1. Molecular Subtipification Network for ETA Surveillance PulseNet Latin America CDC-INPPAZ-OPS/OMS, INEI - ANLIS Instituto Nacional de Salud Microbiology Group Bogotá, Colombia Third International Meeting Buenos Aires, Argentina – June 17-18, 2005

2. Colombia ADD surveillance network 1997 - 2004 Total number of clinical laboratories: 138 MicrobiologyGroup Instituto Nacional de Salud Instituto Nacional de Salud Public Health Laboratories (PHL) 24/33 states (73%)

3. Serotypen(%) Typhimurium49632 Enteritidis45730 Typhi9056 Others (57)48832 Total1531100 Salmonella spp. isolates recovered COLOMBIA ADD surveillance Network 1997 - 2004

4. PFGE in Surveillance Studies PulseNet Network’s Protocol Colombia  PFGE application of the standarized technique by the CDC – USA (2004), for the molecular subtipification of Salmonella spp isolates, recovered in the national surveillance system of the ADD 1997-2004.

5. Quality Control Program

6. 1- Serotyping: The strains were correctly serotyped. 2- Comparison of elecrophoretic profiles obtained in Colombia and Argentina First Test-Proof Activity – 2005 Colombia (n= 7 isolates)

7. 3- PFGE profiles’ analyses with the BioNumerics program version 3.5 (applied Maths). 4- Dendogram of the the band patterns obtained from each strain in Argentina and Colombia.

8. PulseNet difussion in the Colombia country INS INVIMA Manuscript will be publish in Informe Quincenal Epidemiológico Nacional (IQEN)

9. Troublesome: We can’t share images because we haven’t software database module. PFGE applications in surveillance ADD Program 1997- 2004 COLOMBIA -Establishing the electrophoretic patterns of the Salmonella isolates and the genetic relationship of the Salmonella isolates in 19 states in the country

10. PFGE application in Colombia surveillance S. Typhimurium n = 490 Patterns: S.Typ0001- S.Typ0185 PFGE Pattern S.Typ Frecuency n% 0001398 01106413 0062378 0058133 0003122 0108 y 0120163 006661 Others (177)30362

11. Colombia PFGE XbaI - Patterns S. Typhimurium n=490 LanePFGE Pattern S.Typ 1, 6, 11 y 16S. Braenderup H9812 20001 30021 40022 50023 70024 80025 90026 100027 120028 130029 140030 150031 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 20.5 1135 Kb

12. Year % Annual surveillance distribution of Colombia PFGE patterns for S. Typhimurium (1997-2004).

13. PFGE application in Colombia surveillance S. Enteritidis n = 445 Patterns: S. En0001-0045 PFGE Pattern S. En Frecuency n% 000132072 0020184 0002174 0017153 0030143 0009112 Other patterns (39)5011

14. LanePFGE pattern S. En 1, 6 y 11S. Braenderup H9812 20001 30008 40009 50010 70011 80012 90013 100014 120015 130016 140017 150018 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 20.5 1135 Kb Colombia PFGE XbaI- Patterns - S. Enteritidis n=445

15. Year % Annual surveillance distribution of Colombia PFGE patterns for S. Enteritidis (1997-2004).

16. PFGE application in Colombia surveillance S. Typhi n = 85 Patterns: S. Ty0001-0045 PFGE Pattern S. Ty Frecuency n% 00011720 00121618 Others (43)5262

17. Colombia PFGE XbaI - Patterns S. Typhi n=85 LanePFGE Pattern S.Ty 1, 6, 11 y 15S. Braenderup H9812 20001 30012 40002 50005 70062 80011 90014 100028 120045 130042 140024 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 20.5 Kb 1135

18. Year % Annual surveillance distribution of Colombia PFGE patterns for S. Typhi (1997-2004).

19. Serotype Year Clinic isolates Food isolates Procedence PFGE Pattern Typhimurium 2000 2003 1414 5353 Nariño S. Typ0066 S. Typ0120 Enteritidis 1997130SantanderS. En0030 1998 2002 2003 2004 12521252 11111111 Bogotá Quindío Nariño Caldas S. En0001 Typhi 2000 2002 6464 0404 Putumayo Antioquia S. Ty0001 S. Ty0012 PFGE Application in outbreak studies S PFGE Application in outbreak studies Salmonella spp - Colombia

20. The participation in the PulseNet-LA network for the molecular subtipification of Salmonella, has allowed us to create a PFGE Colombian database with isolates from the National Program of ADD Surveillance. Coments The routine use of the molecular subtification process for Salmonella isolates will strengthen the ADD surveillance in our country.

21. To knowledge the PFGE patterns will allow us to: Assign and identify priorities in the treatment of patients Avoid unnecesary research in cases where PFGE patterns occur occasionally Detect disease spread that cannot be uncovered by the traditional surveillance methods Control the infection source transmission outbreaks. Coments