Multiplex real-time PCR assay for detection of pathogenic Vibrio parahaemolyticus strains

Foodborne disease caused by pathogenic Vibrio parahaemolyticus has become a serious public health problem in many countries. Rapid diagnosis and the identification of pathogenic V. parahaemolyticus are very important in the context of public health. In this study, an EvaGreen-based multiplex real-time PCR assay was established for the detection of pathogenic V. parahaemolyticus. This assay targeted three genetic markers of V. parahaemolyticus (species-specific gene toxR and virulence genes tdh and trh). The assay could unambiguously identify pathogenic V. parahaemolyticus with a minimum detection limit of 1.4 pg genomic DNA per reaction (concentration giving a positive multiplex real-time PCR result in 95% of samples). The specificity of the assay was evaluated using 72 strains of V. parahaemolyticus and other bacteria. A validation of the assay with clinical samples confirmed its sensitivity and specificity. Our data suggest the newly established multiplex real-time PCR assay is practical, cost-effective, specific, sensitive and capable of high-throughput detection of pathogenic V. parahaemolyticus.     

基于多重PCR的副溶血弧菌大流行菌群及其毒力基因检测方法的建立与评价

目的 基于多重聚合酶链反应（PCR）建立一种快速方便的检测副溶血弧菌大流行菌群及其毒力基因的方法。方法 结合副溶血弧菌大流行菌群的群特异鉴定方法GS-PCR,与副溶血弧菌致病相关的耐热直接溶血素基因（tdh）和耐热直接溶血素相关溶血素基因（trh）序列设计引物,建立并优化多重PCR检测方法。用已知的大流行菌株和非大流行临床分离株,对其进行特异性、灵敏度等性能的评价。并对224株食品分离株和3株临床分离株副溶血弧菌进行了再鉴定。结果 副溶血弧菌大流行菌群有群特异PCR标识基因和tdh扩增条带。而其他细菌扩增结果呈阴性。检测灵敏度可达到105 CFU/ml。对实验室保存的224株食品分离株和3株临床分离株进行再鉴定表明,其中5株为副溶血弧菌大流行菌群,其中3株为tdh阳性、trh阴性,2株tdh、trh均阴性。结论 本研究所建立的多重PCR方法特异性好、灵敏度高。为副溶血弧菌大流行菌群及其毒力基因的快速大规模检测提供良好的技术支持。     

Evaluation of a multiplex PCR assay for simultaneous detection of bacterial and viral enteropathogens in stool samples of paediatric patients

We evaluated a multiplex PCR assay, the Seeplex Diarrhoea ACE detection, that simultaneously detects 15 enteric pathogens, including Salmonella spp., Shigella spp., Vibrio spp., toxin B producer Clostridium difficile, Campylobacter spp., Clostridium perfringens, Yersinia enterocolitica, Aeromonas spp., Escherichia coli O157:H7, verocytotoxin-producing Escherichia coli, adenovirus, Group A rotavirus, norovirus GI and GII, and astrovirus. We compared this assay with clinical methods routinely used in our laboratory, for detecting enteropathogens in stool samples collected from 245 paediatric patients with suspected infectious gastroenteritis. We recovered 61 bacterial pathogens and 121 enteric viruses with our laboratory assays, while we detected 78 bacteria and 167 viruses with the molecular assay. We calculated specificity and sensitivity for both methods after analysis of discordant results and demonstrated greater sensitivity for multiplex PCR than for our routine methods, with the exception of Salmonella spp. and toxigenic C. difficile detection. The multiplex PCR assay proved to be a reliable tool to directly detect the most common enteropathogens in stool samples but with some limitations.     

多重PCR快速检测3种食源性致病菌

目的建立一种能同时检测金黄色葡萄球菌、产单核李斯特菌和沙门菌3种致病菌的多重PCR检测方法。方法采用LB培养液对金黄色葡萄球菌、产单核李斯特菌和沙门菌标准菌株进行增菌。根据金黄色葡萄球菌的nuc基因、产单核李斯特氏菌的hlvA基因、沙门氏菌的invA基因设计引物,通过多重聚合酶链反应（PCR）对上述3种食源性致病菌的目的基因进行扩增,同时对反应体系进行优化。结果对平均浓度为5cfu／ml的金黄色葡萄球菌、产单核李斯特菌和沙门氏菌在LB培养液中进行8h振荡培养,可以检出阳性结果;把金黄色葡萄球菌、产单核李斯特菌、沙门菌、志贺菌、蜡样芽孢杆菌、大肠埃希菌0157、阪崎肠杆菌7种菌混合在一起提取混合基因组DNA进行PCR扩增,显示出很好的特异性结果。结论建立的多重PCR检测方法适用于金黄色葡萄球菌、产单核李斯特菌和沙门菌的快速检测,具有快速、简便、灵敏的特点,可广泛应用于食品卫生检测、食物中毒应急处理和临床检验等领域。     

类志贺邻单胞菌实时荧光TaqMan PCR快速检测体系的建立

目的建立针对类志贺邻单胞菌的高灵敏、高特异的实时荧光TaqMan聚合酶链式反应(PCR)快速检测体系。方法根据类志贺邻单胞菌23S rRNA基因的一段特异性序列设计引物及TaqMan探针,利用实时荧光PCR检测平台探讨该检测体系的灵敏度;用30种其他肠道致病菌及院内感染中常见的致病菌评价该检测体系的特异性。结果实时荧光TaqMan PCR快速检测体系对类志贺邻单胞菌重组质粒的检测灵敏度为1×102拷贝/反应体系;对类志贺邻单胞菌基因组的检测灵敏度为3×10-2pg/反应体系;该检测体系在检测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,整个反应在2 h内完成。结论本研究建立的实时荧光TaqMan PCR检测体系可作为类志贺邻单胞菌灵敏、特异、快速的检测方法。     

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.     

Rapid and specific identification of 5 human pathogenic Vibrio species by multiplex polymerase chain reaction targeted to dnaJ gene

A multiplex polymerase chain reaction (PCR) method, specifically designed for application in routine diagnostic laboratories, was developed for identifying 5 human pathogen Vibrio species: Vibrio cholerae, Vibrio parahaemolyticus, Vibrio vulnificus, Vibrio mimicus, and Vibrio alginolyticus. This assay directed toward the dnaJ gene was tested on a total of 355 strains representing 13 Vibrio species and 17 non-Vibrio species. Specific PCR fragments were produced in isolates belonging to the 5 target species and were absent from all strains other than these 5 species and non-Vibrio strains, indicating a high specificity of this multiplex PCR. The multiplex PCR for the detection of Vibrio pathogens in clinical specimens was experimentally applied to spiked stool samples. Only 1 specific amplicon was observed, corresponding to the pathogen spiked into the stool sample. The detection limitation was 10(5) to 10(6) cells per milliliter stool. Our data showed that this method represented a robust tool for the specific and rapid detection of the 5 major pathogenic Vibrio species.     

空肠弯曲菌、单增李斯特菌和大肠杆菌O157多重PCR分子检测研究

目的建立同时检测空肠弯曲菌、单核细胞增生性李斯特菌（简称单增李斯特菌）和大肠杆菌O157的多重聚合酶链反应（PCR）检测技术。方法根椐空肠弯曲菌mapA基因序列、单增李斯特菌的编码溶血素（hly）基因序列和大肠杆菌的O157抗原（rfbE）基因序列,分别设计了3对特异引物,PCR扩增的目的基因片段为589 bp、360 bp和194bp;并对反应条件进行了优化。结果对3种致病菌检测,多重PCR检测DNA的敏感度分别为空肠弯曲菌2.264 ng、单增李斯特菌37.92 ng、大肠杆菌2.100 ng,样品检测时间6-8 h。结论该方法操作简便,检测周期短,特异性和敏感度高,为同时检测污染样品中空肠弯曲菌、单增李斯特菌和大肠杆菌O157奠定了基础。     

Prevalence of antimicrobial-resistant Cutibacterium isolates and development of multiplex PCR method for Cutibacterium species identification

IntroductionCutibacterium species such as C. acnes, C. avidum, and C. granulosum are known anaerobic skin inhabitants and often cause surgical site infections. These species are genetically similar and are difficult to identify rapidly. In addition, their pathogenicity and antimicrobial resistance remain unknown. In this study, antimicrobial resistance in Cutibacterium isolates was studied and a multiplex PCR method for their identification was developed.MethodsA total of 497 C. acnes, 71 C. avidum, and 25 C. granulosum strains which were isolated from the acne pustule and infectious regions, were used.ResultsThe antimicrobial resistance rates of C. acnes, C. avidum, and C. granulosum strains isolated from patients with acne vulgaris were higher than those of strains isolated from patients with infectious diseases. In particular, macrolide-clindamycin-resistant strains were isolated most frequently from all species. Among the resistant strains, strains with 23S rRNA mutations were the most common in C. acnes (24.3%, 71/292), whereas C. avidum and C. granulosum strains were most frequently found with erm(X). For the first time, a C. granulosum strain carrying pTZC1, which codes erm(50) and tet(W), was isolated from patients with acne vulgaris. Regarding the rapid identification of causative pathogens from infectious regions, three Cutibacterium species were identified with 100% sensitivity and specificity using multiplex PCR method.ConclusionsOur data showed that antimicrobial resistance differed among Cutibacterium species. The multiplex PCR method may contribute to the rapid detection of Cutibacterium species and selection of appropriate antimicrobial agents.     

空肠弯曲菌、单增李斯特菌和大肠杆菌O157多重PCR分子检测研究

目的建立同时检测空肠弯曲菌、单核细胞增生性李斯特菌(简称单增李斯特菌)和大肠杆菌O157的多重聚合酶链反应(PCR)检测技术。方法根椐空肠弯曲菌mapA基因序列、单增李斯特菌的编码溶血素(hly)基因序列和大肠杆菌的O157抗原(rfbE)基因序列,分别设计了3对特异引物,PCR扩增的目的基因片段为589 bp、360 bp和194bp;并对反应条件进行了优化。结果对3种致病菌检测,多重PCR检测DNA的敏感度分别为空肠弯曲菌2.264 ng、单增李斯特菌37.92 ng、大肠杆菌2.100 ng,样品检测时间6~8 h。结论该方法操作简便,检测周期短,特异性和敏感度高,为同时检测污染样品中空肠弯曲菌、单增李斯特菌和大肠杆菌O157奠定了基础。     

Novel universal primer-pentaplex PCR assay based on chimeric primers for simultaneous detection of five common pig viruses associated with diarrhea

Viral pathogens associated with diarrhea in pigs include porcine circovirus 2 (PCV2), porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine rotavirus A (RVA) and C (RVC) among others. In this study, a novel universal primer-based pentaplex PCR (UP-M-PCR) assay was developed for simultaneous detection and differentiation of these five viruses. The assay uses a short-cycle multiplex amplification by chimeric primers (CP), which are virus specific, with a tail added at the 5′ end of the universal primer (UP), followed by universal amplification using UPs and a regular cycle amplification. Five universal primers with CPs (UP1-5) were designed and evaluated in an UP-based single PCR (UP–S-PCR). All five UPs were found to work efficiently and UP2 exhibited the best performance. After system optimizations, the analytical sensitivity of the UP-M-PCR, using plasmids containing the specific viral target fragments, was 5 copies/reaction for each of the five viruses irrespective of presence of a single or multiple viruses in the reaction. No cross-reaction was observed with other non-target viruses. When 273 fecal samples from clinically healthy pigs were tested, the assay sensitivity was 90.9–100%, the specificity was 98.0–100%, and the agreement rate with the UP-S-PCR was 98.5–99.6% with a Kappa value being 0.95–0.98. In summary, the UP-M-PCR developed here is a rapid and highly sensitive and specific detection method that can be used to demonstrate mixed infections in pigs with diarrhea.     

Multiplex PCR for the detection and differentiation of Vibrio parahaemolyticus strains using the groEL,tdh and trh genes

Vibrio parahaemolyticus is a significant cause of human gastrointestinal disorders worldwide, transmitted primarily by ingestion of raw or undercooked contaminated seafood. In this study, a multiplex PCR assay for the detection and differentiation of V. parahaemolyticus strains was developed using primer sets for a species-specific marker, groEL, and two virulence markers, tdh and trh.Multiplex PCR conditions were standardised, and extracted genomic DNA of 70 V. parahaemolyticus strains was used for identification. The sensitivity and efficacy of this method were validated using artificially inoculated shellfish and seawater. The expected sizes of amplicons were 510 bp, 382 bp, and 171 bp for groEL, tdh and trh, respectively. PCR products were sufficiently different in size, and the detection limits of the multiplex PCR for groEL, tdh and trh were each 200 pg DNA. Specific detection and differentiation of virulent from non-virulent strains in shellfish homogenates and seawater was also possible after artificial inoculation with various V. parahaemolyticus strains.This newly developed multiplex PCR is a rapid assay for detection and differentiation of pathogenic V. parahaemolyticus strains, and could be used to prevent disease outbreaks and protect public health by helping the seafood industry maintain a safe shellfish supply.     

多重PCR/反向线点杂交检测B族溶血性链球菌耐药相关基因的研究

目的建立和评价多重PCR一反向线点杂交方法（multiplex PCR／reverse line blot hybridization，mPCR／RLS）检测B族溶血性链球菌（GBS）9个耐药及耐药相关基因[erm（A／TR）、erm（B）、mef（A／E）、tet（M）、tet（O）、aphA-3、aad-6、int-Tn和mreA]的方法。方法针对GBS的9个耐药及耐药相关基因分别设计9对引物及寡核苷酸探针。多重PCR同时扩增9个目的基因，获得生物素标记的PCR产物后，反向线点杂交同时检测上述9个基因。为明确mPCR／RLB方法的特异性和敏感性，对其中318株菌株的9个基因分别进行单个基因PCR扩增，比较两种检测方法结果。结果用mPCR／RLB方法成功检测512株GBS分离株的9个耐药相关基因，除8株int-Tn和21株mef单个基因PCR阳性的菌株，RLB结果表现为单探针杂交外，其余菌株所有耐药基因Iu卫检测结果和单个基因PCR完全一致。结论我们建立的多重PCR／RLB方法具有良好的敏感性和特异性，为GBS耐药基因的流行病学调查和监控提供了一个良好的检测工具。     

Multiplex PCR assay for identification of three major pathogenic Vibrio spp., Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus

A multiplex PCR assay was developed based on atpA-sequence diversification for molecular identification of 3 major pathogenic Vibrio species: Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus. It specifically identified them from among 133 strains of various Vibrio species and other genera, and was applicable for testing seawater, suggesting its usefulness.     

A multiplex PCR/LDR assay for simultaneous detection and identification of the NIAID category B bacterial food and water-borne pathogens

Enteric pathogens that cause gastroenteritis remain a major global health concern. The goal of this study was to develop a multiplex PCR/ligation detection reaction (LDR) assay for the detection of all NIAID category B bacterial food and water-borne pathogens directly from stool specimens. To validate the PCR/LDR assay, clinical isolates of Campylobacter spp., Vibrio spp., Shigella spp., Salmonella spp., Listeria monocytogenes, Yersinia enterocolitica, and diarrheagenic Escherichia coli were tested. The sensitivity and specificity of the assay were assessed using a large number of seeded culture-negative stool specimens and a smaller set of clinical specimens from Haiti. The overall sensitivity ranged from 91% to 100% (median 100%) depending on the species. For the majority of organisms, the sensitivity was 100%. The overall specificity based on initial testing ranged from 98% to 100% depending on the species. After additional testing of discordant samples, the lowest specificity was 99.4%. PCR/LDR detected additional category B agents (particularly diarrheagenic E. coli) in 11/40 specimens from Haiti that were culture-positive for V. cholerae and in approximately 1% of routine culture-negative stool specimens from a hospital in New York. This study demonstrated the ability of the PCR/LDR assay to detect a large comprehensive panel of category B enteric bacterial pathogens as well as mixed infections. This type of assay has the potential to provide earlier warnings of possible public health threats and more accurate surveillance of food and water-borne pathogens.     

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.     

Development of a multiplex TaqMan real-time PCR assay for the detection of Chlamydia psittaci and Chlamydia pneumoniae in human clinical specimens

Diagnosis of Chlamydia psittaci and Chlamydia pneumoniae infections has traditionally relied on serological assays. We developed a multiplex real-time PCR assay for detection of C. psittaci, C. pneumoniae and an internal control. Results of this assay demonstrated 100% concordance compared to results of previously tested human clinical specimens.     

A real-time multiplex PCR for the identification and typing of Vibrio cholerae

We report the development and validation of a duo-triplex real-time polymerase chain reaction (PCR) for the rapid identification and typing of Vibrio cholerae. The PCR assay targets a species-specific toxR gene present in all strains of V. cholerae and used as a marker for the species wbeO1 and wbfO139, encoding the O1 and O139 somatic antigens, and ctxA, encoding cholera toxin (CT). The two tcpA variants associated with the classical and El-Tor biotypes are used to infer biotype. The assay was evaluated using 178 isolates comprising eight different Vibrio species, including 122 isolates of V. cholerae. The PCR results of 171/178 (96.1%) isolates were concordant with the serotyping, biotyping, and expected CT results. Variants of toxR (n = 3), nonfunctional wbeO1 (n = 1), and CT-negative isolates of V. cholerae O1 (n = 3) were likely explanations for the mismatched results. This duo-triplex real-time PCR is a reproducible and robust assay for the rapid identification and typing of V. cholerae belonging to the highly pathogenic, pandemic lineages.     

Early diagnosis of Cryptococcus neoformans var. grubii meningitis using multiplex PCR assay in an immunocompetent patient

Cryptococcosis is an invasive fungal infection that mainly affects the lungs and central nervous system. While patients with cell-mediated immunodeficiency are at high risk of developing cryptococcosis, there have been increasing reports of cryptococcosis in immunocompetent individuals with no underlying conditions. Herein, we report a case of cryptococcal meningitis in a 55-year-old apparently immunocompetent man with a history of heavy alcohol consumption. Although the patient was initially treated for tuberculous meningitis and varicella-zoster virus induced vasculopathy due to a history of exposure to tuberculosis and a presence of stroke, a multiplex polymerase chain reaction (PCR) assay of cerebrospinal fluid (CSF) identified Cryptococcus species unexpectedly, enabling swift treatment and a favorable clinical outcome. The multiplex PCR assay, which can identify multiple pathogens simultaneously and instantly, may lead to early diagnosis and treatment by detecting unanticipated pathogens. Furthermore, the strain was identified through multilocus sequence typing (MLST) analysis as Cryptococcus neoformans var. grubii, Sequence Type 5, molecular type: VNI. Although simplified microbial identification techniques such as mass spectrometry have recently been developed, molecular biological assays are still essential for the accurate identification of infectious strains.