Microbial Strain-Typing Order form Client Invoice Department Your Purchase Order number #: Name of sender: Administrator: Institute / Company: Invoice department: Department: Invoice address: Shipment address: Zip/City: Zip/City: Country: Country: e-mail address: e-mail address: Phone number: Phone number: VAT #: Fax number: Other contact person: e-mail address: Quotation #: Year contract #: ORDER (please use the sample sheet) THE FOLLOWING OPTIONS ARE AVAILABLE, PLEASE INDICATE YOUR CHOICE ON THE SAMPLESHEET: Typing of bacteria/ fungi: BC-311: Strain Typing using rep-PCR, A DNA fingerprint will be generated using repetitive element sequence-based (rep) PCR. The PCR-products are separated by a microfluidics-based platform for sizing and a species (sometimes strain)-specific pattern is obtained. Isolates with similar patterns (i.e. belonging to the same species) will cluster together. Delivery time of this service is 5 days. This service can be used for all type of organisms. BC-312: Strain Typing using MLST, Multilocus sequence typing (MLST) is an unambiguous procedure for characterizing isolates of micro-organisme using the sequences of internal fragments of (usually) seven house-keeping genes. For each of these housekeeping genes, the different sequences are assigned as alleles and the alleles at the loci provide an allelic profile or sequence type (ST). A series of profiles can then be the identification marker for strain typing. Delivery time of this service is 5 days. This service can be used for a limited number of organisms, please contact BaseClear for the complete list. BC-307/BC-308/ BC-309: Microbial identification: DNA isolation, PCR, purification and double stranded sequencing of the partial/ complete 16S (in case of bacteria) or ITS region (in case of fungal samples). Identification results can be of additional value when strain typing is requested RESULTS The results will be send by email and regular mail. I accept the general terms and conditions of BaseClear* Name : ______________________ Signature : ______________________ Date :__ / __/ ____ To be filled out by BaseClear: Project Code : __________________ Date of registration : _ _ / _ _ / _ _ _ _ *Our General Terms and Conditions apply to all projects BaseClear carries out and can be downloaded from our website (www.baseclear.com/labservices/terms_conditions). BaseClear B.V. The Netherlands Version: 3 F089-MICRO-05 P.O. Box 1336 2302 BH Leiden Einsteinweg 5 2333 CC Leiden T +31 71 523 3917 F +31 71 523 5594 W www.baseclear.com E info@baseclear.com Page 1 of 3 Microbial Strain-Typing Order form SAMPLES We can only process live Class I, non-pathogenic micro-organism that are provided to us according to Dutch regulations. In brief, this means that bacteria or fungi should be delivered on petri-dishes or on slants that are sealed with parafilm. Sealed dishes/ slants should be wrapped in absorbing tissue, and enclosed in an unbreakable and watertight cover. Please make sure that you clearly indicate the sample names on the petridishes. If you suspect the micro-organisms to be pathogenic please contact us beforehand so we can discuss alternative means of transportation. TERMS OF DELIVERY Microbial typing using repetitive element sequence-based PCR (BC-311) DNA-isolation, PCR, running the PCR products on a microfluidics-based platform and reporting will be performed using BaseClear’s custom protocols. A full report including the identification results of the samples and the typing groups will be mailed to the client within 5 working days. Microbial typing using Multilocus sequence typing (BC-312) DNA-isolation, PCR, sequencing, data analyses, assigning allele numbers, combining them to get a sequence type (ST) and reporting will be performed using BaseClear’s custom protocols. A full report including the allele number and sequence type (ST) will be mailed to the client within 5 working days. Identification of bacterial samples using custom protocols (BC-308 and BC-309) We offer two possibilities for identification of bacterial samples using our custom kits. For a custom ID <700bp (BC-308) approximately 600 base pairs of the 16S rRNA gene will be amplified and sequenced on both strands. A full report including the homology search in our internal or online database and sequence data will be mailed to the client within 5 working days. For a custom ID <1400bp (BC-309) approximately 1400 base pairs of the 16S rRNA gene will be amplified and sequenced on both strands. A full report including the homology search in an online database and sequence data will be mailed to the client within 5 working days. The reported result is the most likely sample identification. However, the client has to make the final conclusion to the identity of the sample. Identification of fungal samples using custom protocols (BC-307) Samples can be analysed by amplification and sequencing of the internal transcribed spacer (ITS) genes (BC307) using custom kits and protocols, and blasting in public databases. The consensus sequence length is about 700 bp long. A full report including the homology search in an online database and sequence data will be mailed to the client within 5 working days. The reported result is the most likely sample identification. However, the client has to make the final conclusion to the identity of the sample. Transport and Storage (To be filled in by client) Transport: liquid nitrogen Frozen (-25C and -15°C) Other, Dry ice Cooled (2-8C) Temperature logger present yes Storage: liquid nitrogen Frozen (-25C and -15°C) Other, Deep frozen(<-60C) Cooled (2-8C) BaseClear B.V. The Netherlands Version: 3 F089-MICRO-05 P.O. Box 1336 2302 BH Leiden Einsteinweg 5 2333 CC Leiden Room temp. (15-25C) (please specify) no Room temp. (15-25C) (please specify) T +31 71 523 3917 F +31 71 523 5594 W www.baseclear.com E info@baseclear.com Page 2 of 3 Microbial Strain-Typing Order form Type of service No Sample name 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Microbial typing using repetitive element sequence-based PCR (BC-311) Microbial typing using Multilocus sequence typing (BC-312) Sample Type Additional identification*** (Samples will be identified using 16S/ITS sequencing) Suspected ID Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… Bacterial Fungal Bacterial partial Bacterial full Fungal ITS No Identification ………………………… ***: Please note: Identification of the samples will be at additional cost! Remarks: BaseClear B.V. The Netherlands Version: 3 F089-MICRO-05 P.O. Box 1336 2302 BH Leiden Einsteinweg 5 2333 CC Leiden T +31 71 523 3917 F +31 71 523 5594 W www.baseclear.com E info@baseclear.com Page 3 of 3 Please leave this column empty