Routine Molecular Epidemiology for Enhanced Detection and Control of Foodborne Outbreaks Lee H. Harrison, MD Associate Professor Departments of Epidemiology and Medicine University of Pittsburgh
What is molecular epidemiology in infectious diseases? Purpose: Determine modes of transmission and source of infection Principal: Exploit pheno-/genotypic differences between strains Practice: Molecular subtyping of bacterial/fungal/viral/parasitic isolates
Molecular Epidemiology in Infectious Diseases: Why molecular methods? Previously used methods: antimicrobial susceptibility patterns serologic/biochemical typing Examples: 95% of invasive H. influenzae were serotype b L. monocytogenes: 3 major serotypes (1/2a, 1/2b, 4b)
Molecular Epidemiology in Infectious Diseases: Basic Types of Methods Genotypic methods DNA based Heritable and stable Not affected by isolation/culture conditions Phenotypic methods Rely on expressed characteristics Affected by isolation/culture/test conditions
Molecular Epidemiology in Infectious Diseases: Common Methods Analysis of chromosomal DNA Restriction endonuclease analysis (REA) Pulse field gel electrophoresis (PFGE) Restriction fragment length polymorphism (RFLP) rDNA gene restriction patterns (ribotyping) Nucleic acid sequencing Nucleic acid hybridization of entire genome
Molecular Epidemiology in Infectious Diseases: Common Methods Analysis of plasmid DNA Plasmid size Restriction digests Protein analysis Outer membrane protein (OMP) analysis Multilocus enzyme typing (MLE)
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Recognition Sequences of Selected Restriction Endonucleases EcoR I Hind III Hha II Source Escherichia coli RY13 H. influenzae Rd H. parainfluenze Sequence GAATTC CTTAAG AAGCTT TTCGAA CCGG GGCC
DNA Cutting by HIND III: Staggered Cuts Leaving “Sticky” Ends TTCGAATAAGCTTCCCTGAG AAGCTTATTCGAAGGGACTC TTCGAATA AAGCTTATTCG AGCTTCCCTGAG AAGGGACTC +
General principals of molecular subtyping using restriction endonucleases Bacterial chromosomal DNA . C . C . C . C Electrophoresis . C . C . . . C C C C . = Restriction endonuclease (“molecular scissors”) = DNA sequence recognized by restriction endonuclease
Molecular Epidemiology in Infectious Diseases: Common Methods Nucleic acid detection Plasmid size Restriction digests Phage typing
Pulsed-Field Gel Electrophoresis
Genetic relatedness (dendrogram) analysis
Molecular Epidemiology in Infectious Diseases: Interpretation of Data Heterogeneity within species Must have knowledge of frequency distribution of subtypes Utility of individual method is species specific
Molecular Epidemiology in Infectious Diseases: Requirements Method must work with vast majority of isolates Reproducibility Discrimination power Ease of method Ease of interpretation