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Applied and Environmental Microbiology, November 1998, p. 4390-4395, Vol. 64, No. 11
0099-2240/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Comparison of the BAX for Screening/E. coli O157:H7
Method with Conventional Methods for Detection of Extremely Low
Levels of Escherichia coli O157:H7 in Ground Beef
Jennifer L.
Johnson,1
Cheryl L.
Brooke,2 and
Scott J.
Fritschel2,*
Deibel Laboratories, Madison, Wisconsin
53704,1 and
Qualicon, a DuPont
Subsidiary, Wilmington, Delaware 19880-03572
Received 6 February 1998/Accepted 12 August 1998
 |
ABSTRACT |
Escherichia coli O157:H7 is an important food-borne
pathogen. Often E. coli O157:H7 is difficult to detect,
because it is present sporadically at very low levels together with
very high levels of competitor organisms which can be difficult to
distinguish phenotypically. Cultural methods are time-consuming and
give variable results in the detection of E. coli O157:H7.
This study examined the performance of BAX for Screening/E.
coli O157:H7, a new rapid method for the detection of E. coli O157:H7, against traditional and improved cultural methods
and an immunodiffusion assay. All cultural methods demonstrated
inadequacy in detecting the presence of E. coli
O157:H7 in inoculated samples. The limitations of these cultural
methods further complicate evaluation of screening methodologies. The
BAX for Screening/E. coli O157:H7 assay outperformed the
other methods, with a detection rate of 96.5%, compared to 39% for
the best cultural method and 71.5% for the immunodiffusion method. The
BAX for Screening/E. coli O157:H7 assay proved to be a
rapid, highly sensitive test for the detection of low levels of
E. coli O157:H7 in ground beef.
 |
INTRODUCTION |
Escherichia coli O157:H7
is recognized as a significant food-borne pathogen. Hemorrhagic colitis
caused by E. coli O157:H7 can lead to complications such
as hemolytic uremic syndrome and thrombotic thrombocytopenic purpura,
which may be fatal to young children or the aged. Further indication of
the marked pathogenicity of this organism is epidemiological evidence
that only a few cells are necessary to cause illness (9).
Johnson et al. reported the presence of 0.9 to 4.3 CFU of E. coli O157:H7 per g in lots of ground beef that had been
implicated in a 1993 outbreak of hemolytic uremic syndrome in humans
(3, 11). U.S. Department of Agriculture Food Safety
Inspection Service (FSIS) regulations declare that the presence of
E. coli O157:H7 at or above 1 CFU/25 g constitutes
adulterated and dangerous ground beef. Consequently, highly
sensitive and reliable methods for the detection of E. coli O157:H7 are critical to ensure food safety.
Cultural methods often fail to detect the presence of low levels of
E. coli O157:H7 in inoculated ground beef samples
(13, 16). High levels of competing microflora in food
samples compound the difficulty of isolating E. coli
O157:H7. The common isolation strategy involves the use of one of
several combinations of selective broths and agars, typically with
indicators for enzymatic activities such as sorbitol fermentation.
These isolation methods can take more than 48 h to complete and
still require expert judgment and further testing to confirm the
presence of E. coli O157:H7.
Immunoassay methods which yield a presumptive positive or negative
screening result in 24 h or less have been developed. Typical sensitivities of immunoassays are approximately 106 CFU/ml,
which may lead to false-negative results, particularly when initial
levels of competing flora reach 105 to 106
CFU/g (7), a situation not uncommon in ground beef. In
addition, positive results must be confirmed by isolation of pure
colonies of the target bacteria. Screening of large numbers of ground
beef samples has resulted in a high percentage of unconfirmed positive results, indicating either insufficient sensitivity of the isolation procedure or nonspecificity of the immunoassay (2, 5, 7). Firstenberg-Eden and Sullivan reported in their study of ground beef
samples that 7.4% of EZ coli-positive samples did not yield E. coli O157:H7 even with the use of immunomagnetic
separation and culturing to isolate the organism (7).
Previous evaluations of conventional methods for the detection of
culture-based E. coli O157:H7 have operated in a
range of 0.1 to >100 CFU/g, with the majority of these studies
investigating levels higher than 1 CFU/g (2, 6, 10, 15,
16). Our study aimed for significantly lower inoculation
levels (94% below 1 CFU/g) in order to further examine the
effects of background flora on the detection rates of
various assays and to evaluate the growth and detection rates near the
regulatory limit of 1 CFU/25 g of ground beef.
New selective media have been developed to increase the effectiveness
of E. coli O157:H7 isolation (16, 17),
as have various other methods (8). BAX for
Screening/E. coli O157:H7 (Qualicon, Wilmington,
Del.) (Fig. 1) is a commercial
genetics-based assay (1) using the technology of PCR
(12). The study reported here compares the performance of
the BAX system assay with traditional culture, enhanced selective
agars, and an immunodiffusion method. Because the natural occurrence of
E. coli O157:H7 is both sporadic and usually
at low levels, the study emphasized the detection of E. coli O157:H7 from ground beef samples inoculated with
very few organisms (fewer than 3 CFU/g).
 |
MATERIALS AND METHODS |
Ground beef samples (25 g each) were obtained from various local
retail outlets in Madison, Wis. Prior to inoculation, each isolate was
grown up in brain heart infusion broth (incubation at 35°C for 16 to
18 h) and transferred twice. Cultures prepared in this fashion
were serially (1 to 10) diluted in 0.1% peptone diluent prior to
addition to the meatballs. Aliquots (0.1 ml) of the appropriate
dilution were added to individual meatballs, and the inoculum was
allowed to soak in for 5 min. Inoculation levels were confirmed by
spread plating 0.1-ml portions of the dilutions onto Trypticase soy
agar plates and incubating at 35°C for 46 to 48 h.
These samples were inoculated at high (7 to 64 CFU/25 g [0.28 to 2.56 CFU/g]) and low (0.7 to 6.4 CFU/25 g [0.03 to 0.26 CFU/g]) levels
with 1 of 10 E. coli strains (9 O157:H7 strains and
1 O157:HNM strain [Table 1]). These
ten strains were previously isolated from food or during outbreak
investigations (4). All strains were received from A. M. Sharar, Microbiology Division, FSIS, U.S. Department of Agriculture.
A 225-ml portion of modified Trypticase soy broth (mTSB) plus
novobiocin was added to each sample (Fig. 2). Sample enrichments were incubated for
6 h, and an aliquot was removed and reincubated for 14 h at
35°C. The 6-hour aliquot was plated onto Petrifilm-HEC (3M Co.,
Minneapolis, Minn.) and incubated for 14 h at 42°C. After 18 to
20 h, aliquots of enrichment cultures were removed, serially
diluted (1:10), and plated onto sorbitol MacConkey agar (SMAC),
tellurite SMAC (TSMAC), and tellurite cefixime SMAC (TCSMAC) (16,
17). Agar plates were incubated at 42°C overnight (18 to
20 h). Aliquots of enrichment cultures were also removed and
processed in parallel through a commercial immunodiffusion system assay
(VIP BioControl Systems, Inc., Bellevue, Wash.) and through the BAX
system assay according to the manufacturer's directions.
Petrifilm-HEC plates were immunoblotted, and positive colonies were
picked for confirmation (11, 15). Up to six characteristic
colonies were picked on as many as three dilution plates from each of
the three agars and Petrifilm for confirmation.
Confirmation included isolation on SMAC, streaking onto eosin-methylene
blue agar for E. coli confirmation, and latex
agglutination testing for O157 and H7 antigens (RIM O157:H7; Remel,
Lenexa, Kans.).
Note that the enrichment method used here is not that recommended by 3M
for the Petrifilm-HEC immunoblot. Differences include the use of
mTSB plus novobiocin (specified for the immunodiffusion assay) rather
than modified E. coli plus novobiocin and the
elimination of shaking during the 6-h initial incubation. For these
reasons, Petrifilm-HEC is regarded as a supplemental tool for the
recovery of E. coli O157:H7 and not as a screening
(detection) method.
The BAX system assay is a simple, PCR-based method employing tableted
PCR reagents. Primer sequences specific for O157:H7 were identified
following screening against a panel consisting of 113 target and 176 non-O157:H7 E. coli strains (1). The primer set chosen amplified a specific 530-bp product in 99% of the
target strains and 0% of the nontarget strains. These primers were
tableted along with Taq polymerase, excipients, and
deoxynucleoside triphosphates. The assay method consists of an
overnight enrichment of homogenized ground beef in mTSB plus
novobiocin, a simple sample lysate preparation, direct addition of 50 µl of the lysate to a tablet, and thermal cycling followed by
agarose gel detection. Lysate preparation consists of 3 µl of
enrichment solution added to 40 µl of buffer containing protease. The
solution is treated at 37°C for 20 min and at 95°C for 10 min and
then chilled for 5 min.
Fifty microliters of lysate is added to the PCR sample and positive
control (containing positive control DNA construct) tablets in 0.2-ml
tubes. The tubes are cycled in a GeneAmp 9600 thermal cycler
(Perkin-Elmer, Branchburg, N.J.) for 35 cycles of a 94°C, 15-s
denaturation followed by annealing temperature-time combinations of 70°C-2 min or 72°C-3 min. Upon completion of cycling,
10 µl of loading dye solution was added to each tube.
Next, 10 µl of each sample was loaded onto a precast, prestained
(with ethidium bromide), 2% agarose gel (FMC) and subjected to
electrophoresis for 25 min at 100 V in 0.5× Tris-borate-EDTA buffer. A
DNA molecular weight standard (Gibco BRL, Gaithersburg, Md.) was
included on each gel. This standard (mass ladder) has fragment sizes of
100, 200, 400, 800, 1,200, and 2,000 bp.
During development of the BAX system assay, sensitivity studies that
demonstrated the ability of the assay to produce a positive band for
105 CFU of E. coli O157:H7 per ml in
the presence of 109 CFU of background flora per ml in the
enriched sample were carried out (data not shown).
Twenty ground beef samples with various fat contents were processed.
Initial aerobic plate counts, inoculation levels, inoculation strains,
and ground beef types for the samples are given in Table 1. Each of the
10 strains was inoculated five times at two levels in various portions
of ground beef to yield a total of 200 samples. Half of these samples
were inoculated at levels higher than 7 CFU/25 g (0.28 CFU/g), and the
other half were inoculated at levels below 6.4 CFU/25 g (0.26 CFU/g).
 |
RESULTS |
Overview.
As previously stated, 200 ground beef samples were
prepared and inoculated at very low levels. We subjected inoculated
samples to a battery of detection and recovery procedures; 42 samples were negative by all detection procedures. Successfully inoculating samples at these extremely low but significant levels was difficult. It
is not unusual to fail to detect or to recover pathogens inoculated into samples at levels of <5 CFU/25 g. This is largely due to statistical considerations. Of the 200 samples in this study, 98 were
inoculated at <5.0 CFU/25 g. By using a Poisson distribution to
calculate the probability of X = 0 cells in an inoculum
of
concentration, 20 samples are predicted to be uninoculated and thus to yield negative results by all methods studied. In addition, one
strain (FSIS-062-93 [strain 2 in Table 1]) failed to produce a
positive result by any method for 19 of 20 samples inoculated with 1.4 to 64 CFU/25 g (0.056 to 2.56 CFU/g). We suspect that this strain had
difficulty competing with the other microflora present in the ground
beef samples. These 19 failures combined with the 20 statistically
predicted failures account for 39 of the 42 inoculated samples that
failed to yield a positive result despite the use of extensive
confirmation procedures. We are forced to conclude that inoculated
samples yielding negative results by every procedure tested did not
receive any viable E. coli O157.
An additional recovery method using
5-bromo-4-chloro-3-indoxyl-

-
D-glucuronide (BCIG) in SMAC
(
14) was also examined. This
method, as recommended by FSIS,
uses 150- by 15-mm petri plates.
Because of the high cost of BCIG, our
experiment used standard
laboratory plates (100 by 15 mm). Use of
standard plates for SMAC-BCIG
resulted in recovery of only 13 of 40 inoculated samples (data
not shown). The high level of background
organisms present in
the enrichment broth may account for this
unacceptable performance.
As this method failed to yield any
significant improvement in
recovery rate compared with other cultural
techniques employed
in this study, its use was not
continued.
Tabulated positive results are given in Table
2. Positive results for BAX system
assays are indicated by the presence of
a band in the appropriate
location, regardless of intensity (Fig.
1). Immunodiffusion
results are considered positive by the presence
of a band in the
sample location as indicated in the manufacturer's
instructions.
Occasionally, immunodiffusion results were rerun
due to a very weak
reaction. In some instances, reruns were positive,
and in other cases,
they were negative; in each case, the rerun
results were recorded
for tabulation. Results from the SMAC, TSMAC,
TCSMAC, and
Petrifilm-HEC methods are considered positive if a
confirmed
E. coli O157:H7 colony was identified. As
previously
explained, 42 samples were negative by all methods.
Therefore,
all calculations are based on the 158 inoculated samples
which
were positive by at least one method, rather than on 200 samples.
Table
2 also contains data for two subsets of samples broken out by
inoculation level. High refers to samples inoculated
with
E. coli O157:H7 levels of 7 to 64 CFU/25 g (0.28 to 2.56
CFU/g) per sample. Low refers to samples inoculated with between
0.7 and 6.4 CFU/25 g (between 0.03 and 0.26 CFU/g).
Conventional agar results.
With individual conventional
agars, recovery rates ranged from 17.7 to 39% for all samples
(Table 2), from 25 to 44.3% for the high inoculation levels, and from
8.5 to 31.4% for the low inoculation levels.
For the purpose of analysis, four methods

Petrifilm-HEC, TCSMAC,
TSMAC, and SMAC

are considered recovery methods
capable of
yielding confirmed colonies. A total of 107 of 158 positive samples
(Table
3) yielded
a confirmed
E. coli O157:H7 isolate by at least
one
of the four recovery procedures.
Immunodiffusion method results.
The immunodiffusion
method recorded a combined 71.5% of the inoculated samples as
positive (Table 2). This method detected 81.8% of the high-inoculation
samples and 58.5% of the low-inoculation samples as positive.
Broths from 18 of the 107 culture-confirmed samples were negative with
the immunodiffusion method, for a demonstrated false-negative
rate
of 16.8%. False negatives spanned both high- and low-inoculum
subsets.
BAX system results.
At high inoculation levels (above 0.28 CFU/g), the BAX system assay detected 100% of the samples, with
no false negatives, while at the low inoculation levels (0.03 to
0.26 CFU/g), the BAX system assay detected 90% of the samples.
Overall, the BAX system assay reported a combined 96.5% of inoculated
samples as positive (Table 2).
Of the 107 samples which yielded a confirmed positive result by
cultural methods (Table
3), the BAX system assay reported
five of those
broths as negative, for a demonstrated false-negative
rate of
4.7%. All false-negative samples were from the
low-inoculum
subset. The false-negative rates of the BAX
system assay (4.7%)
and the immunodiffusion method (16.8%) are
significantly different
(
P = 0.05).
Even use of a combination of four recovery methods and definition of a
positive as any positive result by any of the four
methods yields an
unacceptably low recovery rate. Because all
of these positive results
were obtained from inoculated samples,
it is our contention that
all of these BAX system-positive results
are true positives. Our
data demonstrate the extreme difficulty
of recovering low but
significant levels of
E. coli O157:H7 by
cultural methods. For samples detected as positive by the BAX
system
assay, additional culture-based methods, perhaps in conjunction
with
immunomagnetic capture techniques (
7), may be required.
Such
additional confirmation may be examined in a future
study.
 |
DISCUSSION |
The results of the detection of low inoculum levels of
E. coli O157:H7 in ground beef on individual
conventional agars were not encouraging. The data shown here also
indicate that as contamination levels decrease, the ability
to recover E. coli O157:H7 is also reduced.
No single conventional agar had a high detection rate (the best
individual agar had a recovery rate of only 39%). These data suggest
that routine cultural isolation and recovery of E. coli O157:H7 in ground beef are best achieved with a
combination of agars, not by relying on any single type. However, the
effort needed to perform four isolation procedures in parallel is
extreme and not feasible in routine laboratory operations.
Additionally, even this extreme effort would have recovered only 67%
(107 of 158) of the positive samples.
Given that it would be highly unusual for a laboratory to perform
four conventional methods simultaneously, the need for a single, rapid,
reliable detection method is increased. The BAX system assay gave
positive results for 96.5% of samples that proved positive by any
available test. This rate of detection is significantly better
statistically than those of the other methods, especially at very low
inoculation levels. The BAX system is easy to use and requires less
labor than conventional methods. The timeliness and superior
sensitivity illustrated here make the BAX for
Screening/E. coli O157:H7 assay the ideal method
for the detection of this potentially lethal pathogen in difficult food
matrices such as ground beef.
 |
ACKNOWLEDGMENTS |
We thank D. Duescher, J. Siehr, and P. M. Mrozinski for
technical assistance and A. M. Sharar, Microbiology Division,
FSIS, USDA, for supplying the isolates used in this study.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Qualicon, Inc.,
Route 141 & Henry Clay Rd., Wilmington, DE 19880-0357. Phone: (302) 695-2262. Fax: (302) 695-4106. E-mail:
Scott.J.fritschel{at}usa.dupont.com.
 |
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Applied and Environmental Microbiology, November 1998, p. 4390-4395, Vol. 64, No. 11
0099-2240/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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