title: Clinical laboratory practices for the isolation and identification of Campylobacter in Foodborne Diseases Active Surveillance Network (FoodNet) sites: baseline information for understanding changes in surveillance data.
abstract: BACKGROUND
  Campylobacter is a leading cause of foodborne illness in the United States. Understanding laboratory practices is essential to interpreting incidence and trends in reported campylobacteriosis over time and provides a baseline for evaluating the increasing use of culture-independent diagnostic methods for Campylobacter infection.
  
  
  METHODS
  The Foodborne Diseases Active Surveillance Network (FoodNet) conducts surveillance for laboratory-confirmed Campylobacter infections. In 2005, FoodNet conducted a survey of clinical laboratories to describe routine practices used for isolation and identification of Campylobacter. A profile was assigned to laboratories based on complete responses to key survey questions that could impact the recovery and isolation of Campylobacter from stool specimens.
  
  
  RESULTS
  Of 411 laboratories testing on-site for Campylobacter, 97% used only culture methods. Among those responding to the individual questions, nearly all used transport medium (97%) and incubated at 42°C (94%); however, most deviated from existing guidelines in other areas: 68% held specimens in transport medium at room temperature before plating, 51% used Campy blood agar plate medium, 52% read plates at <72 hours of incubation, and 14% batched plates before placing them in a microaerobic environment. In all, there were 106 testing algorithms among 214 laboratories with a complete profile; only 16 laboratories were fully adherent to existing guidelines.
  
  
  CONCLUSIONS
  Although most laboratories used culture-based methods, procedures differed widely and most did not adhere to existing guidelines, likely resulting in underdiagnosis. Given the availability of new culture-independent testing methods, these data highlight a clear need to develop best practice recommendations for Campylobacter infection diagnostic testing.
authors.affiliation: Connecticut Emerging Infections Program, Yale School of Public Health, 1 Church St, 7th Fl, New Haven, CT 06510, USA. sharon.hurd@yale.edu
authors.forename: Sharon
authors.initials: S
authors.lastname: Hurd
authors.forename: Mary
authors.initials: M
authors.lastname: Patrick
authors.forename: Julie
authors.initials: J
authors.lastname: Hatch
authors.forename: Paula
authors.initials: P
authors.lastname: Clogher
authors.forename: Katie
authors.initials: K
authors.lastname: Wymore
authors.forename: Alicia B
authors.initials: AB
authors.lastname: Cronquist
authors.forename: Suzanne
authors.initials: S
authors.lastname: Segler
authors.forename: Trisha
authors.initials: T
authors.lastname: Robinson
authors.forename: Samir
authors.initials: S
authors.lastname: Hanna
authors.forename: Glenda
authors.initials: G
authors.lastname: Smith
authors.forename: Collette
authors.initials: C
authors.lastname: Fitzgerald
mesh_terms: D001431:Bacteriological Techniques; D002167:Campylobacter / Q000302:isolation & purification*; D002169:Campylobacter Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D002487:Centers for Disease Control and Prevention, U.S.; D004196:Disease Outbreaks; D005517:Foodborne Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D007753:Laboratories; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology