Qualitative Detection Research Articles

Limited stability of Hepatitis B virus RNA in plasma and serum

Pregenomic hepatitis B virus RNA (HBV pgRNA) is a potential biomarker in the management of HBV infected patients. However, prior to the use in routine clinical practice potential confounders of test results need to be identified. This study investigates the stability of HBV pgRNA under various storage conditions. HBV-RNA level of 26 HBV patients were determined using the Roche cobas® 6800/8800 investigational HBV-RNA assay. Plasma and serum were stored for 6,48,169 h at 4,25 and 42 °C, respectively. Additionally, 10 serum and plasma samples underwent 4 or 11 cycles of freezing (−80 °C) and thawing (25 °C). A significant decline in mean pgRNA concentration compared to baseline was observed after storage for 48 h at 25 °C as well as after 6 h of storage at 42 °C. Accordingly, sub-analyses of predefined pgRNA baseline concentrations (≤ 10 cp/mL, > 10–100 cp/ml, > 100 cp/mL) revealed significant changes in pgRNA level after storage at 25 and 42 °C. No effect of freezing and thawing on pgRNA level was observed. A qualitative detection of HBV pgRNA is feasible in samples with > 100 cp/mL up to 48 h under storage temperatures of 4–42 °C. For most stable quantitative HBV pgRNA values storage at 4 °C should be preferred.

MSL-CCRN: Multi-stage self-supervised learning based cross-modality contrastive representation network for infrared and visible image fusion

Infrared and visible image fusion (IVIF) facing different information in two modal scenarios, the focus of research is to better extract different information. In this work, we propose a multi-stage self-supervised learning based cross-modality contrastive representation network for infrared and visible image fusion (MSL-CCRN). Firstly, considering that the scene differences between different modalities affect the fusion of cross-modal images, we propose a contrastive representation network (CRN). CRN enhances the interaction between the fused image and the source image, and significantly improves the similarity between the meaningful features in each modality and the fused image. Secondly, due to the lack of ground truth in IVIF, the quality of directly obtained fused image is seriously affected. We design a multi-stage fusion strategy to address the loss of important information in this process. Notably, our method is a self-supervised network. In fusion stage I, we reconstruct the initial fused image as the new view of fusion stage II. In fusion stage II, we use the fused image obtained in the previous stage to carry out three-view contrastive representation, thereby constraining the feature extraction of the source image. This makes the final fused image introduce more important information in the source image. Through a large number of qualitative, quantitative experiments and downstream object detection experiments, our propose method shows excellent performance compared with most advanced methods.

Rapid qualitative and quantitative detection for adulteration of Atractylodis Rhizoma using hyperspectral imaging combined with chemometric methods

In the field of traditional Chinese medicine, Atractylodis Rhizoma (AR) is commonly used for various diseases due to its excellent ability to dry dampness and strengthen the spleen, especially popular in East Asia. The aim of this study is to proposed Hyperspectral Imaging (HSI) in combination with chemometric methods for the rapid qualitative and quantitative detection of AR adulteration with other types of powder. Partial Least Squares Discriminant Analysis (PLS-DA) was used to construct the classification models the best, with the First-order Derivative (F-D) preprocessing method. The accuracy values of the test sets for classification models were above 99%. Furthermore, Partial Least Squares Regression (PLSR), Random Forest Regression (RFR), and BP Neural Network (BPNN) were used to quantitatively analyze the adulteration level. On the whole, the BPNN model has a relatively stable effect. The R-square (R2) values of different models were all greater than 0.97, the Root Mean Square Error (RMSE) values were all less than 0.0300, and the Relative Percentage Difference (RPD) values were over 6.00. After applying three characteristic wavelength selection algorithms, namely Iterative Retained Information Variable (IRIV), Successive Projections Algorithm (SPA), and Variable Iterative Space Shrinkage Approach (VISSA) algorithms, the classification accuracy values remained over 99.00% while the quantification models’ RPD values were over 4.00. These results demonstrate the reliability of using hyperspectral imaging combined with chemometrics methods for the adulteration problems in AR.

Nanopore-assisted ELISA for ultrasensitive, portable, and on-site detection of ricin

Effective detection technologies in food safety with the merits of portable and on-site detection potential are always in pressing demand. Herein, we developed a nanopore-assisted Enzyme-linked immunosorbent assay (NELISA) platform, which innovatively introduced hairpin DNA (HP DNA) probes as reaction substrates. This innovation of substrates effectively avoided the inherent limitations of colorimetric signals (i.e., low sensitivity and inaccurate results) and greatly improved the sensitivity and accuracy of NELISA platform. The alkaline phosphatase (ALP)-modified detection antibody (ALP-Ab2) can specifically bind to ricin and hydrolyze the phosphate groups modified on the HP DNA probes. Nanopore recordings demonstrated that two states of probes produced highly distinguishable nanopore events, enabling the qualitative and quantitative detection of ricin. This NELISA platform fully combined the specificity of ELISA with the ultra-sensitivity, and unique single-molecule fingerprint recognition of nanopore, showing a great on-site detection potential. This method achieved the ultrasensitive and reliable detection of ricin down to 2.46 fg/mL, which enhanced the detection sensitivity by at least 106-fold compared to traditional ELISA. Furthermore, the proposed method was capable of accurately detecting ricin in real food samples with satisfactory recoveries.

Enhancing accuracy and reproducibility in asphalt VOCs qualitative and quantitative analysis: Insights from laboratory studies on emission characteristics

Asphalt pavement will emit Volatile Organic Compounds (VOCs) during life cycle, posing environmental and health risks. Precise understanding of the emission characteristics of asphalt VOCs will facilitate the formulation of targeted measures for reducing emissions. Simulating the emission characteristics of VOCs from asphalt under laboratory conditions is an effective method for predicting asphalt VOCs pollution and implementing effective control measures. In this study, a quality control method for qualitative and quantitative detection of asphalt VOCs in laboratory settings was established based on sample storage time, asphalt sources, and temperature sensor positions. Furthermore, the study investigated the influence of mixing speed and sampling pump speed during asphalt VOCs generation on the emission characteristics. The results demonstrate that the quality control methods exhibit excellent reproducibility and reliability, making them valuable for future research and emission control strategies. Furthermore, the total concentration of asphalt VOCs increases with higher mixing speeds, but stabilizes when the mixing speed reaches 750–1250 r/min. As mixing speed increases, the proportion of alkane groups significantly decreases, while the proportion of aldehydes markedly increases, with the overall proportion remaining relatively stable. Decreasing sampling pump speed leads to a gradual increase in asphalt VOCs concentration. At lower pump speeds, a nonlinear increase in concentration occurs due to VOCs enrichment effects. Asphalt VOCs concentrations exhibit a proportional increase with sampling pump speeds exceeding 1000 ml/min. Finally, based on the results of the three-level analysis of "total concentration-group-substance" and taking into account the energy consumption, it is recommended that the mixing speed be set at 1000 r/min and the sampling pump speed be set at 1000 ml/min for the generation and collection of asphalt-related VOCs. This study can provide a reliable method for generating and collecting asphalt-related VOCs and offer critical insights for optimizing VOCs emission reduction strategies.

TERTmonitor Efficacy and Performance in Detecting Mutations by Droplet Digital PCR

Background: The screening of TERT promoter (TERTp) mutations is essential in cancer research and diagnostics, due to its prevalence in tumours associated with low self-renewal rates. TERTmonitor is a diagnosis kit primarily designed for real-time qPCR qualitative detection of −124C>T and −146C>T TERTp mutations, which are highly prevalent in several malignancies, particularly in bladder carcinoma. Objective: This study aims to investigate TERTmonitor performance in droplet digital PCR (ddPCR) in urine samples from bladder cancer patients. Methods: A total of 45 urine samples were examined by real-time qPCR and ddPCR techniques, and their performances were compared. Results: TERTmonitor had similar performance in both real-time qPCR and ddPCR platforms. Specifically, the methods exhibited a concordance rate of 95.45% and 90% for −124C>T and −146C>T mutations, respectively. Importantly, an enhanced sensitivity in certain scenarios was exhibited by ddPCR when compared to real-time qPCR, detecting mutations that the latter failed to identify in approximately 4.55% and 10% of the samples for −124C>T and −146C>T mutations, respectively. This enhanced sensitivity of ddPCR was particularly evident in samples with low-frequency mutations. Conclusions: The findings highlight the usefulness of TERTmonitor for cancer surveillance either in real-time qPCR or ddPCR platforms.

Epidemiological Dynamics of Canine Morbillivirus in Resident Dogs of Makurdi Metropolis, Benue State, Nigeria

Canine distemper is an endemic viral disease of dogs in Nigeria. Knowledge of the carrier status of dogs is key to successful control of the disease. In this study, the carrier status of apparently healthy dogs’ resident in parts of Makurdi metropolis was determined using the immunochromatographic rapid antigen assay kit for qualitative detection of canine morbillivirus antigens in ante-mortem samples. Ocular-, nasal-, and rectal- swabs, as well as serum were taken from each of 204 dogs bringing a total of 816 samples. The results showed that 26.96 % of the dogs sampled were positive for Canine morbillivirus antigens. Viral antigens were detected in 9.8%, 11.27%, and 4.41% of nasal, ocular, and rectal swaps respectively, and in 6.37% of the serum samples collected. An age-related susceptibility was observed as viral antigens detection rate was higher in younger dogs compared to older ones. Similarly, 40.43% of vaccinated and 22.93% of unvaccinated dogs were positive for canine morbillivirus antigens. Of significant importance is the prevalence rate in unvaccinated population of dogs. In terms of breed-related detection rate, 23.93% of Nigerian local dogs and 40.63% of exotic breeds tested positive for viral antigens, and it was observed that 25.54% of dogs which had history of contact with other dogs and 40% of dogs which had no such history carried canine morbillivirus antigens. The significance of this study is that it details the current epidemiological dynamics of canine morbillivirus in resident dogs of Makurdi metropolitan area, and the findings are discussed. Subject Areas: Animal infectious disease epidemiology.

A comparative study of extraction free detection of HBV DNA using sodium dodecyl sulfate, N-lauroylsarcosine sodium salt, and sodium dodecyl benzene sulfonate

This study aimed to develop an extraction-free method for quantitative and qualitative detection of HBV DNA compared to traditional nucleic acid extraction. Paired serum and dried blood spot (DBS) samples from 67 HBsAg-positive and 67 HBsAg-negative individuals were included. Two samples with known HBV DNA titers (~ 109 copies/mL) were examined by extraction-free detection using three surfactants (0.2 to 1% of Sodium dodecyl sulfate:SDS, N-Lauroylsarcosine sodium salt:NL, Sodium dodecyl benzene sulfonate:SDBS), two stabilizing agents (0.1 or 0.01% 2-Mercaptoethanol:2ME and 3.5 or 7% Bovine Serum Albumin:BSA) and two Taq polymerases (Fast Advanced and Prime Direct Probe). HBV DNA in all 67 HBsAg-positive and 67 HBsAg-negative serum and DBS samples was directly quantified by Rt-PCR using 0.4% SDS or 0.4% NL with Fast Advance or Prime Direct Probe Taq. Extraction-free amplification was also performed. Detection limits were varied by different surfactants and Taq. SDS combined with Fast Advanced Taq showed lower detection limits, while SDS with Prime Direct Probe Taq outperformed NL or SDBS-based detection. Adding 2ME to SDS improved detection limit with Prime Direct Probe Taq but not significantly compared to SDS alone. BSA did not significantly enhance detection limits but provided insights into sample stability. The senitivity and specificity of 0.4% SDS and NL in combination with either Fast advanced or Prime Direct Probe Taq polymerase in serum samples were > 90% and 100% resepctively, while it was > 80% and 100% respectively in DBS samples. Extraction-free HBV DNA amplification provided 100% identity with original genomes. Our study suggests that SDS, NL or SDBS-based extraction-free HBV DNA detection strategies using Prime Direct Probe Taq have potential to simplify and accelerate HBV DNA detection with high sensitivity and specificity in both serum and DBS samples, with implications for resource-limited settings and clinical applications. Utilizing surfactants with 2ME is optional, and further research and validation are necessary to broaden its application in real-world diagnostics.

On-site detection of OTA and AFB1 based on branched hybridization chain reaction coupled with lateral flow assay

Mycotoxins are widely prevalent in various agricultural commodities, whose excessive consumption can pose significant risks to human health. In this study, we developed a facile mycotoxin detection platform based on branched hybridization chain reaction coupled with lateral flow assay. Ochratoxin A/Aflatoxin B1 bind to aptamers triggering the release of initiators, which leads to bHCR amplification and forms three-dimensional dendritic DNA nanostructures. Using the functionalized quantum dots as a fluorescent label, by leveraging smartphones and handheld ultraviolet lamps, the qualitative and quantitative detection of OTA and AFB1 can be achieved with a significantly enhanced sensitivity level, surpassing that of commercial test strips by 2–3 orders of magnitude. The visual detection limits for OTA and AFB1 were 30 pg/mL and 4 pg/mL, respectively. This approach eliminates the necessity for enzyme catalysis or the preparation and purification of antibodies and/or hapten, thereby reducing testing expenses and streamlining operational procedures. Moreover, substituting aptamer and nucleic acid sequences can effectively expand the scope of detection targets. Consequently, the as-proposed strategy exhibits great potential as a versatile technique, suitable for various analytical scenarios due to its sensitivity, accuracy, simplicity, and portability.

Isolation and purification of lactic acid bacteria and yeasts based on a multi-channel magnetic flow device and rapid qualitative and quantitative detection

Rapid isolation and identification of lactic acid bacteria and yeasts during fermentation is of great significance for quality control and regulation of fermented foods. In this study, we prepared a multi-channel magnetic flow device for rapid separation and purification of lactic acid bacteria and yeast, and based on SERS spectrum, we made rapid qualitative and quantitative analysis of Lactobacillus plantarum, Lactococcus lactis and Saccharomyces cerevisiae. The results showed that the synthesized Synthesized Fe3O4-Van antibiotic magnetic beads are paramagnetic; Fe3O4-Van antibiotic magnetic beads achieved capture efficiencies of more than 98.5 % for both L. plantarum and L. lactis at 102–104 CFU/mL, respectively. Separation and purification efficiency of single S. cerevisiae, L. plantarum and L. lactis by multi-channel magnetic flow device all reached more than 98 % with good isolation and purification results. The SERS spectra of the three microorganisms were classified and analyzed using linear discriminant analysis (LDA), and the accuracy of the established LDA model was 100 %, which completely differentiated the SERS spectra of the three microorganisms,and realized the qualitative identification of L. plantarum, L. lactis, and S. cerevisiae, and finally, quantitative model was established with the logarithmic values (lg C) of different concentrations of L. plantarum, L. lactis, and S. cerevisiae as the horizontal coordinates, and the Raman intensities at their strongest characteristic peaks of 512 cm−1, 1669 cm−1, and 1125 cm−1, respectively, were used as vertical coordinates to establish a quantitative model, with the lowest detection limit of 10 CFU/mL, and the digital quantification of lactic acid bacteria and yeast were achieved. It provided an effective means for real-time monitoring and tracking of the dynamics of lactic acid bacteria and yeast in the fermentation process and the quality control of fermented foods.

Machine learning-aided quantitative detection of two mixed antibiotics in a narrow concentration range based on oxygen incorporation-induced 3D SERS substrates

Amoxicillin (AMO) and ciprofloxacin (CIP) as frequently-used antibiotics are often simultaneously taken for anti-infection to protect pig and poultry production, while their effective therapeutic window is narrow. How to quantitatively detect the two antibiotics mixed in a narrow concentration range is essential to ensure their treatment efficacy and food safety. In this study, quantitative detection of AMO and CIP mixed in animal flesh in one order of magnitude concentration range was performed using a triple SERS signal amplification sensor combined with machine learning. The SERS sensor based on oxygen incorporation (Oi)-induced 3D NiO nanoflowers (NFs) coated with Ag nanoparticles included 3D hot spot effect from strong internal electromagnetic couple in NiO NFs, the Oi effect of NiO and synergistic charge transfer effect of between NiO and Ag. Based on triple enhancement effects, sensitive SERS detection of AMO and CIP was made with the limits of detection of 1 nM and 100 nM. Through the use of machine learning techniques like principal component analysis and partial least square regression, qualitative and quantitative detection of AMO and CIP in their mixture from 1.33 μM to 8.69 μM was successfully achieved, where the average proportion of absolute prediction error (p ≤ 0.15) for concentration was 98.06 %.

Development of a fully automated chemiluminescent immunoassay for the quantitative and qualitative detection of antibodies against African swine fever virus p72.

African swine fever (ASF), caused by ASF virus (ASFV), is a highly infectious and severe hemorrhagic disease of pigs that causes major economic losses. Currently, no commercial vaccine is available and prevention and control of ASF relies mainly on early diagnosis. Here, a novel automated double antigen sandwich chemiluminescent immunoassay (DAgS-aCLIA) was developed to detect antibodies against ASFV p72 (p72-Ab). For this purpose, recombinant p72 trimer was produced, coupled to magnetic particles as carriers and labeled with acridinium ester as a signal trace. Finally, p72-Ab can be sensitively and rapidly measured on an automated chemiluminescent instrument. For quantitative analysis, a calibration curve was established with a laudable linearity range of 0.21 to 212.0 ng/mL (R2 = 0.9910) and a lower detection limit of 0.15 ng/mL. For qualitative analysis, a cut-off value was set at 1.50 ng/mL with a diagnostic sensitivity of 100.00% and specificity of 98.33%. Furthermore, antibody response to an ASF gene-deleted vaccine candidate can be accurately quantified using this DAgS-aCLIA, as evidenced by early seroconversion as early as 7 days post-immunization and high antibody levels. Compared with available enzyme-linked immunosorbent assays, this DAgS-aCLIA demonstrated a wider linearity range of 4 to 16-fold, and excellent analytical sensitivity and agreement of over 95.60%. In conclusion, our proposed DAgS-aCLIA would be an effective tool to support ASF epidemiological surveillance.IMPORTANCEAfrican swine fever virus (ASFV) is highly contagious in wild boar and domestic pigs. There is currently no vaccine available for ASF, so serological testing is an important diagnostic tool. Traditional enzyme-linked immunosorbent assays provide only qualitative results and are time and resource consuming. This study will develop an automated chemiluminescent immunoassay (CLIA) that can quantitatively and qualitatively detect antibodies to ASFV p72, greatly reducing detection time and labour-intensive operation, and improving detection sensitivity and linearity range. This novel CLIA would serve as a reliable and convenient tool for ASF pandemic surveillance and vaccine development.

A-279 Performance Evaluation of the Respiratory Viral for BD MAX™ System in Geriatric Population

Abstract Background Respiratory Viral Infection is one of the most common infection in the geriatric population and cause major concern in the Long-Term Care Facilities. Influenza A and B, SARS-CoV-2, and respiratory syncytial virus (RSV) are responsible for most of the hospitalization and deaths among elderly patients. Rapid identification, treatment, and isolation are among the most important steps to fight the spreading of the infection. Methods The BD Respiratory Viral Panel for BD MAX™ System is an automated multiplexed real-time reverse transcriptase polymerase chain reaction (RT- PCR) test intended for the simultaneous, qualitative detection and differentiation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A, influenza B, and/or respiratory syncytial virus (RSV) nucleic acid in nasopharyngeal swab (NPS) and anterior nasal swab (ANS) specimens from individuals with signs and symptoms of respiratory tract infection. The assay is targeting RNA from the nucleocapsid phosphoprotein gene (N1 and N2 regions) of the SARS-CoV-2, a conserved region of the matrix protein M1 gene for influenza A, conserved regions of the matrix protein M1 gene and HA gene for influenza B, conserved regions of the N and M genes for RSV, and the human RNase P gene. The assay was evaluated for: precision, reproducibility, accuracy, and correlation with BioGx for SARS-CoV-2, Solana (Quidel) for influenza A, influenza B and RSV; the percentage agreement for the evaluation steps was calculated. We ran 86 samples collected from patients residing in Long-Term Care Facilities. Statistical analyses were done using Analyse-it. Results The percentage agreement for precision, reproducibility, and accuracy were 100%. The patients’ correlation was 100% when compared to the existing molecular testing in the laboratory. Female patients accounted for 62.8% (54 female and 32 male); 2 patients were positive for both influenza A and RSV, and one patient was positive for both influenza A and SAR-CoV-2. Conclusions The Respiratory Viral panel for BD MAX™ System gave the benefit of a fully automated, high precision, accuracy and acceptable sensitivity assay; in addition, it offers easier collection (one swabs versus multiple swabs), faster turnaround time for four targets in less than three hours which allow for earlier isolation to prevent the spreading of the infection and initiating treatment when needed. As with every molecular assay avoiding contamination is very important to eliminated false positive results.

A-240 Validation of the OSOM Flu SARS-CoV-2 Combo Home Test

Abstract Background COVID-19 and Influenza respiratory infections often cause similar symptoms, however, treatment is different for each infection. Delay in diagnosis can be fatal in some cases, therefore rapid detection and differentiation are critical for appropriate medical treatment. The OSOM Flu SARS-CoV-2 Combo Home Test is a lateral flow immunoassay intended for the qualitative and differential detection of nucleocapsid protein from SARS-CoV-2 and influenza A/B proteins using self-collected anterior nasal swab samples (self-collection is only recommended for those 14 years of age and older). An interpretation card, included with the test, is used to reliably distinguish among possible testing results. Methods A prospective study was conducted at multiple geographically distinct sites in the U.S during the 2023-2024 season for the validation of the OSOM Flu SARS-CoV-2 Combo Home Test to detect SARS-CoV-2/Flu A/Flu B in self-collected anterior nasal swab samples. The study evaluated the performance in symptomatic individuals only. A total of 703 prospective samples were evaluable for SARS. For Flu A/B, four additional subject samples were unevaluable due to comparator results not being available and a total of 699 samples were included in the data analysis. The comparator tests were FDA 510(k)-cleared molecular assays. Results Influenza A was detected with a sensitivity of 93.1% (95% CI: 84.8%-97.0%) and a specificity of 99.5% (95% CI: 98.6% - 99.8%). Influenza B was detected with a sensitivity of 89.1% (95% CI: 77.0% - 95.3%) and a specificity of 99.7% (95% CI: 98.9% - 99.9%). SARS CoV-2 was detected with a sensitivity of 87.0% (95% CI 78.6% - 92.4%) and a specificity of 99.1% (95% CI: 97.9% - 99.6%) when Ct values are standardized and 10% of samples are considered low positives, having a Ct value of ≥ 30. Conclusions With respiratory infections often showing indistinguishable symptoms and the possibility of co infection, lowering the testing hurdles for individuals to be able to perform a rapid differential test at home without the aid from a healthcare worker is the most effective way to mitigate spread and patient management from a public health perspective. Comparing the OSOM Flu SARS-CoV-2 Combo Home test to the FDA cleared comparators in a clinical setting, the OSOM Flu SARS-CoV-2 Combo Home test retains acceptable sensitivity and specificity. Using self-collected anterior nasal swabs which are minimally invasive alongside the low cost of a lateral flow immunochromatographic assay remains the most effective way to perform the serial screening testing recommended by the CDC in situations where transmission and severe outcome risk is high.

Construction of fluorescent probe based on phenoxazine for the detection of N2H4 in environmental, biological and food samples

Hydrazine (N2H4) is widely used in agrochemicals and pharmaceuticals, but unintentional releases of hydrazine can be transmitted through food, organisms and the environment, ultimately posing a serious hazard to human health. Consequently, the development of a rapid and sensitive analytical tool for the detection of N2H4 is necessary. In this study, we present the synthesis and application of a novel molecular probe (Probe PM). The probe is characterised by its simple synthesis, high yield and a range of analytical properties including very high sensitivity (limit of detection as low as 17.1 nM) and a pronounced fluorescence spectral blue shift of 146 nm. These attributes have enabled the successful implementation of Probe PM in the qualitative and quantitative detection and visualization of hydrazine in diverse environmental and biological matrices, including water samples, soil samples, food products, and biological systems. The probe has great potential for detecting environmental and food safety.

B-201 Clinical Performance Evaluation of IRON-qPCR™ RV, a Novel Molecular POCT system, for the Qualitative Detection of Respiratory Viruses in Nasopharyngeal Swab

Abstract Background The availability of Point-of-Care testing (POCT) based on molecular diagnostics to test simultaneously for multiple respiratory viruses is very limited though significant progress has been made in molecular testing for COVID-19 during the pandemic. Considering the similar symptoms presented by patients infected with various respiratory pathogens, it is crucial to have multiple POCT systems capable of detecting multiple respiratory pathogens while distinguishing SARS-CoV-2 from other pathogens. To meet the growing demand for multiplex testing for respiratory pathogens, a molecular POCT, IRON-qPCR™ RV has been developed. IRfON-qPCR™ RV is a multiplex real-time RT-PCR assay designed for the qualitative detection and differentiation of SARS-CoV-2, Influenza A, Influenza B, RSV-A, and RSV-B RNA from human nasopharyngeal swab specimens. The IRON-qPCR™ proceeds the entire process automatically from nucleic acid extraction to real-time RT-PCR within 40 minutes. The main goal of this study is to evaluate the clinical performance of IRON-qPCR™ RV in comparison with other assays and kits using nasopharyngeal swab samples. Methods To assess the clinical performance of the IRON-qPCR™ RV, specimen collection and evaluation were conducted at a clinical institution in France, utilizing a total of 980 nasopharyngeal swab samples. The comparators used were the Xpert® Xpress CoV-2/Flu/RSV plus Kit and the RealStar® RSV RT-PCR Kit 3.0. Since RSV subtypes are not distinguished by the Xpert kit, all RSV without subtype distinction were compared. Additionally, RealStar kit was used to compare the results of IRON-qPCR™ RV for RSV subtypes A and B. Clinical samples showing discrepancies between Xpert and RealStart, and the IRON-qPCR™ RV were further analyzed using Allplex™ SARS-CoV-2/FuA/FluB/RSV Assay and sequencing. Results Through the comparison of clinical performance of the IRON-qPCR™ RV with Xpert for SARS-CoV-2, Influenza A, and Influenza B in nasopharyngeal swab samples, the clinical sensitivity was analyzed to be over 95.5%, and the clinical specificity was over 99.6%. For RSV, compared to Xpert, the clinical sensitivity was analyzed to be 96.9%, and the clinical specificity was 98.9%. Furthermore, in comparison with RealStar, the clinical sensitivity and specificity of IRON-qPCR™ RV for RSV-A were determined to be 96.2% and 100%, respectively, and the clinical sensitivity and specificity for RSV-B were 96.0% and 100%. Additionally, discrepant samples in comparison with Xpert were further tested using the Allplex as a resolver kit. The result showed that the clinical sensitivity and specificity of IRON-qPCR™ RV for SARS-CoV-2, Influenza A, and Influenza B were over 98.3% and 100%. For RSV, the clinical sensitivity and specificity were 99.5% and 99.1%. Conclusions The clinical performance of IRON-qPCR™ RV was analyzed with the clinical sensitivity of over 95% and the clinical specificity of over 99%. Upon analysis including the results of the resolver kit for discrepant samples, increased clinical sensitivity and specificity were determined. The results of this study strongly support that the IRON-qPCR™ RV is a reliable POCT system for the simultaneous detection and differentiation of multiple respiratory viruses. Furthermore, it is applicable to district hospitals as well as clinical laboratories for accurate and timely testing.

A-278 Prevalence of Clostridium Difficile in Long-Term Care Facilities Using BD Max Cdiff Molecular Assay

Abstract Background Clostridium difficile (C.Diff) is a gram positive anaerobe producing Enterotoxin and Cytotoxin (toxin A and B respectively); more than half of million infection is diagnosed yearly with more than 10% of the cases are in patients over 65 years old. Residents in Long-Term Care Facilities (LTCF) are more prone to have C. Diff infection (CDI) because of their age, the frequent use of antibiotics, fragilities, co-morbidity, and living environment. Diagnosing CDI is based on clinical signs and symptoms as well as laboratory tests; however, the enzyme immunoassays are reliable, the tissue culture cytotoxicity is labor intensive. The nucleic acid amplification tests are becoming more the standard as first step in the diagnosis. The BD MAX™ System is a PCR walkaway instrument that provides the sensitivity, specificity and faster turnaround for the C. diff. Methods The BD MAX™ System is an automated in-vitro diagnostic test for the direct qualitative detection of the C. difficile toxin B gene (tcdB) in human liquid or soft stool specimens from patients suspected of having Clostridium difficile Infection (CDI). Premier Toxins A & B is an enzyme immunoassay for the direct detection of Clostridium difficile toxin A and toxin B in stool samples. We collected data from 5,267 samples were collected from resident in LTCF and were run using the EIA assay, 275 samples were ran using the BD Max molecular assay. We had 31 samples that were run using both assays. Statistical analyses were done using Analyse-it. Results Female accounted for 60% of the patients tested; the positivity rate was 13.2% for female and 17.2 for male using the EIA. The positivity rate was 19.2% for female and 30.6% for male when using the molecular assay. The agreement between the EIA and the PCR was 87% based on 31 samples that were run for both assays. Conclusions The BD Max gave the benefit of a fully automated with high sensitivity and specificity for the presence of toxin B producing C. Diff. The difference between the methods could be due to the lack of the sensitivity in the EIA and the fact that the molecular assay might be picking up colonized specimen or the beginning or end of infection. However, the ability to diagnose CDI early and prevent spreading of the disease to other patients is a huge benefit to the facilities. We have to keep in mind also that C.diff infection can be prevented with appropriate use of antibiotics and implementing antibiotic stewardship and infection control plan to prevent and stop spreading of the infection.

B-072 Analytical Evaluation of a Novel Fully Automated Multiplexed Microarray Immunoassay for the Simultaneous Detection of Eleven Autoantibodies Associated with Connective Tissue Diseases in a Spanish Reference Laboratory

Abstract Background Detection of different autoantibodies is key in the identification of autoimmune diseases; however, most available devices are either individual tests and/or manual/semi-automated. Development of fully-automated multiplexed devices for autoantibody testing is needed. We evaluated the analytical performance of the novel MosaiQ® AiPlex CTD (AiPlex-CTD) microarray, used with the fully-automated MosaiQ system, for simultaneous qualitative detection of eleven autoantibodies associated with connective tissue diseases (CTD), compared with selected CE-marked devices. Methods AiPlex-CTD microarrays (AliveDx, Switzerland) were prepared by printing antigens onto functionalized glass chips. Microarrays consisting of 2 separate sides (1 side was printed, leaving the other side available for future addition of antigens) were assembled into magazines (containing 250 microarrays) for processing on the MosaiQ 125 instrument. Serum samples from a Spanish refence laboratory, characterized as reactive to ≥1 autoantibodies using Quanta Flash® CTD Screen (Werfen, Spain) or as non-reactive by FIDISTM Connective Profile (Theradiag, France). All samples were tested with AiPlex-CTD. Positive percent agreement (PPA) and negative percent agreement (NPA), overall and for individual analytes were calculated. Results Compared with Quanta Flash® CTD Screen, AiPlex-CTD showed PPA ranging from 80% for Sm to 100% for SS-A 60, TRIM21, U1RNP, Jo-1 and Scl-70. No reactive samples were available for Sm/RNP and Ribosomal P. Compared with FIDIS, NPA ranged from 95% for dsDNA, Scl-70 and CENP-B and 100% for SS-A 60, TRIM21, SS-B, Sm, Sm/RNP, U1RNP, Jo-1 and Ribosomal P. Performance details for individual analytes are shown in the Table. Conclusions In this sample cohort, AiPlex-CTD demonstrated high concordance with the compared CE-marked devices for the automated qualitative detection of the autoantibodies included in the assay, which is line with previous observations in a larger cohort using FIDIS and other CE-marked devices. This high throughput multiplexed platform has the potential to help optimize CTD testing by simplifying complex testing pathways.

Analysis of tetrahydroisoquinolines formed after simultaneous consumption of ethanol and amphetamine or its derivatives by LC-MS/MS in human blood, brain, and liver tissue.

The effects of the simultaneous consumption of amphetamine or amphetamine derivatives and alcohol have not yet been adequately clarified, particularly concerning potential condensation products resulting from the endogenous reaction between these substances and their metabolites (e.g., acetaldehyde, a metabolite of ethanol). In this study, we developed an LC-MS/MS method employing liquid-liquid extraction for the qualitative detection of some relevant condensation products belonging to the class of tetrahydroisoquinolines and their derivatives in human blood, brain, and liver samples. This includes the analysis of the substrates amphetamine, methamphetamine, methylenedioxymethamphetamine, methylenedioxyamphetamine, as well as the condensation products 1,3-dimethyl-1,2,3,4-tetrahydroisoquinoline, N-methyl-1,3-dimethyl-1,2,3,4-tetrahydroisoquinoline, 1,3-dimethyl-7,8-methylenedioxy-1,2,3,4-tetrahydroisoquinoline, and N-methyl-1,3-dimethyl-7,8-methylenedioxy-1,2,3,4-tetrahydroisoquinoline. Therefore, the reference standards of the mentioned tetrahydroisoquinolines were synthesized in advance and the method was validated with regard to the question of the qualitative detection of these compounds. The validation parameters included selectivity, specificity, limit of detection, lower limit of quantification, recovery, matrix effects, and stability for blood, brain, and liver samples. Following the analysis of human blood and post-mortem tissue samples, evidence of the condensation product 1,3-dimethyl-1,2,3,4-tetrahydroisoquinoline originating from the interaction between amphetamine and acetaldehyde was identified in two liver samples. On the contrary, no evidence of this or other tetrahydroisoquinolines was found in the remaining tissue and serum samples.

B-281 Performance Characteristics Evaluation of the ARK Diagnostics Immunoassay for Xylazine/4-HydroxyXylazine in Urine

Abstract Background Xylazine exposure is currently common in some US cities, but routine laboratory testing is not available. We evaluated the ARK Diagnostics immunoassay for qualitative detection of xylazine/4-hydroxy Xylazine in urine, prior to its anticipated release as a Forensic Use Only assay. Evaluation of performance characteristics of the ARK assay were conducted at two university hospitals, using either the semi-quantitative application of the assay, as performed on the Roche Cobas 503 analyzer (Institution A), or the qualitative application of the assay, as performed on the Beckman Coulter AU480 analyzer (Institution B). Methods Xylazine (X) and 4-hydroxy Xylazine (4-OHX) were obtained from Cayman Chemical (Ann Arbor, MI). Pooled xylazine-free urine was spiked either with X or 4-OHX in the range of 0-2000 ng/mL. De-identified, to-be-discarded patient urine samples were obtained from among those submitted for routine drugs-of-abuse panel testing. X measurements on all samples were performed by LC-MS/MS; samples were segregated into X-NEGATIVE (X<10 ng/mL) and X-POSITIVE (X>=10 ng/mL). The ARK assay was conducted according to manufacturer’s instructions, either as a semi-quantitative assay (Institution A, Roche analyzer) or as a qualitative assay (Institution B, Beckman Coulter analyzer), with 10 ng/mL as the manufacturer-specified cutoff for ARK POSITIVE, using manufacturer-supplied calibration standards ranging from 0-500 ng/mL X. Results The ARK semi-quantitative analysis (Roche analyzer) showed essentially equivalent curvilinear response curves for either X or 4-OHX at concentrations below 1000 ng/mL; for the semi-quantitative ARK assay, we use “>1200 ng/mL” for X-ARK >1200 ng/mL. By mixing studies (Roche), there were neither positive nor negative interferences observed as assessed for common drugs of abuse or for common therapeutic drugs. The presence of hemoglobin, bilirubin or moderate lipemia were devoid of assay interference. Precision studies for manufacturer-supplied controls were as follows: intra-assay CVs were 6.9% for the NEGATIVE control (5.1±0.35 ng/mL) and 5.9% for the POSITIVE control (15.7±0.53 ng/mL) (n=20); interassay CVs were 7.8% for the NEGATIVE control (5.1±0.40 ng/mL) and 5.7% for the POSITIVE control (15.9±0.90 ng/mL) (n=20). For the qualitative ARK assay as performed on the Beckman analyzer, POSITIVE and NEGATIVE controls ran invariably according to their designations. For the semi-quantitative assay application (Roche analyzer): among 78 X-NEGATIVE samples by LC-MS/MS, there were 0% ARK-POSITIVE results (false-positive rate=0%); among 74 X-POSITIVE samples by LC-MS/MS, there was one ARK-NEGATIVE result (false-negative rate=1.4%); this sample (X=65 ng/mL) was found to have a high amorphous crystalline content, and was unable to be reanalyzed. For the qualitative assay application (Beckman Coulter analyzer): among 78 X-NEGATIVE samples there was one ARK-POSITIVE sample (false-positive rate=1.3%) for a sample with xylazine=8.8 ng/mL by LC-MS/MS, with undetectable 4-OHX (<10 ng/mL); among 74 X-POSITIVE samples, there were no ARK-NEGATIVE results (false-negative rate=0%). Conclusions The ARK xylazine immunoassay demonstrated acceptable analytical performance with respect to detection of xylazine in urine at 10 ng/mL. With additional consideration of the assay’s cross reactivity with the major xylazine metabolite, 4-OH-xylazine, the assay was judged to be highly suitable for routine use as a screening test for detection of xylazine exposure via urine testing.