1
|
Zhao X, Zeng Y, Yan B, Liu Y, Qian Y, Zhu A, Zhao Y, Zhang X, Zhang C, Wan Z. A novel extraction-free dual HiFi-LAMP assay for detection of methicillin-sensitive and methicillin-resistant Staphylococcus aureus. Microbiol Spectr 2024; 12:e0413323. [PMID: 38376361 PMCID: PMC10986577 DOI: 10.1128/spectrum.04133-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/26/2024] [Indexed: 02/21/2024] Open
Abstract
Staphylococcus aureus (S. aureus) is a leading cause of bacteremia and blood stream infections. Methicillin-resistant S. aureus (MRSA) that first appeared in 1961 often caused hospital-acquired infections (HAIs) and community-acquired infections (CAIs) and was associated with high mortality rate. Accurate and rapid point-of-care testing (POCT) of MRSA is crucial for clinical management and treatment of MRSA infections, as well as the prevention and control of HAIs and CAIs. Here, we reported a novel extraction-free dual HiFi-LAMP assay for discriminative detection of methicillin-susceptible S. aureus and MRSA. The dual HiFi-LAMP assay can detect 30 copies/reaction of nuc and mecA genes with detection limits of 147 and 158 copies per 25 µL reaction, respectively. A retrospective clinical evaluation with 107 clinical S. aureus isolates showed both sensitivity and specificity of 100%. A prospective clinical evaluation with 35 clinical samples revealed a specificity of 100% and a sensitivity of 92.3%. The dual HiFi-LAMP assay can detect almost all S. aureus samples (141/142; 99.3%) within 20 min, implying that the entire HiFi-LAMP assay (including sample process) can be completed within 40 min, extremely significantly shorter than 3-5 days by the traditional clinical microbial culture and antibiotic susceptibility testing. The novel extraction-free dual HiFi-LAMP assay can be used as a robust POCT tool to promote precise diagnosis and treatment of MRSA infections in hospitals and to facilitate surveillance of MRSA at hospital and community settings.IMPORTANCEMethicillin-resistant Staphylococcus aureus (MRSA) was associated with high mortality rate and listed as a "priority pathogen" by the World Health Organization. Accurate and rapid point-of-care testing (POCT) of MRSA is critically required for clinical management and treatment of MRSA infections. Some previous LAMP-based POCT assays for MRSA might be questionable due to their low specificity and the lack of appropriate evaluation directly using clinical samples. Furthermore, they are relatively tedious and time-consuming because they require DNA extraction and lack multiplex detection capacity. Here, we reported a novel extraction-free dual HiFi-LAMP assay for discriminative detection of MRSA and methicillin-susceptible S. aureus. The assay has high specificity and sensitivity and can be completed within 40 min. Clinical evaluation with real clinical samples and clinical isolates showed excellent performance with 100% specificity and 92.3%-100% sensitivity. The novel extraction-free assay may be a robust POCT tool to promote precise diagnosis of MRSA infections and facilitate surveillance of MRSA at hospital and community settings.
Collapse
Affiliation(s)
- Xiuli Zhao
- Medical Laboratory of Taizhou Fourth People’s Hospital, Taizhou, China
| | - Yi Zeng
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Beibei Yan
- Medical Laboratory of Taizhou Fourth People’s Hospital, Taizhou, China
| | - Yanping Liu
- Medical Laboratory of Taizhou Fourth People’s Hospital, Taizhou, China
| | - Yueqin Qian
- Medical Laboratory of Taizhou Fourth People’s Hospital, Taizhou, China
| | - Aiping Zhu
- Medical Laboratory of Taizhou Fourth People’s Hospital, Taizhou, China
| | - Yongjuan Zhao
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xiaoling Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Chiyu Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zhenzhou Wan
- Medical Laboratory of Taizhou Fourth People’s Hospital, Taizhou, China
| |
Collapse
|
2
|
Nan X, Yao X, Yang L, Cui Y. Lateral flow assay of pathogenic viruses and bacteria in healthcare. Analyst 2023; 148:4573-4590. [PMID: 37655501 DOI: 10.1039/d3an00719g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Healthcare-associated pathogenic viruses and bacteria can have a serious impact on human health and have attracted widespread global attention. The lateral flow assay is a unidirectional detection based on the binding of a target analyte and a bioreceptor on the device via lateral flow. With incredible advantages over traditional chromatographic methods, such as rapid detection, ease of manufacture and cost effectiveness, these test strips are increasingly considered the ideal form for point-of-care applications. This review explores lateral flow assays for pathogenic viruses and bacteria, with a particular focus on methodologies, device components, construction methods, and applications. We anticipate that this review could provide exciting opportunities for developing new lateral flow devices for pathogens and advance related healthcare applications.
Collapse
Affiliation(s)
- Xuanxu Nan
- School of Materials Science and Engineering, Peking University; First Hospital Interdisciplinary Research Center, Peking University, Beijing 100871, P.R. China.
| | - Xuesong Yao
- School of Materials Science and Engineering, Peking University; First Hospital Interdisciplinary Research Center, Peking University, Beijing 100871, P.R. China.
| | - Li Yang
- Peking University First Hospital; Peking University Institute of Nephrology, Beijing 100034, P. R. China.
| | - Yue Cui
- School of Materials Science and Engineering, Peking University; First Hospital Interdisciplinary Research Center, Peking University, Beijing 100871, P.R. China.
| |
Collapse
|
3
|
Long LJ, Lin M, Chen YR, Meng X, Cui TT, Li YP, Guo XG. Evaluation of the loop-mediated isothermal amplification assay for Staphylococcus aureus detection: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob 2022; 21:27. [PMID: 35751121 PMCID: PMC9233341 DOI: 10.1186/s12941-022-00522-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 06/06/2022] [Indexed: 12/14/2022] Open
Abstract
Background Staphylococcus aureus can cause many diseases and even death. It’s important to detect Staphylococcus aureus rapidly and reliably. The accuracy of a novel test named LAMP in detecting Staphylococcus aureus is unclear. Therefore, a systematic review and meta-analysis were conducted to evaluate the accuracy of the LAMP assay for Staphylococcus aureus detection. Methods Four databases were searched for relevant studies. Meta-DiSc 1.4.0 and Stata 12.0 were used for statistical analysis. At the same time, we used QUADAS-2 to assess the studies we included. Two groups of subgroup analysis were done to differentiate the diagnostic effects of various LAMP tests and in cases of different gold standards. Results 11 studies were identified and 19 2 × 2 contingency tables were extracted in our study. The results showed that both pooled sensitivity and specificity of the LAMP assay were 99% (95% CI 99–100). Conclusion The LAMP assay demonstrated high sensitivity and specificity in diagnosing Staphylococcus aureus. Supplementary Information The online version contains supplementary material available at 10.1186/s12941-022-00522-6.
Collapse
Affiliation(s)
- Li-Jun Long
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Medical Laboratory Technology, The King Med School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Min Lin
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Traditional Chinese and Western Medicine in Clinical Medicine, The Clinical School of Traditional Chinese and Western Medicine of Guangzhou Medical University, Guangzhou, 511436, China
| | - Yu-Ran Chen
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Medical Laboratory Technology, The King Med School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 511436, China
| | - Xin Meng
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Medical Imageology, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Ting-Ting Cui
- Department of Pediatrics, Pediatrics School, Guangzhou Medical University, Guangzhou, 511436, China
| | - Ya-Ping Li
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Department of Medical Imageology, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China. .,Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.
| |
Collapse
|
4
|
Tutorial: design and fabrication of nanoparticle-based lateral-flow immunoassays. Nat Protoc 2020; 15:3788-3816. [PMID: 33097926 DOI: 10.1038/s41596-020-0357-x] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 05/12/2020] [Indexed: 12/20/2022]
Abstract
Lateral-flow assays (LFAs) are quick, simple and cheap assays to analyze various samples at the point of care or in the field, making them one of the most widespread biosensors currently available. They have been successfully employed for the detection of a myriad of different targets (ranging from atoms up to whole cells) in all type of samples (including water, blood, foodstuff and environmental samples). Their operation relies on the capillary flow of the sample throughout a series of sequential pads, each with different functionalities aiming to generate a signal to indicate the absence/presence (and, in some cases, the concentration) of the analyte of interest. To have a user-friendly operation, their development requires the optimization of multiple, interconnected parameters that may overwhelm new developers. In this tutorial, we provide the readers with: (i) the basic knowledge to understand the principles governing an LFA and to take informed decisions during lateral flow strip design and fabrication, (ii) a roadmap for optimal LFA development independent of the specific application, (iii) a step-by-step example procedure for the assembly and operation of an LF strip for the detection of human IgG and (iv) an extensive troubleshooting section addressing the most frequent issues in designing, assembling and using LFAs. By changing only the receptors, the provided example procedure can easily be adapted for cost-efficient detection of a broad variety of targets.
Collapse
|
5
|
Direct detection of methicillin-resistant in Staphylococcus spp. in positive blood culture by isothermal recombinase polymerase amplification combined with lateral flow dipstick assay. World J Microbiol Biotechnol 2020; 36:162. [PMID: 32989593 DOI: 10.1007/s11274-020-02938-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/17/2020] [Indexed: 12/14/2022]
Abstract
Methicillin-resistant staphylococci (MRS) are important antimicrobial-resistant pathogens in sepsis. Conventional blood cultures take 24-72 h. The polymerase chain reaction (PCR)-based methods give faster results (2-3 h) but need expensive thermal cyclers. We therefore developed an isothermal recombinase polymerase amplification (RPA) combined with lateral flow dipstick (LFD) assay for rapid detection of MRS in spiked blood culture samples. Fifty-six clinical isolates including 38 mecA-carrying staphylococci and 18 non-mecA-carrying organisms as confirmed by PCR methods were studied. RPA primer set and probe specific for mecA gene (encoding penicillin-binding protein 2a) were designed. RPA reaction was carried out under isothermal condition (45 °C) within 20 min and read by LFD in 5 min. The RPA-LFD provided 92.1% (35/38) sensitivity for identifying MRS in positive blood culture samples, and no cross-amplification was found (100% specificity). This test failed to detect three mecA-carrying S.sciuri isolates. The detection limits of RPA-LFD method for identifying MRS were equal to those of PCR method. The RPA-LFD is simple, fast, and user-friendly. This method could detect the mecA gene directly from the positive blood culture samples without requirement for special equipment. This method would be useful for appropriate antibiotic therapy and infection control, particularly in a low-resource setting.
Collapse
|
6
|
Xiong J, Huang B, Xu JS, Huang WS. A Closed-Tube Loop-Mediated Isothermal Amplification Assay for the Visual Detection of Staphylococcus aureus. Appl Biochem Biotechnol 2020; 191:201-211. [DOI: 10.1007/s12010-020-03278-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/13/2020] [Indexed: 02/04/2023]
|
7
|
Aptamer-based fluorometric assay for direct identification of methicillin-resistant Staphylococcus aureus from clinical samples. J Microbiol Methods 2018; 153:92-98. [PMID: 30243766 DOI: 10.1016/j.mimet.2018.09.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 12/11/2022]
Abstract
Accurate and rapid identification of methicillin-resistant Staphylococcus aureus (MRSA) is of important clinical significance. In this study, a novel aptamer-based fluorometric assay was developed for detection of MRSA in clinical samples by coupling with immunomagnetic separation. The S. aureus cells in clinical specimens were enriched by magnetic separation. Following lysis by staphylococcal lysin, the PBP2a proteins were released from S. aureus cells and detected by the aptamer-based fluorometric assay. Without lengthy period of bacteria cultivation in the traditional susceptibility testing, this test has an overall testing time of only 2 h with the detection limit of 2.63 × 103 and 1.38 × 103 CFU/mL in PBS and spiked nasal swab, respectively. Since it is simple, rapid and sensitive, this method could be used for the detection of MRSA in various clinical samples.
Collapse
|
8
|
Wong YP, Othman S, Lau YL, Radu S, Chee HY. Loop-mediated isothermal amplification (LAMP): a versatile technique for detection of micro-organisms. J Appl Microbiol 2018; 124:626-643. [PMID: 29165905 PMCID: PMC7167136 DOI: 10.1111/jam.13647] [Citation(s) in RCA: 347] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 12/11/2022]
Abstract
Loop‐mediated isothermal amplification (LAMP) amplifies DNA with high specificity, efficiency and rapidity under isothermal conditions by using a DNA polymerase with high displacement strand activity and a set of specifically designed primers to amplify targeted DNA strands. Following its first discovery by Notomi et al. (2000Nucleic Acids Res 28: E63), LAMP was further developed over the years which involved the combination of this technique with other molecular approaches, such as reverse transcription and multiplex amplification for the detection of infectious diseases caused by micro‐organisms in humans, livestock and plants. In this review, available types of LAMP techniques will be discussed together with their applications in detection of various micro‐organisms. Up to date, there are varieties of LAMP detection methods available including colorimetric and fluorescent detection, real‐time monitoring using turbidity metre and detection using lateral flow device which will also be highlighted in this review. Apart from that, commercialization of LAMP technique had also been reported such as lyophilized form of LAMP reagents kit and LAMP primer sets for detection of pathogenic micro‐organisms. On top of that, advantages and limitations of this molecular detection method are also described together with its future potential as a diagnostic method for infectious disease.
Collapse
Affiliation(s)
- Y-P Wong
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - S Othman
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Y-L Lau
- Department of Parasitology, Faculty of Medicine, Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia
| | - S Radu
- Centre of Excellence for Food Safety Research (FOSREC), Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Malaysia
| | - H-Y Chee
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| |
Collapse
|
9
|
Henares D, Brotons P, Buyse X, Latorre I, de Paz HD, Muñoz-Almagro C. Evaluation of the eazyplex MRSA assay for the rapid detection of Staphylococcus aureus in pleural and synovial fluid. Int J Infect Dis 2017; 59:65-68. [PMID: 28450195 DOI: 10.1016/j.ijid.2017.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/07/2017] [Accepted: 04/13/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Loop-mediated isothermal amplification (LAMP) is a simple and sensitive technique for rapid microbiological diagnosis. The aim of this study was to evaluate the analytical and diagnostic performance of the LAMP eazyplex MRSA test for the direct detection and differentiation of methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) in synovial/pleural fluid. METHODS Analytical validation included the determination of the limit of detection (LoD) and analytical specificity of the eazyplex MRSA test. A diagnostic evaluation of the eazyplex test against bacterial culture was performed on routine pleural/synovial samples collected prospectively from patients aged less than 18 years with complicated pneumonia with empyema or arthritis admitted to the Children's Hospital Sant Joan de Déu in Barcelona, Spain, between April 2015 and May 2016. RESULTS The new system appropriately detected a quality control panel of clinical samples with DNA of MSSA, MRSA, and other pathogens. The LoD was established at 6.4×103 CFU/ml for S. aureus and 1.0×104 CFU/ml for MRSA. Diagnostic validation of the eazyplex MRSA assay was performed on 51 prospective clinical invasive samples, resulting in sensitivity and specificity values of 83.3% and 97.8%, respectively, for S. aureus detection. The mean turnaround time was 70min. CONCLUSIONS The eazyplex MRSA assay was found to be a useful test for the rapid detection of S. aureus in invasive samples such as pleural/synovial fluid.
Collapse
Affiliation(s)
- D Henares
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain
| | - P Brotons
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - X Buyse
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain
| | - I Latorre
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain; Institut d'Investigació Germans Trias i Pujol, Badalona, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - H D de Paz
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain
| | - C Muñoz-Almagro
- Institut de Recerca Pediàtrica, Departament de Microbiologia Molecular, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Internacional de Catalunya, School of Medicine, Barcelona, Spain.
| |
Collapse
|