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Stool PCR may not be a substitute for enrichment culture for the detection of salmonella

C T Hapuarachchi1, Katie J M Jeffery1, I C J W Bowler1

  • 11 Department of Microbiology, Level 6, The John Radcliffe Hospital, Oxford, OX3 9DU, UK.

Journal of Medical Microbiology
|January 22, 2019
PubMed
Abstract

Insights

Enrichment culture is more sensitive than polymerase chain reaction (PCR) for detecting salmonella in stool samples. Continued parallel use of both methods is recommended for accurate enteric pathogen detection.

Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Polymerase chain reaction (PCR) is a widely adopted method for detecting enteric pathogens.
  • National Institute for Health and Care Excellence (NICE) guidelines recommend PCR for pathogen detection.

Purpose of the Study:

  • To evaluate the real-world performance of PCR for salmonella detection in stool samples.
  • To compare PCR diagnostic accuracy against the gold standard of enrichment culture.

Main Methods:

  • A prospective study analyzed 6,372 stool samples over 9 months.
  • Samples were tested using both selenite enrichment culture and BD MAX Enteric Bacterial Panel PCR.
  • Sensitivity, specificity, and predictive values were calculated for PCR against culture.

Main Results:

  • Salmonella prevalence was 1.2% in the study population.
  • PCR sensitivity was 89%, specificity 99.8%, PPV 86%, and NPV 99.9% compared to culture.
  • Enrichment culture demonstrated higher sensitivity than the tested PCR method.

Conclusions:

  • Enrichment culture is significantly more sensitive for salmonella detection than the BD MAX Enteric Bacterial Panel PCR.
  • Parallel use of PCR and enrichment culture is advised for enteric pathogen detection until PCR methods achieve equivalent sensitivity.
Keywords:
Enteric Bacterial Panel PCRFaecal PCRSalmonella enrichment cultureSalmonella spp.Stool multiplex PCR

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