with and without broad screening PCR. A total of 1458 STEC cases were notified to MSIS
(2007–2017), median age 21 years, 51% female. Cases were categorised as having 475 (33%) high-virulent, 652 (45%) low-virulent,
and 331 (23%) unclassifiable STEC infections.We observed a higher increasingmonthly trend in cases (aIRR = 1.020; 95% CI 1.016–
1.024) notified from laboratories with broad screening PCR (n = 4) compared to laboratories (n = 17) without (aIRR = 1.011; 95% CI
1.007–1.014). Notification of low-virulent STEC infections increased from laboratories with broad screening PCR. The increase in
notified STEC cases was prominent in cases categorised with a low-virulent STEC infection and largely attributable to unselective
screening methods. We recommend NIPH to maintain differentiated control measures for STEC cases to avoid follow-up of lowvirulent
STEC infections. We recommend microbiological laboratories in Norway to consider a more cost-effective broad screening
PCR strategy that enables differentiation of high-virulent STEC infections.
Keywords STEC diagnostic . Multiplex PCR panels . Incidence of STEC . High-virulent STEC . Low-virulent STEC
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