Abstract

Droplet digital PCR (ddPCR) is a third generation of PCR that was recently developed to overcome the challenges of real-time fluorescence-based quantitative PCR (qPCR) in absolute quantification of pathogens. Few studies have been done on tuberculosis (TB) detection and quantification using ddPCR despite its many advantages over qPCR. From the few studies, none explores a single dye duplex assay for the detection and quantification of TB. In this study, steps toward developing and evaluating a duplex single dye (FAM) assay for detecting two targets (IS6110 and IS1081) are clearly described using simplex and duplex experiments. To achieve this, various parameters are investigated, including annealing temperature, primer and probe concentration, sensitivity and specificity, sample concentration, and inter/intra-assay variability. From the results, primer and probe concentration, annealing temperature, and sample concentration have an effect on the position and separation of droplets in both simplex and duplex assays. The copies of target genes in a duplex assay can be estimated accurately using the threshold tool with little inter-assay (CV <1%) and intra-assay (CV <6%) variability when compared to simplex assays. The ddPCR assay specificity and sensitivity are both 100% when compared to qPCR. This work shows steps toward the detection and quantification of two targets in a single channel, enabling higher multiplexing to include more targets in future works.

Highlights

  • Tuberculosis (TB), a disease caused by the bacterium Mycobacterium tuberculosis (Mtb), still remains the top infectious disease killer worldwide, ranking above HIV/AIDS [1]

  • An in silico test using the basic local alignment search tool (BLAST) available online from NCBI showed that the primers were highly specific to different strains of Mycobacterium tuberculosis complex

  • We tested 15 samples including 10 nontuberculous mycobacteria (NTM) and five different respiratory tract bacteria that did not belong to the Mycobacterium tuberculosis complex

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Summary

Introduction

Tuberculosis (TB), a disease caused by the bacterium Mycobacterium tuberculosis (Mtb), still remains the top infectious disease killer worldwide, ranking above HIV/AIDS [1]. This old fashioned gold standard technique may be effective but suffers many limitations, especially when it comes to the rapid diagnosis of TB disease [2] Such limitations have driven scientists to come up with modernized techniques for TB diagnosis, including microscopic observation drug susceptibility (MODS) and molecular diagnostic systems [3]. Quantification systems like the real-time quantification PCR (qPCR) and digital PCR (dPCR) were recently developed to quantify nucleic acid targets within a sample Both these two are extensively used in the diagnosis of a variety of pathogens, including tuberculosis with dPCR, which shows many advantages over qPCR, as it does not need a standard curve during quantification [4,5]

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