Objective To retrospective investigate the infection status and genotype of diarrheagenic Escherichia coli(DEC)in diarrhea cases in Qingdao, Shandong with FilmArray gastrointestinal panel (FA GI) combining with real-time PCR, and the results were compared with traditional detection method to discuss the application of different detection method in diarrhea surveillance.
Methods A total of 263 stool samples were collected from diarrhea cases by two hospitals in Qingdao. DEC strains were isolated by traditional culture method and submitted to Qingdao Municipal Center for Disease Control and Prevention for the identification by multiple real-time PCR, and at the same time DEC was detected directly from stool samples by FA GI combining with real-time PCR. Every five stool samples were mixed for one detection by FA GI. The positive results indicated that every sample needed to be detected again for DEC by real-time PCR.
Results A total of 15 samples were DEC positive (5.7%) by traditional culture, in which 7, 4, 3, 1 were ETEC, EPEC, EAEC, EIEC positive, respectively. 35 DEC positive samples (13.3%) were detected with FA GI, in which 12, 12, 9, 2 were ETEC, EAEC, EPEC and EIEC positive, respectively. No sample was Shiga toxin-producing Escherichia coli (STEC) positive by both two methods. The virulence genes carriages in DEC indicated by two different methods were similar, i.e. pic in EAEC, estIb in ETEC and eae in EPEC.
Conclusion The direct detection method of FA GI combining with real-time PCR can significantly improve the positive detection rate of DEC in stool samples from diarrhea cases due to its high sensitivity and specificity. This detection method can save both time and labor and can be used as supplementary investigation for routine surveillance for the better understanding of the prevalence and genotype distribution of DEC in diarrhea patients and strengthening of laboratory capability.
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