Abstract

BackgroundThe increased transmission of multidrug-resistant (MDR) tuberculosis (TB) poses a challenge to tuberculosis prevention and control in Sri Lanka. Isoniazid (INH) is a key element of the first line anti tuberculosis treatment regimen. Resistance to INH may lead to development of MDR TB. Therefore, early detection of INH resistance is important to curb spread of resistance. Due to the limited availability of rapid molecular methods for detection of drug resistance in Sri Lanka, this study was aimed at developing a simple and rapid gold nanoparticle (AuNP) based lateral flow strip for the simultaneous detection of the most common INH resistance mutation (katG S315 T, 78.6%) and Mycobacterium tuberculosis (MTb).MethodsLateral flow strip was designed on an inert plastic backing layer containing a sample pad, nitrocellulose membrane and an absorption pad. Biotin labeled 4 capture probes which separately conjugated with streptavidin were immobilized on the nitrocellulose. The test sample was prepared by multiplex PCR using primers to amplify codon 315 region of the katG gene and MTb specific IS6110 region. The two detection probes complementary to the 5′ end of each amplified fragment was conjugated with gold nanoparticles (20 nm) and coupled with the above amplified PCR products were applied on the sample pad. The hybridization of the amplified target regions to the respective capture probes takes place when the sample moves towards the absorption pad. Positive hybridization is indicated by red colour lines.ResultsThe three immobilized capture probes on the strip (for the detection of TB, katG wild type and mutation) were 100 and 96.6% specific and 100 and 92.1% sensitive respectively.ConclusionThe AuNP based lateral flow assay was capable of differentiating the specific mutation and the wild type along with MTb identification within 3 h.

Highlights

  • The increased transmission of multidrug-resistant (MDR) tuberculosis (TB) poses a challenge to tuberculosis prevention and control in Sri Lanka

  • Detection of MDR using lateral flow nucleic acid biosensors focusing katG315 and rpoB531 common mutations [7] and detection of RIF resistance using magnetic nanobead based read out [8] are two other recently reported molecular methods based on padlock probes for determination of drug resistance

  • 41 INH resistant Mycobacterium tuberculosis (MTb) strains isolated from sputum samples received from chest clinics were directly collected from National Tuberculosis Reference Laboratory (NTRL), Welisara, Sri Lanka

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Summary

Introduction

The increased transmission of multidrug-resistant (MDR) tuberculosis (TB) poses a challenge to tuberculosis prevention and control in Sri Lanka. Due to the limited availability of rapid molecular methods for detection of drug resistance in Sri Lanka, this study was aimed at developing a simple and rapid gold nanoparticle (AuNP) based lateral flow strip for the simultaneous detection of the most common INH resistance mutation (katG S315 T, 78.6%) and Mycobacterium tuberculosis (MTb). 3.1% among retreatment cases, with 23 laboratory confirmed MDR TB cases and an estimated TB incidence remaining stable at 65 new cases per 100 000 population [5] Irrespective of this incidence rate, early diagnosis of MDR TB is essential to control the spread of the disease to reach the goals of the End TB strategy [2]. An assay based on AuNP to differentiate MTb from MTC using clinical specimens was developed by Soo and co-workers in 2009 [9]

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