Development and validation of cost-effective one-step multiplex RT-PCR assay for detecting the SARS-CoV-2 infection using SYBR Green melting curve analysis

Validation and implementation of TaqMAMA RT-PCR for SARS-CoV-2 variant surveillance: experience from a high-volume setting

BACKGROUND

The genomic surveillance of SARS-CoV-2 is challenging in high-volume, resource-limited settings. Faster and less expensive methods are required for the prompt detection of variants of interest. This study aimed to validate and implement the TaqMAMA RT-PCR method for the detection of SARS-CoV-2 variants.

METHODS

We developed the TaqMAMA RT-PCR method for SARS-CoV-2 variants. From the viral genomes obtained from the GISAID database, fluorescent amplification probes and oligonucleotides were designed to detect two specific mutations for each variant. The study consisted of an assay validation phase comparing the newly designed method to WGS in COVID-19-positive samples, followed by a large-scale implementation phase to calculate its performance.

RESULTS

During the assay validation phase, we included 232 samples for analysis using TaqMAMA and WGS. TaqMAMA identified 82.3% as positive, and had sensitivities of 82%, 100%, and 50%, specificities of 91%, 99%, and 100%, with PPVs of 99%, 75%, and 100%, and NPVs of 20%, 100%, and 100% for the Delta, Alpha, and Gamma variants, respectively. For the implementation phase, we included 1315 samples, TaqMAMA identified 68% positive samples, 97.5% as delta. The predicted performance using Bayesian statistics was 95%, 55%, and 0% for the positive, and 29%, 0%, and < 1% for the negative delta, alpha, and gamma variants, respectively.

CONCLUSIONS

The diagnostic performance of TaqMAMA RT-PCR was acceptable for the detection of the most prevalent SARS-CoV-2 variants of interest. This method offers a cost and time-saving alternative for the genomic surveillance of SARS-CoV-2 in high-volume settings.

Escherichia coli O157:H7, a Common Contaminant of Raw Milk from Ecuador: Isolation and Molecular Identification

Escherichia coli (E. coli), especially the Shiga toxin-producing O157:H7 strain, poses severe health risks. In rural Ecuador, raw milk consumption heightens contamination risks. This study analyzed 633 raw milk samples from Pichincha and Manabí to assess E. coli O157:H7 prevalence. The samples were enriched using BHI broth, and then specific culture media were used to isolate E. coli O157:H7. The pathogen in the enriched raw milk was identified, and the isolates were specifically confirmed through the application of a newly designed qPCR assay. The novel qPCR assay demonstrated remarkable sensitivity, capable of detecting up to one copy of genetic material, and specificity (no amplification of other bacteria). An extremely high E. coli O157:H7 prevalence of 0.63 (n = 401) was detected, where the province with the highest number of positive samples was Manabí with 72.8% (n = 225/309) and 54.3% (n = 179/324) for Pichincha. In both provinces, the presence of E. coli O157:H7 contamination exhibited a favorable correlation with small-scale farms and elevated temperatures. This research provides valuable data on the microbiological contamination of E. coli O157:H7 present in raw milk, in addition to an improved method that has been demonstrated to be faster, more sensitive, and more specific than conventional and previously published methods, highlighting the associated risk of food-borne infections and pointing out potential shortcomings in the regulation of agricultural practices and the need for periodic monitoring of bacterial contamination levels with updated methods.

A one-step low-cost molecular test for SARS-CoV-2 detection suitable for community testing using minimally processed saliva

The gold standard for coronavirus disease 2019 diagnostic testing relies on RNA extraction from naso/oropharyngeal swab followed by amplification through reverse transcription-polymerase chain reaction (RT-PCR) with fluorogenic probes. While the test is extremely sensitive and specific, its high cost and the potential discomfort associated with specimen collection made it suboptimal for public health screening purposes. In this study, we developed an equally reliable, but cheaper and less invasive alternative test based on a one-step RT-PCR with the DNA-intercalating dye SYBR Green, which enables the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) directly from saliva samples or RNA isolated from nasopharyngeal (NP) swabs. Importantly, we found that this type of testing can be fine-tuned to discriminate SARS-CoV-2 variants of concern. The saliva RT-PCR SYBR Green test was successfully used in a mass-screening initiative targeting nearly 4500 asymptomatic children under the age of 12. Testing was performed at a reasonable cost, and in some cases, the saliva test outperformed NP rapid antigen tests in identifying infected children. Whole genome sequencing revealed that the antigen testing failure could not be attributed to a specific lineage of SARS-CoV-2. Overall, this work strongly supports the view that RT-PCR saliva tests based on DNA-intercalating dyes represent a powerful strategy for community screening of SARS-CoV-2. The tests can be easily applied to other infectious agents and, therefore, constitute a powerful resource for an effective response to future pandemics.

Assessing Different PCR Master Mixes for Ultrarapid DNA Amplification: Important Analytical Parameters

The basic principles of ultrafast plasmonic PCR have been promulgated in the scientific and technological literature for over a decade. Yet, its everyday diagnostic utility remains unvalidated in pre-clinical and clinical settings. Although the impressive speed of plasmonic PCR reaction is well-documented, implementing this process into a device form compatible with routine diagnostic tasks has been challenging. Here, we show that combining careful system engineering and process control with innovative and specific PCR biochemistry makes it possible to routinely achieve a sensitive and robust "10 min" PCR assay in a compact and lightweight system. The critical analytical parameters of PCR reactions are discussed in the current instrument setting.

Evaluation of RT-PCR assays for detection of SARS-CoV-2 variants of concern

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic has been considered with great importance on correct screening procedure. The detection efficiency of recent variants of concern were observed by comparing 5 commercial RT-PCR kits and a SYBR-green method developed and validated in our laboratory. The RNA was extracted from nasopharyngeal samples from suspected COVID-19 patients and RT-PCR assay was performed according to the instruction of the respective manufacturers. The specificity and sensitivity of Maccura kit was 81.8% and 82.5%, A*Star kit was 100% and 75.4%, Da An Gene kit was 100% and 68.4%, Sansure kit was 54.5% and 91.2% and TaqPath kit was 100% and 70.2% respectively. Our in house SYBR-Green method showed a consistent detection result with 90.9% specificity and 91.2% sensitivity. We also found that detection kits targeting more genes showed better accuracy which facilitates less false positive results (< 20%). Our study found a significant difference (p < 0.005) in Ct value reported for common target genes shared by the RT-PCR kits in relation with different variants of COVID-19 infection. Recent variants of concerns contain more than 30 mutations in the spike proteins including 2 deletion and a unique insertion mutation by which makes detection of these variants difficult and these facilitates the variants to escape from being detected.

Identification of mutations in SARS-CoV-2 PCR primer regions

Due to the constantly increasing number of mutations in the SARS-CoV-2 genome, concerns have emerged over the possibility of decreased diagnostic accuracy of reverse transcription-polymerase chain reaction (RT-PCR), the gold standard diagnostic test for SARS-CoV-2. We propose an analysis pipeline to discover genomic variations overlapping the target regions of commonly used PCR primer sets. We provide the list of these mutations in a publicly available format based on a dataset of more than 1.2 million SARS-CoV-2 samples. Our approach distinguishes among mutations possibly having a damaging impact on PCR efficiency and ones anticipated to be neutral in this sense. Samples are categorized as "prone to misclassification" vs. "likely to be correctly detected" by a given PCR primer set based on the estimated effect of mutations present. Samples susceptible to misclassification are generally present at a daily rate of 2% or lower, although particular primer sets seem to have compromised performance when detecting Omicron samples. As different variant strains may temporarily gain dominance in the worldwide SARS-CoV-2 viral population, the efficiency of a particular PCR primer set may change over time, therefore constant monitoring of variations in primer target regions is highly recommended.