Laboratory Criteria for Exclusion and Readmission of Potentially Infectious Persons in Sensitive Settings in the Age of Culture-Independent Diagnostic Tests: Report of a Multidisciplinary Workgroup

John Besser; Rachael Singer; Rachel H Jervis; David Boxrud; Kirk Smith; Elizabeth R Daly; Members of the APHL, CSTE Enteric Disease Exclusion Policies Workgroup

doi:10.1016/j.jfp.2023.100173

Laboratory Criteria for Exclusion and Readmission of Potentially Infectious Persons in Sensitive Settings in the Age of Culture-Independent Diagnostic Tests: Report of a Multidisciplinary Workgroup

J Food Prot. 2023 Dec;86(12):100173. doi: 10.1016/j.jfp.2023.100173. Epub 2023 Oct 4.

Authors

John Besser¹, Rachael Singer², Rachel H Jervis³, David Boxrud⁴, Kirk Smith⁵, Elizabeth R Daly⁶; Members of the APHL, CSTE Enteric Disease Exclusion Policies Workgroup

Affiliations

¹ Association of Public Health Laboratories, 284 Vickers DR NE, Atlanta, GA 30307, USA. Electronic address: bessej1@gmail.com.
² Council of State and Territorial Epidemiologists, 2635 Century Parkway NE, Suite 700, Atlanta, GA 30345, USA. Electronic address: rsinger@cste.org.
³ Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive South, Denver, CO 80246, USA. Electronic address: rachel.jervis@state.co.us.
⁴ Centers for Disease Control and Prevention, 1600 Clifton Road NE. Atlanta GA 30329, USA. Electronic address: zaj3@cdc.gov.
⁵ Minnesota Department of Health, 625 Robert St. N. P.O. Box 64975, St. Paul, MN 55164, USA. Electronic address: kirk.smith@state.mn.us.
⁶ Council of State and Territorial Epidemiologists, 2635 Century Parkway NE, Suite 700, Atlanta, GA 30345, USA. Electronic address: edaly@cste.org.

PMID: 37797737
DOI: 10.1016/j.jfp.2023.100173

Abstract

Culture-independent diagnostic tests (CIDTs) are increasingly used for clinical diagnosis of gastrointestinal diseases such as salmonellosis, Shiga toxin-producing E. coli disease, and shigellosis because of their speed, convenience, and generally high-performance characteristics. These tests are also used to screen potentially infectious asymptomatic persons during outbreak investigations in sensitive settings such as childcare, food service, and healthcare. However, only limited performance data are available for CIDTs used on specimens from asymptomatic persons. The Association of Public Health Laboratories (APHL) and Council of State and Territorial Epidemiologists (CSTE) convened a workgroup to examine the available scientific data to inform interim decision-making related to exclusion and readmission criteria for potentially infectious persons in sensitive settings, the risks and benefits of different testing strategies, and to identify knowledge gaps for further research. This is the report on the Workgroup findings.

Keywords: Culture-independent diagnostic tests; Exclusion criteria; Readmission criteria; STEC; Salmonella; Shigella.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Escherichia coli
Escherichia coli Infections* / epidemiology
Humans
Laboratories
Patient Readmission
Salmonella Infections*
Shiga-Toxigenic Escherichia coli*