Emerging Infectious Disease ISSN: 1080-6059

back to article

- Add this to...
- Favorites
- Del.icio.us
- Digg
- Facebook
- Google Bookmarks
- Yahoo MyWeb

Molecular Subtyping of Bacillus anthracis and the 2001 Bioterrorism-Associated Anthrax Outbreak, United States

Alex R. Hoffmaster*

, Collette C. Fitzgerald*, Efrain Ribot*, Leonard W. Mayer*, and Tanja Popovic*

Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

Main Article

Table 3

Molecular subtyping by MLVA and pagA sequencing performed on 28 clinical specimens from seven patients with inhalational anthrax^a,b

Patient no.^b	Specimen type^c	Interval after antimicrobial therapy (days)^d	MLVA loci detected	pagA	Bacillus anthracis LRN PCR^e
1	Pleural fluid	4	All negative	Negative	Positive
	Pleural fluid	4	All negative	Negative	Positive
	Blood	4	All negative	Negative	Negative
	Lung	4	All negative	ND	ND
	Lung	4	vrrA	ND	Negative
	Heart blood	4	vrrA, vrrB₁	Negative	Negative
	Pericardial blood	4	All negative	Negative	Positive
2	Thoracentesis fluid	4	vrrA	Negative	Positive
	Serum	10	All negative	Negative	Positive
	Respiratory wash	4	All negative	Negative	Positive
	Pleural fluid	4	All negative	Negative	Positive
3	Blood culture	0	All negative	Negative	Positive
5	Blood culture	0	All negative	Negative	Positive
	Blood culture	0	All negative	Negative	Positive
6	Blood culture	0	vrrA, vrrB₁, vrrB₂,,vrrC₂	Negative	Positive
10	Pleural fluid	1	vrrA, vrrB₁, vrrB₂, vrrC₁, vrrC₂, CG3, pXO1, pXO2	Positive	Positive
	Pleural fluid	1	vrrA, vrrB₁, vrrB₂, vrrC₁, vrrC₂, CG3, pXO1, pXO2	Positive	Positive
	Blood	1	All negative	Negative	Positive
	CSF	3	All negative	Negative	Positive
	Lung	3	vrrA, CG3	Negative	Positive
	Lymph node	3	vrrA, vrrB₁, vrrB₂, vrrC₁, vrrC₂, CG3, pXO1, pXO2	Positive	Positive
11	Pleural fluid	2	All negative	Positive	Positive
	Blood	2	All negative	Negative	Negative
	Blood culture	-1	All negative	ND	ND
	Blood culture	-1	All negative	ND	Positive
	Blood culture	-1	All negative	ND	ND
	Blood culture	-1	All negative	ND	Positive
	Lymph node	4	vrrA, vrrB₁, vrrB₂, vrrC₁, vrrC_2, CG3	Positive	Positive

^aMLVA, multiple-locus variable-number tandem repeat analysis; pagA, protective antigen gene; LRN, Laboratory Response Network; PCR, polymerase chain reaction.
^bPatients 1–10 described in Jernigan et al. (19) and patient 11 in Barakat et al (20)
^cSpecimens collected postmortem.
^dNumber of days the specimen was collected following or before the initiation of antimicrobial therapy. Specimens collected the same day as the initiation of therapy were designated as day 0 but were collected before antibiotic therapy.
^eResults using the Laboratory Response Network PCR assay for detection of B. anthracis during the outbreak (18).