Abstract

BackgroundThe speed and sensitivity of real-time polymerase chain reaction (PCR) have made it a popular method for the detection of microbiological agents in both research and clinical specimens. For the detection and genotyping of herpes simplex virus (HSV) in clinical specimens, real-time PCR has proven to be faster, more sensitive and safer than earlier methods which included isolation of the virus in cell culture followed by immunofluorescence microscopy. While PCR-based assays for HSV detection posses clear advantages over these earlier techniques, certain aspects of the PCR method remain onerous. The process of extraction and purification of nucleic acid from clinical specimens prior to PCR is particularly cumbersome. Nucleic acid extraction is expensive, time-consuming and provides a step whereby specimens can become contaminated prior to their analysis. Herein, we investigate the necessity of nucleic acid extraction from swab-based clinical specimens for HSV detection by real-time PCR. We find that nucleic acid extraction is unnecessary for specific and sensitive detection of HSV in clinical specimens using real-time PCR.MethodsProspective (n = 36) and retrospective (n = 21) clinical specimens from various anatomical sites were analyzed for the presence of herpes simplex virus 1 or 2 by real-time PCR using the RealArt HSV 1/2 LC PCR Kit. Specimens were analyzed by PCR both before and following automated nucleic acid extraction. PCR using extracted and unextracted specimens was also compared to cell culture as a means of detecting HSV.ResultsDetection of HSV 1/2 DNA in clinical specimens by real-time PCR did not require that the specimen be subjected to nucleic acid extraction/purification prior to analysis. Each specimen that was detectable by real-time PCR when analyzed in the extracted form was also detectable when analyzed in the unextracted form using the methods herein. The limit of detection of HSV-1 and HSV-2 particles when analyzed in the unextracted form was found to be approximately 17 and 32 virus particles respectively, compared to a sensitivity of 10 copies, for analysis of purified DNA. Omission of the nucleic acid extraction step shortened both the assay time and cost.ConclusionOmission of the nucleic acid extraction step prior to real-time PCR for detection of herpes simplex virus resulted in a more rapid and cost-effective assay, with little impact upon the sensitivity of detection.

Highlights

  • The speed and sensitivity of real-time polymerase chain reaction (PCR) have made it a popular method for the detection of microbiological agents in both research and clinical specimens

  • Determining the feasibility of efficient detection of herpes simplex virus (HSV) DNA by real-time PCR on untreated clinical specimens Having established real-time PCR within our laboratory as the method of choice for detection of HSV in clinical specimens, we sought to explore the temporal efficiency of our real-time PCR procedure

  • We investigated whether it would be feasible to detect HSV DNA in crude clinical specimens using the same RealTime PCR reagents and methods currently utilized in our laboratory

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Summary

Introduction

The speed and sensitivity of real-time polymerase chain reaction (PCR) have made it a popular method for the detection of microbiological agents in both research and clinical specimens. Reliable methods for detection and sub-typing of HSV infections have included enzyme-linked immunosorbent assay (ELISA), immunofluorescence microscopy (IFA) and virus isolation by cell culture. While each of these methods has been very useful in assisting clinical diagnosis, time and technological progress have revealed the limitations of these assays. All three assays are laborious and time consuming, with cell culture often requiring as long as seven days before results are obtained The sensitivities of these techniques have been questioned, in reference to more recent methodologies, such as polymerase chain reaction (PCR). Polymerase chain reactions require evaluation on a case-by-case basis to determine their efficiency

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