Development of a TaqMan array card for acute-febrile-illness outbreak investigation and surveillance of emerging pathogens, including ebola virus

  • Jie Liu
  • , Caroline Ochieng
  • , Steve Wiersma
  • , Ute Ströher
  • , Jonathan S. Towner
  • , Shannon Whitmer
  • , Stuart T. Nichol
  • , Christopher C. Moore
  • , Gilbert J. Kersh
  • , Cecilia Kato
  • , Christopher Sexton
  • , Jeannine Petersen
  • , Robert Massung
  • , Christine Hercik
  • , John A. Crump
  • , Gibson Kibiki
  • , Athanasia Maro
  • , Buliga Mujaga
  • , Jean Gratz
  • , Shevin Jacob
  • Patrick Banura, W. Michael Scheld, Bonventure Juma, Clayton O. Onyango, Joel M. Montgomery, Eric Houpt, Barry Fields

Research output: Contribution to journalArticlepeer-review

109 Citations (Scopus)

Abstract

Acute febrile illness (AFI) is associated with substantial morbidity and mortality worldwide, yet an etiologic agent is often not identified. Convalescent-phase serology is impractical, blood culture is slow, and many pathogens are fastidious or impossible to cultivate. We developed a real-time PCR-based TaqMan array card (TAC) that can test six to eight samples within 2.5 h from sample to results and can simultaneously detect 26 AFI-associated organisms, including 15 viruses (chikungunya, Crimean-Congo hemorrhagic fever [CCHF] virus, dengue, Ebola virus, Bundibugyo virus, Sudan virus, hantaviruses [Hantaan and Seoul], hepatitis E, Marburg, Nipah virus, o'nyong-nyong virus, Rift Valley fever virus, West Nile virus, and yellow fever virus), 8 bacteria (Bartonella spp., Brucella spp., Coxiella burnetii, Leptospira spp., Rickettsia spp., Salmonella enterica and Salmonella enterica serovar Typhi, and Yersinia pestis), and 3 protozoa (Leishmania spp., Plasmodium spp., and Trypanosoma brucei). Two extrinsic controls (phocine herpesvirus 1 and bacteriophage MS2) were included to ensure extraction and amplification efficiency. Analytical validation was performed on spiked specimens for linearity, intra-assay precision, interassay precision, limit of detection, and specificity. The performance of the card on clinical specimens was evaluated with 1,050 blood samples by comparison to the individual real-time PCR assays, and the TAC exhibited an overall 88% (278/315; 95% confidence interval [CI], 84% to 92%) sensitivity and a 99% (5,261/5,326, 98% to 99%) specificity. This TaqMan array card can be used in field settings as a rapid screen for outbreak investigation or for the surveillance of pathogens, including Ebola virus.
Original languageEnglish
Pages (from-to)49-58
Number of pages10
JournalJournal of Clinical Microbiology
Volume54
Issue number1
DOIs
Publication statusPublished - 1 Jan 2016
Externally publishedYes

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