Detection of Streptobacillus moniliformis in whole blood by real-time PCR and review of clinical cases 2004-2015 in New York State

Objectives: Early identification of Streptobacillus moniliformis infections that cause rat bite fever (RBF) can be challenging and treatment of these infections is important for the reduction of morbidity and mortality. We report a rapid and sensitive real-time PCR assay for use on whole blood (WB) specimens in less than 3 hrs. Materials and Methods: We developed a novel two-target real-time PCR assay and assessed sensitivity, specificity, and compared assay performance to 16S rDNA analysis. A retrospective study of 9 clinical specimens received from 2004-2015 was performed and available epidemiological data was compiled. Results: This assay was found to have a limit of detection of <1 colony forming unit in WB and to be specific for S. moniliformis as well as provide detection of S. felis, S. notomytis, and S. ratti. Analysis of retrospective specimens determined this assay to be 100% concordant with 16S rDNA analysis and epidemiological data review provided insight into exposures, symptoms and treatment. Conclusion: This real-time PCR assay represents a valuable tool as it can be performed with instrumentation available in many public health and clinical laboratories, providing results within 3 hours from receiving a WB specimen. Its utilization may improve the detection of RBF and further the understanding of the burden of this disease. J Microbiol Infect Dis 2017; 7(2): 88-92 

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