The Molecular Unit activities play an important role in foodborne disease prevention, surveillance and response as well as surveillance and response to CRE. The analyses performed by the Molecular Unit are critical in assisting with the prevention of further illnesses.
Outbreak investigations associated with foodborne illnesses have resulted in:
Outbreak investigations associated with identification of CP-CRE have resulted in:
Public Health Emergency Preparedness (PHEP) cooperative agreement supported staff in the Molecular Unit provide molecular testing for high consequence pathogens such as bacterial pathogens including Bacillus anthracis, Brucella spp., Francisella tularensis, Ebola virus, and Middle Eastern Respiratory Syndrome - Coronovirus (MERS-CoV).
CDC PulseNet participating laboratories perform molecular characterization and surveillance of foodborne disease by WGS. As the name indicates, it is the process of sequencing the entire genome of an organism. The information obtained from WGS can tell you everything about the organism, such as genetic relatedness, serotype, resistance and virulence factors. Therefore, this technology will allow for better characterization and improved surveillance. WGS is performed on all shiga-toxin producing E. coli, Salmonella, and Listeria monocytogenes. For more information about WGS, please go to PulseNet at CDC.
Norovirus testing is performed on outbreaks with 5 or more specimens, which have been approved for testing by State Epidemiologists (Communicable Disease Branch). Real-time RT-PCR is performed on stools from possible outbreak situations. Positive outbreaks are carried through to sequencing for CDC CaliciNet. Specimens for norovirus testing must be accompanied by requisitions filled out appropriately, with the name on sample matching name on requisition and requesting that Norovirus testing be done. For more information about norovirus, please go to CaliciNet at CDC.
Sequencing is performed on hard to identify bacteria, as well as strain typing of viruses for epidemiologic investigations and surveillance. Sequence data is analyzed and compared to reference sequences found in CDC databases and online genome libraries.
Organisms from the family Enterobacteriaceae that are resistant to carbapenems have been detected throughout the United States and are the cause of increasingly hard to eradicate healthcare-associated infections. Testing is performed on all isolates received from healthcare facilities and reference laboratories for confirmation of carbapenem resistance. Molecular and phenotypic methods are used for the accurate determination and detection of organisms resistant to carbapenems. Currently, a CDC-developed real-time PCR method is used to detect KPC, NDM, and OXA-48-like and VIM-like gene targets gene targets. The Modified Carbapenem Inactivation Method (mCIM) is used to detect carbapenem activity in Enterobacteriaceae and Pseudomonas aeruginosa in organisms producing the KPC, NDM, VIM, IMP, OXA-48-like, SPM, SME, or IMI/NMC group enzymes. The NCSLPH reports results to the submitting facility and to the NC Epidemiology Communicable Disease branch for surveillance purposes. For more information about CRE in North Carolina, visit: https://epi.dph.ncdhhs.gov/cd/diseases/cre.html.
Real-time PCR
mCIM
Note: All photos on this page taken by SLPH staff.