Biocrime or bioterrorism is the threat or use of microorganisms, toxins, pests, prions, or their associated ancillary products to commit acts of crime or terror. Microorganisms can malevolently be used as biological warfare agents, in bioterrorist acts, and in crimes without political intentions. Such actions can be directed against humans and animals and can lead to outbreaks of infections with high morbidity and mortality. In recent years microbial forensics has been established as a new scientific discipline to strengthen the law enforcement response especially in a bioterrorism event . These tools can also be applied to investigate the transmission of pathogenic microorganism caused by sexual abuse and other physical offenses .
The aim of this review is to describe the corner stones of microbial forensics as a novel type of forensic analysis defined as “the detection of reliably measured molecular variations between microbial strains and their use to infer the origin, relationships, or transmission route of a particular isolate” .
Several microorganisms are a severe threat to human and/or animal health and a country's agricultural economy. Their malevolent use can have a major socio-economic impact. A number of these pathogens can affect both humans and animals [zoonoses], can contaminate the environment for decades, or may establish new enzootic foci. The World Organisation for Animal Health [OIE] lists several of these agents as diseases of importance to international trade with serious export restrictions for countries where the diseases are endemic.
Biological warfare agents to be used against humans and animals were developed and weaponized in the fifties of the last century in several countries including the USA, the former Soviet Union and the United Kingdom. An international arms control and disarmament treaty, the Biological Weapons Convention [BWC], banned the use of biological weapons in 1972 [http://www.opbw.org/convention/documents/btwctext.pdf]. Today only few states are under suspicion of having biological warfare programs. Politically-binding confidence building measures provide a permanent transparency tool for building confidence in compliance with the BWC.
In the aftermath of the anthrax letters attacks in October 2001 that killed five people it has become evident that biocrimes can only be solved when genomic information can be used to identify the source of an organism. Evidence in a criminal investigation must be collected within the constraints of legal rules to ensure that any prosecution based upon that evidence can withstand judicial review in a court. Therefore, first responders must learn how to secure evidence and preserve the chain of custody . Quality-assurance and –control procedures have to assure that reliable evidence can be presented in court . Laboratories that have been officially accredited will be able to provide all relevant documents regarding quality control and assurance, proficiency test results, qualification of laboratory personnel etc. Also case specific material like photographs of gels, benchnotes, validation studies, and controls will usually be adequately documented. Evidence collection, transport, and storage need more attention than is usually needed for clinical routine samples. Test procedure will be according to standard operating procedures [SOPs] and any deviation of protocols will have to be documented. The final report should contain information about the specificity and accuracy of the applied tests and provide an interpretation of the result and its limitations.
Nucleic amplification and molecular-epidemiological techniques are essential tools in clinical microbiology for identifying pathogens and in outbreak investigations. Various typing tools have been developed for phylogenetic and phylogeographic studies. In forensic microbiology these methodologies can be used to detect and trace back the spread of microorganisms in the context of a crime. Whole-genome sequencing provides the most comprehensive, reliable and reproducible information about a strain, but until recently this technique was expensive and time consuming. The subsequent annotation of sequences was also a major endeavor. Nowadays this technique has become affordable and reference genomes for all select agents have been sequenced. They can be used to clarify the relationship of suspicious isolates with reference genomes.
Centralized reporting and surveillance systems on the national and international level are essential as single cases may be regarded as sporadic although they are part of a larger transboundary outbreak. Surveillance systems have already been established that store and provide DNA fingerprints of microbes being major causes of hospital-acquired or food borne infections.
Descriptive epidemiological data have to be analyzed with caution. Natural outbreaks can be difficult to discriminate from intentional use of microorganisms, especially if the organisms are endemic. Only molecular-epidemiological tools can corroborate the chain of infection.
This review will discuss the value of diagnostic and molecular-epidemiological tools developed for select agents and will provide examples of investigations focused on for example
2. Sample collection
Laboratories involved in forensic microbiology analysis must be prepared to deal with chain-of-custody documentation, secure storage of evidence, tracking of individual items of evidence and their derivatives and all the legal requirements for handling evidence. Chain- of-custody protocols document the unbroken chain of records showing who had handled the evidence, where and under which conditions [temperature, time etc.] the material had been stored and whether access to the samples was restricted . The NATO document AEP-10 “Handbook for Sampling and Identification of Biological and Chemical Agents [SIBCA]”, 2007, 5th Edition, Procedures and Techniques, Volume 1 [STANAG 4329] provides practical guidelines how to sample select agents in the field even in a contaminated environment. These guidelines are used by NATO and Partnership for Peace [PFP] countries. Countries may have different national requirements, but general principles can be a guideline for Civilian-Military Cooperation [CIMIC] or purely civilian operational and forensic investigation teams. The European Guideline on Principles of Field Investigation “Biological Incident Response and Environmental Sampling” was published by the EU Commission, DG Health and Consumer Protection, Health Threats Unit in October 2006 and “describes the principles of response in the initial phase of a biological incident where the goal is to identify what has happened in order to initiate appropriate countermeasures”. These documents underline the necessity of planning and pre-mission briefings as the environment may be life-threatening. Moreover, the quality of primary samples is critical for subsequent analyses. The personal protective equipment is also affecting personnel by limiting mobility, flexibility, and time available to work at the scene .
3. Sample matrix analysis
In clinical microbiology the sample matrix is important to decide, whether the analyses requested by the clinician are appropriate and which tests should be performed. Unfortunately, requests are not always justified by the clinical presentation and the sample matrix is sometimes conflicting. For example a microscopical inspection of sputum samples will indicate, if the quality of the specimens is adequate. In forensic microbiology the same rules apply, but more detailed investigations may be necessary to obtain relevant information about the history of a specimen, environmental conditions, chemical and physical constitution of the matrix, presence of pollen etc. .
This can be achieved by particle sizing, electron microscopy, analytical chemistry, isotope analysis, and other techniques. However, several analyses will have to be performed outside appropriate laboratory safety containment [e.g. BSL-3 for
4. Biological agents
The Centers for Disease Control [CDC] in Atlanta have evaluated the priority of agents according to their relevance for national security due to ease of dissemination and transmission from person to person, high mortality rates, the potential for major public health impact, risk of public panic and social disruption, and the requirement of special action for public health preparedness. Category A includes the most dangerous agents:
4.1. Microbe identification by classical microbiology
The identification of microbial agents – as defined by the SIBCA handbook - can be provisional [presumptive], when immunological methods, nucleic acid detection or cultivation and metabolic assays have been tested positive. Identification is confirmed by the combination of at least two of the above mentioned criteria. Unambiguous identification requires cultivation and
Biological agents can be difficult to cultivate due to sample contamination, low number of bacteria or pretreatment of patients with antibiotics. Some bacteria are fastidious [
Handling of select agents is highly dangerous and cumbersome and restricted to laboratories with biosafety-level 3 containment. Biosafety-level 3 laboratories have to be operated according to special regulations that require e.g. a sophisticated ventilation system and personal protective equipment [e.g. FFP3 masks, overalls, face shields, gloves etc.].
4.2. Nucleic acid amplification techniques
Many real-time PCR assays are highly specific and sensitive and shorten the time required to establish a diagnosis in comparison with conventional PCR protocols, cultivation, and biochemical identification methods. Therefore, real-time PCR assays have been developed for the identification of
Seroconversion may prove the exposure to a certain agent in the past. However, seroconversion can be expected only after several days or weeks and is of little use for rapidly diagnosing infections caused by highly pathogenic agents. It will be difficult to organize serological investigations [including follow-up tests] when a terrorist attack causes mass casualties that need medical treatment or when the situation is complicated by civil unrest, war or natural catastrophes at the same time.
Various immunological assays have also been used to identify pathogens in samples of patients and environmental samples. Hand-held test kits can be used as bed-side tests and are useful under field conditions, but clinical validations hardly exist and most tests are “for scientific use only”. Immunochromatographic lateral-flow assays have been developed e.g. for brucellosis, tularemia, and plague [4; 29; 37; 44]. Limitations of these immunological assays are that they are frequently not available commercially, not specific enough, or have not been validated and licensed for use in humans or animals. Moreover, cross-reactions may cause false positives and modified or missing antigenic structures can cause false negatives.
5. Typing and strain identification
Differences among microbes have to be assessed to determine whether strains are from the same source or lineage or from a different origin. The accuracy and precision will depend on the typing method, expected mutation rates, and other characteristics of the organism. In court scientists may need to quantify the reliability of a relationship among strains determined using molecular phylogenetic analyses. This will establish the probability of association to a certain source of infection .
Techniques for forensic microbiology can be very similar to those being used for phylogenetic and epidemiological investigations e.g. for food-borne outbreaks.
Molecular-epidemiological tools used for genotyping are most promising and have been applied in the past to elucidate the origin of biological agents. Especially whole genome sequencing and bioinformatic tools for comparison of genomes are potent tools, but technical complexity and costs are still prohibitive for routine application.
In several chapters of the highly recommendable book “Microbial Forensics” by Bruce Budowle and many other “founders” of this new scientific discipline it was demonstrated that only highly specialized knowledge of microbial genetics will allow an assessment of the relevance of typing results obtained by Multi-locus Sequence Typing [MLST], Variable Number of Tandem Repeats [VNTR], Single Nucleotide Polymorphisms [SNPs] analysis or other typing tools [“Microbial Forensics” B. Budowle. ISBN 978-0-12-382006-8]. Validation of typing assays and data of large collections of strains from all over the world are crucial for microbial forensic investigations. Typing methods should be reproducible, stable during the study period, applicable to every isolate, discriminating among isolates, and discrimination should be concordant with the epidemiological picture . DNA sequence-based data are robust, portable, easy to compare, and amenable to computerised analysis for phylogeographical and epidemiological studies. However, the quality of open access sequence databases depends on the accuracy of submitted sequences and is consequently sometimes not reliable.
6. Select agents
In the fall of 2001 an attack with “anthrax letters” resulted in 22 cases including five deaths in the USA. This incident was investigated using VNTR analysis as described by Keim  and sequencing of
Plague is caused by the gram-negative bacterium
The validation of diagnostic assays for infectious diseases like plague can be demanding because of very limited access to clinical samples and isolates. None of the previously published real-time PCR assays for diagnosing plague had been clinically validated so far.
In Madagascar a relevant number of cases is reported each year and a good surveillance system based on the well equipped laboratory facility at the Institut Pasteur in the capital Antananarivo is in place. In a retrospective clinical study we evaluated real-time PCR assays by testing lymph node aspirates from 149 patients with a clinical diagnosis of bubonic plague. In this study results of real-time PCR assays targeting the virulence plasmids pPCP1 [
The evolution and phylogenetic analysis of
Whole-genome characterization of
6.3. Glanders and melioidosis
Glanders in horses presents with pneumonia, purulent nasal discharge, and poor general condition, whereas farcy is a chronic cutaneous disease with massively enlarged lymph vessels [“farcy-pipes”] and nodules developing into ulcers. Equines are the only known reservoir for sporadic infections in humans. Humans develop a clinical picture resembling melioidosis which is caused by the closely related bacterium
In 2004, an outbreak of glanders in horses was reported to the Office International des Epizooties by the United Arab Emirates. In addition to cultivation and phenotypical identification a new real-time PCR assay was developed for the specific identification of
Real-time PCR assays have been developed as rapid identification tools, but several assays were evaluated with strain collections and spiked samples only [30; 40; 41; 43]. In fatal septicaemia the amount of bacterial DNA that can be extracted from blood is high enough to be detectable using real-time PCR , but a study in Thailand has shown that this diagnostic tool may be of little clinical value when compared with conventional diagnostic approaches . MLST analyses have shown that strains from Thailand and Australia can be discriminated and that some sequence types found in environmental samples are underrepresented among clinical isolates thus indicating that they may be less pathogenic for humans [12; 48]. However, VNTR typing did not reproduce this geographic discrimination, but proved to have a higher resolving power that can be used to analyse outbreaks for microbial forensic purposes [11; 45].
In the above mentioned study it was not possible to clarify the phylogeographic expansion of
7. Animal pathogens and agroterrorism
“Agroterrorism is the deliberate tampering with and/or contamination of the food supply with the intent of adversely affecting the social, economic, physical and psychological well-being of society” . Agroterrorism carries less risk for the terrorist, could be carried out more covertly, and does not require sophisticated methodology for weaponization . Important vulnerabilities are intensive production practices, increased susceptibility of immunologically naïve animal populations, and rapid and fast movement of animals and their products over long distances . Attacks can result in disastrous economic losses due to eradication measures [mass culling], international trade embargos, loss of jobs, increased consumer costs, and may even cause difficulties in sustaining the food supply .
8. Quality assurance
Quality assurance is required to verify whether practices and test results are providing reliable and relevant information and quality control can verify whether test conditions are functioning appropriately to yield reproducible results. The Scientific Working Group on Microbial Genetics and Forensics has developed
9. Reporting and surveillance systems
The Global Early Warning and Response System for Major Animal Diseases, including Zoonoses [GLEWS] is the combined effort of WHO, FAO, and OIE. For zoonotic events, alerts of animal outbreaks can provide direct early warning so that human surveillance could be enhanced and preventive action taken.
Crops, rangeland and forests can also be targets of biological attacks. However, the field of plant pathogen forensics is beyond the scope of this chapter. The interested reader can be referred to a comprehensive review written by Fletcher et al. .
Profiling of forensic soil samples by determining the bacterial content may provide valuable information, but depends on several factors such as heterogeneity within a habitat, distance of collection sites, and time [15; 28].
Microbial forensics is a young scientific discipline and probably only few scientists and institutions are aware of the methodological and quality assurance requirements. Epidemiological tools can be used to trace strains and to clarify the chain of infection, but typing systems have to be especially evaluated for forensic purposes. Classical microbiological techniques are indispensable, but most recent developments including very rapid whole genome sequencing complement the polyphasic approach needed for diagnostics and typing. Only large collections of strains from all over the world and high quality sequence data will provide the basis for meaningful results in microbial forensic investigations. International and interdisciplinary cooperation will improve our capabilities to rapidly identify the agents, elucidate the source, and provide these results as evidence in court.
The authors thank Lisa Sprague, Helmut Hotzel and Sascha Rommeiss for reading the manuscript and valuable discussions.
Banaschak S. Werwein M. Brinkmann B. Hauber I. 2000Human immunodeficiency virus type 1 infection after sexual abuse: value of nucleic acid sequence analysis in identifying the offender. Clin Infect Dis 31 1098 100
Budowle B. Schutzer S. E. Burans J. P. Beecher D. J. Cebula T. A. Chakraborty R. Cobb W. T. Fletcher J. Hale M. L. Harris R. B. Heitkamp M. A. Keller F. P. Kuske C. Leclerc J. E. Marrone B. L. Mc Kenna T. S. Morse S. A. Rodriguez L. L. Valentine N. B. Yadev J. 2006Quality sample collection, handling, and preservation for an effective microbial forensics program. Appl Environ Microbiol 72 6431 8
Budowle, B., S. E. Schutzer, A. Einseln, L. C. Kelley, A. C. Walsh, J. A. Smith, B. L. Marrone, J. Robertson, and J. Campos. 2003. Public health. Building microbial forensics as a response to bioterrorism. Science 301 1852 3
Chanteau S. Rahalison L. Ralafiarisoa L. Foulon J. Ratsitorahina M. Ratsifasoamanana L. Carniel E. Nato F. 2003Development and testing of a rapid diagnostic test for bubonic and pneumonic plague. Lancet 361 211 6
Chantratita N. Wuthiekanun V. Limmathurotsakul D. Thanwisai A. Chantratita W. Day N. P. Peacock S. J. 2007Prospective clinical evaluation of the accuracy of 16S rRNA real-time PCR assay for the diagnosis of melioidosis. Am J Trop Med Hyg 77 814 7
Chaudhuri R. R. Ren C. P. Desmond L. Vincent G. A. Silman N. J. Brehm J. K. Elmore M. J. Hudson M. J. Forsman M. Isherwood K. E. Gurycova D. Minton N. P. Titball R. W. Pallen M. J. Vipond R. 2007Genome sequencing shows that European isolates of subspecies tularensis are almost identical to US laboratory strain Schu S4. PLoS One 2:e352.
Crutchley T. M. Rodgers J. B. Whiteside H. P. Jr Vanier M. Terndrup T. E. 2007Agroterrorism: where are we in the ongoing war on terrorism? J Food Prot 70 791 804
Cui Y. Li Y. Gorge O. Platonov M. E. Yan Y. Guo Z. Pourcel C. Dentovskaya S. V. Balakhonov S. V. Wang X. Song Y. Anisimov A. P. Vergnaud G. Yang R. 2008Insight into microevolution of by clustered regularly interspaced short palindromic repeats. PLoS One 3: e2652 EOF
Cummings C. A. Bormann C. A. Chung R. Fang M. Barker P. Brzoska P. C. Williamson J. Beaudry M. Matthews J. Schupp D. M. Wagner D. Birdsell A. J. Vogler M. R. Furtado P. Keim Budowle B. 2010Accurate, rapid and high-throughput detection of strain-specific polymorphisms in and Yersinia pestis by next-generation sequencing. Investig Genet 1: 5 EOF
Cummings, C. A. and D. A. Relman. 2002. Genomics and microbiology. Microbial forensics--"cross-examining pathogens". Science 296 1976 9
Currie B. J. Haslem A. Pearson T. Hornstra H. Leadem B. Mayo M. Gal D. Ward L. Godoy D. Spratt B. G. Keim P. 2009Identification of melioidosis outbreak by multilocus variable number tandem repeat analysis. Emerg Infect Dis 15 169 74
Currie B. J. Thomas A. D. Godoy D. Dance D. A. Cheng A. C. Ward L. Mayo M. Pitt T. L. Spratt B. G. 2007Australian and Thai isolates of are distinct by multilocus sequence typing: revision of a case of mistaken identity. J Clin Microbiol 45 3828 9
Filippov A. A. Solodovnikov N. S. Kookleva L. M. Protsenko O. A. 1990Plasmid content in strains of different origin. FEMS Microbiol Lett 55 45 8
Fletcher J. Bender C. Budowle B. Cobb W. T. Gold S. E. Ishimaru C. A. Luster D. Melcher U. Murch R. Scherm H. Seem R. C. Sherwood J. L. Sobral B. W. Tolin S. A. 2006Plant pathogen forensics: capabilities, needs, and recommendations. Microbiol Mol Biol Rev 70 450 71
Foran D. R. Starrs J. E. 2004In search of the Boston Strangler: genetic evidence from the exhumation of Mary Sullivan. Med Sci Law 44 47 54
Gonzalez-Candelas F. Bracho M. A. Moya A. 2003Molecular epidemiology and forensic genetics: application to a hepatitis C virus transmission event at a hemodialysis unit. J Infect Dis 187 352 8
Gurycova D. 1998First isolation of subsp. tularensis in Europe. Eur J Epidemiol 14 797 802
Hoffmaster, A. R., C. C. Fitzgerald, E. Ribot, L. W. Mayer, and T. Popovic. 2002. Molecular subtyping of Bacillus anthracis and the 2001 bioterrorism-associated anthrax outbreak, United States. Emerg Infect Dis 8 1111 6
Inglesby, T. V., D. T. Dennis, D. A. Henderson, J. G. Bartlett, M. S. Ascher, E. Eitzen, A. D. Fine, A. M. Friedlander, J. Hauer, J. F. Koerner, M. Layton, J. McDade, M. T. Osterholm, T. O’Toole, G. Parker, T. M. Perl, P. K. Russell, M. Schoch-Spana, and K. Tonat. 2000. Plague as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. JAMA 283 2281 90
Johansson A. Farlow J. Larsson P. Dukerich M. Chambers E. Bystrom M. Fox J. Chu M. Forsman M. Sjostedt A. Keim P. 2004Worldwide genetic relationships among isolates determined by multiple-locus variable-number tandem repeat analysis. J Bacteriol 186 5808 18
Jones S. W. Dobson M. E. Francesconi S. C. Schoske R. Crawford R. 2005DNA assays for detection, identification, and individualization of select agent microorganisms. Croat Med J 46 522 9
Keim P. Price L. B. Klevytska A. M. Smith K. L. Schupp J. M. Okinaka R. Jackson P. J. Hugh-Jones M. E. 2000Multiple-locus variable-number tandem repeat analysis reveals genetic relationships within . J Bacteriol 182 2928 36
Levin J. Gilmore K. Nalbone T. Shepherd S. 2005Agroterrorism workshop: engaging community preparedness. J Agromedicine 10 7 15
Li Y. Cui Y. Hauck Y. Platonov M. E. Dai E. Song Y. Guo Z. Pourcel C. Dentovskaya S. V. Anisimov A. P. Yang R. Vergnaud G. 2009Genotyping and phylogenetic analysis of by MLVA: insights into the worldwide expansion of Central Asia plague foci. PLoS One 4: e6000 EOF
Lowell J. L. Wagner D. M. Atshabar B. Antolin M. F. Vogler A. J. Keim P. Chu M. C. Gage K. L. 2005Identifying sources of human exposure to plague. J Clin Microbiol 43 650 6
Mc Ewen S. A. Wilson T. M. Ashford D. A. Heegaard E. D. Kournikakis B. 2006Microbial forensics for natural and intentional incidents of infectious disease involving animals. Rev Sci Tech 25 329 39
Mc Ewen S. A. Wilson T. M. Ashford D. A. Heegaard E. D. Kournikakis B. 2006Microbial forensics for natural and intentional incidents of infectious disease involving animals. Rev Sci Tech 25 329 39
Meyers M. S. Foran D. R. 2008Spatial and temporal influences on bacterial profiling of forensic soil samples. J Forensic Sci 53 652 60
Mizanbayeva S. Smits H. L. Zhalilova K. Abdoel T. H. Kozakov S. Ospanov K. S. Elzer P. H. Douglas J. T. 2009The evaluation of a user-friendly lateral flow assay for the serodiagnosis of human brucellosis in Kazakhstan. Diagn Microbiol Infect Dis 65 14 20
Novak R. T. Glass M. B. Gee J. E. Gal D. Mayo M. J. Currie B. J. Wilkins P. P. 2006Development and evaluation of a real-time PCR assay targeting the type III secretion system of . J Clin Microbiol 44 85 90
Popovic T. Glass M. 2003Laboratory aspects of bioterrorism-related anthrax--from identification to molecular subtyping to microbial forensics. Croat Med J 44 336 41
Riehm J. M. Rahalison L. Scholz H. C. Thoma B. Pfeffer M. Razanakoto L. M. Al S. Dahouk H. Neubauer Tomaso H. 2010Detection of using real-time PCR in patients with suspected bubonic plague. Mol Cell Probes.
Rotz L. D. Khan A. S. Lillibridge S. R. Ostroff S. M. Hughes J. M. 2002Public health assessment of potential biological terrorism agents. Emerg Infect Dis 8 225 30
Schutzer S. E. Budowle B. Atlas R. M. 2005Biocrimes, microbial forensics, and the physician. PLoS Med 2:e337.
Sinclair R. Boone S. A. Greenberg D. Keim P. Gerba C. P. 2008Persistence of category A select agents in the environment. Appl Environ Microbiol 74 555 63
Sjodin A. Svensson K. Lindgren M. Forsman M. Larsson P. 2010Whole-genome sequencing reveals distinct mutational patterns in closely related laboratory and naturally propagated strains. PLoS One 5: e11556 EOF 6 EOF
Splettstoesser W. Guglielmo-Viret V. Seibold E. Thullier P. 2010Evaluation of an immunochromatographic test for rapid and reliable serodiagnosis of human tularemia and detection of -specific antibodies in sera from different mammalian species. J Clin Microbiol 48 1629 34
Supaprom C. Wang D. Leelayuwat C. Thaewpia W. Susaengrat W. Koh V. Ooi E. E. Lertmemongkolchai G. Liu Y. 2007Development of real-time PCR assays and evaluation of their potential use for rapid detection of in clinical blood specimens. J Clin Microbiol 45 2894 901
Svensson K. Granberg M. Karlsson L. Neubauerova V. Forsman M. Johansson A. 2009A real-time PCR array for hierarchical identification of isolates. PLoS One 4: e8360 EOF 14 EOF
Thibault F. M. Valade E. Vidal D. R. 2004Identification and discrimination of , B. mallei, and B. thailandensis by real-time PCR targeting type III secretion system genes. J Clin Microbiol 42 5871 4
Tomaso H. Pitt T. L. Landt O. Al S. Dahouk H. C. Scholz E. C. Reisinger L. D. Sprague I. Rathmann Neubauer H. 2005Rapid presumptive identification of with real-time PCR assays using fluorescent hybridization probes. Mol Cell Probes 19 9 20
Tomaso H. Scholz H. C. Al S. Dahouk M. Eickhoff T. M. Treu R. Wernery U. Wernery Neubauer H. 2006Development of a 5’-nuclease real-time PCR assay targeting fliP for the rapid identification of in clinical samples. Clin Chem 52 307 10
Tomaso H. Scholz H. C. Al S. Dahouk T. L. Pitt T. M. Treu Neubauer H. 2004Development of 5’ nuclease real-time PCR assays for the rapid identification of the complex. Diagn Mol Pathol 13 247 53
Tomaso H. Thullier P. Seibold E. Guglielmo V. Buckendahl A. Rahalison L. Neubauer H. Scholz H. C. Splettstoesser W. D. 2007Comparison of hand-held test kits, immunofluorescence microscopy, enzyme-linked immunosorbent assay, and flow cytometric analysis for rapid presumptive identification of . J Clin Microbiol 45 3404 7
U’Ren J. M. Schupp J. M. Pearson T. Hornstra H. Friedman C. L. Smith K. L. Daugherty R. R. Rhoton S. D. Leadem B. Georgia S. Cardon M. Huynh L. Y. De Shazer D. Harvey S. P. Robison R. Gal D. Mayo M. J. Wagner D. Currie B. J. Keim P. 2007Tandem repeat regions within the genome and their application for high resolution genotyping. BMC Microbiol 7: 23 EOF
van Belkum A. Tassios P. T. Dijkshoorn L. Haeggman S. Cookson B. Fry N. K. Fussing V. Green J. Feil E. Gerner-Smidt P. Brisse S. Struelens M. 2007Guidelines for the validation and application of typing methods for use in bacterial epidemiology. Clin Microbiol Infect 13 Suppl 3 1 46
Van Ert M. N. Easterday W. R. Simonson T. S. U’Ren J. M. Pearson T. Kenefic L. J. Busch J. D. Huynh L. Y. Dukerich M. Trim C. B. Beaudry J. Welty-Bernard A. Read T. Fraser C. M. Ravel J. Keim P. 2007Strain-specific single-nucleotide polymorphism assays for the Ames strain. J Clin Microbiol 45 47 53
Vesaratchavest M. Tumapa S. Day N. P. Wuthiekanun V. Chierakul W. Holden M. T. White N. J. Currie B. J. Spratt B. G. Feil E. J. Peacock S. J. 2006Non-random distribution of clones in relation to geographical location and virulence. J Clin Microbiol 44 2553 7
Vogler, A. J., D. Birdsell, L. B. Price, J. R. Bowers, S. M. Beckstrom-Sternberg, R. K. Auerbach, J. S. Beckstrom-Sternberg, A. Johansson, A. Clare, J. L. Buchhagen, J. M. Petersen, T. Pearson, J. Vaissaire, M. P. Dempsey, P. Foxall, D. M. Engelthaler, D. M. Wagner, and P. Keim. 2009. Phylogeography of Francisella tularensis: global expansion of a highly fit clone. J Bacteriol 191 2474 84
Welch T. J. Fricke W. F. Mc Dermott P. F. White D. G. Rosso M. L. Rasko D. A. Mammel M. K. Eppinger M. Rosovitz M. J. Wagner D. Rahalison L. Leclerc J. E. Hinshaw J. M. Lindler L. E. Cebula T. A. Carniel E. Ravel J. 2007Multiple antimicrobial resistance in plague: an emerging public health risk. PLoS One 2: e309 EOF
Williams J. E. Harrison D. N. Quan T. J. Mullins J. L. Barnes A. M. Cavanaugh D. C. 1978Atypical plague bacilli isolated from rodents, fleas, and man. Am J Public Health 68 262 4
Wilmoth B. A. Chu M. C. Quan T. J. 1996Identification of by BBL Crystal Enteric/Nonfermenter Identification System. J Clin Microbiol 34 2829 30
Wilson T. M. Gregg D. A. King D. J. Noah D. L. Perkins L. E. Swayne D. E. Inskeep W. 2nd 2001Agroterrorism, biological crimes, and biowarfare targeting animal agriculture. The clinical, pathologic, diagnostic, and epidemiologic features of some important animal diseases. Clin Lab Med 21 549 91