Multisite Evaluation of the BD Max Extended Enteric Bacterial Panel for Detection of Yersinia enterocolitica, Enterotoxigenic Escherichia coli, Vibrio, and Plesiomonas shigelloides from Stool Specimens

• Published in: Journal of clinical microbiology Vol. 55; no. 11; pp. 3258 - 3266
• Main Authors: Simner, Patricia J, Oethinger, Margret, Stellrecht, Kathleen A, Pillai, Dylan R, Yogev, Ram, Leblond, Helene, Mortensen, Joel
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 01.11.2017
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Automation, Laboratory - methods; Bacteriological Techniques - methods; Bacteriology; Child; Child, Preschool; Diarrhea - diagnosis; Diarrhea - microbiology; Feces - microbiology; Female; Gram-Negative Bacteria - classification; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - microbiology; Humans; Infant; Infant, Newborn; Male; Middle Aged; Molecular Diagnostic Techniques - methods; Polymerase Chain Reaction - methods; Prospective Studies; Retrospective Studies; Young Adult; Yersinia enterocolitica; multiplex PCR; Plesiomonas shigelloides; enteric pathogens; gastrointestinal panel; enterotoxigenic Escherichia coli; extended enteric bacterial panel; BD Max; Vibrio
• ISSN: 0095-1137; 1098-660X
• DOI: 10.1128/JCM.00911-17

The purpose of this study was to perform a multisite evaluation to establish the performance characteristics of the BD Max extended enteric bacterial panel (xEBP) assay directly from unpreserved or Cary-Blair-preserved stool specimens for the detection of , enterotoxigenic (ETEC), , and The study included prospective, retrospective, and prepared contrived specimens from 6 clinical sites. BD Max xEBP results were compared to the reference method, which included standard culture techniques coupled with alternate PCR and sequencing, except for ETEC, for which the reference method was two alternate PCRs and sequencing. Alternate PCR was also used to confirm the historical results for the retrospective specimens and for discrepant result analysis. A total of 2,410 unformed, deidentified stool specimens were collected. The prevalence in the prospective samples as defined by the reference method was 1.2% ETEC, 0.1% , 0% , and 0% Compared to the reference method, the positive percent agreement (PPA) (95% confidence interval [CI]), negative percent agreement (NPA) (95% CI), and kappa coefficient (95% CI) for the BD Max xEBP assay for all specimens combined were as follows: ETEC, 97.6% (87.4 to 99.6), 99.8% (99.5 to 99.9), and 0.93 (0.87 to 0.99); , 100% (96.4 to 100), 99.7% (99.4 to 99.8), and 0.96 (0.93 to 0.99); , 99.0% (94.8 to 99.8), 99.9% (99.8 to 99.9), and 0.99 (0.98 to 1); , 100% (96.4 to 100), 99.8% (99.5 to 99.9), and 0.98 (0.95 to 1), respectively. In this multicenter study, the BD Max xEBP showed a high correlation (kappa, 0.97; 95% CI, 0.95 to 0.98) with the conventional methods for the detection of ETEC, , , and in stool specimens from patients suspected of acute gastroenteritis, enteritis, or colitis.