The goal of this project is to facilitate rapid diagnosis of drug resistant tuberculosis from sputum at the point of care in primary health care facilities using a handheld, easy to use, inexpensive, closed unit fully integrated nucleic acid testing device. The cost of the envisioned system will be 10-100 times lower and the size will be significantly smaller than current PCR-based fully integrated benchtop systems for point of care nucleic acid testing. The project builds upon ongoing work aimed at developing a similar albeit simpler system for detection of Herpes Simplex Virus from swab samples. The assay is based on the isothermal EXponential Amplification Reaction (EXPAR) coupled to visual detection using lateral flow. Simple and rapid sample preparation utilizes a miniaturized bead blender originally development for mechanical lysis of anthrax spores, which in its current version is also capable of nucleic acid purification. The proposed concept involves a handheld, battery operated instrument, to which a disposable plastic cartridge is attached. The cartridge houses chambers, valves, and fluid conduits for sample preparation, amplification and detection, all in a single, closed system. In its final form, the cartridge will contain all necessary reagents on board. The handheld instrument controls the pumping, valving and isothermal heating steps necessary for test execution. The operator simply attaches the cartridge to the instrument, inserts the sample, initiates the test by pushing a button, and after approximately 30 minutes to one hour reads off the result. Such a system will allow health care professionals in a point-of- care setting to diagnose and treat drug resistant tuberculosis in a timely manner, thereby improving patient outcomes and preventing further spread.
Aim 1 of this project focuses on establishing a simple, rapid and effective sample preparation method applicable to Mycobacterium tuberculosis in sputum.
Under Aim 2, we will establish multiplexed isothermal nucleic acid amplification assays based on EXPAR, coupled with lateral flow based detection.
Aim 3 of this project focuses on developing cartridge and instrument prototypes to execute the sample preparation, isothermal amplification, and visual detection methods developed under aims 1 and 2. Performance verification for tasks described under Aims 1-3 will initially involve BSL2 surrogates and DNA extracts of M. tuberculosis, followed by drug susceptible and resistant M. tuberculosis grown in culture and spiked into TB negative sputum, and ultimately clinical sputum samples that have been tested for M. tuberculosis and antimicrobial susceptibility using established methods. This project presents a unique opportunity to bring together multidisciplinary expertise to develop a next generation of assays and analyzers for nucleic acid testing. In the long term, the assays and devices developed herein can be applied to a spectrum of pathogens relevant to biothreat detection and infectious disease diagnosis in resource-limited settings. The goal of this project is to facilitate rapid diagnosis of drug resistant tuberculosis from sputum at the point of care in primary health care facilities using a handheld, easy to use, inexpensive, closed unit fully integrated nucleic acid testing device. The cost of the envisioned system will be 10-100 times lower and the size will be significantly smaller than current PCR-based fully integrated benchtop systems for point of care nucleic acid testing.

Public Health Relevance

The goal of this project is to facilitate rapid diagnosis of drug resistant tuberculosis from sputum at the point of care in primary health care facilities using a handheld, easy to use, inexpensive, closed unit fully integrated nucleic acid testing device. The cost of the envisioned system will be 10-100 times lower and the size will be significantly smaller than current PCR-based fully integrated benchtop systems for point of care nucleic acid testing.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI090831-04
Application #
8493985
Study Section
Special Emphasis Panel (ZAI1-LR-M (M2))
Program Officer
Jacobs, Gail G
Project Start
2010-07-01
Project End
2014-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
4
Fiscal Year
2013
Total Cost
$803,134
Indirect Cost
$161,341
Name
Keck Graduate Institute of Applied Life Scis
Department
Type
DUNS #
011116907
City
Claremont
State
CA
Country
United States
Zip Code
91711
Ferguson, Tanya M; Weigel, Kris M; Lakey Becker, Annie et al. (2016) Pilot study of a rapid and minimally instrumented sputum sample preparation method for molecular diagnosis of tuberculosis. Sci Rep 6:19541
Roskos, Kristina; Hickerson, Anna I; Lu, Hsiang-Wei et al. (2013) Simple system for isothermal DNA amplification coupled to lateral flow detection. PLoS One 8:e69355
Vandeventer, Peter E; Mejia, Jorge; Nadim, Ali et al. (2013) DNA adsorption to and elution from silica surfaces: influence of amino acid buffers. J Phys Chem B 117:10742-9
Hickerson, Anna I; Lu, Hsiang-Wei; Roskos, Kristina et al. (2013) Disposable Miniature Check Valve Design Suitable for Scalable Manufacturing. Sens Actuators A Phys 203:76-81
Qian, Jifeng; Ferguson, Tanya M; Shinde, Deepali N et al. (2012) Sequence dependence of isothermal DNA amplification via EXPAR. Nucleic Acids Res 40:e87
Vandeventer, Peter E; Lin, Jessica S; Zwang, Theodore J et al. (2012) Multiphasic DNA adsorption to silica surfaces under varying buffer, pH, and ionic strength conditions. J Phys Chem B 116:5661-70
Niemz, Angelika; Boyle, David S (2012) Nucleic acid testing for tuberculosis at the point-of-care in high-burden countries. Expert Rev Mol Diagn 12:687-701
Vandeventer, Peter E; Weigel, Kris M; Salazar, Jose et al. (2011) Mechanical disruption of lysis-resistant bacterial cells by use of a miniature, low-power, disposable device. J Clin Microbiol 49:2533-9
Niemz, Angelika; Ferguson, Tanya M; Boyle, David S (2011) Point-of-care nucleic acid testing for infectious diseases. Trends Biotechnol 29:240-50