Center for Virus Research and Testing, Korea Research Institute of Chemical Technology, Daejeon, Republic of Korea; Department of Medicinal Chemistry and Pharmacology, University of Science and Technology, Daejeon, Republic of Korea.
Department of Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
J Mol Diagn. 2017 Nov;19(6):817-827. doi: 10.1016/j.jmoldx.2017.06.007. Epub 2017 Aug 12.
Middle East respiratory syndrome (MERS) is an emerging zoonotic viral respiratory disease that was first identified in Saudi Arabia in 2012. In 2015, the largest MERS outbreak outside of the Middle East region occurred in the Republic of Korea. The rapid nosocomial transmission of MERS-coronavirus (MERS-CoV) in Korean health care settings highlighted the importance and urgent need for a rapid and reliable on-site diagnostic assay to implement effective control and preventive measures. Here, the evaluation and validation of two newly developed reverse transcription-insulated isothermal PCR (RT-iiPCR) methods targeting the ORF1a and upE genes of MERS-CoV are described. Compared with World Health Organization-recommended singleplex real-time quantitative RT-PCR (RT-qPCR) assays, both RT-iiPCR assays had comparable analytical sensitivity for the detection of MERS-CoV RNA in tissue culture fluid and in sputum samples spiked with infectious virus. Furthermore, clinical evaluation was performed with sputum samples collected from subjects with acute and chronic respiratory illnesses, including patients infected with MERS-CoV. The overall agreement values between the two RT-iiPCR assays and the reference RT-qPCR assays were 98.06% (95% CI, 94.43%-100%; κ = 0.96) and 99.03% (95% CI, 95.88%-100%; κ = 0.99) for ORF1a and upE assays, respectively. The ORF1a and upE MERS-CoV RT-iiPCR assays coupled with a field-deployable system provide a platform for a highly sensitive and specific on-site tool for diagnosis of MERS-CoV infections.
中东呼吸综合征(MERS)是一种新兴的人畜共患病毒性呼吸道疾病,于 2012 年在沙特阿拉伯首次被发现。2015 年,中东地区以外发生了最大的 MERS 疫情,地点在韩国。MERS 冠状病毒(MERS-CoV)在韩国医疗机构中的快速医院内传播,凸显了快速、可靠的现场诊断检测方法的重要性和紧迫性,以便实施有效的控制和预防措施。本研究描述了两种新开发的针对 MERS-CoV 的 ORF1a 和 upE 基因的逆转录恒温扩增(RT-iiPCR)方法的评估和验证。与世界卫生组织推荐的单重实时定量 RT-PCR(RT-qPCR)检测方法相比,两种 RT-iiPCR 方法在检测组织培养液和含感染性病毒的痰液样本中的 MERS-CoV RNA 时具有相当的分析灵敏度。此外,还对患有急性和慢性呼吸道疾病的患者(包括感染 MERS-CoV 的患者)的痰液样本进行了临床评估。两种 RT-iiPCR 方法与参考 RT-qPCR 方法之间的总一致性值分别为 98.06%(95%置信区间,94.43%-100%;κ=0.96)和 99.03%(95%置信区间,95.88%-100%;κ=0.99),用于 ORF1a 和 upE 检测。ORF1a 和 upE MERS-CoV RT-iiPCR 检测方法与现场可部署系统相结合,为 MERS-CoV 感染的高度敏感和特异性现场诊断工具提供了一个平台。
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