High throughput multiplex PCR and probe-based detection with Luminex beads for seven intestinal parasites

Abstract

Polymerase chain reaction (PCR) assays for intestinal parasites are increasingly being used on fecal DNA samples for enhanced specificity and sensitivity of detection. Comparison of these tests against microscopy and copro-antigen detection has been favorable, and substitution of PCR-based assays for the ova and parasite stool examination is a foreseeable goal for the near future. One challenge is the diverse list of protozoan and helminth parasites. Several existing real-time PCR assays for the major intestinal parasites-Cryptosporidium spp., Giardia intestinalis, Entamoeba histolytica, Ancylostoma duodenale, Ascaris lumbricoides, Necator americanus, and Strongyloides stercoralis-were adapted into a high throughput protocol. The assay involves two multiplex PCR reactions, one with specific primers for the protozoa and one with specific primers for the helminths, after which PCR products are hybridized to beads linked to internal oligonucleotide probes and detected on a Luminex platform. When compared with the parent multiplex real-time PCR assays, this multiplex PCR-bead assay afforded between 83% and 100% sensitivity and specificity on a total of 319 clinical specimens. In conclusion, this multiplex PCR-bead protocol provides a sensitive diagnostic screen for a large panel of intestinal parasites.

Figure 1.

Correlation between multiplex real-time polymerase chain reaction (PCR) cycle threshold (Ct) and the multiplex PCR-Luminex corrected mean fluorescence intensity (cMFI) values on clinical specimens. Each of the quantitative PCR (qPCR) positive/Luminex-positive specimens of Table 4 was plotted for potential correlation. Trendlines indicate statistically significant Spearman's correlation, if present.