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Explore basic categories of analysis used to characterize DNA & RNA, principles of NA amplification technologies, PCR-based modifications, impact on clinical bacteriology, and applications in medical microbiology. Discover advanced methods for pathogen detection and identification using molecular techniques.
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BASIC MOLECULAR TECHNIQUES IN INFECTIOUS DISEASES Dr.Sarookhani
Clinical laboratory • 1)bacteriology & mycology • 2)parasitology & protozoalogy • 3)virology • 4)hematology • 5)biochemistry&hormon&metabolism • 6)immunology&serology • 7)cytology&histo-pathology & genetics Dr.Sarookhani
Types of laboratory methods(for infectious diseases) • Direct methods • look for/detect the agent • Indirect methods • detect host response to the agent Dr.Sarookhani
Ag Ab Reactions • PRIMARY • IF٬ RIA ٬ ELISA ,CLIA • SECONDARY • Percipitation • Agglutination • Fulccolation Dr.Sarookhani
Direct methods(Bacteriology&mycology& Parasitology&Virology) • Macroscopic evaluation • Staining • Direct microscopy • Electron microscopy • Rapid tests • Molecular methods • Propagate the agent (culture&sensitivity) No propagation required Dr.Sarookhani
MOLECULAR TECHNIQUES ADVANTAGES • High speed • high analytical sensitivity • high clinical sensitivity • conceptually simple • highly specific • Amenable to full automation Dr.Sarookhani
BASIC CATEGORIES OF ANALYSIS USED TO CHARACTERIZE DNA&RNA • 1)electrophoretic seperations(total,RE,PFGE) • 2)hybridization assays • 3)amplification techniques (NAAT) • 4)restriction fragment length polymorphism(RFLP) • 5)sequencing Dr.Sarookhani
1)whole blood& PBMC 2)serum 3)body fluids (urine, semen, CSF,ameniotic fluid,...) 4)biopsies 5) placenta & CVS 6)blastomer cells of embryo 7)others(hair,stool,smears,..) LABORATORY SPECIMENS FOR MOLECULAR TECHNIQUES Dr.Sarookhani
ELECTROPHORETIC SEPERATION OF NUCLEIC ACIDS Dr.Sarookhani
RFLP CONCEPT Dr.Sarookhani
HYBRIDIZATION ASSAY FORMATS 1)liquid or solution phase hybridization 2)solid support hybridization a)DOT/blot(&inverse DOT/blot)hybridization b)southern&northern blot hybridization c)in situ hybridization(tissue,cells,chromosomes ) d)NA chip technology Dr.Sarookhani
HYBRIDIZATION CONCEPT Dr.Sarookhani
SOUTHERN&NORTHERN BLOT HYBRIDIZATION Dr.Sarookhani
FLOURESCENT IN SITU HYBRIDIZATION (FISH) • Whole cells or tissue section affixed to glass slides. • Clinical applications in formalin-fixed paraffin embedded tissues. tissue Dr.Sarookhani
NA CHIP TECHNOLOGY Dr.Sarookhani
MICRO ARRAY TECHNOLOGY Dr.Sarookhani
Application of microarray for pathogen detection Dr.Sarookhani
DNA SEQUENCING Dr.Sarookhani
Nucleic Acid Amplification Technologies (NAAT) • 1)TARGET AMPLIFICATION METHODS a)PCR & modifications b)NASBA c)TMA d)SDA • 2)PRIMER(PROB) AMPLIFICATION METHODS a)LCR b)Q-beta replicase c)cleavase / invader technology • 3)SIGNAL AMPLIFICATION METHODS a)b DNA & b)HCA Dr.Sarookhani
principles Dr.Sarookhani
PCR-based modification techniques • RT-PCR • nested PCR • hot start PCR • PCR-LiPA • PCR-SSP • PCR-ARMS • PCR-RFLP • multiplex PCR • PCR-SSCP • RACE-PCR • Real time PCR Dr.Sarookhani
Locus C Locus A Locus B A B C small large Schematic of Multiplex PCRIn multiplex PCR more than one target sequence can be amplified by including more than one pair of primers in the reaction. ( Amplifying various genes simultaneously) Dr.Sarookhani
Multiplex PCR Dr.Sarookhani
In the field of infectious diseases the technique has been shown to be a valuable method for identification of: • viruses • bacteria • fungi • parasites • All Dr.Sarookhani
REAL TIME PCR Dr.Sarookhani
APPLICATIONS OF MOLECULAR TECHNIQUES IN MEDICAL MICROBIOLOGY Dr.Sarookhani
Microbiology Laboratory • Clinical Microbiology comprises essentially 5 sections. • Aerobic and anerobic bacteriology • Mycology • Mycobacteriology (also called Acid-fast Bacteriology, AFB) • Parasitology • Virology Dr.Sarookhani
IMPACT OF MOLECULAR METHODS ON CLINICAL BACTERIOLOGY • 1)DIAGNOSIS & PATHOGEN IDENTIFICATION a)for slow growing or difficult-to- culture organisms b)further examination & identification of agar-grown pure cultures c)simultaneous isolation of pathogens from specimens • 2)THERAPY • 3)EPIDEMIOLOGY & CONTROL MEASURES Dr.Sarookhani
MOLECULAR METHODS IN CLINICAL BACTERIOLOGY LAB. • PCR & other amplification techniques • nucleic acid hybridization techniques • use of RE,s • DNA sequencing analysis • gene chip technology Dr.Sarookhani
MOLECULAR METHODS FOR IDENTIFICATION OF BACTERIA(1) Dr.Sarookhani
MOLECULAR METHODS FOR IDENTIFICATION OF BACTERIA(2) Dr.Sarookhani
MOLECULAR METHODS FOR IDENTIFICATION OF BACTERIA(3) Dr.Sarookhani
PCR of M.tuberculosis Dr.Sarookhani
Molecular detection of mycoplasma Dr.Sarookhani
PCR DETECTION OF BRUCELLA Dr.Sarookhani
PCR-based detection of H.pylori (cag A gene) Dr.Sarookhani
PCR-based detection of T.pallidum Dr.Sarookhani
PCR-based detection of Mycobacterium lepre in skin biopsy Dr.Sarookhani
PCR-based detection of Yersinia entrocolitica (chromosomal ail gene) Dr.Sarookhani
APPLICATIONS OF MOLECULAR EPIDEMIOLOGY • Detection of identity of strains • detection of genotypes • detection of emergence & spread of strains of an organism with unusual resistance patterns or pathogenicity • determining the efficiency of infection control procedures • identification of source in outbreaks Dr.Sarookhani
APPLICATION OF MOLECULAR METHODS IN VIROLOGY • Hepatitis viruses(HBV,HCV,HDV):PCR&RT-PCR • herpesviridae(CMV,HSV,EBV,VZV,...):PCR • HTLV1 & HIV1,2, : nested RT-PCR • ENTOVIRUSES :RT-PCR • PARVOVIRUS B19 : HB & PCR • HPV : FISH • mumps,adenovridae,LCM,measles : PCR&RT-PCR • rubella : RT-PCR Dr.Sarookhani
QUANTITATIVE AMPLIFICATION RESULTS MAY USEFUL FOR: • Viral load • prognosis • monitoring response to therapy Dr.Sarookhani
HCV RNA ( RT-PCR) Dr.Sarookhani
QUANTITATIVE AMPLIFICATION FOR HIV DETECTION • branched DNA assay Dr.Sarookhani
Laboratory Diagnosis of Influenza Dr.Sarookhani
Specimen Types • Upper respiratory tract • Nasal or naso-pharyngeal (NP) swabs • Throat swabs • NP aspirates or washes • Lower respiratory tract • Tracheal aspirates • Bronchoalveolar lavages • Store at 2-8°C < 72 hours or freeze at < -70°C. • Transport with cool-pack Dr.Sarookhani
Possible contamination due to the throat- wash sampling method Dr.Sarookhani