A Simple and Rapid Identification Method for Mycobacterium bovis BCG with Loop-Mediated Isothermal Amplification

PLoS One. 2015 Jul 24;10(7):e0133759. doi: 10.1371/journal.pone.0133759. eCollection 2015.

Abstract

Bacillus Calmette-Guérin (BCG) is widely used as a live attenuated vaccine against Mycobacterium tuberculosis and is an agent for standard prophylaxis against the recurrence of bladder cancer. Unfortunately, it can cause severe infectious diseases, especially in immunocompromised patients, and the ability to immediately distinguish BCG from other M. tuberculosis complexes is therefore important. In this study, we developed a simple and easy-to-perform identification procedure using loop-mediated amplification (LAMP) to detect deletions within the region of difference, which is deleted specifically in all M. bovis BCG strains. Reactions were performed at 64 °C for 30 min and successful targeted gene amplifications were detected by real-time turbidity using a turbidimeter and visual inspection of color change. The assay had an equivalent detection limit of 1.0 pg of genomic DNA using a turbidimeter whereas it was 10 pg with visual inspection, and it showed specificity against 49 strains of 44 pathogens, including M. tuberculosis complex. The expected LAMP products were confirmed through identical melting curves in real-time LAMP procedures. We employed the Procedure for Ultra Rapid Extraction (PURE) kit to isolate mycobacterial DNA and found that the highest sensitivity limit with a minimum total cell count of mycobacterium (including DNA purification with PURE) was up to 1 × 10(3) cells/reaction, based on color changes under natural light with FDA reagents. The detection limit of this procedure when applied to artificial serum, urine, cerebrospinal fluid, and bronchoalveolar lavage fluid samples was also about 1 × 10(3) cells/reaction. Therefore, this substitute method using conventional culture or clinical specimens followed by LAMP combined with PURE could be a powerful tool to enable the rapid identification of M. bovis BCG as point-of-care testing. It is suitable for practical use not only in resource-limited situations, but also in any clinical situation involving immunocompromised patients because of its convenience, rapidity, and cost effectiveness.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • BCG Vaccine / adverse effects
  • Bacterial Typing Techniques / methods*
  • Base Sequence
  • Body Fluids / microbiology
  • Colorimetry
  • DNA Primers
  • DNA, Bacterial / genetics*
  • Diagnosis, Differential
  • Genes, Bacterial
  • Humans
  • Molecular Sequence Data
  • Mycobacterium bovis / genetics*
  • Mycobacterium bovis / isolation & purification
  • Mycobacterium tuberculosis / genetics
  • Nephelometry and Turbidimetry
  • Nucleic Acid Amplification Techniques / methods
  • Nucleic Acid Denaturation
  • Point-of-Care Testing
  • Sensitivity and Specificity
  • Sequence Alignment
  • Sequence Homology, Nucleic Acid
  • Species Specificity
  • Temperature
  • Tuberculosis / diagnosis
  • Tuberculosis / etiology
  • Tuberculosis / microbiology*

Substances

  • BCG Vaccine
  • DNA Primers
  • DNA, Bacterial

Grants and funding

The authors have no support or funding to report.