Development of conventional and real-time PCR assays for the rapid detection of group B streptococci

BACKGROUND: Group B streptococci (GBS), or Streptococcus agalactiae, are the leading bacterial cause of meningitis and bacterial sepsis in newborns. Currently available rapid methods to detect GBS from clinical specimens are unsuitable for replacement of culture methods, mainly because of their lack of sensitivity. METHODS: We have developed a PCR-based assay for the rapid detection of GBS. The cfb gene encoding the Christie-Atkins-Munch-Petersen (CAMP) factor was selected as the genetic target for the assay. The PCR primers were initially tested by a conventional PCR method followed by gel electrophoresis. The assay was then adapted for use with the LightCycler(TM). For this purpose, two fluorogenic adjacent hybridization probes complementary to the GBS-specific amplicon were designed and tested. In addition, a rapid sample-processing protocol was evaluated by colony-forming unit counting and PCR. A total of 15 vaginal samples were tested by both standard culture method and the two PCR assays. RESULTS: The conventional PCR assay was specific because it amplified only GBS DNA among 125 bacterial and fungal species tested, and was able to detect all 162 GBS isolates from various geographical areas. This PCR assay allowed detection of as few as one genome copy of GBS. The real-time PCR assay was comparable to conventional PCR assay in terms of sensitivity and specificity, but it was more rapid, requiring only approximately 30 min for amplification and computer-based data analysis. The presence of vaginal specimens had no detrimental effect on the sensitivity of the PCR with the sample preparation protocol used. All four GBS-positive samples identified by the standard culture method were detected by the two PCR assays. CONCLUSION: These assays provide promising tools for the rapid detection and identification of GBS.     

DNA degradation test predicts success in whole-genome amplification from diverse clinical samples

The need to apply modern technologies to analyze DNA from diverse clinical samples often stumbles on suboptimal sample quality. We developed a simple approach to assess DNA fragmentation in minute clinical samples of widely different origin and the likelihood of success of degradation-tolerant whole genome amplification (restriction and circularization-aided rolling circle amplification, RCA-RCA) and subsequent polymerase chain reaction (PCR). A multiplex PCR amplification of four glyceraldehyde-3-phosphate dehydrogenase amplicons of varying sizes was performed using genomic DNA from clinical samples, followed by size discrimination on agarose gel or fluorescent denaturing high-performance liquid chromatography (dHPLC). RCA-RCA followed by real-time PCR was also performed, for correlation. Even minimal quantities of longer PCR fragments ( approximately 300 to 400 bp), visible via high-sensitivity fluorescent dHPLC or agarose gel, were essential for the success of RCA-RCA and subsequent PCR-based assays. dHPLC gave a more accurate correlation between DNA fragmentation and sample quality than agarose gel electrophoresis. Multiplex-PCR-dHPLC predicted correctly the likelihood of assay success in formalin-fixed, paraffin-embedded samples fixed under controlled conditions and of different ages, in laser capture microdissection samples, in tissue print micropeels, and plasma-circulating DNA. Estimates of the percent information retained relative to snap-frozen DNA are derived for real-time PCR analysis. The assay is rapid and convenient and can be used widely to characterize DNA from any clinical sample of unknown quality.     

Single-run, parallel detection of DNA from three pneumonia-producing bacteria by real-time polymerase chain reaction

A molecular assay for parallel detection of three bacteria, Chlamydia (C.) pneumoniae, Legionella (L.) spp., and Mycoplasma (M.) pneumoniae, in clinical specimens by a set of real-time polymerase chain reactions (PCRs) in a single run was evaluated. Bacterial DNAs were extracted by an automated DNA extraction protocol on the MagNA Pure LC System. Amplification and detection were done by real-time PCR on the LightCycler (LC) instrument. For amplification, specific oligonucleotides derived from the 16s rRNA genes of C. pneumoniae, L. spp., and M. pneumoniae were used. The three assays were complemented with an internal control (IC), a specially designed DNA fragment which contains the specific primer binding sites for the three PCRs. The IC was added to the samples, co-extracted, and co-amplified. Primers and hybridization probes were designed to suit one LC PCR program. LC PCRs were established, detection limits were determined, and clinical samples were tested. The detection limits were found between 5.0 and 0.5 IFU/CFU per PCR reaction for each of the bacteria. A total number of 100 clinical specimens were tested for validation of the molecular assay. Tested samples included 63 bronchoalveolar lavages (BALs) and 37 induced sputa specimens. The internal control was detected in all negative and low-positive samples; no inhibition was found throughout the whole study. Additionally, samples underwent testing by culture for L. spp., and M. pneumoniae; for C. pneumoniae, the serological microimmunofluorescence (MIF) test was used. In conclusion, the developed set of LC PCR assays permits parallel detection of C. pneumoniae, L. spp., and M. pneumoniae in a single LC run. This molecular assay may lead to accurate and early diagnosis of pneumonia produced by these three types of bacteria. The assay proved to be suitable for the high-throughput routine diagnostic laboratory.     

应用TaqMan实时荧光-聚合酶链反应方法快速检测粪便标本空肠弯曲菌的研究

目的建立空肠弯曲菌TaqMan实时荧光-PCR方法,用于粪便标本的直接检测。方法根据空肠弯曲菌特异性基因hipO和mapA分别设计引物和探针,在对2组引物和探针进行灵敏度、特异性和重复性评价的基础上,对45例临床腹泻患者粪便标本提取DNA之后,荧光PCR检测,同时进行分离培养。 结果两组引物和探针能准确检测空肠弯曲菌菌株2株,检测限可达到10~20 cfu/ml,并与其他肠道致病菌无交叉反应。检测45份腹泻病例粪便标本,该方法检测到3份为阳性,同时进行的传统培养方法仅从该3份标本中的两份中分离到空肠弯曲菌。 结论本研究建立的TaqMan荧光PCR检测粪便标本中所携带的空肠弯曲菌灵敏度高,特异性好,能够提高粪便中空肠弯曲菌的阳性检出率和缩短检测时限。     

Survey of urine from transplant recipients for polyomaviruses JC and BK using the polymerase chain reaction.

Using polymerase chain reaction (PCR), we examined 108 urine specimens from 39 post transplant patients for polyomaviruses JC (JCV) and BK (BKV). Urine sediments were collected and subjected to 30 cycles of amplification. PCR products were resolved by agarose gel electrophoresis, transferred to nylon membranes by Southern blot, and hybridized with radiolabelled probes. Polyomavirus DNA was found in urine specimens from 17 out of 39 patients (44%). Both viruses were detected in specimens from nine patients, JCV alone in five, and BKV alone in three. In comparison, polyomavirus was detected in only five of 22 PCR positive specimens by shell vial cell culture assay. Our results show a high prevalence of polyomavirus shedding after transplantation and suggest a higher rate of JC viruria than previously reported.     

Improved diagnosis of porcine proliferative enteropathy caused by Lawsonia intracellularis using polymerase chain reaction-enzyme-linked oligosorbent assay (PCR-ELOSA)

Proliferative enteropathy (PE) caused by Lawsonia intracellularis is a major diarrheal disease affecting swine worldwide. Routine laboratory diagnosis of PE is done by amplification of L. intracellularis -specific DNA sequences by PCR followed by agarose gel electrophoresis and staining of PCR products with ethidium bromide. We report the development of an enzyme-linked oligosorbent assay (ELOSA) for specific identification of chromosomal L. intracellularis 328-bp PCR amplified products. The ELOSA involved determination of optical density value at 450 nm (OD(450)) after hybridization of biotin-labelled PCR products with an amine-modified internal oligonucleotide capture probe immobilized in microwell plates, and avidin-biotin-peroxidase complex. A positive ELOSA cut-off value of > or =0.375 was established using the mean OD(450)of negative control specimens plus three times the standard deviation. Using this value, the detection limit of PCR amplified L. intracellularis -specific products by ethidium bromide-stained agarose gel electrophoresis, Southern blot, and ELOSA were estimated to be 6.1 ng, between 0.8 and 3.0 ng, and 0.8 ng of DNA, respectively. Comparison of ethidium bromide-stained agarose gel analysis with ELOSA for detection of L. intracellularis -specific PCR products from 315 clinical specimens revealed 78% sensitivity, 100% specificity and 94% accuracy. The ELOSA produced a spectrophotometric signal that confirmed the authenticity of PCR products without subjective interpretation of ethidium bromide-stained PCR products after agarose gel electrophoresis.     

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。     

聚合酶链反应—增强化学发光检测结核分枝杆菌

目的 探讨微孔板杂交技术结合增强化学发光（ECL）检测结核分枝杆菌（MTB）。方法 同时应用聚合酶链反应（PCR）－ECL、PCR－比色法与PCR电泳检测60例活动性肺结核和54例健康对照痰标本，比较结果。结果 PCR－ECL、PCR－比色法与PCR电泳总阳性率分别为76.7%、63.3%、50.0%，其中PCR－ECL阳性率显著高于PCR电泳（P＜0.05)；对涂片阳性标本，阳性率分别为85.7%、85.7%、71.4%，差异无显著性（P＞0.05)；对涂片阴性标本，阳性率分别为73.9%、56.5%、43.5%，PCR－ECL阳性率高于PCR电泳（P＜0.05)。另外PCR－ECL、PCR－比色法与PCR电泳特异性分别为92.6%、96.3%、96.3%，差异无显著性（P＞0.05)。结论 PCR－ECL灵敏度高，能提高临床标本MTB检出率，尤其是对涂片阴性痰标本，并且该方法操作简单，结果客观。     

细菌革兰双检荧光定量PCR方法检测新生儿败血症

目的 建立细菌革兰阴、阳性菌双重实时荧光定量检测体系,探讨其检测败血症的临床应用价值.方法 分析细菌16SrRNA基因序列,在高度保守区自行设计通用引物和革兰阴性和阳性分型探针,选取临床较常见的35株菌株进行细菌革兰双检实时荧光定量PCR方法检测;对临床疑为败血症的512例新生患儿分别做细菌革兰双检荧光定量PCR和血培养检测.结果 细菌革兰双检荧光定量PCR具有较好的敏感性和特异性,能稳定检测到10 CFU左右细菌数.35株菌株进行细菌革兰双检荧光定量PCR检测,均为阳性,且革兰阴、阳性菌能正确分型和定量.巨细胞病毒、EB病毒、乙肝病毒、新型隐球菌及白色念珠菌、人基因组DNA及空白对照均为阴性.对临床疑为败血症的512份新生患儿标本中,革兰双检荧光定量PCR检测血标本阳性率8.20%(42/512),血培养阳性率6.25%(32/512),前者明显高于后者,差异具有统计学意义(χ<'2>=8.10,P<0.01),30例非感染性疾病同期患儿血标本革兰双检荧光定量PER及细菌培养均为阴性.若以血培养作为对照,细菌革兰双检荧光定量PCR方法的诊断敏感度为100%,特异度为97.92%,准确性98.05%.结论 建立了用通用引物和分型双荧光探针的细菌革兰双检荧光定量PER方法.其检测快速、准确,具有很大的临床推广价值.     

Detection of hepatitis B virus DNA using the polymerase chain reaction technique

The polymerase chain reaction (PCR) technique has been utilized for the detection of hepatitis B virus (HBV) DNA, and several factors related to the selection of primer pairs for the PCR amplification have been demonstrated. The sensitivity of the PCR assay was compared with that of slot-blot hybridization for detecting HBV-DNA. Analysis by the PCR technique with Southern blot hybridization provided a greater than 10(4)-fold increase in sensitivity over the slot-blot hybridization analysis. Also, a rapid and sensitive PCR method for the detection of serum HBV-DNA was developed: HBV-DNA is released from virions by incubating serum with NaOH followed by neutralization with HCl. HBV-DNA sequences are then detected by agarose gel electrophoresis and ethidium bromide staining after PCR amplification with successive sets of primer pairs. In testing serial samples from chimpanzees experimentally infected with HBV, HBV-DNA was detected 2-3 wk before the appearance of hepatitis surface antigen (HBsAg) and continued to be detectable for a short period after the production of antibody to HBsAg. Results from testing of human serum demonstrated that the majority of patients with HBsAg in serum had HBV-DNA as well and that some patients had HBV-DNA in serum in the absence of HBsAg.     

Genotyping of the 19-bp insertion/deletion polymorphism in the 5' flank of beta-hydroxylase gene by dissociation analysis of allele-specific PCR products.

The 19-bp insertion/deletion polymorphism in the 5' flank of the dopamine beta-hydroxylase (DBH) gene has been associated with psychiatric disorders. We have developed a simple, reliable and inexpensive closed-tube assay for genotyping of this polymorphism based upon T(m) determination of amplified DNA fragments. Mistyping of heterozygote samples due to preferential allele amplification was prevented by use of an optimized concentration of Mg(2+), addition of dimethyl sulfoxide and annealing/extension at an appropriate temperature. Comparison of results achieved by the closed-tube assay and a conventional approach based upon agarose gel electrophoresis of amplified fragments revealed complete concordance between the two procedures. The insights obtained in this study may be utilized to develop assays based upon dissociation analysis of PCR products for genotyping of other insertion/deletion polymorphisms.     

实时荧光定量-聚合酶链反应方法检测肺炎支原体

目的 建立一种快速、灵敏、特异的肺炎支原体实时荧光定量-聚合酶链反应(real-time PCR)检测方法,以期用于临床肺炎支原体感染检测。 方法 通过测序分析和序列比对,选取肺炎支原体p1基因中保守区域设计特异性引物和荧光探针,建立和完善此real-time PCR检测方法,并进行扩增效率、灵敏度及特异度评价。与已报道的肺炎支原体常规聚合酶链反应(PCR)方法进行150份临床标本检测能力比较。 结果 建立的real-time PCR方法对肺炎支原体的检测限约为10 cfu。使用该方法对9株肺炎支原体ATCC标准株和30株临床分离株核酸扩增均为阳性;对10种其他支原体、13种常见呼吸道病原菌染色体及人类染色体扩增结果均为阴性。同时,临床标本的检测结果显示该方法检测灵敏度优于常规PCR。 结论 本研究建立的real-time PCR方法可快速、灵敏、特异地检测标本中肺炎支原体核酸,可适用于临床肺炎支原体诊断。     

Sequence-specific identification of 18 pathogenic microorganisms using microarray technology

We have developed a Multi-Pathogen Identification (MPID) microarray for high confidence identification of eighteen pathogenic prokaryotes, eukaryotes and viruses. Analysis of amplified products from pathogen genomic DNA using microarray hybridization allows for highly specific and sensitive detection, and allows the discrimination between true amplification products and false positive amplification products that might be derived from primers annealing to non-target sequences. Species-specific primer sets were used to amplify multiple diagnostic regions unique to each individual pathogen. Amplified products were washed over the surface of the microarray, and labelled with phycoerythrin-streptavidin for fluorescence detection. A series of overlapping 20-mer oligonucleotide probes hybridize to the entire diagnostic region, while parallel hybridizations on the same surface allow simultaneous screening for all organisms. Comparison to probes that differ by a single mismatch at the central position reduced the contribution of non-specific hybridization. Samples containing individual pathogens were analyzed in separate experiments and the corresponding species-specific diagnostic regions were identified by fluorescence among their highly redundant probe sets. On average, 91% of the 53 660 pathogen probes on the MPID microarray performed as predicted. The limit of detection was found to be as little as 10 fg of B. anthracis DNA in samples that were amplified with six diagnostic primer-pairs. In contrast, PCR products were not observed at this concentration when identical samples were prepared and visualized by agarose gel electrophoresis.     

The use of real-time PCR and fluorogenic probes for rapid and accurate genotyping of newborn mice

Real-time PCR and fluorogenic probes were combined in a simple, rapid and sensitive method to genotype murine breeding stocks and their progeny for a point mutation. DNA from tail biopsies of newborn mice was mixed with amplification primers and fluorogenic hybridization probes in a PCR mixture. The primers were designed to amplify a region of the Fas-Ligand gene including the site for the gld natural point mutation. The fluorogenic hybridization probes overlaid this target sequence and were used to detect amplification of the PCR fragment as well as determine the presence of the point mutation using fluorescence resonance energy transfer (FRET). Both mutated and wild-type forms of the gene fragment were amplified as detected with real-time PCR. Melting curve profiles completed on each amplified sample revealed the genotype for each mouse. These genotypes were confirmed by sequencing the amplified fragments. These results suggest real-time spectrofluorometric PCR techniques incorporating FRET-based hybridization probes may be used for rapid, sensitive, inexpensive and reliable genotyping.     

Development of a PCR-based method coupled with a microplate colorimetric assay for the detection of Porcine Parvovirus and application to diagnosis in piglet tissues and human plasma

A new method for Porcine Parvovirus (PPV) diagnosis was developed. The method is based on polymerase chain reaction (PCR) amplification followed by hybridization and colorimetric detection of PCR products in microwell plates. A highly specific and sensitive amplification step was ensured by primers carefully selected in the VP2 structural gene and optimized PCR conditions. Uracyl-DNA-Glycosylase (UDG) in combination with dUTP was used to avoid false-positive results, and 100 copies of internal control (IC) were added to each PCR reaction to reveal any false-negative samples. Biotinylated amplified fragments were hybridized on specific capture probes covalently linked to microwell plates. Finally, the detection of hybridized PCR products was performed by means of a colorimetric reaction, which was automated. The method permitted the detection of 10³copies (6 fg) of replicative form DNA (RF-DNA) in 20 mg of lung sample, and 500 copies (3 fg) in 100μl of plasma. It was used to analyse 24 field piglet tissue samples, and 35 human plasma or serum specimens collected from patients treated with porcine Factor VIII concentrates.     

Real-time PCR for the rapid detection of vanA and vanB genes

A real-time PCR assay suitable for use on the Roche LightCycler platform was developed to replace an existing gel-based PCR assay for the simultaneous detection of the vanA & vanB genes in enterococcal isolates. Novel Fluorescence Resonance Energy Transfer (FRET) hybridization probes were designed. The multiplex real-time PCR assay and the existing gel-based assay were 100% concordant and both correctly detected the vanA or vanB genes in 4/4 VanA E. faecium and 25/25 VanB E. faecium. Additionally, 1/1 VanC1 E. gallinarum, 1/1 VanC2 E. casseliflavus and 47/47 vancomycin susceptible enterococci were negative for the vanA and vanB genes in both PCR assays. Results were available within 1.5 h for the real-time PCR assay compared to up to 5.5 h for the conventional PCR assay.     

PCR法扩增脲酶B基因在快速诊断幽门螺杆菌感染中的应用研究

应用基于幽门累杆菌脲酶Ｂ基因的引物建立了检测幽门螺杆菌的ＰＣＲ方法。５６例内窥镜胃组织标本中,细菌培养阳性３４份,ＰＣＲ阳性３６份;１７２份用自制采样器所取的胃粘液标本中,ＰＣＲ阳性１０６份,其中经组织培养ＨＰ阳性的３４例患者的胃粘标本ＰＣＲ阳性。研究结果提示,ＰＣＲ方法扩增酶基因检测幽螺杆菌具有快速、简便、准确的优点,在幽门螺杆菌感染的快速诊断、疗效观察、复发机理和流行病学调查研究中均有重要价值     

A simple method for diagnosing M. tuberculosis infection in clinical samples using PCR.

Species identification of Mycobacterium tuberculosis remains a cumbersome process. We have developed a simple method for treating clinical samples which permits direct polymerase chain reaction (PCR) amplification of mycobacterial target DNA without organic extraction. Samples were boiled for 30 min in TE-Triton, then were subjected to 30 cycles of amplification using primers derived from the repetitive clone pMTb4 developed by Patel and coworkers (1990; Journal of Clinical Microbiology 28, 513). Specificity of amplification was confirmed by hybridization with a specific probe labelled non-isotopically. In a model system consisting of cultured bacilli, this system routinely allows detection of a single organism in a sample. In preliminary studies examining applicability of this method to 96 clinical samples, 74 were positive by both PCR and mycobacterial culture, and eight were negative by both methods. Fourteen samples were negative by culture and positive by PCR, and none were positive by culture and negative by PCR. These results suggest that the PCR method may provide a sensitive alternative to conventional species-specific diagnostic methods, and that non-isotopic labelling can be used to detect hybridization in this assay.     

Detection of cytomegalovirus by dot-blot DNA hybridization using probes labelled with 32P by nick translation or random hexanucleotide priming

A DNA hybridization assay for the detection of human cytomegalovirus (HCMV) DNA was developed using random hexanucleotide-primed 32P-labelled Hind III restriction fragments of HCMV DNA as probes, and compared with a DNA hybridization assay using probes labelled with 32P by nick translation. Nick-translated probes were shown to be able to detect between 1 and 10 pg of homologous DNA or the DNA of 10-50 HCMV-infected fibroblasts. Random hexanucleotide-primed DNA probes lowered these detection limits to 0.1-0.5 pg of homologous DNA or one to five HCMV-infected fibroblasts. An increase in the autoradiographic exposure time from 18 h to 4 days increased the level of detection for homologous DNA or HCMV-infected fibroblast DNA by approximately five-fold. Preliminary screening of 35 urine samples by DNA hybridization using a random hexanucleotide-primed probe correctly identified three samples positive by virus isolation in tissue culture or immediate-early nuclear antigen detection and 29 of 32 samples negative by tissue culture.