Evaluation of the Vitek EPS enteric pathogen screen card for detecting Salmonella, Shigella, and Yersinia spp.
We evaluated the Vitek EPS card as a screen for the enteric pathogens Salmonella spp., Shigella spp., and Yersinia enterocolitica. Salmonella spp., Shigella spp., and Y. enterocolitica (125, 54, and 5 isolates, respectively) and 81 nonenteric pathogens that might be selected for screening from primary plates (non-lactose fermenters) were tested. The EPS card correctly identified 183 of 184 pathogens tested (sensitivity, 99.5%). Of 81 nonenteric pathogens screened with the EPS card, 8 were identified as possible enteric pathogens (specificity, 90.1%). We reviewed our stool culture records over the past 1.5 years and analyzed the specificities of TSI-urea screens for 300 stool cultures that had suspicious colonies. From 55 of 300 stool cultures, either Salmonella spp. or Shigella spp. were isolated, and from 245 stool cultures, no pathogen was isolated. Of the 245 negative cultures, 166 gave false-positive screening-test results that resulted in further biochemical identification procedures (Analytab Products or Vitek identification). Thus, the specificity of the TSI-urea screen in our experience was 32.2%. The Vitek EPS card was shown to be a more cost-effective screening procedure than the TSI-urea screen.
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Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia 19104-4283.
Nachamkin
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D001431:Bacteriological Techniques / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D004405:Dysentery, Bacillary / Q000175:diagnosis; D005069:Evaluation Studies as Topic; D005759:Gastroenteritis / Q000175:diagnosis; D006801:Humans; D012475:Salmonella / Q000302:isolation & purification*; D012480:Salmonella Infections / Q000175:diagnosis; D012680:Sensitivity and Specificity; D012760:Shigella / Q000302:isolation & purification*; D015009:Yersinia Infections / Q000175:diagnosis; D015008:Yersinia enterocolitica / Q000302:isolation & purification*