Development of diagnostic kits for selected markers of resistance, virulence and zoonotic transmission among methicillinresistant

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Development of diagnostic kits for selected markers of resistance, virulence and zoonotic transmission among methicillinresistant Staphylococcus aureus strains Dr. Boris Oberheitmann, Constanze Seidel Q Bioanalytic GmbH, BMBF Projekt MetVetStaph II, IP11

Content 1. Background a) Q Bioanalytic GmbH b) NALFIA 2. Developments 1. Triplex NALFIA test for meca, mecc and cyt b 2. Improved DNA purification and optimization of sampling 3. Triplex CC398, meca and cyt b Real Time PCR 3. Outlook

Q Bioanalytic GmbH Existing portfolio More than 20 Real Time PCR kits for food safety and quality testing Selection of Real Time PCR Kits 1. QuickBlue MRSA 2. OneCup Salmonella 3. OneCup Listeria spec. 4. QuickBlue Listeria monocytogenes 5. QuickBlue Staphylococcus aureus 6. QuickBlue Cronobacter sakazakii 7. QuickBlue Clostridium perfringens 8. QuickBlue E. coli 9. QuickBlue Campylobacter jejuni 10. QuickBlue E. coli, EHEC, EPEC, EIEC, Shigella 11. QuickBlue EHEC (stx1, stx2, eaea) 12. QuickBlue Vibrio vulnificus 13. QuickBlue Vibrio parahaemolyticus 14. QuickBlue Vibrio cholerae 15. QuickBlue Vibrio alginolyticus 16. QuickBlue Legionella pneumophila 17. QuickBlue Legionella spec. 18. QuickBlue Pseudomonas aeruginosa

Q Bioanalytic GmbH Existing portfolio in medical microbiology IVD CE marked Real Time PCR for MRSA DNA Purification kit based on magnetic nano particles

Q Bioanalytic GmbH Tasks: Development of PCR based test kits using NALFIA and Real Time PCR for rapid multianalyte diagnosis of resistance determinants a) meca and new mecc homologues b) Differentiate between human and livestock related MRSA lineages such as CC398 c) Typical relevant virulence or resistance markers

NALFIA Nucleic acid lateral flow immuno assay (NALFIA) = Combining molecular biological principle of detection with immunochemical principle of visualization

NALFIA

Why NALFIA? 1. Bringing PCR to environments outside of labs and to Point of Care applications 2. Bringing the analytical knowledge to Point of Care users through smartphone applications

Developments 1. NALFIA test addressing meca, mecc and cyt b Detection of meca, mecc gene and cyt b as internal amplification control (IAC) using NALFIA. Detection limit: SCCmec VI (meca) 1.5 pg, 10 100 cfu SCCmec XI (mecc), 15 pg, 100 1000 cfu Seidel et al. "Development of a nucleic acid lateral flow immunoassay (NALFIA) for reliable, simple and rapid detection of the methicillin resistance genes meca and mecc." Veterinary Microbiology (2016).

DNA purification and optimization of sampling Risk assessment concerning limit of detection in clinical samples revealed: Insufficient DNA purification can lead to false negative results Sampling with certain swabs can lead to insufficient release of the material into the purification reagents Time of analysis is a critical factor for acceptance of the methods in clinical settings Conclusion: DNA extraction and/or sampling have to be optimized

Developments Performance of prior existing DNA purification methods QuickBlue DNA extraction kit (QBA): Extraction using spin column technology : LoD: 300 cfu 3 x 10 4 cfu

Developments 2. New optimized DNA purification procedure Step 1 Swab sample transferred into a tube with lysis buffer (thermal lysis) Step 2 Supernatant transferred to tube with binding buffer and silica magnetite nanoparticles Step 3 Nano particles are magnetically immobilized and re suspended in 100μL elution buffer Purification time max 30 min

Developments: 2. New DNA purification Optimized QuickBlue DNA extraction kit (QBA) 15000 cfu 1500 cfu 150 cfu 15 cfu

Optimization of sampling Comparison of detection efficiency by Real Time PCR Classiq Swabs by COPAN: Tip wrapped with traditional Polyester fiber. Flocked Swabs by COPAN: FLOQSwabs

Optimization of sampling, Testing by dipping swabs in a decadal dilution series. A MRSA strain was grown 48hrs in Giolitti broth. Subsequently the culture was diluted and swabs were dipped into it in the presence and absence of 30µl blood. Classiq Swabs by COPAN: Flocked Swabs by COPAN: Dipping 30 sec. in each dilution and drying for 5 min.

Optimization of sampling Classiq Swabs by COPAN FLOQSwabs by COPAN 10 0 10 1 10 0 10 1 10 2 10 2 10 3 Results of experiments in the presence of blood

Results optimization of DNA purification and sampling 1. Risk of false negative results due to insufficient DNA purification could be reduced by reducing the limit of detection from 300 cfu to 15 150 cfu (30 minutes purification time) 2. Recovery rates from swabs in the presence of blood could be enhanced by an order of magnitude through application of FLOQSwabs

Developments 3. Triplex CC398, meca and cyt b Real Time PCR Specific primers for LA MRSA CC398 after Stegger et al. (2011) Primers for the detection of meca and cyt b Real Time PCR with SybrGreen Real Time PCR with TaqMan probe

Developments 3. Triplex CC398, meca and cyt b Real Time PCR Pure culture with matrix Sample NC PC Sample NC PC CC398, 296 bp meca, 171 bp cyt b, 123 bp

Developments 3. CC398 Real Time PCR Detection of cc398 in HEX channel Detection of meca in Cy5 channel Detection of cyt b in FAM channel 0,460 4,138 0,977

3. Summary Developments: a) Multiplex test for meca, mecc gene and cyt b (IAC) using NALFIA b) Optimization of magnetic nano particle based purification method in combination with FLOQSwabs c) Triplex test cc398 with Real Time PCR including internal control Outlook: Validation of the CC398 Real Time PCR

4. Outlook Optimization work of the triplex Real Time PCR system for detection of cc398, meca, and cyt b Validation of the Real Time PCR for detection of CC398: Sensitivity Specificity Limit of detection Robustness Development of NALFIAs to detect: meca/c, S. aureus and IAC other MRSA resistance genes MRSA virulence genes

Constanze Seidel Dipl. Biol. Sonja Peters PD Dr. rer. nat. Maren von Köckritz-Blickwede Prof. Dr. med. vet. Stefan Schwarz Andrea T. Feßler, PhD Vielen Dank für Ihre Aufmerksamkeit! Thanks for your co operation