title: Evaluation of pulsed-field gel electrophoresis in epidemiological investigations of meningococcal disease outbreaks caused by Neisseria meningitidis serogroup C.
abstract: Since 1990, the frequency of Neisseria meningitidis serogroup C (NMSC) outbreaks in the United States has increased. Based on multilocus enzyme electrophoresis (MEE), the current molecular subtyping standard, most of the NMSC outbreaks have been caused by isolates of several closely related electrophoretic types (ETs) within the ET-37 complex. We chose 66 isolates from four well-described NMSC outbreaks that occurred in the United States from 1993 to 1995 to evaluate the potential of pulsed-field gel electrophoresis (PFGE) to identify outbreak-related isolates specific for each of the four outbreaks and to differentiate between them and 50 sporadic isolates collected during the outbreak investigations or through active laboratory-based surveillance from 1989 to 1996. We tested all isolates collected during the outbreak investigations by four other molecular subtyping methods: MEE, ribotyping (ClaI), random amplified polymorphic DNA assay (two primers), and serotyping and serosubtyping. Among the 116 isolates, we observed 11 clusters of 39 NheI PFGE patterns. Excellent correlation between the PFGE and the epidemiological data was observed, with an overall sensitivity of 85% and specificity of 71% at the 95% pattern relatedness breakpoint using either 1.5 or 1.0% tolerance. For all four analyzed outbreaks, PFGE would have given public health officials additional support in declaring an outbreak and making appropriate public health decisions.
authors.affiliation: Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: T
authors.initials: T
authors.lastname: Popovic
authors.forename: S
authors.initials: S
authors.lastname: Schmink
authors.forename: N A
authors.initials: NA
authors.lastname: Rosenstein
authors.forename: G W
authors.initials: GW
authors.lastname: Ajello
authors.forename: M W
authors.initials: MW
authors.lastname: Reeves
authors.forename: B
authors.initials: B
authors.lastname: Plikaytis
authors.forename: S B
authors.initials: SB
authors.lastname: Hunter
authors.forename: E M
authors.initials: EM
authors.lastname: Ribot
authors.forename: D
authors.initials: D
authors.lastname: Boxrud
authors.forename: M L
authors.initials: ML
authors.lastname: Tondella
authors.forename: C
authors.initials: C
authors.lastname: Kim
authors.forename: C
authors.initials: C
authors.lastname: Noble
authors.forename: E
authors.initials: E
authors.lastname: Mothershed
authors.forename: J
authors.initials: J
authors.lastname: Besser
authors.forename: B A
authors.initials: BA
authors.lastname: Perkins
mesh_terms: D001130:Arizona / Q000453:epidemiology; D002140:California / Q000453:epidemiology; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000382:microbiology*; D009345:Neisseria meningitidis / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D009516:New Mexico / Q000453:epidemiology; D011159:Population Surveillance; D019105:Random Amplified Polymorphic DNA Technique; D021521:Ribotyping; D012680:Sensitivity and Specificity; D012703:Serotyping; D013781:Texas / Q000453:epidemiology