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Volume 8, Number 10—October 2002
Letter

Evaluation and Validation of a Real-Time Polymerase Chain Reaction Assay for Rapid Identification of Bacillus anthracis Supplement

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Table 1

Laboratory methods used for confirmation of 11 inhalational anthrax casesa,b

Patient no.c Laboratory confirmation Other laboratory tests positive for Bacillus anthracis
1 CSF culture IHC of multiple (postmortem) tissues, blood culture
2 PCR of pleural fluid; IHC of pleural fluid; serology Transbronchial biopsy IHC, pleural biopsy IHC
3 Blood culture PCR of blood; serology
4 Blood culture Serology
5 Blood culture IHC of mediastinal lymph nodes; PCR of blood
6 Blood culture IHC of mediastinal lymph nodes; PCR of blood
7 Blood culture Serology
8 PCR of pleural fluid; IHC of pleural fluid Serology
9 IHC of pleural fluid and bronchial biopsy; serology
10 Blood and pleural fluid culture IHC of multiple organs; PCR of multiple organs
11 Blood culture PCR of multiple organs; IHC of multiple organs

aAll initial isolation of Bacillus anthracis from clinical specimens took place at the local health facility where the patients were treated.
bCSF, cerebrospinal fluid; IHC, immunohistochemical stain; PCR, polymerase chain reaction.
cPatients 1–10 described in Jernigan et al. (1) and patient 11 in Barakat et al. (5).

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References
  1. Jernigan  JA, Stephens  DS, Ashford  DA, Omenaca  C, Topiel  MS, Galbraith  M, Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States. Emerg Infect Dis. 2001;7:93344.PubMedGoogle Scholar
  2. Centers for Disease Control and Prevention. Update: investigation of anthrax associated with intentional exposure and interim public health guidelines, 2001. MMWR Morb Mortal Wkly Rep. 2001;50:88993.PubMedGoogle Scholar
  3. Centers for Disease Control and Prevention. Update: investigation of bioterrorism-related anthrax and adverse events from antimicrobial prophylaxis, 2001. MMWR Morb Mortal Wkly Rep. 2001;50:9736.PubMedGoogle Scholar
  4. Centers for Disease Control and Prevention. Update: investigation of bioterrorism-related inhalational anthrax—Connecticut, 2001. MMWR Morb Mortal Wkly Rep. 2001;50:104951.PubMedGoogle Scholar
  5. Barakat  LA, Quentzel  HL, Jernigan  JA, Kirschke  DL, Griffith  K, Spear  SM, Fatal inhalational anthrax in a 94-year-old Connecticut woman. JAMA. 2002;287:8638. DOIPubMedGoogle Scholar
  6. Gallagher  TC, Strober  BE. Cutaneous Bacillus anthracis infection. N Engl J Med. 2001;345:16467. DOIPubMedGoogle Scholar
  7. Logan  NA, Turnbull  PC. Bacillus and recently derived genera. In: Murray PR, editor. Manual of clinical microbiology. Washington (DC): ASM Press; 2001. p. 357–69.

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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.
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