Novel Quantitative PCR for Rhodococcus equi and Macrolide Resistance Detection in Equine Respiratory Samples.

Abstract

Simple SummaryMultidrug-resistant (MDR) Rhodococcus equi (R. equi) is rapidly spreading across the US in equine breeding farms, causing devastating untreatable disease in foals. There is a critical need for new diagnostic tools that can identify R. equi and its antibiotic resistance profile accurately and fast. This project aimed to develop and standardize a novel multiplex quantitative real-time PCR (qPCR) to detect R. equi and its most clinically relevant antimicrobial resistance genes directly from equine respiratory samples. We have designed three pairs of oligos (a.k.a primers or oligonucleotides) to identify R. equi and MLSB (macrolide, lincosamide, streptogramin B) resistance genes erm(46) and erm(51) that can be used in single-plex and multiplex qPCR assays. Furthermore, our new qPCR shows high sensitivity and specificity in in-silico analysis and when tested in mock equine respiratory samples. Therefore, we believe it can be used for a fast-preliminary diagnosis of R. equi and the simultaneous prediction of its most critical resistant profile. The new molecular diagnostic tool presented here will shorten the waiting time from the moment the practitioner sees the equid patient until it is diagnosed and appropriately treated.R. equi is an important veterinary pathogen that takes the lives of many foals every year. With the emergence and spread of MDR R. equi to current antimicrobial treatment, new tools that can provide a fast and accurate diagnosis of the disease and antimicrobial resistance profile are needed. Here, we have developed and analytically validated a multiplex qPCR for the simultaneous detection of R. equi and related macrolide resistance genes in equine respiratory samples. The three sets of oligos designed in this study to identify R. equi housekeeping gene choE and macrolide resistance genes erm(46) and erm(51) showed high analytic sensitivity with a limit of detection (LOD) individually and in combination below 12 complete genome copies per PCR reaction, and an amplification efficiency between 90% and 147%. Additionally, our multiplex qPCR shows high specificity in in-silico analysis. Furthermore, it did not present any cross-reaction with normal flora from the equine respiratory tract, nor commonly encountered respiratory pathogens in horses or other genetically close organisms. Our new quantitative PCR is a trustable tool that will improve the speed of R. equi infection diagnosis, as well as helping in treatment selection.