Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 8, Number 10—October 2002
THEME ISSUE
Bioterrorism-related Anthrax
Bioterrorism-related Anthrax

Two-Component Direct Fluorescent-Antibody Assay for Rapid Identification of Bacillus anthracis

Barun K. De*Comments to Author , Sandra L. Bragg*, Gary N. Sanden*, Kathy E. Wilson*, Lois A. Diem*, Chung K. Marston*, Alex R. Hoffmaster*, Gwen A. Barnet*, Robbin S. Weyant*, Teresa G. Abshire†, John W. Ezzell†, and Tanja Popovic*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †U.S. Army Medical Institute of Infectious Diseases, Fort Detrick, Maryland, USA;

Main Article

Table 3

Results of 26 clinical specimens from seven inhalational anthrax patients analyzed by direct fluorescent-antibody assay, culture, and polymerase chain reaction assaya

Patient identifierb Specimen
 Results
Type Number Date collected DFA Culture PCRc
1 Heart bloodd,e 1 10/6 (-) ND (-)
1 Bloodd,e 1 10/6 (-) ND (-)
1 Lung tissued,e 2 10/6 (+) ND (-)
1 Chest fluidd,e 2 10/6 (-) ND (+)
1 Pericardial fluidd,e 1 10/6 (-) ND (+)
2 Bloodd 3 10/5 (-) (-) (-)
2 Pleural fluidd 1 10/5 (+) (-) (+)
2 Pleural fluidd 1 10/5 (-) (-) (+)
2 Unspecified body fluidd 1 10/5 (+) (-) (-)
3 Bloodd 1 10/19 (+) (-) (+)
5 Bloodd 2 10/21 (+) (+) (+)
6 Blood 1 10/22 (+) (+) (+)
10 Lung tissued,e 1 10/31 (-) (-) (+)
10 Lymph noded,e 1 10/31 (-) (-) (+)
10 Pleural fluidd 1 10/29 (+) (-) (+)
10 Pleural fluidd 1 10/29 (-) (-) (+)
11 Blood 2 11/17 (+) (+) ND
11 Blood 2 11/17 (+) (+) ND
11 Lymph noded-f 1 11/21 (+) (-) (+)

aDFA, direct fluorescent-antibody assay; PCR, polymerase chain reaction; ND, not done.
bPatients 1, 2, 3, 5, 6, 10 reported by Jernigan et al. (6), and patient 11 reported by Barakat et al. (18).
cReal-time PCR as described by Hoffmaster et al. (20). All DNA samples tested positive by human beta actin PCR.
dSpecimens collected the day on or after antimicrobial treatment was begun.
eSpecimens collected postmortem.
fDocumented culture negative; previously reported as culture positive (18).

Main Article

References
  1. Pile  J, Malone  J, Eitzen  E, Friedlander  A. Anthrax as a potential biological warfare agent. Arch Intern Med. 1998;158:429–34. DOIPubMedGoogle Scholar
  2. Inglesby  T, Henderson  D, Bartlett  J, Ascher  M, Eitzen  E, Friedlander  A, Anthrax as a biological weapon. JAMA. 1999;281:1735–45. DOIPubMedGoogle Scholar
  3. Christopher  G, Cieslak  T, Pavlin  A, Eitzen  E. Biological warfare. A historical perspective. JAMA. 1997;278:412–7. DOIPubMedGoogle Scholar
  4. Kliemann  W, Ruoff  K. Bioterrorism: implications for the clinical microbiologist. Clin Microbiol Rev. 2001;14:364–81. DOIPubMedGoogle Scholar
  5. Khan  A, Morse  S, Lillibridge  S. Public-health preparedness for biological terrorism in the USA. Lancet. 2000;356:1179–82. DOIPubMedGoogle Scholar
  6. Jernigan  J, Stephens  D, Ashford  D, Omenaca  C, Topiel  M, Galbraith  M, Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States. Emerg Infect Dis. 2001;7:933–48.PubMedGoogle Scholar
  7. Isenberg  H. Clinical microbiology procedures handbook. vol.1 & 2. Washington: American Society for Microbiology Press; 1992.
  8. Phillips  A, Ezzell  J. Identification of Bacillus anthracis by polyclonal antibodies against extracted vegetative cell antigens. J Appl Bacteriol. 1989;66:419–32.PubMedGoogle Scholar
  9. Franek  J. Application of fluorescent antibodies for demonstrating B. anthracis in the organs of infected animals. J Hyg Epidemiol Microbiol Immunol. 1964;8:111–9.
  10. Helgason  E, Okstad  D, Caugant  H, Johansen  A, Fouet  M, Mock  M, Bacillus anthracis, Bacillus cereus, and Bacillus thuringiensis—one species on the basis of genetic evidence. Appl Environ Microbiol. 2000;66:2627–30. DOIPubMedGoogle Scholar
  11. Ezzell  J, Abshire  T. Immunological analysis of cell-associated antigens of Bacillus anthracis. Infect Immun. 1988;56:349–56.PubMedGoogle Scholar
  12. Ezzell  J, Abshire  T, Little  S, Lidgerding  B, Brown  C. Identification of Bacillus anthracis by using monoclonal antibody to cell wall galactose-N-acetylglucosamine polysaccharide. J Clin Microbiol. 1990;28:223–31.PubMedGoogle Scholar
  13. Fouet  A, Mesnage  S, Tosi-Couture  E, Gounon  P, Mock  M. Bacillus anthracis surface: capsule and S-layer. J Appl Microbiol. 1999;87:251–5. DOIPubMedGoogle Scholar
  14. Etienne-Toumelin  I, Sirard  J, Duflot  E, Mock  M, Fouet  A. Characterization of the Bacillus anthracis S-layer: cloning and sequencing of the structural gene. J Bacteriol. 1995;177:614–20.PubMedGoogle Scholar
  15. Ezzell  J, Welkos  S. The capsule of Bacillus anthracis, a review. J Appl Microbiol. 1999;87:250. DOIPubMedGoogle Scholar
  16. Ezzell  J, Abshire  T. Encapsulation of Bacillus anthracis spores and spore identification. Proceedings of the International Workshop on Anthrax. Salisbury Medical Bulletin 1999:87:42.
  17. Mina  B, Dym  F, Kuepper  F, Tso  R, Arrastia  C, Kaplounova  I, Fatal inhalational anthrax with unknown source of exposure in a 61-year-old woman in New York City. JAMA. 2002;287:858–62. DOIPubMedGoogle Scholar
  18. Barakat  L, Quentzel  H, Jernigan  J, Kirschke  D, Griffith  K, Spear  S, Fatal inhalational anthrax in a 94-year-old Connecticut women. JAMA. 2002;287:863–8. DOIPubMedGoogle Scholar
  19. Keim  P, Price  L, Klevytska  A, Smith  K, Schupp  J, Okinaka  R, Multi-locus variable-number tandem repeat analysis reveals genetic relationships with Bacillus anthracis. J Bacteriol. 2000;182:2928–36. DOIPubMedGoogle Scholar
  20. Hoffmaster  A, Meyer  R, Bowen  M, Marston  C, Weyant  R, Barnett  G, Evaluation and validation of a real-timepolymerase chain reaction assay for rapid identification of Bacillus anthracis. Emerg Infect Dis. 2002;8:1178–82.PubMedGoogle Scholar

Main Article

Page created: July 19, 2010
Page updated: July 19, 2010
Page reviewed: July 19, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external