Multiplex Molecular Point-of-Care Test for Syndromic Infectious Diseases

Abstract

Point-of-care (POC) molecular diagnostics for clinical microbiology and virology has primarily focused on the detection of a single pathogen. More recently, it has transitioned into a comprehensive syndromic approach that employs multiplex capabilities, including the simultaneous detection of two or more pathogens. Multiplex POC tests provide higher accuracy to for actionable decisionmaking in critical care, which leads to pathogen-specific treatment and standardized usages of antibiotics that help prevent unnecessary processes. In addition, these tests can be simple enough to operate at the primary care level and in remote settings where there is no laboratory infrastructure. This review focuses on state-of-the-art multiplexed molecular point-of-care tests (POCT) for infectious diseases and efforts to overcome their limitations, especially related to inadequate throughput for the identification of syndromic diseases. We also discuss promising and imperative clinical POC approaches, as well as the possible hurdles of their practical applications as front-line diagnostic tests.

Keywords: Molecular diagnosis; Multiplex molecular point-of-care testing; POCT; Syndromic infectious disease.

Fig. 1

Clinical diagnosis of infection according to a diagnostic platform. The implementation of a multiplex point-of-care (POC) test reduces diagnostic cycles for faster and better treatment decisions

Fig. 2

Integrated molecular diagnostic assay-based microfluidic devices. a SIMPLE chip for blood sample prep, simultaneous digital amplification, and quantitative nucleic acid testing with minimal handling and no-power source. b A foldable all-in-one microdevice for the entire process of multiplex pathogen molecular test by a folding and stacking motion. c Polarized anisotropy diagnostics (PAD) system for the detection of bacterial total RNA. (a From Lee, L.P. et al., Sci Adv 2017, 3 (3), e1501645 under open access license CC BY-NC, reprinted with permission from AAAS/b Reprinted from Lee, N. Y. et al., Sens. Actuators B Chem 2020, 314, 128,057. Copyright by Elsevier/ (C) From Lee, H. et al., Sci Adv 2016, 2 (5), e1600300 under open access license CC BY-NC, Reprinted with permission AAAS)