MST JQ-EZ-05 analysis was completed within four working days. Analysis of the sequence combinations determined three new genetic profiles, including profile ST43, which characterized the three isolates derived from patients A, D, and E; profile ST44, which characterized the two isolates derived from patient B and the index patient C; and profile ST45, which was discovered
in the isolate derived from patient F (Figure 1). These new profiles resulted from a novel combination of the following spacer alleles: the ST43 profile combined alleles 1/MST1, 1/MST2, 1/MST3, 2/MST4, 1/MST8, 3/MST11, 4/MST12, and allele 4/MST13; the ST44 profile combined alleles 1/MST1, 1/MST2, 2/MST3, 2/MST4, 1/MST8, 3/MST11, 4/MST12, and allele 4/MST13; and the ST45 profile combined alleles 1/MST1, 1/MST2, 1/MST3, Luminespib 1/MST4, 3/MST8, 3/MST11, 4/MST12, and allele 4/MST13. The profiles for ST43, ST44, and ST45 have been added to our free and accessible MST database http://ifr48.timone.univ-mrs.fr/MST_Mtuberculosis/mst. MST genotyping data were assumed to be authentic based on the observations Combretastatin A4 cost that the PCR-negative controls remained negative, coupled with the observation that all PCR products were of the predicted size. Moreover, analysis of the spacer sequences edited in this work identified three new profiles, clearly
indicating that amplicons did not result from laboratory contamination as a consequence of previous experiments. The MST genotyping data provided evidence to support epidemiological and clinical data
C59 in vitro that confirmed laboratory cross-contamination. Specifically, one profile (ST43) comprised three isolates recovered from epidemiologically-linked patients, whereas a different profile (ST45) characterized only one isolate from a specimen collected from an unrelated patient F. The profile ST44 was discovered for two M. tuberculosis isolates obtained from the index patient C and one unrelated patient B. Microscopic examination of a respiratory tract specimen collected from patient B indicated the presence of acid-fast bacilli, while the same analysis performed for a specimen from the respiratory tract of the index patient C showed no indication of acid-fast bacilli. Both of the latter two specimens were handled in the same laboratory, on the same day, and within the same batch of sample preparations, which explains the observation that the specimen recovered from the index patient (patient C) was contaminated by the specimen collected from patient B. Such a situation has been previously observed in cases of laboratory cross-contamination [19, 20]. Interestingly, the frequency of false-positive cultures has been shown to be higher for laboratories that do not process high numbers of specimens , as was the case in the present report.