Role of Reference Laboratories in Detecting Laboratory Contamination Niall De Lappe National Salmonella Reference Laboratory, Galway, Ireland.

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Presentation transcript:

Role of Reference Laboratories in Detecting Laboratory Contamination Niall De Lappe National Salmonella Reference Laboratory, Galway, Ireland

Introduction  Why does it occur? Positive Control Other Positive Isolates  Problem Pseudo-Outbreaks Potential Cost to Food Industry

Scale of Problem  M.tuberculosis % misdiagnosis  Estimating causes and Rate of laboratory contamination Sinnika Pelkolen

Incidence of False Positive Salmonella Isolations  (n = 6)  (n =11)  (n = 9)  (n = 9)  (n = 9)  (n = 2)  (n = 1)

Lab A  S.Typhimurium DT132 Oct 2003Beef (n=1) Nov 2003Beef (n=4) & Drain swab (n=1) Dec 2003Pork (n=1) Jan 2004Beef (n=1) Feb 2004Pork (n=1) and Powder (n=1) Apr 2004Beef (n=1) Sent Positive Control S.Typhimurium DT132

Lab B  Clinical case 78 y.o. patient hospitalised > 30 days Developed diarrhoea Isolated salmonella from selenite broth  Salmonella from other patient same day Primary plate Both typed as Enteritidis PT1, Na resistant  Considered cross-contaminant

Lab C  Isolate from Milk Powder S.Typhimurium, Phage Type Untypable, ASSuT  Asked to send all group B isolates from 2007  S.Typhimurium(n = 17)  S.Derby(n = 26)  S.Reading(n = 4)  S.Bredeney(n = 2)  S.Manhattan(n = 1)  S.Agama(n = 1)

Phage Typing and Antibiograms Index Isolate Untypable/ ASSuT DT104 / ACSSuT(n = 4) DT193 / ACSuTm (n = 3) / ACSSuTTm (n = 1) DT12 / A(n = 1) DT2 / T (n = 1) DT120 / none (n = 1) U302 / ACSSuTTm (n = 1) RDNC / T(n = 2) Untypable / SSu(n = 1) / ASSuT(n = 1)* from swine

S.Typhimurium, ASSuT, Untypable  Literature Review Associated with Swine  NSRL Databases Human isolates (n = 2) Swine (n = 6) Unknown (n = 2) Milk Powder (n = 2)

PFGE BlnI XbaI

Variable Number Tandem Repeats

No.DateLabSourcePFGEVNTR dHumanIndistinguishable fPork2 band difference fUnknownIndistinguishable fUnknownIndistinguishable eHumanIndistinguishable fPorkIndistinguishable fPorkIndistinguishable CMilk Powder Indistinguishable CSwineIndistinguishable CMilk Powder Indistinguishable CSwineIndistinguishable fSwineIndistinguishable Results

Lessons Positive ControlS.Nottingham Value of Subtyping strains routinely Value of different subtyping methods Sensitive Products Store Product for Retesting Test in different area/time than other samples

Acknowledgements  NSRL staff  EnterNet  All for listening