utility of multiplexed molecular panels for infectious disease … · 2018-11-08 · heterogeneous,...

Utility of SyndromicMolecular Panels for Infectious Disease Testing

Ted E. Schutzbank, PhD, D(ABMM)

Laboratory Director

Quantigen LLC

Syndromic Infectious Disease Panels

• Detection of organisms specific to distinct syndromes

• Respiratory infections• Gastrointestinal infections• CNS disease• Sepsis• Urinary tract infections (UTI)• Women’s health• Sexually transmitted infections (STI)

• Test panels are not restricted to a specific organism type

• Bacteria• Viruses• Fungi• Parasites

Syndromic ID panels – Major Advantages

• Increased diagnostic yield to multiple targets from a single available sample

• Conserve and optimize analysis of rare and difficult samples (e.g. CSF)

• Simplify ordering algorithm• Streamline workflow in the laboratory

while reducing hands-on time• Consolidation of multiple flows into a single

method• reduces turn-around time and

labor/reagent/supply costs

• Savings compared to testing for organisms in individual assays

• Standardization of testing

Adapted from E. Palavecino, AACC Clin Lab News, April 1, 2015

Syndromic ID Panels –HistoricalChallenges

• False positive results due to cross reactivity or non-specific amplification caused by multiple primers/targets in the reaction

• False negative results due to preferential amplification of one target over another

• Added cost of testing for inappropriate target organisms

• High cost of commercial kits and instruments

Adapted from E. Palavecino, AACC Clin Lab News, April 1, 2015

Commercially Available

Syndromic tests

Respiratory Disease

Ramanan et al, Clinical Microbiology Reviews, 31: 1 – 28, 2018)

Respiratory Syndromic Testing

in the ED –Outcomes Study

Arch Pathol Lab Med 139, 636-641, 2015

Respiratory Syndromic

Testing in the ED –

Outcomes Study

• Mean time to the test result was shorter (6.4 hours versus 18.6 hours)

• The percentage of patients having a diagnostic test result in the emergency department was greater (51.6% versus 13.4%)

• There was no difference in whether antibiotics were prescribed, but the duration of antibiotic use was shorter

• dependent on receiving test results within 4 hours

• If the test result was positive, the inpatient length of stay (P = .03) and the time in isolation (P = .03) were decreased

• Overall conclusion: Use of panel basedrespiratory PCR testing in the ED decreases the duration of antibiotic use, the length of inpatient stay, and the time in isolation.

Commercially Available

Syndromic Panels

GI Infections


Current Commercially

Available Syndromic

PanelsGI Infections

cont.

BD MAX™ ENTERIC BACTERIAL PANEL

Salmonella spp.

Shigella spp./EIEC,

Campylobacter spp. (jejuni and coli)

Shiga toxin-producing organisms (STEC, Shigella

dysenteriae)

BD MAX™ EXTENDED ENTERIC BACTERIAL

PANEL

Yersinia enterocolitica

Enterotoxigenic E. coli (ETEC)

Plesiomonas shigelloides

Vibrio(V. vulnuficus/ V. parahaemolyticus/V.

cholerae)

BD MAX™ Enteric Parasite Panel

Giardia lamblia

Cryptosporidium spp. (C. parvum and C. hominis)

Entamoeba histolytica

BD MAX™ ENTERIC VIRAL PANEL

Norovirus

Rotavirus

Adenovirus (40/41)

Sapovirus

Human Astrovirus

Panel Based Gastrointestinal

PCR Testing: Clinical

Outcomes

Clinical Infectious Diseases, ciy357, https://doi.org/10.1093/cid/ciy357

https://doi.org/10.1093/cid/ciy357

Improved Detection by Gastrointestinal Syndromic Panel PCR Compared to Conventional Testing

Cybulski et al

Cybulski et al Study Results

• A total of 1887 consecutive fecal specimens were tested in parallel by Gastrointestinal Panel PCR (GIPCR) and stool culture.

• GIPCR detected pathogens in 35.3% of specimens, compared to 6.0% for culture

• GIPCR allowed increased recognition of coinfections

• Median time from collection to result was 18 hours for GIPCR and 47 hours for culture

• Median time from collection to initiation of antimicrobial therapy was 22 hours for GIPCR and 72 hours for culture.

• Patients diagnosed by GIPCR were more likely to receive targeted rather than empirical therapy, compared to those diagnosed by culture (P = .0148)

• Positive Shiga-like toxin-producing E. coli results were reported 47 hours faster with GIPCR and facilitated discontinuation of empirical antimicrobials

PCR Panels -Blood Culture Applications


PCR Panels -Blood Culture

Patient Outcomes

Mortality outcomes with molecular rapid diagnostic

testing (mRDT) versus conventional testing in bloodstream infection

Odds ratios (ORs) were determined with

the Mantel-Haenszel random-effects method.

Abbreviations:ASP, antimicrobial stewardship program

CI, confidence interval.

Timbrook et al, CID 2017:64, 15-23

Advantages and Disadvantages Current Commercially Marketed Testing Platforms/Tests

• Advantages• Standardized systems needing minimal effort to

set up• Established test performance characteristics• Rapid turn-around time• Simple to use “sample to answer” format• Moderate complexity

• Disadvantages• High cost per patient test• Locked into target organisms selected by the

manufacturer• Appropriateness of target organisms chosen by

the manufacturer• Scalability

Why Custom Syndromic Arrays?

• Flexibility• You test for only those molecular targets that are

appropriate for your laboratory

• Higher throughput• Multiple patient samples can be tested per array

• Sample number depends on number of molecular targets on the array

• Lower per patient cost per test

Why Custom Syndromic Arrays?

BV Open Array Panel Target Organisms

Pathogenic Commensal lactobacilli

Atopobium vaginae Lactobacillus crispatus

BVAB2* Lactobacillus gasseri

Gardnerella vaginalis Lactobacillus iners Lactobacillus iners

Megasphaera 1 Lactobacillus jensenii Lactobacillus jensenii

Megasphaera 2 Lactobacillus jensenii

Mobiluncus curtisii

Mobiluncus mulieris

Mycoplasma hominis

Prevotella bivia

Ureaplasma urealyticum

*Bacterial Vaginosis–Associated Bacterium type 2

Jarvis et al.

BV Open Array Panel Target Organisms

Jarvis et al.

Example of a Custom Panel: Women’s Health Testing

“Thermo Fisher Scientific and its affiliates are not endorsing, recommending, or promoting any use or application of Thermo Fisher Scientific products presented by third parties during this seminar. Information and materials presented or provided by third parties are provided as-is and without warranty of any kind, including regarding intellectual property rights and reported results. Parties presenting images, text and material represent they have the rights to do so. “

Application of OpenArray real-time PRC technology in

Vaginal Microbiota Investigations

Sandeep Mukherjee, PhD

Scientific Director, Women’s Health & Infectious Diseases,

PathGroup

Disclosure

• For Research Use Only. Not for use in diagnostic procedures

• Thermo Fisher Scientific and its affiliates are not endorsing, recommending, or promoting any

use or application of Thermo Fisher Scientific products presented by third parties during this

seminar. Information and materials presented or provided by third parties are provided as-is

and without warranty of any kind, including regarding intellectual property rights and

reported results. Parties presenting images, text and material represent they have the rights to

do so.

Disclaimer

• Microbiomes in health and disease– Vaginal microbiota: finely balanced mutualistic association

– Indigenous bacterial communities prevent colonization by pathogenic

organisms

– concept of normal versus abnormal microbiota

– humans coexist with complex bacterial communities that are relatively

unique to specific niches such as the gastrointestinal tract and the oral

cavity

– Impact in human health

• Symptomatic/asymptomatic bacterial vaginosis, yeast infections, STI, UTI

Overview

• Culture has been inadequate (>99% cannot be cultivated)

• 16S rRNA gene sequencing

• Unprecedented detail, ID low abundance taxa

• Cpn60, rpoC, uvrB, RecA

• Several distinct vaginal communities with different species

composition

– Variation in different ethnic groups

• Differences in species composition correlate with response to

“disturbances”

Overview

• Inflammation of the vagina; discharge, itching and pain (11 million office

visits per year)

– Bacterial vaginosis: associated with an altered microbial flora (absence of gross

appearance of inflammation)

– Vulvovaginal candidiasis: caused by naturally occurring fungus of Candida spp.

• 2nd most common cause of vaginitis symptoms

– Trichomonal vaginitis: sexually transmitted parasite Trichomonas vaginalis

– Aerobic vaginitis: Depletion of healthy Lactobacillus species with aerobic pathogens,

mostly of intestinal origin

– Vaginal atrophy (atrophic vaginitis): reduced estrogen levels after menopause

– Overlapping symptoms

Vaginitis

Shift in vaginal flora from homogeneous, lactobacillus dominated state to a

heterogeneous, complex population of anaerobic & microaerophilic organisms -

Polybacterial dysbiosis

– Upper genital tract infections

– Pelvic Inflammatory Disease (PID)

– Adverse pregnancy outcomes

– Increased risk of STI

CDC:

– most commonly reported microbiological syndrome among women of childbearing age

– 15% to 50% of vaginitis/vaginosis depending upon the patient population

– Prevalence: 29.2%, among women ages 14 to 49

– 84% of women with BV do not report symptoms

Bacterial Vaginosis

• Hallmark of healthy vagina; dominant vaginal bacterial species in majority of

women

• Vaginal pH ~3.5 to 4.5, lactic acid production through fermentation

• Protection against non-commensal & potentially pathogenic organisms

• Distribution of Lactobacillus dominated community types varies among

different ethnicities

• 20% to 30% of asymptomatic healthy women lack significant numbers of

Lactobacillus spp.

Lactobacillus spp.

• Aerobic Vaginitis

– Escherichia coli, Group B Streptococcus, Staphylococcus aureus, Enterococcus faecalis

– Localized vaginal inflammatory immune response

– Confused with common vaginitis etiologies

– 4.3% to 7.9% women attending vaginitis clinics were found to have moderate to severe

symptoms of AV

• Genital Ulcer

– Young, sexually active patients with genital, anal, or perianal ulcers

– Genital herpes (HSV-1/HSV-2)

– Syphillis (Treponema pallidum)

– Chancroid (Haemophilus ducreyi)

– Chlamydia trachomatis

– Differentiate from non-sexually acquired genital ulceration

Related panels

• Conventional microbiological approaches – limited utility

• Quantitative/semi-quantitative PCR for BV diagnosis

– Lack of standardization (different marker organisms, different thresholds)

– Limited number of organisms

• Need for a multi-variate analysis of BV associated marker

organisms

– Microbiome?

Rationale

• Custom panel/s based on clinical association and potential utility

• Consolidation of targets

• Flexibility

• Sensitive, specific, rapid

• Detection of BV, non-BV targets

• Variability of specimen collection, multiplicity of targets

Potential Utility

– “Pan-bacteria” control

– Normalization to standardize results

– Integrated interpretation – “normal", "borderline”,

“abnormal”

– ThinPrep or BD Universal Swab

Highlights

• OpenArray Digital PCR plates

– 48 subarrays; 64 through-holes/subarray

– 3,072 individual real-time PCR assays in parallel on

a single OpenArraay

– 4 arrays can be run at the same time (12,288

assays)

– 33 nL reaction volume

– Hydrophilic interior & external hydrophobic

coatings

• 48 specimen per OpenArray

– 192 specimens per run (6 hours)

– 26 organisms per specimen

• Simple workflow

OpenArray from Life Technologies

For Research Use Only. Not for use in diagnostic procedures.

Assay Workflow

DNA isolation

Load samples

Apply lid and fill

Cycle, image, analyze data

Automated liquid handling


• relative quantitative data for each organisms by comparing to total bacterial

load

– Internal control

• Compared this data in symptomatic/asymptomatic subjects

• statistically determined cut-offs based on a bimodal distribution of the data

to determine normal versus elevated levels

• Statistical analyses to identify patterns of clustering of organisms between

symptomatic/asymptomatic status

• reference lab results for comparison

• samples from our routine screening population

Assay design/Verification

Statistical Clustering

Heat map representation/cluster analysis

probability of being symptomatic, observed symptomatic status and observed covariates, as predicted

by Probability model

Six separate groups, based on composition of the bacterial communities

• Prediction of symptomatic status– Specificity: 88.5%

– Sensitivity: 90.1%

• Analytical Sensitivity:

– ThinPrep: 1.5 X 104 - 7.5 X 103 targets/ml

– Swab: 2.5 – 5.0 X 104 targets/ml

• Specificity: ~100%

Technical Specifications

BV+ Abnormal Report

BV+ Performance

>150,000 subjects tested

Normal = 60.3%

Borderline = 10.2%

Abnormal = 29.5%

CDC Statistics

Prevalence estimated at 21.2 million (29.2%) among women ages 14 to 49

84% reported no symptoms

Related panels

• High-throughput

• Sensitive/Specific

• Investigation of vaginal infections by evaluating a large

panel of pathogenic and commensal organisms

– Syndromic testing

• Faster TAT, without subjectivity associated with culture

• Operational efficiency

• Integrated, pre-microbiome

Conclusion

• Charles P. Cartwright et al. Development and Validation of a Semiquantitative,

Multitarget PCR Assay for Diagnosis of Bacterial Vaginosis. J Clin Microbiol. 2012

Jul;50(7):2321-9.

• Srinivasan et al. Bacterial communities in women with bacterial vaginosis: high

resolution phylogenetic analyses reveal relationships of microbiota to clinical criteria.

PLoS One. 2012;7(6):e37818.

• van de Wijgert JH et al. The vaginal microbiota: what have we learned after a decade of

molecular characterization? PLoS One. 2014 Aug 22;9(8):e105998.

• Ma B et al. Vaginal microbiome: rethinking health and disease. Annu Rev

Microbiol. 2012;66:371-89.

References

https://www.ncbi.nlm.nih.gov/pubmed/?term=Development+and+Validation+of+a+Semiquantitative,+Multitarget+PCR+Assay+for+Diagnosis+of+Bacterial+Vaginosis

https://www.ncbi.nlm.nih.gov/pubmed/22719852

https://www.ncbi.nlm.nih.gov/pubmed/25148517

https://www.ncbi.nlm.nih.gov/pubmed/?term=the+vaginal+microbiome:+rethinking

• Pranil Chandra, DO, FCAP, FASCP

• Scott Wheeler, PhD

• James Prescott, PhD

• Zeq Ma, PhD

• Mathew Rodgers

• Criziel Quinn

• Vickie Clinard

• Joni Williams

• Melody Hedjnal

• Dustin Murdock

Acknowledgements

The world leader in serving science

Kelly Li, PhD

Associate Director, Clinical R&D, Genetic Sciences Division

Microfluidics qPCR Solution for Respiratory Pathogen Detection

Nov 7th, 2018

Webinar: The Impact of Flexible Panel-Based Solutions for Pathogen Detection

47

Applied Biosystems - Microbial Detection Solutions

End to end solution approach for supporting pathogen testing

INSTRUMENTATIONCombining flexible throughput capabilities with a streamlined

workflow

PLATFORMForm factors to suit different sample number, target number and throughput needs

CONSUMABLESSupporting workflow reagents including controls, sample prep, master mixes

COVERAGEAllows to select clinical

research studies and population demographics relevant genomic targets

SERVICE & SUPPORTInstrument OQ/IQ/PV, training and support your analytical validation


48

Vaginal Microbiota

Collection of 34 Pathogens (24 Bacteria, 7 Fungi, 1 Protozoa, 2 Virus)www.thermofisher.com/vm

Urinary Tract Microbiota

Collection of 17 Pathogens (16 Bacteria, 1 Fungi)www.thermofisher.com/utm

Uro-Genital Pathogen Detection Solutions on Nanofluidics

The traditional tools (i.e. culture) in these areas are inadequate, providing an opportunity for molecular solutions to

address current pain points

Current solution

includes optimized

protocols for sample

prep and qPCR

workflows as well as

synthetic controls

and master mix.


49

Building a Throughput Continuum for Customizable Pathogen Detection

Sample Tested

Ta

rgets

Te

ste

d

10 20 40

10

50

200

24-48 Targets

6-16 Samples

18-56 Targets

20-48 Samples

Microfluidics

TaqMan® Array Card

Nanofluidics

TaqMan® OpenArray

33 nl rx volume1 ul rx volume

• Pre-spotted

Arrays

• High-throughput

• Customization

18-56 Targets

192 Samples


50

TAC has over 50 peer reviewed publications on microbial detection

covering clinical research and epidemiological studies

Performance ProficiencyHigh Sensitivity and Specificity

Cost EffectivenessAligned to acceptable payment by users

Ease of UseFast and easy setup in a closed system

Coverage FlexibilityChoice of target aligned to need

Flexible Microfluidic Solution


51

Groundbreaking ANISA Study Using Microfluidic Card (Saha et al, 2018)

Bill & Melinda Gates

Foundation funded study

published in Lancet

investigates incidence of

community-acquired infections

caused by specific organisms

among neonates in 3rd world

countries. More than half a

million neonatal deaths per

year results from possible

serious bacterial infections

(pSBIs) which is investigated

in this study using blood

cultures and TAC platform

Lancet 2018 v392: p145–59


52

Microfluidic Card Workflow


Ease of use enabled through a close system

53

Flu Common Symptoms

Targeted Species for Respiratory Tract Microbiota (RTM)

3rd Leading Cause of Mortality

The Leading Cause of

Pediatric Hospital Admissions

A Primary Danger for the Immuno-compromised

Multiple Pathogens

Overlapping Symptoms

28 viral targetsAdenovirus

Bocavirus

Coronavirus 229E

Coronavirus HKU1

Coronavirus NL63

Coronavirus OC43

Enterovirus

HHV3 (Varicella Zoster Virus)HHV4 (Epstein-Barr Virus)

HHV5 (Cytomegalovirus)

Human Herpesvirus 6

Human Metapneumovirus

Influenza A H1-2009

Influenza A H3

Influenza A pan

Influenza-B

Measles

MERS_CoV

Mumps

Parainfluenza virus 1




Parechovirus

Respiratory Syncytial Virus A

Respiratory Syncytial Virus B

Rhinovirus

SARS_CoV

12 Bacterial TargetsBordetella (PAN)

Bordetella holmesii

Bordetella pertussis

Chlamydophila pneumoniae

Coxiella burnetii

Haemophilus Influenzae

Klebsiella pneumoniae

Legionella pneumoniae

Moraxella catarrhalis

Mycoplasma pneumoniae

Streptococcus pneumoniae

Staphylococcus aureus

3 ControlsIC Bacillus Atropheus

IC Rnase P

IC Xeno

1 Fungal TargetPneumocystis jiroveci


54

Example of Microfluidic Card Layout

Adenovirus 1of2 1

Adenovirus 2of2 2

Bocavirus 3

HHV3 (VZV) 4

HHV4 (EBV) 5

HHV5 (CMV) 6

HHV6 7

Influenza A virus (pan) 8

Influenza A H1 9

Influenza A H3 10

IC 18S rRNA 11

Influenza_B 12

hPIV1 13

hPIV2 14

hPIV3 15

hPIV4 16

RSVA 17

RSVB 18

hMPV 19

Measles 20

Coronavirus_229E 21

Coronavirus_HKU1 22

Coronavirus_NL63 23

Coronavirus_OC43 24

25 Mumps

26 MERS_CoV

27 SARS_CoV

28 Enterovirus (pan)

29 Enterovirus_D68

30 Rhinovirus 1of2

31 Rhinovirus 2of2

32 Parechovirus

33 IC Xeno

34 Bordetella (pan)

35 B_holmesii

36 B_pertussis

37 C_burnetii

38 C_pneumoniae

39 H_influenzae

40 K_ pneumoniae

41 L_pneumophila

42 M_catarrhalis

43 M_pneumoniae

44 S_aureus

45 S_pneumoniae

46 P_jirovecii

47 IC B_atropheus

48 IC RNase P

Available for early access


Xeno RNA can be used as

a process control

Bacillus atropheus can be

used as an end to end

workflow control

55

1 card x 6 per day

Reporting Run real-time PCRAnalysis

Sample prep RT & Sample ProcessingSample type: NT swabs

Sample-to-Answer Workflow for RTM

Thermo Scientific™ KingFisher™ Flex system

with Applied Biosystems™ MagMAX kits

Applied Biosystems™ ProFlex™ 96-well PCR

System for RT

1.5

hr

Service and support

available throughout

the entire process

Total Turnaround Time

5.5 Hours / Run

Up to 6

runs

per day

Respiratory Pathogen Detection Assays

1

hr

<2

Hrs

Data Analysis

In-house LIMS or CLS


56

Analytical Sensitivity for RTM Assays Using Synthetic Template on TAC

10

15

20

25

30

35

10^1 10^2 10^3 10^4 10^5 10^6

y=-3.3936x+34.542

R²=0.99911

0

5

10

15

20

25

30

35

0 2 4 6 8

Flu_A_H1_2009

y=-3.3361x+34.993

R²=0.99973

0

5

10

15

20

25

30

35

0 2 4 6 8

Flu_A_H3

y=-3.3859x+33.642

R²=0.99988

0

5

10

15

20

25

30

35

0 2 4 6 8

Flu_A_pan

y=-3.2487x+34.134

R²=0.99981

0

5

10

15

20

25

30

35

0 2 4 6 8

Flu_B

y=-3.3506x+34.995

R²=0.9999

0

5

10

15

20

25

30

35

0 2 4 6 8

RSV_A

y=-3.4199x+35.096

R²=0.99939

0

5

10

15

20

25

30

35

0 2 4 6 8

RSV_B

Assays R2

Slope

PCR

Efficiency

Adenovirus_pan_1 0.9993 -3.37 98.1%

Adenovirus_pan_2 0.9996 -3.30 100.8%

Bocavirus 0.9997 -3.36 98.4%

Bordetella_holm 0.9997 -3.29 101.3%

Bordetella_pan 0.9998 -3.35 99.0%

Bordetella_pert 1.0000 -3.33 99.6%

Chlamyd_pneumoniae 1.0000 -3.34 99.3%

Coronavirus_229E 0.9999 -3.35 98.8%

Coronavirus_HKU1 0.9999 -3.44 95.2%

Coronavirus_NL63 0.9997 -3.42 96.2%

Coronavirus_OC43 0.9999 -3.40 97.0%

Coxiella_burneti 0.9993 -3.39 97.3%

Cytomegalovirus 0.9999 -3.35 98.9%

Enterovirus_D68 0.9997 -3.37 98.1%

Enterovirus_pan 0.9999 -3.35 98.9%

Epstein-Barr 0.9993 -3.34 99.3%

Flu_A_H1_2009 0.9991 -3.39 97.1%

Flu_A_H3 0.9997 -3.34 99.4%

Flu_A_pan 0.9999 -3.39 97.4%

Flu_B 0.9998 -3.25 103.1%

HaemophilusInfluenzae 0.9996 -3.41 96.4%

HHV-6 0.9999 -3.43 95.7%

hMPV 0.9994 -3.33 99.5%

Legionella_pneumoniae 0.9997 -3.32 100.0%

M_catarrhalis 0.9999 -3.41 96.5%

Measles 0.9989 -3.41 96.3%

MERS-CoV 0.9987 -3.39 97.3%

Mumps 0.9999 -3.31 100.6%

Mycoplas_pneumoniae 0.9988 -3.33 99.7%

Parainfluenza_1 1.0000 -3.31 100.4%

Parainfluenza_2 1.0000 -3.34 99.4%

Parainfluenza_3 0.9994 -3.35 99.0%

Parainfluenza_4 0.9999 -3.24 103.7%

Parechovirus 0.9998 -3.25 102.9%

Pneumocystisjirovecii 0.9998 -3.35 99.0%

Rhinovirus_A 0.9998 -3.30 100.8%

Rhinovirus_B_C 0.9996 -3.29 101.5%

RSV_A 0.9999 -3.35 98.8%

RSV_B 0.9994 -3.42 96.1%

SARS 0.9999 -3.37 98.1%

Staphylococcusaureus 0.9993 -3.34 99.4%

Strep_pneumoniae 1.0000 -3.35 98.7%

VZV 0.9996 -3.35 98.9%

• Serial dilution was done w/ synthetic control

• Similar results were obtained from Synthetic

RNA and ATCC gDNA / gRNA controls


57

RTM Assay Specificity with ATCC gDNA and gRNA Controls

Assays/Controls

Humanadenovirus2

Humanadenovirus7

Humanadenovirus12

Bord

etellabro

nch

isepetica

Bord

etellaparapertussis

Bord

etellaholm

esii

Bord

etellapertussis

Chlamydophila

pneumoniae

Chlamydophila

pneumoniae

Humancoro

navirus

229E

Betaco

ronavirus1

strainO

C43

HumanH

erp

esvirus5

HCM

V

Entero

virusD68

(US/KY/14-18953)

Entero

virusD68

(US/M

O/14-18947)

Haemophilusinfluenza

e

Influenza

Avirus(H

1N1)

strainA/

Influenza

Avirus(H

3N2)

Influenza

Bvirus

Kiebsiellapneumoniae

Legionellapneumophila

Measlesvirus

Moraxellacatarrhalis

Mumpsvirus

Myco

plasm

apneumoniae

Parainfluenza

PIV-1

Parainfluenza

PIV-2

Parainfluenza

PIV-3

Parainfluenza

PIV-4

Humanresp

irato

rySyncy

tial

Virus

Humanresp

irato

rySyncy

tial

Virus

Humanrhinovirus17

Staphyloco

ccusaureus

Strepto

coccuspneumoniae

Humanherp

esvirus3

Adenovirus_pan_1 21.8 20.4

Adenovirus_pan_2 20.7 21.0

Bordetella_pan 23.9 22.7 22.4

B_holmesii 22.6

B_pertussis 22.6

C_pneumoniae 22.3 20.2

Coronavirus_229E 22.6

Coronavirus_OC43 21.7

HHV5_CMV 20.1

Enterovirus_D68 23.6 23.6

Enterovirus_pan 28.4

H_influenzae 19.7

Influenza_A_H1 23.2

Influenza_A_pan 20.7 22.6

Influenza_B 21.6

K_pneumoniae 20.1

L_pneumophila 20.8

Measles 21.6

M_catarrhalis 20.9

Mumps 23.0

M_pneumoniae 20.7

PIV_1 22.0

PIV_2 22.1

PIV_3 21.4

PIV_4 20.4

RSVA 20.0

RSVB 28.5 21.8

Rhinovirus_pan_1 25.5

S_aureus 20.1

S_pneumoniae 19.0

HHV3_VZV 20.7


No significant off-target or cross-species activity was observed.

58

• Applied Biosystems offers an end to end solution for

supporting pathogen testing

• We currently offer microbial detection solutions for uro-genital

pathogens on nanofluidics platform

• Microbial detection solutions for respiratory tract microbiota on

microfluidics platform allows customization of both the size

and content of the panel.

• The RTM panel demonstrates high sensitivity and specificity

• Our solution offers a simple workflow, fast turnaround time

and high throughput with flexible sample/target combinations.

Summary

Nanofluidics platform

Microfluidics platform


The world leader in serving science

Thank you

For Research Use Only. Not for use in diagnostic procedures. © 2018 Thermo Fisher Scientific Inc. All rights reserved. All trademarks are the property of Thermo Fisher Scientific

and its subsidiaries unless otherwise specified. TaqMan is a registered trademark of Roche Molecular Systems, Inc., used under permission and license. COL15382 0218

utility of multiplexed molecular panels for infectious disease … · 2018-11-08 · heterogeneous,...

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