Journal Article

Impacts of Culture-Independent Diagnostic Practices on Public Health Surveillance for Bacterial Enteric Pathogens

Robinson, Trisha, Nicholson, Cynthia, Besser, John, Cronquist, Alicia B., Hurd, Sharon, D'Angelo, Melissa Tobin, Mahon, Barbara E., Atkinson, Robyn, Mody, Rajal K.

2012

Overview

For decades, culture has been the mainstay of diagnostic testing for bacterial enteric pathogens. This paradigm is changing as clinical laboratories adopt culture-independent methods, such as antigen-based tests and nucleic acid—based assays. Public health surveillance for enteric infections addresses 4 interrelated but distinct objectives: case investigation for localized disease control; assessment of disease burden and trends to prioritize and assess impact of population-based control measures; outbreak detection; and microbiologic characterization to improve understanding of pathogens, their virulence mechanisms, and epidemiology. We summarize the challenges and opportunities that culture-independent tests present and suggest strategies, such as validation studies and development of culture-independent tests compatible with subtyping, that could be adopted to ensure that surveillance remains robust. Many of these approaches will require time and resources to implement, but they will be necessary to maintain a strong surveillance system. Public health practitioners must clearly explain the value of surveillance, especially how outbreak detection benefits the public, and collaborate with all stakeholders to develop solutions.

• Publisher: Oxford University Press
• Subject: Bacteria / Bacterial infections / Blood tests / Campylobacter / Centers for Disease Control and Prevention (U.S.) / Culture Techniques - methods / Culture Techniques - standards / Diagnostic tests / Diagnostic Tests, Routine - methods / Diagnostic Tests, Routine - trends / Disease control / Disease Outbreaks / Enterobacteriaceae - isolation & purification / Enterobacteriaceae Infections - diagnosis / Epidemiology / Female / Food Microbiology - methods / Food Microbiology - trends / Foodborne illnesses / Humans / Infection / Infections / Laboratories - standards / Male / Microbiological Techniques - methods / Microbiological Techniques - trends / Nucleic acids / Outbreaks / Pathogens / Population Surveillance - methods / Preventive medicine / Public health / Reviews / Salmonella / Stakeholders / Surveillance / United States / Virulence