Interpretation of pulsed-field gel electrophoresis patterns in foodborne disease investigations and surveillance

Since the establishment of the well-known Tenover criteria in 1995 (Tenover et al., 1995), relatively few papers have been published about the interpretation of subtyping data generated by pulsed-field gel electrophoresis (PFGE). This paper describes the approach that has been used in the PulseNet network during the past 10 years. PFGE data must always be interpreted in the proper epidemiological context and PFGE data can not alone prove an epidemiological connection. The Tenover criteria are not generally applicable to the interpretation of PFGE subtyping data of foodborne pathogens. The reproducibility of the method with a particular organism, the quality of the PFGE gel, the variability of the organism being subtyped, and the prevalence of the pattern in question must always be considered. Only isolates displaying indistinguishable patterns should be included in the detection of clusters of infections or the initial case definition in a point-source outbreak. More variability (patterns differing from each other in two to three band positions) may be accepted if the outbreak has been going on for some time or if person-person spread is a prominent feature. If epidemiological information is sufficiently strong, isolates with markedly different PFGE patterns may be included in an outbreak.