Application of Rapid-Cycle Real-Time Polymerase Chain Reaction for Diagnostic Testing in the Clinical Microbiology Laboratory

2003 ◽  
Vol 127 (9) ◽  
pp. 1112-1120 ◽  
Author(s):  
Franklin R. Cockerill

Abstract Context.—Rapid-cycle real-time polymerase chain reaction (PCR) technology combines rapid thermocycling with real-time fluorescent probe detection of amplified target nucleic acids. Objectives.—To review and compare the method of rapid-cycle real-time PCR to conventional PCR methods. To describe the application of rapid-cycle real-time PCR for diagnostic testing in the microbiology laboratory. Data Selection.—Information is presented from published literature as well as from personal experience at the Mayo Clinical Microbiology Laboratory (Rochester, Minn). Conclusions.—Compared to conventional PCR methods, rapid-cycle real-time PCR diagnostics are much faster and easier to perform, and, because both PCR and probe detection occur in the same reaction vessel, the possibility of amplified product (amplicon) contamination is lessened. Furthermore, compared to conventional culture-based or direct antigen detection methods, rapid-cycle real-time PCR assays are frequently more sensitive and much more rapid techniques for detecting or quantifying microorganisms in human samples and for identifying genes or mutations in pathogens associated with antimicrobial resistance.

2003 ◽  
Vol 127 (9) ◽  
pp. 1106-1111 ◽  
Author(s):  
Betty A. Forbes

Abstract Context.—In the mid-1980s, the polymerase chain reaction methodology for the amplification of minute amounts of target DNA was successfully developed and then introduced into clinical use; such technology has led to a revolution in diagnostic testing. Despite enormous advances in the detection of infectious agents by amplification methods, there are also limitations that must be addressed. Objective.—To highlight the pertinent steps and issues associated with the introduction of an amplification assay into a clinical microbiology laboratory as well as the subsequent ongoing activities following its introduction into routine laboratory use. Data Sources.—Data were obtained from literature searches from 1990 through September 2002 using the subject headings “polymerase chain reaction,” “molecular assays,” and “amplification” as well as publications of the National Committee for Clinical Laboratory Standards. Data Extraction and Synthesis.—Using the findings obtained from these studies and publications, the process of introducing a molecular assay into the clinical microbiology laboratory was broken down into 4 major components: (1) initial phase of assay development, (2) polymerase chain reaction assay verification in which analytic sensitivity and specificity is determined, (3) assay validation to determine clinical sensitivity and specificity, and (4) interpretation of results and ongoing, required activities. The approach, as well as the advantages and limitations involved in each step of the process, was highlighted and discussed within the context of the published literature. Conclusions.—The application of molecular testing methods in the clinical laboratory has dramatically improved our ability to diagnose infectious diseases. However, the clinical usefulness of molecular testing will only be maximized to its fullest benefit by appropriate and careful studies correlating clinical findings with assay results.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Natasya Y. Damo ◽  
John P. Porotu'o ◽  
Glady I. Rambert ◽  
Fredine E. S. Rares

Abstract: The world is in fear of the pandemic Coronavirus Disease (COVID-19) which is so deadly, the World Health Organization (WHO) declared the world a global health emergency. The number of confirmed cases is still very high until now, even in Indonesia this pandemic is still not over. The transmission is so fast and wide, plus the current clinical manifestations of COVID-19 have varied, ranging from asymptomatic to severe. This literature review aims to determine the Diagnostic of COVID-19 with the most appropriate Clinical Microbiology Laboratory Examination and to find out the importance of Clinical Microbiology Laboratory examinations in COVID-19 Diagnostics. The method used is in the form of literature studies from several scientific sources that are accurate and valid regarding the Diagnostic of COVID-19 with Clinical Microbiology Laboratory Examination. The results showed that Polymerase Chain Reaction (PCR) is the gold standard in detecting COVID-19 although there are several factors that can affect the results of the PCR examination which then cause false negatives / positives. Conclusion Clinical Microbiology Laboratory Examination is very important and very helpful. Diagnostic COVID-19 in the Microbiology Laboratory can be done by using Rapid Diagnostic Test (RDT) Antigen, RDT Antibody, PCR, and Virus Culture. Diagnostic COVID-19 with the recommended Clinical Microbiology Laboratory Examination and the gold standard is PCR examination. However, there are also several factors that can affect the results of the PCR examination.Keywords: diagnostic, COVID-19, Clinical Microbiology Laboratory  Abstrak: Dunia sedang dalam ketakutan dengan pandemi Coronavirus Disease (COVID-19) yang begitu mematikan, Organisasi Kesehatan Dunia (WHO) menyatakan dunia sebagai darurat kesehatan global. Jumlah kasus yang terkonfirmasi masih sangat tinggi hingga saat ini, bahkan di Indonesia pandemi ini masih belum berakhir. Penularannya begitu cepat dan luas, sertta manifestasi klinis COVID-19 yang bervariasi, mulai dari asimtomatik hingga parah. Tinjauan pustaka ini bertujuan untuk mengetahui Diagnostik COVID-19 dengan Pemeriksaan Laboratorium Mikrobiologi Klinik yang paling sesuai dan untuk mengetahui pentingnya pemeriksaan Laboratorium Mikrobiologi Klinik dalam Diagnostik COVID-19. Metode yang digunakan berupa studi pustaka dari beberapa sumber ilmiah yang akurat dan valid mengenai Diagnostik COVID-19 dengan Pemeriksaan Laboratorium Mikrobiologi Klinik. Hasil penelitian menunjukkan bahwa Polymerase Chain Reaction (PCR) merupakan gold standard dalam mendeteksi COVID-19 meskipun terdapat beberapa faktor yang dapat mempengaruhi hasil pemeriksaan PCR yang kemudian menimbulkan false negatif/positif. Kesimpulan Pemeriksaan Laboratorium Mikrobiologi Klinik sangat penting dan sangat membantu. Diagnostik COVID-19 di Laboratorium Mikrobiologi dapat dilakukan dengan menggunakan Antigen Rapid Diagnostic Test (RDT), Antibodi RDT, PCR, dan Kultur Virus. Diagnostik COVID-19 dengan Pemeriksaan Laboratorium Mikrobiologi Klinik yang direkomendasikan dan menjadi gold standard adalah PCR. Namun, ada juga beberapa faktor yang dapat mempengaruhi hasil pemeriksaan PCR.Kata Kunci: diagnostik, COVID-19, Laboratorium Mikrobiologi Klinik


Plant Disease ◽  
2007 ◽  
Vol 91 (4) ◽  
pp. 430-434 ◽  
Author(s):  
M. P. Grisham ◽  
Y.-B. Pan ◽  
E. P. Richard

A real-time, polymerase chain reaction (PCR) assay was developed for detecting Leifsonia xyli subsp. xyli in sugarcane leaf tissue. Real-time PCR assays were conducted on the youngest, fully expanded leaf of three cultivars collected bi-weekly from field nurseries between 11 April and 19 July 2005. L. xyli subsp. xyli infection was detected in leaves collected at all sampling dates, including those from 1-month-old plants on 11 April. Assays conducted on older, more rapidly growing plants (28 July and 21 October 2005) indicated that leaf position affects assay efficiency. Conventional PCR was less efficient than real-time PCR for detecting L. xyli subsp. xyli in leaf tissue. Real-time PCR was used to rank cultivars for susceptibility to L. xyli subsp. xyli infection based on the relative titer of L. xyli subsp. xyli in leaves of inoculated, 3- and 4-month-old greenhouse-grown plants. The ranking of cultivars by real-time PCR was in close agreement with the ranking determined by tissue-blot enzyme immunoassay performed on tissue from 7- to 9-month-old stalks.


Plant Disease ◽  
2006 ◽  
Vol 90 (12) ◽  
pp. 1523-1530 ◽  
Author(s):  
G. Licciardello ◽  
F. M. Grasso ◽  
P. Bella ◽  
G. Cirvilleri ◽  
V. Grimaldi ◽  
...  

Phoma tracheiphila is the causal agent of a tracheomycotic disease of citrus called mal secco causing the dieback of twigs and branches. This pathogen is of quarantine concern; therefore, fast and reliable protocols are required to detect it promptly. A specific primer pair and a dual-labeled fluorogenic probe were used in a real-time polymerase chain reaction (PCR) with the Cepheid Smart Cycler II System (Transportable Device TD configuration) to detect this fungus in citrus samples. Real-time PCR assay was compared to modified conventional PCR assay. The sensitivity of the former was evaluated by testing P. tracheiphila DNA dilutions, and the minimum amount detectable was about 500 fg, whereas the linear quantification range was within 100 ng to 1 pg. Conventional PCR sensitivity was 10 pg. Conventional and real-time PCR successfully detected the fungus in woody samples of naturally infected lemon and artificially inoculated sour orange seedlings. Nevertheless, real-time PCR was about 10- to 20-fold more sensitive than conventional PCR, and preliminary results indicate that the former technique achieves quantitative monitoring of the fungus in tissues. Simple and rapid procedures to obtain suitable DNA samples from fungal cultures and citrus woody samples for PCR assays enable diagnosis to be completed in a short time.


Author(s):  
Dinh Thi Thu Hang ◽  
Vu Thi Nga ◽  
Hoang Van Tong ◽  
Hoang Xuan Su ◽  
Le Quoc Tuan ◽  
...  

This article aims to establish a novel cytochrome b real-time PCR assay using Taqman probe for identification of P. malariae and its discrimination from other Plasmodium human infecting species. The optimization of real-time PCR assay with 1X QuantiTect Probe PCR Master Mix, primers and probe used at concentrations of 0.4 μM and 0.1 μM, respectively; and 2.5 mM MgCl2, 5 μl DNA template and deionized H2O of 20 μl, was performed using a real-time PCR instrument. The developed real-time PCR assay was evaluated for the limit of detection, stability on standard panels (109-100 copies/ µl), as well as the sensitivity, specificity on control groups. The probit analysis demonstrates that the 95% detection limit was <0.5 parasite/μl, both the sensitivity and specificity of the assay were 100% when evaluated on the control groups.  Additionally, the assay initially evaluated on 41 clinical samples including 21 malaria samples and 20 samples of volunteer blood donors, identified 1 positive sample with P. malariae from the disease group, which shows a concordant result with nested PCR. This novel Cyt b real-time PCR assay for identifying P. malariae may also facilitate earlier discrimination of P. malariae from other Plasmodium parasites with high sensitivity. Keywords Cytochrome b, malaria parasite, plasmodium malariae, mitochondria, real-time PCR. References [1] B. Singh, C. Daneshvar, Human infections and detection of Plasmodium knowlesi, Clinical microbiology reviews 26(2) (2013) 165-84. https://doi.org/10.1128/cmr.00079-12.[2] World Health Organization, Regional and global trends in burden of malaria cases and deaths, World malaria report 2019, Geneva, pp. 4-12.[3] World Health Organization, Progress towards elimination during the RBM decade 2000-2010, Eliminating malaria: learning from the past, looking ahead, Geneva (2011), pp. 39-70.[4] J.M. Vinetz, J. Li, T.F. McCutchan, et al., Plasmodium malariae infection in an asymptomatic 74-year-old Greek woman with splenomegaly, N Engl J Med 338(6) (1998) 367-71. https://doi.org/10.1056/NEJM199802053380605.[5] E. Lo, K. Nguyen, J. Nguyen, et al., Plasmodium malariae Prevalence and csp Gene Diversity, Kenya, 2014 and 2015, Emerg Infect Dis 23(4) (2017) 601-610. https://doi.org/10.3201/eid2304.161245.[6] W.E. Collins, G.M. Jeffery, Plasmodium malariae: parasite and disease, Clinical microbiology reviews 20(4) (2007) 579-92. https://doi.org/10.1128/CMR.00027-07.[7] M. Adams, S.N. Joshi, G. Mbambo, et al., An ultrasensitive reverse transcription polymerase chain reaction assay to detect asymptomatic low-density Plasmodium falciparum and Plasmodium vivax infections in small volume blood samples, Malar J 14 (2015) 520. https://doi.org/10.1186/s12936-015-1038-z.[8] W. Xu, U. Morris, B. Aydin-Schmidt, et al., SYBR Green real-time PCR-RFLP assay targeting the plasmodium cytochrome B gene-a highly sensitive molecular tool for malaria parasite detection and species determination, PloS one 10(3) (2015) e0120210. https://doi.org/10.1371/journal.pone.0120210.[9] E.M. Burd, Validation of laboratory-developed molecular assays for infectious diseases, Clinical microbiology reviews 23(3) (2010) 550-76. https://doi.org/10.1128/CMR.00074-09.[10] G. Snounou, S. Viriyakosol, X.P. Zhu, et al., High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction, Molecular and biochemical parasitology 61(2) (1993) 315-20. https://doi.org/10.1016/0166-6851(93)90077-b.[11] C.G. Haanshuus, K. Morch, B. Blomberg, et al., Assessment of malaria real-time PCR methods and application with focus on low-level parasitaemia, PloS one 14(7) (2019) e0218982. https://doi.org/10.1371/journal.pone.0218982.[12] F. Perandin, N. Manca, A. Calderaro, et al., Development of a real-time PCR assay for detection of Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale for routine clinical diagnosis, Journal of clinical microbiology 42(3) (2004) 1214-9. https://doi.org/10.1128/jcm.42.3.1214-1219.2004.[13] C.E. Oriero, J.P. van Geertruyden, J. Jacobs, et al., Validation of an apicoplast genome target for the detection of Plasmodium species using polymerase chain reaction and loop mediated isothermal amplification, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases 21(7) (2015) 686 e1-7. https://doi.org/10.1016/j.cmi.2015.02.025.[14] D.F. Echeverry, N.A. Deason, J. Davidson, et al., Human malaria diagnosis using a single-step direct-PCR based on the Plasmodium cytochrome oxidase III gene, Malaria journal 15 (2016) 128. https://doi.org/10.1186/s12936-016-1185-x.[15] P. Li, Z. Zhao, H. Xing, et al., Plasmodium malariae and Plasmodium ovale infections in the China-Myanmar border area, Malaria journal 15(1) (2016) 557. https://doi.org/10.1186/s12936-016-1605-y.[16] E.T.J. Chong, J.W.F. Neoh, T.Y. Lau, et al., Genetic and haplotype analyses targeting cytochrome b gene of Plasmodium knowlesi isolates of Malaysian Borneo and Peninsular Malaysia, Acta tropica 181 (2018) 35-39. https://doi.org/10.1016/j.actatropica.2018.01.018.[17] C. Farrugia, O. Cabaret, F. Botterel, et al., Cytochrome b gene quantitative PCR for diagnosing Plasmodium falciparum infection in travelers, Journal of clinical microbiology 49(6) (2011) 2191-5. https://doi.org/10.1128/JCM.02156-10.[18] C. Wongsrichanalai, M.J. Barcus, S. Muth, et al., A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT), The American journal of tropical medicine and hygiene 77(6 Suppl) (2007) 119-27.[19] H.V. Nguyen, P.V.D. Eede, C. van Overmeir, et al., Marked age-dependent prevalence of symptomatic and patent infections and complexity of distribution of human Plasmodium species in central Vietnam, The American journal of tropical medicine and hygiene 87(6) (2012) 989-995. https://doi.org/10.4269/ajtmh.2012.12-0047.  


2009 ◽  
Vol 99 (5) ◽  
pp. 582-590 ◽  
Author(s):  
Renaud Ioos ◽  
Céline Fourrier ◽  
Gabriela Iancu ◽  
Thomas R. Gordon

Fusarium circinatum is the causal agent of pitch canker disease on numerous Pinus spp. This aggressive fungus may infect pine seed cryptically and, therefore, can easily be spread long distances by the seed trade. F. circinatum has recently been listed as a quarantine organism in numerous countries throughout the world, which prompted the development of a specific and sensitive tool for the detection of this pathogen in conifer seed. A new detection protocol for F. circinatum based on a biological enrichment step followed by a real-time polymerase chain reaction (PCR) assay was developed. Several enrichment protocols were compared and a 72-h incubation of the seed with potato dextrose broth was the most efficient technique to increase F. circinatum biomass before DNA extraction. The relative accuracy, specificity, and sensitivity of the real-time PCR assay was evaluated in comparison with a previously published conventional PCR test on 420 seed DNA extracts. The real-time PCR described here proved to be highly specific and significantly more sensitive than the conventional PCR, and enabled the detection of F. circinatum in samples artificially contaminated with less than 1/1,000 infected seed, as well as in naturally infected samples. Last, in order to routinely check the quality of the seed DNA extracts, a primer–probe combination that targets a highly conserved region within the 18S ribosomal DNA in plants or fungi was successfully developed. This assay allows for quick and reliable detection of F. circinatum in seed, which can help to prevent long-distance spread of the pathogen via contaminated seed lots.


Author(s):  
Ika Yasma Yanti ◽  
Dalima Ari Wahono Astrawinata

Toxigenic Clostridium difficile infection, causing a Pseudo Membrane Colitis (PMC) and Clostridium Difficile Associated Diarrhea(CDAD) has increased sharply. The largest risk factor is the use of antibiotics. The purpose of this study was to know how to determinethe prevalence and characteristics of subjects with Toxigenic Clostridium difficile and to assess the ability of the toxin rapid test comparedto real-time PCR. Ninety adult subjects with antibiotic therapy more than two (2) weeks were enrolled in this study. The results of toxinrapid test and real-time PCR were presented in a 2x2 table, statistical test used was Chi square. The prevalence of Toxigenic Clostridiumdifficile based on the toxin rapid test and by real-time PCR was 27.3% and 37.5%, respectively. There were significant differences betweenstool consistency and number of antibiotics used with the detection of Toxigenic Clostridium difficile. There was a relationship betweenthe duration of antibiotic therapy with the detection of Toxigenic Clostridium difficile using real-time PCR (p=0.010, RR=2.116). Thesensitivity, specificity, PPV, NPV, PLR and NLR rapid test against real-time PCR were 69.7%; 98.2%; 95.8%; 84.4%; 39.2 and 0.31,respectively. This study concluded that the prevalence of Clostridium difficile in RSCM was higher compared to that in Malaysia, Thailandand India; the subjects with antibiotic therapy for more than four (4) weeks had a double risk to have Toxigenic Clostridium difficilethan subjects with antibiotic therapy for less than that time (4 weeks). Thus, in this study, toxin rapid test could be used as a tool todetect Toxigenic Clostridium difficile.


Sign in / Sign up

Export Citation Format

Share Document