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Test Code PFGE Bacterial Typing by Pulsed-Field Gel Electrophoresis (PFGE)

Biohazard Infectious

Performing Laboratory

Mayo Medical Laboratories in Rochester

Reporting Name

Bacterial Typing

Specimen Type

Varies


Advisory Information


This test compares bacterial strains of non-aureus Staphylococcus species; non-pneumophila Legionella species; Enterobacteriaceae other than Klebsiella pneumoniae; non-fermenting Gram-negative bacilli other than Acinetobacter baumannii; Listeria species, Bacillus species, Enterococcus species, Streptococcus species, Lactobacillus species, and Clostridium perfringens.

 

For Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae, Legionella pneumophila or Clostridioides (Clostridium) difficile isolates, order BTWGS / Bacterial Typing by Whole Genome Sequencing.



Shipping Instructions


1. See Infectious Specimen Shipping Guidelines in Special Instructions for shipping information.

2. Place isolates in a large infectious container (T146) and label as an etiologic agent/infectious substance.

3. Place all pulsed-field gel electrophoresis (PFGE) isolates (all patients and/or sites to be compared) together in 1 large bag, and send in the same shipping container. This is necessary for comparison of isolates by this method.



Necessary Information


Organism identification and specimen source are required for processing.

Results will be faxed to the client.



Specimen Required


Supplies: Infectious Container, Large (T146)

Container/Tube: Agar slant

Specimen Volume: Isolates on separate agar slants in pure culture

Collection Instructions: Organism must be in pure culture, actively growing. Do not submit mixed cultures.

Additional Information:

1. Each slant must be submitted under a separate order.

2. Original isolates should be saved at the client site if additional PFGE testing may be needed (eg, to compare to future outbreak isolates that may occur).


Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)
  Refrigerated 

Day(s) and Time(s) Performed

Monday through Friday; Continuously

Specimen Retention Time

1 month

Analytic Time

5 days

Reference Values

Reported as isolates are "indistinguishable" or "different" by pulsed-field gel electrophoresis.

Useful For

Investigating infection outbreaks by a single bacterial species

Method Name

Pulsed-Field Gel Electrophoresis of DNA Fragments

Test Classification

This test uses a standard method. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

87152

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PFGE Bacterial Typing In Process

 

Result ID Test Result Name Result LOINC Value
PFGE Bacterial Typing In Process

Clinical Information

Bacterial-typing techniques are useful for determining strain relatedness in the setting of nosocomial outbreaks or apparent outbreaks. Serial isolates obtained from the same patient can be typed to determine whether they are the same or different. Typing allows discrimination between isolates of the same species, informing recognition of a potential outbreak.

 

In the past, strain typing was accomplished by testing for different biochemical, phage, or antibiotic resistance patterns. Antibiograms are often unreliable because they are easy to over-interpret or under-interpret. Other strain-typing methods are often organism-specific and each requires a unique set of reagents and procedures. The availability of classical strain-typing techniques has been limited.

Interpretation

Isolates that show identical DNA restriction fragment length polymorphism patterns are considered to be closely related.

Cautions

The fact that 2 strains share the same pattern does not prove that they are epidemiologically related. Establishment of an epidemiologic relationship depends on the frequency with which the "indistinguishable" pattern is seen among epidemiologically unrelated isolates and correlation with clinical and epidemiological information.

 

Obviously, if common contact between 2 patients with strains with the same pulsed-field gel electrophoresis (PFGE) type can be established, the chances are greater that an epidemiologic link can be ascribed. Thus, the greatest power of PFGE typing is in showing strain dissimilarity, not in proving similarity or relatedness.

Clinical Reference

1. Arbeit RD, Arthur M, Dunn R, et al: Resolution of recent evolutionary divergence among Escherichia coli from related lineages: the application of pulsed field electrophoresis to molecular epidemiology. J Infect Dis 1990;161:230-235

2. Arbeit RD: Laboratory procedures for the epidemiologic analysis of microorganisms. In Manual of Clinical Microbiology, Seventh edition. Edited by PR Murray, ASM Press, Washington, DC, 1999, pp 116-137

3. Trees E, Rota RA, MacCannell D, Gerner-Smidt P: Molecular epidemiology. In Manual of Clinical Microbiology, 11th edition. Edited by J Jorgensen, ASM Press, Washington, DC, 2015, pp 131-160

Method Description

Typing of bacterial isolates is accomplished by comparing the DNA restriction fragment length polymorphism (RFLP) patterns of large DNA fragments separated by pulsed-field gel electrophoresis (PFGE) of 2 or more bacterial isolates. Identical RFLP patterns indicate similarity of the isolates. The test is performed by isolating the DNA from the organism, cutting the DNA with a restriction enzyme which recognize 10 to 20 sites on the genome, and separating the fragments using PFGE. The size pattern of DNA fragments in the electrophoresis gel of different isolates is then compared.(Tenover FC, Arbeit RD, Goering RV, et al: Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233-2239)