Lab Matters Summer 2019 - Page 59

APHL 2019 POSTER ABSTRACTS positives were African American, 27.5% were Caucasian, and 7.7% were identified as unknown. In men, 82.9% of positives were African American, 14.3% were Caucasian, and 2.8% were unknown. Conclusions: This study demonstrates that Mycoplasma genitalium is highly prevalent in our patient population, indeed higher than that of the other STI’s evaluated in this same study (CT, NG or TV). Our M.gen prevalence of 13% correlates to recently published studies that show M.gen prevalence between 11-17%. Risk factors associated with M.gen infection in our study were African American race and young age, with more than half of all infections occurring in patients under 25. The observation of disease burden in the younger age group, combined with the morbidities of untreated M.gen infections, demonstrates the need for routine M.gen testing amongst the symptomatic patient population. Presenter: Traci Dailey, Alabama Dept. of Public Health, Montgomery, AL, Application of PCR-based Methods to Assess Optimal Sample Types for Detection of Sin Nombre Virus (SNV) Nucleic Acid in Deer Mice S. Messenger, K. Hsieh, M. Deldari, K. Padgett, B. Jackson, M. Yoshimizu and M. Novak, California Department of Public Health Objective: The California Department of Public Health (CDPH) performs environmental surveillance for SNV to assess potential risks for human transmission and support human case investigations. Rodent surveillance focused on detection of SNV- specific IgG, an indicator of past exposure. Recently, testing was updated to include detection of SNV RNA in blood by real-time RT-PCR (RT-PCR) as a better indicator of the prevalence of currently infectious rodents. It was not known, however, whether blood was an optimal sample to detect SNV RNA, or if other tissues must be sampled if our goal was to identify infectious rodents. In this study, we compared different tissue samples to identify optimal sample type(s) to detect SNV RNA in rodents. Study Design and Results: 157 rodents from known SNV hotspots in California were collected between 2002 to 2017. For 105 rodents, we collected eight different sample types; heart, lung, spleen, kidney, bladder, salivary gland, oral swab and fecal material. For the remaining 52 rodents we collected; heart, lung, spleen, and kidney. The relative viral load in a sample was estimated by the Ct value of extracted SNV RNA tested by RT-PCR. In Phase 1, 20 rodents from site one were selected and all eight sample types (i.e., six tissues and an oral and fecal sample) were tested. Results indicated that lung, followed by spleen, was the most sensitive sample type for detection of SNV RNA. In Phase 2, lung tissue for the remaining 105 rodents from “site one” was tested; 40 of 105 (38%) rodents were positive. Of interest, among the 40 SNV-positive rodents, 50% had positive oral swabs and 20% positive fecal samples indicating that less invasive samples can yield SNV RNA. In Phase 3, lung tissue was tested from 59 rodents which had blood samples previously tested by RT-PCR. While 20% of rodent bloods had detectable SNV RNA, 30% of lung tissues were positive. Conclusion: In field surveillance studies of SNV, seroprevalence in sampled rodent populations is a primary indicator of Hantavirus risk. Because serology tests (i.e., IgG EIA) are not specific to SNV and indicate both current and past infections, seroprevalence studies identify animals that were previously exposed at an PublicHealthLabs @APHL undetermined time to either Sin Nombre or another related Hantavirus. Addition of molecular tests for surveillance of SNV in California rodent populations may improve our understanding of the prevalence of infectious mice that may be shedding virus. This study evaluated a variety of sample types and determined that addition of extracted lung tissue can improve detection of SNV in rodents, but less invasive sample types (i.e., blood, oral, and fecal samples) while slightly less sensitive, can be obtained with minimal handling and from rodents released after capture. SNV RNA screening could be a valuable addition to field surveillance and molecular epidemiological studies. Presenter: Mojgan Deldari, California Department of Public Health, Richmond, CA, Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Collected Through the Emerging Infections Program, 2017 D. Campbell 1 , J. Daniels 1 , R. Stanton 1 , V. Albrecht 1 , S. Janelle 2 , K. Schutz 2 , C. Bower 3 , J. Jacob 3 , 4 , P. Rebolledo 4 , E. Phipps 5 , K. Flores 5 , G. Dumyati 6 , R. Tsay 6 , H. Kopin 6 , M. Kainer 7 , D. Muleta 7 , H. Reses 1 , N. Duffy 1 , J.K. Rasheed 1 , J. Lutgring 1 , M. Karlsson 1 , 1 Centers for Disease Control and Prevention, 2 Colorado Department of Public Health and Environment, 3 Georgia Emerging Infections Program, 4 Emory University School of Medicine, 5 University of New Mexico, 6 University of Rochester Medical Center, 7 Tennessee Department of Health Background: Extended-spectrum β-lactamases (ESBLs), named for their expanded substrate spectrum for hydrolyzing β-lactam antibiotics (penicillins, third generation cephalosporins and monobactams), have disseminated globally since their initial report in 1983. ESBLs are often plasmid-mediated and produced by Enterobacteriaceae such as Klebsiella pneumoniae and Escherichia coli. ESBL-producing Enterobacteriaceae are responsible for both hospital-acquired and community-onset infections. Here we describe the antimicrobial susceptibility profile and molecular epidemiology of ESBL-producing isolates collected through the Emerging Infections Program (EIP) at the Centers for Disease Control and Prevention (CDC). Methods: In 2017, 5 EIP sites (Colorado, Georgia, New Mexico, New York, and Tennessee) submitted a convenience sample of E. coli, K. oxytoca, and K. pneumoniae clinical isolates meeting the case definition (resistant to ceftazidime, cefotaxime, or ceftriaxone and non-resistant to all carbapenems tested) based on clinical laboratory results to CDC. Isolates underwent reference antimicrobial susceptibility testing (AST) with broth microdilution, phenotypic screening for ESBLs using ceftazidime or cefotaxime alone and in combination with clavulanate, and whole genome sequencing (WGS) (Illumina, MiSeq). Results: Among 136 isolates submitted, 122 (89.7%) met the case definition using reference AST whereas 116 (85.3%) were ESBL screen-positive. Among the 122 isolates meeting the case definition, 104 (85.2%) isolates were identified as E. coli, 16 (13.1%) as K. pneumoniae, and 2 (1.6%) as K. oxytoca. By WGS, 113 of 122 isolates meeting the case definition harbored an ESBL gene (92.6%). The most commonly identified ESBL gene was blaCTX-M-15 (n=69, 61.1%) followed by blaCTX-M-14 (n=17, 15.0%) and blaCTX-M-27 (n=14, 12.4%). The most prevalent E. coli sequence types were ST131 (n=52), ST38 (n=12), and ST10 (n=5); ST45 was Summer 2019 LAB MATTERS 57