Bacterial species identification after DNA amplification with a universal primer pair.

The diagnosis of bacterial infections can be difficult and time consuming. Rapid and reliable molecular triage of potentially infected patients, particularly the young and the elderly, would prevent unnecessary hospitalizations, reduce associated medical costs, and improve the quality of care. Polymerase chain reaction (PCR) amplification utilizing a universal bacterial primer pair, followed by hybridization with species-specific probes, would allow rapid identification of the presence or absence of bacterial DNA, along with an identification of the bacterial species present. Molecular microbiological analyses will require access to bacterial strain standards that can be catalogued and distributed to clinical laboratories. We amplified template DNA in filter paper spots containing boiled bacteria from 14 clinical isolates using a universal primer pair for the 16S ribosomal RNA (rDNA) coding sequence. Species-specific probes were hybridized to the amplification products for bacterial species identification. We conclude that template DNA can be identified with species-specific probes after universal bacterial amplification with a single primer pair. We also demonstrate a rapid and efficient method for the long-term storage and cataloguing of bacterial DNA for use in quality control at clinical laboratories adopting molecular diagnostic methodologies. We speculate that PCR amplification combined with species-specific probe hybridization not only will represent an improvement over culture-based methods in terms of speed, sensitivity, and cost, but will also allow for the identification of unculturable bacteria and emerging or reemerging pathogenic organisms.

[1]  M. Altwegg,et al.  Homogeneity of 16S-23S Ribosomal Intergenic Spacer Regions of Tropheryma whippelii in Swiss Patients with Whipple’s Disease , 1999, Journal of Clinical Microbiology.

[2]  P. Mccarthy Controversies in Pediatrics: What Tests Are Indicated for the Child Under 2 with Fever , 1979, Pediatrics In Review.

[3]  R. Mcnutt,et al.  Management of infants at risk for occult bacteremia: a decision analysis. , 1991, The Journal of pediatrics.

[4]  G. Church,et al.  Genomic sequencing. , 1993, Methods in molecular biology.

[5]  E. McCabe,et al.  Amplification of bacterial DNA using highly conserved sequences: automated analysis and potential for molecular triage of sepsis. , 1995, Pediatrics.

[6]  E. McCabe,et al.  Molecular genetic diagnosis of infectious diseases. , 1997, Pediatric annals.

[7]  N. Pace,et al.  Phylogenetic analysis of Aquaspirillum magnetotacticum using polymerase chain reaction-amplified 16S rRNA-specific DNA. , 1991, International journal of systematic bacteriology.

[8]  M. Loeffelholz,et al.  PCR primers and probes for the 16S rRNA gene of most species of pathogenic bacteria, including bacteria found in cerebrospinal fluid , 1994, Journal of clinical microbiology.

[9]  Gabriel J. Escobar,et al.  Score for neonatal acute physiology: validation in three Kaiser Permanente neonatal intensive care units. , 1995, Pediatrics.

[10]  D. Relman,et al.  Identification of the uncultured bacillus of Whipple's disease. , 1992, The New England journal of medicine.

[11]  W. Carroll,et al.  Treatment of occult bacteremia: a prospective randomized clinical trial. , 1983, Pediatrics.

[12]  M. Polycarpou,et al.  Multiparameter models for the prediction of sepsis outcome. , 1996, Annals of clinical and laboratory science.

[13]  J. Freney,et al.  Identification of Staphylococcus species by 16S-23S rDNA intergenic spacer PCR analysis. , 1998, International journal of systematic bacteriology.

[14]  K. Mullis,et al.  Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for diagnosis of sickle cell anemia. , 1985, Science.

[15]  C. Nozicka Evaluation of the febrile infant younger than 3 months of age with no source of infection. , 1995, The American journal of emergency medicine.

[16]  H. Wigder,et al.  A comparative study of the prevalence, outcome, and prediction of bacteremia in children. , 1983, The Journal of pediatrics.

[17]  S. Yoshida,et al.  Development of a new seminested PCR method for detection of Legionella species and its application to surveillance of legionellae in hospital cooling tower water , 1997, Applied and environmental microbiology.

[18]  Norman R. Pace,et al.  The largest bacterium , 1993, Nature.

[19]  D. Persing,et al.  Diagnostic molecular microbiology : principles and applications , 1993 .

[20]  S. Brodine,et al.  Infections among patients in nursing homes: policies, prevalence, problems. , 1981, The New England journal of medicine.

[21]  J. Radolf,et al.  Sensitive detection of Treponema pallidum by using the polymerase chain reaction , 1991, Journal of clinical microbiology.

[22]  K. Batts,et al.  Diagnosis and Monitoring of Whipple Disease by Polymerase Chain Reaction , 1997, Annals of Internal Medicine.

[23]  P. Normand,et al.  Species identification of Legionella via intergenic 16S-23S ribosomal spacer PCR analysis. , 1998, International journal of systematic bacteriology.

[24]  I. Weinstein,et al.  Direct detection and amplification of Helicobacter pylori ribosomal 16S gene segments from gastric endoscopic biopsies. , 1990, Diagnostic microbiology and infectious disease.

[25]  E. McCabe,et al.  Utility of PCR for DNA analysis from dried blood spots on filter paper blotters. , 1991, PCR methods and applications.

[26]  B. Lesourd Protein undernutrition as the major cause of decreased immune function in the elderly: clinical and functional implications. , 2009, Nutrition reviews.

[27]  E. McCabe,et al.  Application of molecular genetics in public health: improved follow-up in a neonatal hemoglobinopathy screening program. , 1994, Biochemical medicine and metabolic biology.

[28]  V. Stanisich,et al.  New approaches to typing and identification of bacteria using the 16S-23S rDNA spacer region. , 1996, Microbiology.

[29]  K. Wilson,et al.  Sequence-based differentiation of strains in the Mycobacterium avium complex , 1993, Journal of bacteriology.

[30]  T. Lieu,et al.  Strategies for diagnosis and treatment of children at risk for occult bacteremia: clinical effectiveness and cost-effectiveness. , 1991, The Journal of pediatrics.

[31]  G. Schoolnik,et al.  Detection of Shigella in feces using DNA amplification. , 1990, The Journal of infectious diseases.

[32]  P. Palittapongarnpim,et al.  Differentiation between Mycobacterium tuberculosis and Mycobacterium avium by Amplification of the 16S-23S Ribosomal DNA Spacer , 1998, Journal of Clinical Microbiology.

[33]  D V Cicchetti,et al.  Predictive value of abnormal physical examination findings in ill-appearing and well-appearing febrile children. , 1985, Pediatrics.

[34]  X. Nassif,et al.  RAPID DIAGNOSIS OF TUBERCULOSIS BY AMPLIFICATION OF MYCOBACTERIAL DNA IN CLINICAL SAMPLES , 1989, The Lancet.

[35]  D. Relman,et al.  Haemophilus parainfluenzae endocarditis: application of a molecular approach for identification of pathogenic bacterial species. , 1994, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[36]  J. Avner,et al.  Failure of infant observation scales in detecting serious illness in febrile, 4- to 8-week-old infants. , 1990, Pediatrics.

[37]  J. W. Bass,et al.  Febrile children with no focus of infection: a survey of their management by primary care physicians. , 1993, The Pediatric infectious disease journal.

[38]  J. Bonnet,et al.  Detection of Mycoplasma pneumoniae by using the polymerase chain reaction , 1989 .