1
|
Wu C, Ling M, Chen Q, Chai H, Chen H. Multiplex Digital PCR-Based Development and discussion of the Detection of Genetic Association Between Staphylococcus aureus and mecA. Infect Drug Resist 2024; 17:2031-2041. [PMID: 38803520 PMCID: PMC11128719 DOI: 10.2147/idr.s464213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a predominant nosocomial infection-causing bacteria. The aim of this study was to develop a novel single-bacteria multiplex digital PCR assays (SMD-PCR), which is capable of simultaneously detecting and discriminating Methicillin-sensitive Staphylococcus aureus (MSSA) and MRSA. This protocol employed TaqMan probes to detect SAOUHSC_00106 and mecA genes, with the latter being linked to methicillin resistance. A total of 72 samples from various specimen types were evaluated. The accuracy rates for the sputum samples, pus samples, swab samples, ear secretion samples, and catheter samples were 94.44%, 100%, 92%, 100%, and 100%, respectively. Our results showed that the clinical practicability of SMD-PCR has applicability to the rapid detection of MRSA without DNA extraction or bacterial culture, and can be utilized for the rapid detection of Staphylococcus aureus and the timely identification of MRSA in clinical samples, thereby providing an advanced platform for the rapid diagnosis of clinical MRSA infection.
Collapse
Affiliation(s)
- Ciming Wu
- Zhejiang Chinese Medical University, College of Life Science, Hangzhou, Zhejiang, 310012, People’s Republic of China
| | - Ming Ling
- Jinhua Institute for Food and Drug Control, Jinhua, Zhejiang, People’s Republic of China
| | - Qiong Chen
- Hangzhou First People’s Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Hui Chai
- Zhejiang Chinese Medical University, College of Life Science, Hangzhou, Zhejiang, 310012, People’s Republic of China
| | - Huan Chen
- Zhejiang Chinese Medical University, College of Life Science, Hangzhou, Zhejiang, 310012, People’s Republic of China
- Hangzhou Digital-Micro Biotech Co, Ltd, Hangzhou, Zhejiang, People’s Republic of China
| |
Collapse
|
2
|
Schulz M, Calabrese S, Hausladen F, Wurm H, Drossart D, Stock K, Sobieraj AM, Eichenseher F, Loessner MJ, Schmelcher M, Gerhardts A, Goetz U, Handel M, Serr A, Haecker G, Li J, Specht M, Koch P, Meyer M, Tepper P, Rother R, Jehle M, Wadle S, Zengerle R, von Stetten F, Paust N, Borst N. Point-of-care testing system for digital single cell detection of MRSA directly from nasal swabs. LAB ON A CHIP 2020; 20:2549-2561. [PMID: 32568322 DOI: 10.1039/d0lc00294a] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We present an automated point-of-care testing (POCT) system for rapid detection of species- and resistance markers in methicillin-resistant Staphylococcus aureus (MRSA) at the level of single cells, directly from nasal swab samples. Our novel system allows clear differentiation between MRSA, methicillin-sensitive S. aureus (MSSA) and methicillin-resistant coagulase-negative staphylococci (MR-CoNS), which is not the case for currently used real-time quantitative PCR based systems. On top, the novel approach outcompetes the culture-based methods in terms of its short time-to-result (1 h vs. up to 60 h) and reduces manual labor. The walk-away test is fully automated on the centrifugal microfluidic LabDisk platform. The LabDisk cartridge comprises the unit operations swab-uptake, reagent pre-storage, distribution of the sample into 20 000 droplets, specific enzymatic lysis of Staphylococcus spp. and recombinase polymerase amplification (RPA) of species (vicK) - and resistance (mecA) -markers. LabDisk actuation, incubation and multi-channel fluorescence detection is demonstrated with a clinical isolate and spiked nasal swab samples down to a limit of detection (LOD) of 3 ± 0.3 CFU μl-1 for MRSA. The novel approach of the digital single cell detection is suggested to improve hospital admission screening, timely decision making, and goal-oriented antibiotic therapy. The implementation of a higher degree of multiplexing is required to translate the results into clinical practice.
Collapse
Affiliation(s)
- Martin Schulz
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Bzdyl NM, Urosevic N, Payne B, Brockenshire R, McIntyre M, Leung MJ, Weaire-Buchanan G, Geelhoed E, Inglis TJJ. Field trials of blood culture identification FilmArray in regional Australian hospitals. J Med Microbiol 2018. [PMID: 29533172 DOI: 10.1099/jmm.0.000714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose. In this field trial of rapid blood culture identification (BCID), we aimed to determine whether the improved speed and accuracy of specific BCID predicted in our earlier pilot study could be obtained in regional hospitals by deploying a multiplex PCR FilmArray (Biomerieux, France) capability in their laboratories.Methods. We trained local hospital laboratory staff to operate the FilmArray equipment and act on the results. To do this, we integrated the multiplex PCR into the standard laboratory blood culture workflow and reporting procedure.Results. Of 100 positive blood culture episodes, BCID FilmArray results were correct in all 42 significant monobacterial cultures, with a fully predictive identity in 38 (90.5 %) and a partial identity in another four (9.5 %). There was one major error; a false positive Pseudomonas aeruginosa. The minor errors were the detection of one methicillin-resistant Staphylococcus aureus, which proved to be a methicillin-sensitive S. aureus mixed with a methicillin-resistant coagulase-negative staphylococcus, five false negative coagulase-negative staphylococci and one false negative streptococcus species. We found that 41/49 (84 %) clinically significant mono- and polymicrobial culture results were fully predictive of culture-based identification to bacterial species level at a mean of 1.15 days after specimen collection.Conclusions. There was a reduction of 1.21 days in the time taken to produce a definitive BCID compared to the previous year, translating into earlier communication of more specific blood culture results to the treating physician. Reduced time to definitive blood culture results has a direct benefit for isolated Australian communities at great distances from specialist hospital services.
Collapse
Affiliation(s)
- Nicole M Bzdyl
- The Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia
| | - Nadezda Urosevic
- The Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia
| | - Ben Payne
- PathWest Laboratory Medicine WA, Broome Health Campus, West Kimberley, WA, Australia
| | - Ray Brockenshire
- PathWest Laboratory Medicine WA, Broome Health Campus, West Kimberley, WA, Australia
| | - Michael McIntyre
- PathWest Laboratory Medicine WA, Bunbury Health Campus, Bunbury, WA, Australia
| | - Michael J Leung
- Department of Microbiology, PathWest Laboratory Medicine WA, PP building, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia.,School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia
| | - Graham Weaire-Buchanan
- The Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia.,Department of Microbiology, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - Elizabeth Geelhoed
- School of Population Health, Faculty of Health and Medical Sciences, University of Western Australia, Stirling Highway, WA 6009, Australia
| | - Timothy J J Inglis
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia.,Department of Microbiology, PathWest Laboratory Medicine WA, PP building, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia.,The Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, WA 6009, Australia
| |
Collapse
|
4
|
Ao W, Clifford A, Corpuz M, Jenison R. A novel approach to eliminate detection of contaminating Staphylococcal species introduced during clinical testing. PLoS One 2017; 12:e0171915. [PMID: 28225823 PMCID: PMC5321469 DOI: 10.1371/journal.pone.0171915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/27/2017] [Indexed: 01/28/2023] Open
Abstract
We describe here a strategy that can distinguish between Staphylococcus species truly present in a clinical sample from contaminating Staphylococcus species introduced during the testing process. Contaminating Staphylococcus species are present at low levels in PCR reagents and colonize lab personnel. To eliminate detection of contaminants, we describe an approach that utilizes addition of sufficient quantities of either non-target Staphylococcal cells (Staphylococcus succinus or Staphylococcus muscae) or synthetic oligonucleotide templates to helicase dependent isothermal amplification reactions to consume Staphylococcus-specific tuf and mecA gene primers such that contaminating Staphylococcus amplification is suppressed to below assay limits of detection. The suppressor template DNA is designed with perfect homology to the primers used in the assay but an internal sequence that is unrelated to the Staphylococcal species targeted for detection. Input amount of the suppressor is determined by a mathematical model described herein and is demonstrated to completely suppress contaminating levels of Staphylococcus while not negatively impacting the appropriate clinical assay limit of detection. We have applied this approach to improve the specificity of detection of Staphylococcus species present in positive blood cultures using a chip-based array that produces results visible to the unaided eye.
Collapse
Affiliation(s)
- Wanyuan Ao
- Great Basin Corporation, Salt Lake City, Utah, United States of America
| | - Adrianne Clifford
- Great Basin Corporation, Salt Lake City, Utah, United States of America
| | - Maylene Corpuz
- Great Basin Corporation, Salt Lake City, Utah, United States of America
| | - Robert Jenison
- Great Basin Corporation, Salt Lake City, Utah, United States of America
- * E-mail:
| |
Collapse
|
5
|
Bandara AB, Zuo Z, Ramachandran S, Ritter A, Heflin JR, Inzana TJ. Detection of methicillin-resistant staphylococci by biosensor assay consisting of nanoscale films on optical fiber long-period gratings. Biosens Bioelectron 2015; 70:433-40. [PMID: 25845336 DOI: 10.1016/j.bios.2015.03.041] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 03/17/2015] [Indexed: 11/29/2022]
Abstract
Methicillin-resistance among Staphylococcus species is a major health problem in hospitals, communities, and animals. There is a need for culture-free diagnostic assays that can be carried out rapidly, and maintain a high degree of sensitivity and specificity. To address this need an ionic self-assembled multilayer (ISAM) film was deposited on the surface of a long-period grating (LPG) optical fiber by immersion alternately in poly-allylamine hydrochloride and in poly-1-[p-(3'-carboxy-4'-hydroxyphenylazo) benzenesulfonamido]-1,2-ethandiyl (PCBS), resulting in terminal carboxyl groups on the LPG-ISAM. The terminal carboxyl groups were covalently conjugated to monoclonal antibodies (MAb) specific to penicillin-binding-protein 2a of methicillin resistant (MR) staphylococci. After exposure of the LPG-ISAM to 10(2) colony forming units (CFU)/ml of MR S. aureus (MRSA) for 50 min., light transmission was reduced by 19.7%. In contrast, after exposure to 10(6) CFU/ml of methicillin-sensitive S. aureus (MSSA) attenuation of light transmission was less than 1.8%. Exposure of the LPG-ISAM to extracts of liver, lungs, or spleen from mice infected with MRSA attenuated light transmission by 11.7-73.5%. In contrast, exposure of the biosensor to extracts from MSSA-infected mice resulted in 5.6% or less attenuation of light transmission. When the sensor was tested with 36 strains of MR staphylococci, 15 strains of methicillin-sensitive staphylococci, 10 strains of heterologous genera (all at 10(4) CFU/ml), or tissue samples from mice infected with MRSA, there was complete agreement between MR and non-MR bacteria determined by antibiotic susceptibility testing and the biosensor assay when the cutoff value for attenuation of light transmission was 6.3%. Thus, the biosensor described has the potential to detect MR staphylococci in clinical samples with a high degree of sensitivity and specificity.
Collapse
Affiliation(s)
- Aloka B Bandara
- Department of Biomedical Sciences and Pathobiology, Life Sciences 1, 970 Washington Street, SW, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Ziwei Zuo
- Department of Physics, 850 West Campus Drive, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Siddharth Ramachandran
- Department of Electrical and Computer Engineering, 8 Saint Mary's Street, Boston University, Boston, MA 02215, USA.
| | - Alfred Ritter
- Virginia nanoTech, LLC, 2200 Kraft Drive, Blacksburg, VA 24060, USA.
| | - James R Heflin
- Department of Physics, 850 West Campus Drive, Virginia Tech, Blacksburg, VA 24061, USA; Virginia nanoTech, LLC, 2200 Kraft Drive, Blacksburg, VA 24060, USA.
| | - Thomas J Inzana
- Department of Biomedical Sciences and Pathobiology, Life Sciences 1, 970 Washington Street, SW, Virginia Tech, Blacksburg, VA 24061, USA; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.
| |
Collapse
|
6
|
Ahmed EF, Gad GFM, Abdalla AM, Hasaneen AM, Abdelwahab SF. Prevalence of methicillin resistant Staphylococcus aureus among Egyptian patients after surgical interventions. Surg Infect (Larchmt) 2014; 15:404-11. [PMID: 24815332 DOI: 10.1089/sur.2013.212] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Staphylococcus aureus (S. aureus) is isolated frequently from surgical site infections and other soft tissue infections. There are limited data examining the prevalence of methicillin resistant S. aureus (MRSA) among Egyptian patients after surgery. The current study determined the prevalence of MRSA isolated from surgical site and soft tissue infections at Minia University Hospital (MUH), determined their susceptibility to β-lactams and other antimicrobials, and examined their mecA gene expression. METHODS A total of 208 hospitalized patients attending the General Surgery Department at MUH were enrolled and all had skin and soft tissue infections (SSTIs) of different causes. These 208 patients (143 males and 65 females) were suffering from surgical site infection (SSI; n=82), diabetic foot (n=52), abscess (n=45), or burn (n=29) infections. Samples were cultured on different media for isolation and identification of S. aureus and the isolates were screened for antibiotic susceptibility. All MRSA isolates were tested by polymerase chain reaction to detect the mecA gene responsible for methicllin resistance. RESULTS 241 Staphylococcal species represented the most common isolates (64.8%) among 371 collected isolates from the 208 patients. Out of the 241 staphylococcal isolates, 127 were S. aureus (61% of the total patients). The prevalence of S. aureus among SSI, diabetic foot, abscess, and burn patients were 59%, 75%, 56%, and 52%, whereas that of MRSA was 16%, 17%, 13%, and 10%, respectively. MRSA isolates (n=31; 15% of patients) showed multiple resistance to at least one member of the antimicrobial groups tested with an average resistance to 6.6±1.9 antimicrobial groups. Polymerase chain reaction data showed that only 29 isolates of the MRSA isolates (94%) were positive for mecA gene. CONCLUSIONS Staphylococcus aureus isolates are the major pathogens responsible for wound and surgical site infections at MUH and MRSA are a potential threat for wound patients in Egypt.
Collapse
Affiliation(s)
- Eman F Ahmed
- 1 Microbiology Department, Faculty of Pharmacy, Minia University , Minia, Egypt
| | | | | | | | | |
Collapse
|
7
|
Molecular Diagnosis Contributing for Multi-Drug Resistant Infection Control. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2014. [DOI: 10.1007/s40506-013-0006-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
8
|
Multiplex real-time PCR assay for detection of methicillin-resistant Staphylococcus aureus (MRSA) strains suitable in regions of high MRSA endemicity. J Clin Microbiol 2012; 51:1008-13. [PMID: 23269729 DOI: 10.1128/jcm.02495-12] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
A multiplex real-time PCR assay that simultaneously detects the mecA, staphylococcal cassette chromosome (SCCmec)-open reading frame X (orfX) junction, and staphylococcal 16S rRNA genes was developed and evaluated using 444 staphylococcal strains. We demonstrated that this assay resulted in fewer false-positive results than a single-locus real-time PCR assay that amplified the SCCmec-orfX junction. This assay would be useful in a clinical laboratory in a region of high endemicity for methicillin-resistant Staphylococcus aureus (MRSA) infections.
Collapse
|
9
|
Söderquist B, Neander M, Dienus O, Zimmermann J, Berglund C, Matussek A, Mölling P. Real-time multiplex PCR for direct detection of methicillin-resistant Staphylococcus aureus (MRSA) in clinical samples enriched by broth culture. APMIS 2012; 120:427-32. [PMID: 22515298 DOI: 10.1111/j.1600-0463.2011.02849.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A real-time multiplex PCR using the orfX and staphylococcal cassette chromosome (SCC) mec of Staphylococcus aureus was developed. The aim was to achieve a rapid and sensitive high-throughput method for direct detection of heterogeneous methicillin-resistant S. aureus (MRSA) in clinical samples, present in a low-endemic population, such as in Sweden. Consecutive broth enriched pooled clinical screening samples (nares, throat and/or perineum/groin) (n = 541 pools), broth enriched clinical samples showing growth of methicillin-sensitive S. aureus (MSSA) (n = 95 pools), clinical MRSA isolates (n = 173), MRSA reference strains (n = 43) and various coagulase-negative staphylococcal isolates (n = 33) were analyzed. The multiplex PCR detected all heterogeneous MRSA strains (n = 173) obtained in our area as well as all pooled consecutive broth enriched clinical samples with MRSA, i. e. 36 of 541 pools. None of the CoNS were positive. However, 18 out of 541 pools (3.3%) were positive in the multiplex PCR but no growth of MRSA could be detected by subculture and were regarded as false positive. Furthermore, the assay is rapid and reliable negative results can be delivered to the clinician within 18 h that will facilitate the infection control management of patients and hospital staff.
Collapse
Affiliation(s)
- Bo Söderquist
- Departments of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Sweden.
| | | | | | | | | | | | | |
Collapse
|
10
|
Dolinger DL, Jacobs AA. Molecular Diagnostics and Active Screening for Health Care-Associated Infections: Stepping-Up the Game: Table 1. Lab Med 2011. [DOI: 10.1309/lmh144zoetkvqcju] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|