建立检测产气肠杆菌的TaqMan荧光定量PCR和普通PCR方法

目的 建立敏感、特异的普通聚合酶链反应(PCR)方法和TaqMan 荧光定量PCR方法对产气肠杆菌进行快速检测。方法 以产气肠杆菌组氨酸脱氢酶基因(hdc)为靶基因设计引物以及TaqMan FAM探针,建立对产气肠杆菌进行检测的普通PCR方法和TaqMan 荧光定量PCR方法,并评价该方法的特异性、灵敏性和稳定性。结果 普通PCR和TaqMan 荧光定量PCR方法均能对产气肠杆菌进行特异检测;普通PCR方法对质粒标准品和粪便模拟标本的检测下限分别为 100 copies/l和1.0105 cfu/g,TaqMan 荧光定量PCR方法对质粒标准品和粪便模拟标本的检测下限分别为33 copies/l和1.0104 cfu/g;TaqMan 荧光定量PCR方法对质粒标准品和粪便模拟标本检测的扩增曲线良好;在稳定性评价试验中,普通PCR方法的重复性良好,TaqMan 荧光定量PCR方法对质粒标准品检测Ct值的组内差异为0.15%~0.98%,组间差异为0.55%~1.63%。结论 本研究建立的检测产气肠杆菌的普通PCR方法和TaqMan 荧光PCR方法特异性好、灵敏度高,能够用于产气肠杆菌的快速检测。     

TaqMan-MGB探针实时荧光定量-聚合酶链反应检测肺炎支原体方法的建立

目的 建立敏感、特异的TaqMan-MGB探针实时荧光定量-聚合酶链反应(real-time PCR)快速检测方法,为临床标本中肺炎支原体快速检测提供技术支持。方法 选取肺炎支原体重复序列RepMP23中保守区域设计、合成特异性扩增引物和TaqMan-MGB探针,建立并优化real-time PCR检测方法。对优化后的方法使用标准浓度核酸进行扩增效率、灵敏度及特异度评价,并与已报道的肺炎支原体荧光PCR方法进行比较。结果 本研究建立的TaqMan-MGB探针荧光PCR方法对肺炎支原体的检测限为0.2 cfu,比普通TaqMan real-time PCR检测限(3～5 cfu)提高了一个数量级。其检测标准曲线的循环阈值(Ct) 与模板拷贝数呈良好的线性关系(R2=0.999)。用该方法扩增23种呼吸道常见病原菌染色体及人类染色体,结果均为阴性,特异度为100%。结论 TaqMan-MGB探针real-time PCR方法可快速、灵敏、特异地检测肺炎支原体,有很好的应用前景与价值。     

多重PCR-核酸探针杂交法同时检测沙眼衣原体、解脲支原体和淋病奈瑟菌

目的：建立一种同时检测沙眼衣原体，解脲支原体，淋病奈瑟菌三种病原体DNA的方法并用于临床标本检测。方法：采用多重PCR－核酸探针杂交技术，结果与常规PCR法比较。结果：本法特异性良好，敏感度达到0.1fg。经过对166例性传播疾病门诊患者标本测定证实，沙眼衣原体，解脲支原体，淋病奈瑟菌检出率分别为22．9％，54．8％，34．3％，并有22．2％的双重复合感染和4．8％的三重复合感染。并与常规PCR法具有很好的一致性。结论：本法快速，简便，特异性好，能指示多重感染。     

A real-time PCR assay for the detection of Neisseria gonorrhoeae by LightCycler

The detection of Neisseria gonorrhoeae by the polymerase chain reaction (PCR) is now recognized as a sensitive and specific method of diagnosing infection by the organism. In this Study 152 urine specimens were examined for N. gonorrhoeae by a real-time PCR method using the LightCycler platform and results were compared to an "in-house" PCR assay using an ELISA-based detection method. N. gonorrhoeae DNA was detected in 29 (19%) specimens by LightCycler PCR (LC-PCR) and in 31 (20%) specimens by the "in house" PCR method. The LightCycler assay proved to be specific and 94% sensitive when compared to the "in house" PCR method. These features combined with the rapid turn-around time for results makes the LC-PCR particularly suitable for the detection of N. gonorrhoeae in a routine clinical laboratory.     

Diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae. Genitourinary infections in males by the Amplicor PCR assay of urine

The Amplicor CT/NG polymerase chain reaction (PCR) test on urine specimens from males was prospectively evaluated against established specimens and laboratory methods for diagnosing Chlamydia trachomatis and Neisseria gonorrhoeae genitourinary infections, in patients from a remote region of Western Australia. Seventy-three males who were tested for both C. trachomatis and N. gonorrhoeae by both conventional methodology and Amplicor PCR on urine were enrolled in the study. Established testing comprised enzyme immunoassay/immunofluorescence antigen testing (EIA/IF) for C. trachomatis and microscopy and/or culture for N. gonorrhoeae on urethral swabs. Positive test results were confirmed using a set of criteria that included supplemental PCR testing and clinical history. Overall, 13.7% of patients were resolved as positive for C. trachomatis and 52.1% as positive for N. gonorrhoeae. The sensitivity and specificity of the Amplicor CT/NG PCR on male urine specimens for C. trachomatis were 80.0% (8/10) and 95.2% (60/63), compared with 60.0% (6/10) and 100.0% (63/63) for EIA/IF on urethral swabs. For N. gonorrhoeae, the sensitivity and specificity of the Amplicor CT/NG PCR on male urine specimens were both 100% (38/38 and 35/35, respectively) compared with 86.8% (33/38) and 100% (35/35) for microscopy and/or culture on urethral swabs. The results of this study indicate that the Amplicor CT/NG multiplex PCR test for C. trachomatis and N. gonorrhoeae performed on urine in males provides a highly sensitive, specific, and robust method for the diagnosis of both C. trachomatis and N. gonorrhoeae, for the early detection of both symptomatic and asymptomatic infected individuals.     

弗氏枸橼酸杆菌TaqMan实时荧光定量-聚合酶链反应检测方法的建立

目的 建立针对弗氏枸橼酸杆菌的TaqMan实时荧光定量-聚合酶链反应(real time-PCR)检测方法。 方法 针对弗氏枸橼酸杆菌的特有序列设计引物和TaqMan探针,扩增目的基因建立标准曲线,确定检测方法的灵敏度;对20种其他肠道致病菌及院内感染中常见的致病菌进行检测,评价该检测方法的特异性;使用牛奶模拟标本评价方法在实际检测工作中应用性。 结果 TaqMan real time-PCR检测方法对弗氏枸橼酸杆菌重组质粒的检测灵敏度为1.0101拷贝／反应体系;该检测方法在检测30种其他肠道致病菌及院内感染中常见的致病菌时未出现特异性扩增。该检测方法对牛奶模拟样本中弗氏枸橼酸杆菌检测下限为1.0102cfu/ml的菌量;通过对1.0107、1.0105和1.0103三个浓度质粒标准品的重复检测,确定本方法的组内变异系数为1.90%~3.91%;组间变异系数为1.52%~1.69%。 结论 本研究建立的TaqMan real time-PCR检测方法可作为检测弗氏枸橼酸杆菌灵敏、特异、快速的方法。     

Evaluation of the cobas 4800 CT/NG Test for detecting Chlamydia trachomatis and Neisseria gonorrhoeae DNA in urogenital swabs and urine specimens

We have evaluated 696 samples (488 swabs and 208 urine specimens) with the cobas 4800 (c4800) CT/NG Test for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae DNA in swab and urine specimens. c4800 results were compared with those obtained from COBAS AMPLICOR (CAM) CT/NG Test. Discordant results were reanalyzed with the MultiNA system and compared with clinical data. For C. trachomatis detection by both methods, we obtained 93.8%, 100%, 100%, and 99.1% for sensitivity, specificity, and positive and negative predictive values, respectively. For urine specimens analyzed in c4800, our results were 96.6%, 100%, 100%, and 99.4%, respectively. For N. gonorrhoeae detection, swab results were:88.0%, 100%, 100%, and 99.4%. For urine specimen, results obtained were 100%, 100%, 100%, and 100%. Reanalyses were all concordant between both methods. c4800 results were comparable with those obtained with the CAM system. We had an excellent correlation between swab and urine specimens analyzed by c4800.     

微板核酸杂交-酶联显色检测性病沙眼衣原体DNA

目的 建立微板核酸杂交—ELISA方法，检测性病沙眼衣原体。方法 采用PCR、核酸杂交和ELISA三大生物技术相结合，建立微板核酸杂交ELISA法，并用此法分别同McCoy细胞培养和免疫学方法检测307份性传播疾病标本进行比较。结果 微板核酸杂交—ELISA法检测的阳性率为40．39％(122／307)，高于细胞培养的9.77％(30／307)和免疫诊断的12．05％(37／307)。结论 微板核酸杂交—ELISA技术检测性病沙眼衣原体灵敏度高、特异性好、简便快速。因此，该方法具有很强的实用价值和发展前景。     

逆转录-环介导等温扩增快速检测EV71病毒

目的建立一种检测肠道病毒71型（EV71）快速、敏感的一步逆转录-环介导等温扩增（RT-LAMP）方法。方法针对EV71病毒VP2基因特异性序列的6个区域设计4条LAMP引物,建立RT-LAMP检测方法,并评价其特异性和灵敏度。结果通过GoldView染色和凝胶电泳均能观察到LAMP扩增产物的存在,且与柯萨奇病毒A16型（CA16）无交叉反应发生。所建立的RT-LAMP检测方法灵敏,最低检测限为1.0×102copies/mL。RT-LAMP检测的41份咽拭子标本中有27份出现EV71阳性反应,与荧光定量PCR结果一致。结论 RT-LAMP是一种快速、敏感、特异、准确的方法,适合用于基层医疗机构临床检测。     

空肠弯曲菌 TaqMan-MGB双重探针实时荧光定量 PCR快速检测

目的　开发一种特异、灵敏的TaqMan MGB 双重探针实时荧光定量PCR 方法,用于空肠弯曲菌的快速定量检 测。方法　针对空肠弯曲菌鞭毛蛋白A 和马尿酸酶基因设计特异性引物和探针,建立一种新型TaqMan-MGB 双重探针 实时荧光定量PCR 检测空肠弯曲菌方法,对该方法的定量检测线性范围、特异度、灵敏度、重复性、稳定性进行评价, 应用该方法对临床标本中的空肠弯曲菌进行检测,同时用细菌培养、普通PCR、基因克隆和测序鉴定。结果　建立的 空肠弯曲菌TaqMan MGB 双重探针实时荧光定量PCR 检测方法专属性强,能准确检出空肠弯曲菌,而与其他细菌无交 叉反应,特异度为100%。该技术灵敏度高,能精确定量检测空肠弯曲菌DNA 线性范围达10 个数量级,最低检测限为 4 个菌落形成单位。重复性和稳定性良好,组内和组间相对标准偏差均小于1%。应用该方法成功从78 例临床标本中定 量检出28 例空肠弯曲菌阳性标本,用普通PCR 和基因克隆测序分析确认,细菌培养方法仅获得6 株存活的空肠弯曲菌。 结论　TaqMan MGB 双重探针实时荧光定量PCR 具有快速简便、可靠稳定、特异灵敏的优点,可用于临床标本中空肠 弯曲菌定量检测,值得推广应用。     

Isolation and detection of Borrelia burgdorferi DNA from cerebral spinal fluid,synovial fluid,blood, urine,and ticks using the Roche MagNA Pure system and real-time PCR

The Roche MagNA Pure automated nucleic acid extraction system was tested for its ability to extract Borrelia burgdorferi DNA from a diverse set of spiked specimen types including blood, cerebral spinal fluid, synovial fluid, urine and ticks. A method comparison between MagNA Pure automated extraction and manual extraction, using either QIAamp columns or phenol/chloroform extraction, showed equivalent detection sensitivities for all methodologies with all specimen types (except for urine, in which case QIAamp extraction was twofold less sensitive). Eighty positive clinical specimens (as determined by an independent testing method), including 76 synovial fluid, and 4 cerebral spinal fluid specimens, were found to be positive by the MagNA Pure/real-time PCR method of extraction and detection. This data shows that the MagNA Pure system can be used to extract B. burgdorferi DNA from clinical specimens, and when combined with real-time PCR, the result is an extremely sensitive assay with limited hands on time and rapid turn around times.     

Detection of Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella spp. in clinical specimens using a single-tube multiplex real-time PCR assay

A multiplex real-time PCR assay for the detection of Mycoplasma pneumoniae (MP181), Chlamydia (Chlamydophila) pneumoniae (CP-Arg), Legionella spp. (Pan-Leg), and the human RNase P (RNase P) gene was developed for rapid testing of atypical bacterial respiratory pathogens in clinical specimens. This method uses 4 distinct hydrolysis probes to detect 3 leading causes of community-acquired pneumonia. The assay was evaluated for specificity and sensitivity by testing against 35 related organisms, a dilution series of each specific target and 197 clinical specimens. Specificity testing demonstrated no cross-reactivity. A comparison to previously validated singleplex real-time PCR assays for each agent was also performed. The analytical sensitivity for specific pathogen targets in both the singleplex and multiplex was identical (50 fg), while efficiencies ranged from 82% to 97% for the singleplex assays and from 90% to 100% for the multiplex assay. The clinical sensitivity of the multiplex assay was improved for the Pan-Leg and CP-Arg targets when compared to the singleplex. The MP181 assay displayed equivalent performance. This multiplex assay provides an overall improvement in the diagnostic capability for these agents by demonstrating a sensitive, high-throughput and rapid method. This procedure may allow for a practical and efficient means to test respiratory clinical specimens for atypical pneumonia agents in health care settings and facilitate an appropriate public health response to outbreaks.     

Diagnostic value of PCR for detection of Borrelia burgdorferi DNA in clinical specimens from patients with erythema migrans and Lyme neuroborreliosis.

BACKGROUND: The aim of the study is to evaluate the diagnostic sensitivity of a 16S ribosomal RNA-based PCR on clinical specimens from patients with erythema migrans (EM) and neuroborreliosis and to compare the sensitivities with those obtained by in vitro culture and serological testing. A semiquantitative detection system, representing the input amount of specific DNA and thus the density of spirochetes in clinical specimens, indicated the preferred clinical sample to obtain for PCR testing. METHODS AND RESULTS: Skin biopsy and urine samples from 31 patients with EM and cerebrospinal fluid (CSF) and urine samples from 30 patients with neuroborreliosis were investigated. Borrelia burgdorferi DNA was detected in 71% of the skin biopsy specimens and 13% of the urine samples from patients with EM. Forty-one percent of the patients with EM were found to have B burgdorferi-specific antibodies in serum, and B burgdorferi was cultured in 29% of the EM specimens. For patients with neuroborreliosis, the diagnostic sensitivities in CSF and urine samples were 17% and 7%, respectively. Specific intrathecal antibody production was found in 90% of the patients, and 87% showed elevated B burgdorferi antibodies in serum. In general, PCR of skin biopsy samples yielded very high amounts of amplicons versus low amounts for CSF and urine samples. CONCLUSIONS: PCR of skin biopsy specimens is currently the most sensitive and specific test for the diagnosis of patients with EM, superior to culture and serological testing. For B burgdorferi-specific CSF disgnosis in patients with neuroborreliosis, the measurement of specific intrathecal antibody synthesis is superior to PCR. However, in patients with a short duration of disease (<14 days), PCR may be a useful diagnostic supplement. PCR of urine samples cannot be recommended at the present time for routine diagnosis of patients with EM or neuroborreliosis.     

Evaluation of a real-time fluorescent PCR assay for rapid detection of Group B Streptococci in neonatal blood

Streptococcus agalactiae (Group B Streptococcus: GBS) is the major causative agent of neonatal sepsis. Neonates at risk for GBS infections are empirically administered broad-spectrum antibiotics for at least 48 h pending blood culture results. A rapid assay to expedite detection of GBS would facilitate initiation of specific antibiotic therapy. Conversely, expeditious proof of absence of infection will avoid unnecessary antibiotic use. Using the LightCycler, we evaluated a hybridization probe polymerase chain reaction (PCR) assay to detect GBS-specific cfb gene target DNA sequence in blood specimens. Both sensitivity and specificity of the real-time PCR assay was 100%. The assay demonstrated 100% specificity when tested against 26 non-GBS bacteria. This method is capable of detecting as few as approximately 100 copies or 10 pg of GBS genomic DNA. This real-time PCR method is rapid, sensitive, and specific for the detection of GBS in neonatal blood samples and holds great promise in its utility in the diagnostic laboratory.     

Identification of diarrheagenic Escherichia coli by a new multiplex PCR assay and capillary electrophoresis

Diarrheagenic Escherichia coli (DEC) is a set of the most common pathogens causing diarrhea. DEC strains are classified into five pathotypes based on the possession of different virulence genes: enteropathogenic E. coli (EPEC), enterohemorrhagic E. coli (EHEC) or Shiga toxin-producing E. coli (STEC), enteroaggregative E. coli (EAEC), enterotoxigenic E. coli (ETEC), and enteroinvasive E. coli (EIEC). The development of an easy-to-use method to detect the specific virulence genes and distinguish the pathotypes is essential for the diagnosis and surveillance of DEC infections. In this study, a multiplex PCR assay (mPCR) specific to nine virulence genes and an internal control was designed for the identification of five DEC pathotypes. A temperature switch PCR (TSP) strategy was used in the PCR amplification. The PCR products were detected by capillary electrophoresis. The limit of detection (LOD) of the 10-plex reaction was 5 × 10³ copies/reaction for stx2 and 5 × 10² copies/reaction for the other targets. The mPCR showed very high specificity, and inclusivity and exclusivity were both 100%. When the mPCR assay was used for the detection of 221 cryopreserved diarrhea specimens, DEC colonies were detected from 49 specimens, and the positive rate was 22.2%. The mPCR assay was sensitive and specific, and the amplified product could be analyzed easily. Thus, this method could be used effectively to identify the suspected colonies of DEC in the primary culture of the specimen.     

荧光定量PCR方法检测儿童下呼吸道感染的人博卡病毒

目的建立并应用检测儿童下呼吸道感染病人博卡病毒的荧光定量PCR方法。方法选择人博卡病毒的NS1基因作为目标基因,设计荧光定量PCR引物和检测探针,以重组质粒为标准品建立标准曲线,从而建立特异性检测人博卡病毒的荧光定量PCR方法,并对该方法的特异性、灵敏度、重复性进行评价;应用该方法对下呼吸道感染患儿的痰或吸痰、咽拭子及血清标本进行定量检测。结果本研究以人博卡病毒NS1基因中85bp的特异性保守片段为目标基因建立荧光定量PCR检测方法,质粒标准曲线的相关系数为0.999,灵敏度可达到50拷贝;应用该方法对下呼吸道感染患儿的痰或吸痰、咽拭子和血清标本进行定量检测,在176例痰或吸痰标本中检测到7例阳性标本,阳性率达到3.98%(7/176),另64例咽拭子标本中未检测到阳性标本,总阳性率为2.92%(7/240),240例血清标本均未检测到阳性标本。结论建立的荧光定量PCR方法可以特异、快速、灵敏地对儿童下呼吸道感染的人博卡病毒进行定量检测。痰或吸痰标本较咽拭子或血清标本更适用于人博卡病毒感染的核酸检测。     

VIDAS CHL检测泌尿生殖道沙眼衣原体感染

目的 探讨VIDAS CHL法用于性病患者尿道拭子标本以及男性首段尿（FCU）标本沙眼衣原体（CT)检测的可行性。方法 使用组织培养法（TC）、VIDAS CHL检测法和聚合酶链反应（PCR）平行检测男性和女性拭子标本中CT，以组织培养为金标准，对VIDAS CHL和PCR进行评价。结果 232例男性标本TC阳性49例；VIDAS CHL和PCR法用于男性尿道拭子标本的敏感性分别为95.9%、93.9%，特异性分别为95.6%、94．5％，差异无显著性；VIDAS CHL法用于男性FCU的敏感性和特异性分别为85．7％和96．7％，与拭子标本作自身配对比较，检测结果无差异。151例女性拭子标本，TC法阳性23例，VIDAS CHL和PCR法的敏感性分别为100％和95．7％，特异性分别为96.1%、93.8%，差异无显著性。结论 VIDAS CHL法用于性病患者男性和女性拭子标本的CT检测，具有很高的敏感性和特异性，用于男性患者FCU的CT检测也是可行的；对于CT阳性率较高的性病人群，VIDAS CHL可以不做阻抑证实试验。