title: Adaptation of red blood cell lysis represents a fundamental breakthrough that improves the sensitivity of Salmonella detection in blood.
abstract: OBJECTIVE
  Isolation of Salmonella Typhi from blood culture is the standard diagnostic for confirming typhoid fever but it is unavailable in many developing countries. We previously described a Microwave Accelerated Metal Enhanced Fluorescence (MAMEF)-based assay to detect Salmonella in medium. Attempts to detect Salmonella in blood were unsuccessful, presumably due to the interference of erythrocytes. The objective of this study was to evaluate various blood treatment methods that could be used prior to PCR, real-time PCR or MAMEF to increase sensitivity of detection of Salmonella.
  
  
  RESULTS
  We tested ammonium chloride and erythrocyte lysis buffer, water, Lymphocyte Separation Medium, BD Vacutainer(®) CPT(™) Tubes and dextran. Erythrocyte lysis buffer was the best isolation method as it is fast, inexpensive and works with either fresh or stored blood. The sensitivity of PCR- and real-time PCR detection of Salmonella in spiked blood was improved when whole blood was first lysed using erythrocyte lysis buffer prior to DNA extraction. Removal of erythrocytes and clotting factors also enabled reproducible lysis of Salmonella and fragmentation of DNA, which are necessary for MAMEF sensing.
  
  
  CONCLUSIONS
  Use of the erythrocyte lysis procedure prior to DNA extraction has enabled improved sensitivity of Salmonella detection by PCR and real-time PCR and has allowed lysis and fragmentation of Salmonella using microwave radiation (for future detection by MAMEF).
  
  
  CONCLUSIONS
  Adaptation of the blood lysis method represents a fundamental breakthrough that improves the sensitivity of DNA-based detection of Salmonella in blood.
authors: Center for Vaccine Development, University of Maryland Baltimore, Baltimore, MD, USA; Department of Pediatrics, University of Maryland Baltimore, Baltimore, MD, USA.
authors: M A
authors: MA
authors: Boyd
authors: S M
authors: SM
authors: Tennant
authors: J H
authors: JH
authors: Melendez
authors: D
authors: D
authors: Toema
authors: J E
authors: JE
authors: Galen
authors: C D
authors: CD
authors: Geddes
authors: M M
authors: MM
authors: Levine
mesh_terms: D053000:Analytic Sample Preparation Methods / Q000379:methods*; D004912:Erythrocytes / Q000737:chemistry*; D006801:Humans; D060888:Real-Time Polymerase Chain Reaction; D012485:Salmonella typhi / Q000235:genetics / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D014435:Typhoid Fever / Q000097:blood / Q000382:microbiology*
keywords: PCR; Salmonella; blood; detection; diagnostic; invasive; sensitive; typhoid
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