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Tabata A, Shirai R, Miki H, Nishikawa Y, Kashima T, Aoyama T, Murakami S, Azuma M, Tomoyasu T, Nagamune H. Hapten-labeled fusion-polymerase chain reaction of multiple marker genes for the application of immunochromatographic test. J Biosci Bioeng 2022; 134:70-76. [PMID: 35450786 DOI: 10.1016/j.jbiosc.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/15/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
A variety of methods have been reported using polymerase chain reaction (PCR)-based nucleic acid testing (NAT) because of its potential to be used in highly sensitive inspection systems. Among these NATs, fusion-PCR (also called as overlap-extension-PCR) has been focused on this study and adopted to generate the fused amplicon composed of plural marker gene fragments for detection. Generally, conventional agarose gel electrophoresis followed by gel staining is employed to check the PCR results. However, these are time-consuming processes that use specific equipment. To overcome these disadvantages, the immunochromatographic test (ICT) for the detection of PCR amplicons with hapten-labels that were generated by PCR using hapten-labeled primers was also adopted in this study. Based on these concepts, we constructed the systems of hapten-labeled fusion-PCR (HL-FuPCR) followed by ICT (HL-FuPCR-ICT) for the two and three marker genes derived from pathogenic microbe. As a result, we successfully developed a two marker genes system for the pathogenic influenza A virus and a three marker genes system for the penicillin-resistant Streptococcus pneumoniae. These detection systems of HL-FuPCR-ICT are characterized by simple handling and rapid detection within few minutes, and also showed the results as clear lines. Thus, the HL-FuPCR-ICT system introduced in this study has potential for use as a user-friendly inspection tool with the advantages especially in the detection of specific strains or groups expressing the characteristic phenotype(s) such as antibiotic resistance and/or high pathogenicity even in the same species.
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Affiliation(s)
- Atsushi Tabata
- Department of Bioscience and Bioindustry, Graduate School of Technology, Industrial and Social Sciences, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8513, Japan; Department of Bioscience and Bioindustry, Faculty of Bioscience and Bioindustry, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8513, Japan; Department of Biological Science and Technology, Faculty of Engineering, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8506, Japan
| | - Rina Shirai
- Department of Bioscience and Bioindustry, Faculty of Bioscience and Bioindustry, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8513, Japan
| | - Haruka Miki
- Department of Bioscience and Bioindustry, Faculty of Bioscience and Bioindustry, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8513, Japan
| | - Yukihiro Nishikawa
- Department of Biological Science and Technology, Faculty of Engineering, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8506, Japan
| | - Tatsuya Kashima
- Department of Biological Science and Technology, Faculty of Engineering, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8506, Japan
| | - Tomomi Aoyama
- Department of Biological Science and Technology, Faculty of Engineering, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8506, Japan
| | - Shu Murakami
- Department of Biological Science and Technology, Faculty of Engineering, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8506, Japan
| | - Momoyo Azuma
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, Tokushima 770-8503, Japan
| | - Toshifumi Tomoyasu
- Department of Bioscience and Bioindustry, Graduate School of Technology, Industrial and Social Sciences, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8513, Japan; Department of Bioscience and Bioindustry, Faculty of Bioscience and Bioindustry, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8513, Japan; Department of Biological Science and Technology, Faculty of Engineering, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8506, Japan
| | - Hideaki Nagamune
- Department of Bioscience and Bioindustry, Graduate School of Technology, Industrial and Social Sciences, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8513, Japan; Department of Bioscience and Bioindustry, Faculty of Bioscience and Bioindustry, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8513, Japan; Department of Biological Science and Technology, Faculty of Engineering, Tokushima University, 2-1 Minamijousanjima-cho, Tokushima, Tokushima 770-8506, Japan.
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El-Kholy A, Badawy M, Gad M, Soliman M. Serotypes and Antimicrobial Susceptibility of Nasopharyngeal Isolates of Streptococcus pneumoniae from Children Less Than 5 Years Old in Egypt. Infect Drug Resist 2020; 13:3669-3677. [PMID: 33116686 PMCID: PMC7586055 DOI: 10.2147/idr.s250315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022] Open
Abstract
Purpose Streptococcus pneumoniae (S. pneumoniae) is the etiology of severe and life-threatening infections in children less than 5 years old. Though pneumococcal conjugate vaccines (PCVs) are effective in the prevention of pneumococcal infections, yet they are not included in the National Immunization Program in Egypt pending the identification of pathogenic serotypes. As S. pneumoniae colonization of the pharynx predisposes to pneumonia and invasive pneumococcal disease (IPD) caused by the colonizing serotypes, identification of the nasopharyngeal (NP) serotypes can be a surrogate to the invasive serotypes. In this study, we aimed to 1. Identify the serotypes and antimicrobial susceptibility testing (AST) of Streptococcus pneumoniae colonizing the nasopharynx of Egyptian children younger than 5 years in two successive winter seasons. 2. Correlate the identified serotypes with vaccine coverage of the 13-valent conjugate pneumococcal vaccines (PCV13). 3. Compare the serotypes and AST of S. pneumoniae from NP to those of IPD that were routinely identified in our clinical laboratory during the study period. Materials and Methods The study was conducted in two successive winter seasons (December 2015–March 2016; December 2016–March 2017). We enrolled 334 children, aged 6 months to 5 years, attending the outpatient general clinics of Cairo University Children Hospital, excluding those with fever, signs of infection, history of antibiotic intake or hospitalization in the preceding month. We tested NP swabs for S. pneumoniae by culture and real-time PCR. Serotyping was performed by sequential multiplex PCR for all positive samples. AST was done to S. pneumoniae isolates by Vitek-2™ (BioMérieux, Marcy-L’Etoile, France). We included routinely detected S. pneumoniae from sterile body sites during the study period, and identified their serotypes and AST. Results PCR was positive for pneumococci in 217 out of 334 pharyngeal swabs (65%), including 186 typable samples. The most common serotypes were serotypes 1, 6ABC, 19 F, 5 and 18ABC. By culture, we isolated only 110 out of 334 pharyngeal swabs (32.9%). The theoretical coverage of the PCV13 vaccine for the detected serotypes was 77.4%. The AST of NP isolates revealed low susceptibility rates to all antimicrobials except for vancomycin, linezolid, levofloxacin and clindamycin. During the study period, we identified 40 IPD; 21 identified by PCR and 19 by culture. The commonest pneumococcal serotypes were 1, 18ABC, 6ABC and 5. The PCV13 coverage was 75%. By Vitek-2, the isolates showed 100%, 100%, 94.7%, 89.5%, 84.2%, 84.2% and 78.9% susceptibility to vancomycin, linezolid, clindamycin, levofloxacin, penicillin, cefotaxim and erythromycin, respectively. Conclusion Based on the serotype vaccine coverage and the emerging antimicrobial resistance of S. pneumoniae, PCVs will be valuable to Egyptian children.
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Affiliation(s)
- Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Magda Badawy
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha Gad
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - May Soliman
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Characteristics of Streptococcus pneumoniae serotype 19A isolates from children in the pre and post Conjugate Vaccine Era. Single center experience 1986–2015. Vaccine 2018; 36:5245-5250. [DOI: 10.1016/j.vaccine.2018.07.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 12/30/2022]
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Alnimr AM, Farhat M. Phenotypic and molecular study of pneumococci causing respiratory tract infections. A 3-year prospective cohort. Saudi Med J 2017; 38:350-358. [PMID: 28397940 PMCID: PMC5447186 DOI: 10.15537/smj.2017.4.17976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/15/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To study serotype distribution and antimicrobial resistance to beta-lactams and macrolides in pneumococci causing respiratory diseases after the introduction of the 13-valent pneumococcal conjugate vaccine in Saudi Arabia. Methods: This is a hospital-based and a cross-sectional prospective surveillance study conducted at King Fahad Hospital of the University, AlKhobar, Kingdom of Saudi Arabia, in which respiratory pneumococcal isolates collected between 2012 and 2014 were serotyped by multiplex sequential polymerase chain reaction (PCR) and Pneumotest-Latex. Resistance genes to beta-lactams and macrolides were detected by multiplex PCR. Results: The most common serotypes encountered were 11A, 19A, 17F, 23F, 3, and 19F, representing 64% of the typeable strains. Interestingly, 24% of the 94 isolates were not typeable and 18% were negative for the housekeeping gene cpsA. Among the 53 typeable pneumococci isolates, 36 (67.9%) carried genes encoding resistance to both penicillin and macrolides, 9 (17%) were penicillin-monoresistant, 3 (5.6%) were macrolide-monoresistant, and 5 (9.4%) were designated non-resistant. The high rate of resistance genes did not significantly differ according to serotype (p=0.76). Similarly, non-typeable pneumococci (cpsA+ and cpsA-) had high rates of resistance to both penicillin (62.5%) and macrolides (47%). Conclusion: These data highlight the emergence of a previously rare capsular type, 11A (mean patient age, 29 years; p=0.001). Moreover, the high percentage of non-typeable isolates shows the emergence of possible atypical pneumococcal serotypes not covered by available vaccines.
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Affiliation(s)
- Amani M Alnimr
- Department of Medical Microbiology, College of Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia. E-mail.
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Kim L, McGee L, Tomczyk S, Beall B. Biological and Epidemiological Features of Antibiotic-Resistant Streptococcus pneumoniae in Pre- and Post-Conjugate Vaccine Eras: a United States Perspective. Clin Microbiol Rev 2016; 29:525-52. [PMID: 27076637 PMCID: PMC4861989 DOI: 10.1128/cmr.00058-15] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Streptococcus pneumoniae inflicts a huge disease burden as the leading cause of community-acquired pneumonia and meningitis. Soon after mainstream antibiotic usage, multiresistant pneumococcal clones emerged and disseminated worldwide. Resistant clones are generated through adaptation to antibiotic pressures imposed while naturally residing within the human upper respiratory tract. Here, a huge array of related commensal streptococcal strains transfers core genomic and accessory resistance determinants to the highly transformable pneumococcus. β-Lactam resistance is the hallmark of pneumococcal adaptability, requiring multiple independent recombination events that are traceable to nonpneumococcal origins and stably perpetuated in multiresistant clonal complexes. Pneumococcal strains with elevated MICs of β-lactams are most often resistant to additional antibiotics. Basic underlying mechanisms of most pneumococcal resistances have been identified, although new insights that increase our understanding are continually provided. Although all pneumococcal infections can be successfully treated with antibiotics, the available choices are limited for some strains. Invasive pneumococcal disease data compiled during 1998 to 2013 through the population-based Active Bacterial Core surveillance program (U.S. population base of 30,600,000) demonstrate that targeting prevalent capsular serotypes with conjugate vaccines (7-valent and 13-valent vaccines implemented in 2000 and 2010, respectively) is extremely effective in reducing resistant infections. Nonetheless, resistant non-vaccine-serotype clones continue to emerge and expand.
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Affiliation(s)
- Lindsay Kim
- Epidemiology Section, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lesley McGee
- Streptococcus Laboratory, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sara Tomczyk
- Epidemiology Section, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bernard Beall
- Streptococcus Laboratory, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Kargar M, Moein Jahromi F, Doosti A, Handali S. Molecular Investigation of Quinolone Resistance of Quinolone Resistance-Determining Region in Streptococcus pneumoniae Strains Isolated from Iran Using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism Method. Osong Public Health Res Perspect 2014; 5:245-50. [PMID: 25389509 PMCID: PMC4225646 DOI: 10.1016/j.phrp.2014.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 08/25/2014] [Accepted: 08/26/2014] [Indexed: 11/19/2022] Open
Abstract
Objectives The resistance of Streptococcus pneumoniae to the recently available antibiotic treatment has been a growing problem. The aim of the study was to determine the quinolone-resistant strains and detect the presence of mutations in the quinolone resistance-determining regions of the gyrA, parE, and parC genes. Methods In this study, for the first time in Iran, the polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) method was used to investigate the presence of mutations at quinolone resistance-determining regions of topoisomerase IV and DNA gyrase on 82 S. pneumoniae strains, among them 45 clinical samples were from patients and 37 from healthy carriers (control group). Results In clinical samples, 34 (75.56%) strains contained mutations in the parC gene, 31 (68.89%) carried mutations in the gyrA gene, and 14 (31.11%) had parE gene mutations. Antibiotic susceptibility test was performed using the CLSI (Clinical and Laboratory Standards Institute) criteria on three different generations of quinolone family, with nalidixic acid (82.22%) showing the highest resistance and levofloxacin (42.22%) the least resistance. Conclusion Results indicated that there is a significant correlation between quinolone resistance development and mutations in the parE gene as well as in the parC and gyrA genes.
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Affiliation(s)
- Mohammad Kargar
- Department of Microbiology, Islamic Azad University, Jahrom Branch, Jahrom, Iran
- Corresponding author.
| | | | - Abbas Doosti
- Biotechnology Research Center, Islamic Azad University, Shahrekord Branch, Shahrekord, Iran
| | - Somayeh Handali
- Nanotechnology Research center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Antimicrobial Resistance and Serotype Distribution of Nasopharyngeal Pneumococcal Isolates From Healthy Toddlers of Evros, Greece. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2014. [DOI: 10.1097/ipc.0b013e31829c3995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kohn S. [110th Scientific Meeting of the Japanese Society of Internal Medicine: Invited lecture: 3. In pursuit of overcoming pneumonia]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2013; 102:2182-2194. [PMID: 24228399 DOI: 10.2169/naika.102.2182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
In recent years, quantitative real-time PCR tests have been extensively developed in clinical microbiology laboratories for routine diagnosis of infectious diseases, particularly bacterial diseases. This molecular tool is well-suited for the rapid detection of bacteria directly in clinical specimens, allowing early, sensitive and specific laboratory confirmation of related diseases. It is particularly suitable for the diagnosis of infections caused by fastidious growth species, and the number of these pathogens has increased recently. This method also allows a rapid assessment of the presence of antibiotic resistance genes or gene mutations. Although this genetic approach is not always predictive of phenotypic resistances, in specific situations it may help to optimize the therapeutic management of patients. Finally, an approach combining the detection of pathogens, their mechanisms of antibiotic resistance, their virulence factors and bacterial load in clinical samples could lead to profound changes in the care of these infected patients.
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Affiliation(s)
- Max Maurin
- Laboratoire de Bactériologie, Département des Agents Infectieux, Institut de Biologie et Pathologie, CHU de Grenoble, Université Joseph Fourier Grenoble 1, France.
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Quadriplex real-time polymerase chain reaction (lytA, mef, erm, pbp2b(wt)) for pneumococcal detection and assessment of antibiotic susceptibility. Diagn Microbiol Infect Dis 2011; 71:453-6. [PMID: 21996097 DOI: 10.1016/j.diagmicrobio.2011.08.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 08/02/2011] [Accepted: 08/25/2011] [Indexed: 11/24/2022]
Abstract
A quadriplex real-time polymerase chain reaction assay was developed for detecting pneumococci, penicillin susceptibility, and macrolide/lincosamide resistance. The assay was sensitive for all 4 targets (<10 copies) and correlated with antimicrobial susceptibilities in 172/180 isolates and 28/29 culture-positive clinical specimens. For 29 lytA-positive culture-negative specimens, the assay allowed interpretation of antimicrobial susceptibility.
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Hashida K, Shiomori T, Hohchi N, Ohkubo JI, Ohbuchi T, Mori T, Suzuki H. Nasopharyngeal Streptococcus pneumoniae carriage in Japanese children attending day-care centers. Int J Pediatr Otorhinolaryngol 2011; 75:664-9. [PMID: 21371759 DOI: 10.1016/j.ijporl.2011.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 02/02/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We conducted a prospective bacteriological survey to investigate antibiotic resistance-related genetic characteristics and the turnover of nasopharyngeal Streptococcus pneumoniae carriage in healthy children in day-care centers (DCCs). METHODS A total of 363 nasopharyngeal mucus samples were collected from children aged 0 to 6 years attending two DCCs in the summer of 2004 (n=181) and the following winter (n=182). We obtained 157 S. pneumoniae isolates and analyzed them by antibiotic susceptibility testing, PCR assay for the penicillin-binding protein (PBP) genes and macrolide-resistance gene, and pulsed-field gel electrophoresis (PFGE). RESULTS The overall carriage rate was 43.3% (157/363). The percentages of penicillin-intermediately resistant S. pneumoniae (PISP) strains, penicillin-resistant S. pneumoniae (PRSP) strains, erythromycin-intermediately resistant S. pneumoniae strains and erythromycin-resistant S. pneumoniae strains were 35.7% (56/157), 0.6% (1/157), 1.9% (3/157), and 69.4% (109/157), respectively. The percentages of S. pneumoniae strains with the pbp mutation(s) and mefA and/or ermB gene(s) were 92.4% (145/157) and 71.3% (112/157), respectively. Fifty strains with different PFGE patterns were obtained from among the 157 isolates. Thirteen strains were observed in both seasons, but only one of these strains was isolated from the same carrier. Twenty-one strains (42.0%) were isolated from two or more children, and 17 of these were each isolated from children attending the same DCC. CONCLUSIONS These results indicate the spread of S. pneumoniae, particularly those with antibiotic-resistance genes, and the vigorous genetic turnover and substantial horizontal transmission of this pathogen in healthy children attending DCCs in Japan.
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Affiliation(s)
- Koichi Hashida
- Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
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Khan SA, Sung K, Nawaz MS. Detection of aacA-aphD, qacEδ1, marA, floR, and tetA genes from multidrug-resistant bacteria: Comparative analysis of real-time multiplex PCR assays using EvaGreen(®) and SYBR(®) Green I dyes. Mol Cell Probes 2011; 25:78-86. [PMID: 21256956 DOI: 10.1016/j.mcp.2011.01.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 01/07/2011] [Accepted: 01/13/2011] [Indexed: 11/18/2022]
Abstract
We have developed multiplex real-time PCR assays that utilize DNA-intercalating dyes, SYBR Green I (SG) and EvaGreen (EG), with two primer sets (set 1=qacEδ1, tetA and aacA-aphD; set 2=tetA, marA, and floR) to simultaneously amplify the qacEδ1, tetA, aacA-aphD, marA, and floR genes. Validity of the multiplex PCR assays was confirmed by testing 83 bacterial isolates, including Staphylococcus aureus (28 isolates), Enterococcus spp. (17 isolates), Salmonella enterica serovar Typhimurium (8 isolates), Citrobacter spp. (9 isolates), Escherichia coli (14 isolates) and Aeromonas veronii (7 isolates), and performing sequence analysis of representative PCR products. Agarose gel analysis revealed the presence of correct size PCR products, and the differences in their thermal melting (T(m)) curves were used to distinguish various PCR products. Although T(m) peaks of different amplicons after EG-based singleplex and multiplex PCR assays were resolved nicely, only one or two peaks were seen for SG-bound amplicons. EG-based multiplex real-time PCR assays provided better peak resolution. There was a good correlation with a better linear relationship between the C(t) and log input DNA concentration for the set 1 and set 2 genes in EG-based assays (R(EG)(2)=0.9813and0.9803) than in SG-based assays (R(SG)(2)=0.5276and0.6255). The sensitivities of detection were 2.5-25fg and 25-250fg of template DNA in EG and SG-based singleplex and multiplex PCR assays, respectively. The assays, which could be completed in less than 45min, offer sensitive and rapid detection of qacEδ1, aacA-aphD, marA, floR, and tetA genes from a diverse group of multiple antibiotic-resistant bacterial strains.
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Affiliation(s)
- Saeed A Khan
- Division of Microbiology, National Center for Toxicological Research, Jefferson, AR 72079, United States.
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Tenover FC. Potential impact of rapid diagnostic tests on improving antimicrobial use. Ann N Y Acad Sci 2010; 1213:70-80. [DOI: 10.1111/j.1749-6632.2010.05827.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
This article familiarizes the clinician with the principles of bacterial susceptibility testing and reporting to facilitate communication with the clinical microbiology laboratory. As resistance continues to emerge among a wide range of clinically relevant bacteria, the complexity of this communication increases. This updated version provides an overview of the important susceptibility concerns for most commonly isolated bacterial pathogens.
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Lawrence KL, Kollef MH. Antimicrobial stewardship in the intensive care unit: advances and obstacles. Am J Respir Crit Care Med 2009; 179:434-8. [PMID: 19136370 DOI: 10.1164/rccm.200809-1394cp] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Antimicrobial stewardship involves a multifaceted approach that strives to combat the emergence of resistance, improve clinical outcomes, and control costs by improving antimicrobial use. Therefore, stewardship is of great importance and relevance in the intensive care unit. Clinical decision support systems, biomarker-derived treatment algorithms, and improved knowledge regarding the different components of antimicrobial therapy represent some of the advances that have been made in stewardship. Yet, significant obstacles have prevented the full achievement of stewardship's goals, and approaches to confronting these obstacles should be appreciated. Clinicians should realize that antimicrobials are important therapeutic agents and strive to use them wisely.
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Affiliation(s)
- Kevin L Lawrence
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri 63110, USA
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