Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium...

71
Polymerase Chain Reaction John G. Routsias, MD, PhD

Transcript of Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium...

Page 1: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Polymerase Chain Reaction

John G. Routsias, MD, PhD

Page 2: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

• DNA/RNA basics

• PCR

• End-point detection of PCR

• Real-time detection of PCR

• TaqMan chemistry

• Multiplex PCR Applications of real-time PCR in Microbiology

PCR/Real-Time PCR

Page 3: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Νουκλεϊκό οξύ, DNA

DNA Strand

Double Helix

DNA Strand Supercoiled

DNA Strand

Chromosome

Page 4: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Νουκλεϊκό οξύ, DNA

Double stranded DNA

Base pairing hydrogen bond

Hydrogen bond

Phosphodiester bond

Page 5: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Hydrogen Bonds Cytosine (C)

Adenine (A)

Thymine (T)

Guanine (G)

Deoxyribose

(Sugar molecule) Phosphoric Acid

(Phosphate molecule)

Cytosine (C)

Adenine (A)

Thymine (T)

Guanine (G)

• Double Helix

• DNA strands run 5´ to 3´

• Adjacent opposing strands

• Complementary base pairing

(A-T, G-C)

• A-T 2 Hydrogen bonds

• G-C 3 Hydrogen bonds

Νουκλεϊκό οξύ, DNA

Page 6: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

5´ to 3´ Orientation of the Sugar - Phosphate Backbone

Δομή

Page 7: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Κατεύθυνση της αλληλουχίας

5'- A T T G T C G C C G A A T A G T C G - 3'

3'- T A A C A G C G G C T T A T C A G C - 5'

Species Specific region

Page 8: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

• DNA/RNA basics

• PCR

• End-point detection of PCR

• Real-time detection of PCR

• TaqMan chemistry

• Multiplex PCR Applications of real-time PCR in Microbiology

PCR/Real-Time PCR

Page 9: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

PCR timeline

• 1953 3D structure of DNA revealed - Watson + Crick

• 1983 PCR invented (Mullis/Cetus)

• 1986 taq DNA polymerase first used

• 1991 Roche pay $300,000,000 for PCR patent

• 1993 real-time PCR (Higuchi)

• 1996 First real-time PCR machine (ABI PRISM 7700

SDS)

Page 10: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

PCR Testing Process

SPECIMEN

Plasma/Serum

Swab

Urine

Purified

Nucleic Acid

DNA or RNA

RESULT

Quantitative

Qualitative

Genetic Predisposition

Sample Prep PCR

Page 11: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Αρχή της PCR

• Αποδιάταξη του DNA • Πρόσδεση του εκκινητή • Επιμήκυνση του εκκινητή

Page 12: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Αποδιάταξη Νουκλεϊκών οξέων

• Θέρμανση • Οξύ ή Βάση • Χημικοί παράγοντες πχ. urea, guanidine hydrochloride

Page 13: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Αποδιάταξη με θέρμανση

Temperature 20 40 60

Tm; melting temp.

DNA

Page 14: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Σταθερότητα υβριδισμού • Hydrogen bonding G C A T • Degree of complementary

• Ion concentration (stringency) high conc. -> high stability

Page 15: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl2), forward and

reverse primers, deoxynucleotides (dNTPs), polymerase, and the sample DNA (template).

Polymerase Chain Reaction (PCR)

Page 16: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Master Mix Components

Mg2+

Mn2+

dCTP

dGTP

dUTP

dATP

Taq DNA Polymerase

rTth DNA Polymerase

AmpErase®

Biotinylated Primer

and

OR

and

Page 17: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Detection

Polymerase & dNTPs

Elongation

Annealing

Denaturation

PCR Stages

Extracted DNA

Denaturation

Page 18: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

PCR Cycle - Step 1 – Αποδιάταξη με θέρμανση

Target Sequence

Target Sequence

Page 19: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

PCR Cycle - Step 2 – Ο βιοτινυλιωμένος εκκινητής

προσδένεται στα άκρα της αλληλουχίας στόχου

Page 20: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

PCR Cycle - Step 3 – Η Taq DNA Polymerase καταλύει την

επιμήκυνσή του εκκινήτη με την ενσωμάτωση

συμπληρωματικών νουκλεοτιδίων

Page 21: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

End of the 1st PCR Cycle – Αποτέλεσμα: παραγωγή δύο

αντίγραφων της αλληλουχίας στόχου

Page 22: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Detection

Polymerase & dNTPs

Elongation

Annealing

Denaturation

2nd cycle

Page 23: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

End of the 2nd PCR Cycle – Αποτέλεσμα: παραγωγή 4 αντίγραφων

της αλληλουχίας στόχου

Page 24: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Target Amplification

No. of No. Amplicon Cycles Copies of Target

1 2

2 4

3 8

4 16

5 32

6 64

20 1,048,576

30 1,073,741,824

1 cycle = 2 Amplicon

2 cycle = 4 Amplicon

3 cycle = 8 Amplicon

4 cycle = 16 Amplicon

5 cycle = 32 Amplicon

6 cycle = 64 Amplicon

7 cycle = 128 Amplicon

Page 25: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Παράγοντες που επηρεάζουν την PCR

• Primers (εκκινητές) • Polymerase enzyme • Co-factors MgCl2 -> DNA polymerase MnCl2 -> RNA polymerase (RT) • Temperature

Page 26: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

• Short oligonucleotides are required to prime DNA synthesis (primers)

• Annealing of the primer to the template depends on complementary base-

pairing

• The position within the template molecule at which DNA copying is

initiated can be specified by synthesising primers with the appropriate

nucleotide sequence

Primers

Page 27: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Primers

• Oligonucleotide; 20-30 bp • G-C content; 50-60% • Tm. 50-80 oC • Target specificity • No primer dimer,hair-pin loop

Page 28: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Temperature

• Denaturation -> 95 οC • Primer annealing Tm-5 οC, Tm-10 οC • Primer extension depending on types of enzyme, eg. Taq DNA polymerase -> 72 οC

Page 29: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

DNA polymerase

Thermus aquaticus, a thermophilic bacteria discovered in 1969 in hot spring of Yellowstone National park . It can tolerate high temperature. The DNA polymerase (Taq polymerase) was isolated.

Page 30: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

DNA polymerase

Taq DNA polymerase • Thermus aquaticus YT1 • Temp 72 οC (75-80 οC) • Rate of nucleotide elongation 60 nucleotide/sec at 70 οC 0.25 nucleotide/sec at 25 οC • No 3’->5’ exonuclease (proof reading) • Error rate 10-5-10-6 per base

Page 31: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

DNA polymerase

Vent DNA polymerase • Thermus litoralis • Temp 75-80 οC • Rate of nucleotide elongation 1000 nucleotides/sec • With 3’ -> 5’ exonuclease

Page 32: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Αξιοπιστία του πολλαπλασιασμού

• Enzyme “ 3’->5’ exonuclease ” • Optimization of reagents Mg++, conc. of nucleotide • Sequence of target dinucleotide repeat; CA repeat > slippage of polymerase -> ladder bands

Page 33: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Τύποι PCR

• Single PCR • Nested PCR • Multiplex PCR • Reverse transcriptase PCR • Asymmetric PCR • Quantitative PCR

Page 34: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Nested PCR

Primary PCR product

Nested PCR product

Target

1ry primer Nested primer

Page 35: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Reverse transcription PCR Amplicor HIV-1 Monitor Test Roche

1.Target RNA

2.Reverse transcription

cDNA synthesis

3.1st cycle of PCR

4.2nd cycle of PCR

Page 36: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Analysis of PCR

Once the amplification has taken place the PCR product (Amplicons) must now be detected.

– End Point Analysis - detection is performed on completion of the PCR

– Real-Time PCR - detection is performed after each PCR cycle

Page 37: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

• DNA/RNA basics

• PCR

• End-point detection of PCR

• Real-time detection of PCR

• TaqMan chemistry

• Multiplex PCR Applications of real-time PCR in Microbiology

PCR/Real-Time PCR

Page 38: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Detection of PCR product

• Electrophoresis

DNA marker

Page 39: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

End Point Analysis

M

M - Molecular Weight Markers

P - Positive Control

P S1 S2 S3 S4 S5 S6 N M M P N S7 S8 S9

N - Negative Control

S1 - S12 = Patient Samples

S3, S8, S9 & S12 = NEG

S10 S11 S12

Page 40: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Detection of PCR product

• Hybridization Dot blot Southern blot

Page 41: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

• DNA/RNA basics

• PCR

• End-point detection of PCR

• Real-time detection of PCR

• TaqMan chemistry

• Multiplex PCR Applications of real-time PCR in Microbiology

PCR/Real-Time PCR

Page 42: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Real-Time Analysis

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0

200000000

400000000

600000000

800000000

1000000000

1200000000

1400000000

1600000000

0 5 10 15 20 25 30 35

PCR CYCLE NUMBER

AM

OU

NT

OF

DN

A

CYCLE NUMBER AMOUNT OF DNA0 11 22 43 84 165 326 647 1288 2569 512

10 1,02411 2,04812 4,09613 8,19214 16,38415 32,76816 65,53617 131,07218 262,14419 524,28820 1,048,57621 2,097,15222 4,194,30423 8,388,60824 16,777,21625 33,554,43226 67,108,86427 134,217,72828 268,435,45629 536,870,91230 1,073,741,82431 1,400,000,00032 1,500,000,00033 1,550,000,00034 1,580,000,000

Page 44: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Real-time PCR fluorescent detection methods

• Generic Detection - Intercalating and DNA binding dyes (Ethidium bromide and minor

groove binding dyes e.g. SYBR Green 1). These dyes bind to dsDNA with enhanced

fluorescence (20-100 fold increase)

• Sequence-specific probes – fluorophore-coupled nucleic acid probes. Higher

specificity. Most methods use the phenomenon of Fluorescent Resonance Energy

Transfer (FRET).

Page 45: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

REAL TIME PCR

• kinetic approach • early stages • while still linear

www.biorad.com

Page 46: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Quantification with real-time PCR

Page 47: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

SERIES OF 10-FOLD DILUTIONS

Page 48: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

• DNA/RNA basics

• PCR

• End-point detection of PCR

• Real-time detection of PCR

• TaqMan chemistry

• Multiplex PCR Applications of real-time PCR in Microbiology

PCR/Real-Time PCR

Page 49: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Real-Time Analysis TaqMan Chemistry

• Double-Dye Oligonucleotide Probes

• Probes contain specific sequence relating to target of interest.

• The probe has a fluorescent label (Reporter) at the 5’ end & a fluorescent quencher at the 3’ end.

• The fluorescent label is quenched due to the FRET principle.

• 5’ exonuclease activity of Taq degrades the probe so

that the fluorescent label is separated from the

quencher (Taq multifunctional)

• When label and quencher are separated the label

fluorescent signal can be detected

Page 50: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Fluorescence

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FRET

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FRET

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TaqMan Chemistry

Page 54: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

TaqMan Chemistry

Page 55: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,
Page 56: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,
Page 57: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,
Page 58: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,
Page 59: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

• DNA/RNA basics

• PCR

• End-point detection of PCR

• Real-time detection of PCR

• TaqMan chemistry

• Multiplex PCR

• Applications of real-time PCR in Microbiology

PCR/Real-Time PCR

Page 60: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Multiplexing

• Diagnostic PCR assays are usually require an internal control (duplex)

• Multiplex assays are separate targets (pathogens)

• Multiplexing more difficult than expected

• Real-time PCR can multiplex 4-6 assays maximum

• Often loose sensitivity by multiplexing (competition)

• For quantification - only duplexing probably OK

Page 61: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

ELOSA

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Luminex microsphere-based multiplexing system

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Luminex detection

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DNA microarray

• Difficult to link with DNA amplification • Difficult to manufacture arrays • Readers and software expensive

Page 65: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

• DNA/RNA basics

• PCR

• End-point detection of PCR

• Real-time detection of PCR

• TaqMan chemistry

• Multiplex PCR

• Applications of real-time PCR in Microbiology

PCR/Real-Time PCR

Page 66: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Pathogen detection

Four main methods

1. Culture

2. Antigen detection

3. Serology

4. Molecular – Hybridization

- Nucleic Acid Amplification Tests

(NAATs) PCR etc.

Page 67: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

PCR - not the only NA amplification method

• Other DNA amplification methods – NASBA/TMA, SDA, Loop-Amp etc.

Isothermal methods - do not require thermal cycling

• Molecular testing in diagnostic microbiology usually restricted to detection

(qualitative), quantification (viral load), and genotyping. Not usually

sequencing.

Page 68: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Molecular Diagnostic Testing-Viruses

• Routine viral detection

– Replace cell culture – sensitive, quick

– BBVs, Intrauterine infections, respiratory viruses, norovirus

• Viral Load Monitoring (treatment monitoring) – HIV, HCV, CMV (pre-

emptive monitoring)

• Genotyping/resistance testing – HIV, HBV, HCV

Page 69: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Molecular Diagnostic Testing – Bacteria/Parasites/Fungi

• Fastidious bacteria – C. trachomatis, GC, pertussis, M. genitalium, T.

whipplei, C. burnetti, B. henselae

• Rapid Bacterial diagnosis – N. meningitidis, S. pneumoniae, H. influenzae

• Antibiotic resistance – MRSA, VRE, ESBL, multi-drug resistant TB

• Parasites/Fungi – T. gondii, Malaria, P. carinii, Aspergillus

Page 70: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

Conclusions

• PCR/real-time PCR – biggest change in technology in microbiology in last

20-25 years

• Real-time PCR implemented faster into diagnostic labs than end-point PCR

as more suitable for diagnostics

• Multiplexing remains a problem and it will be interesting to see if other

technologies supersede real-time PCR for detection/genotyping but probably

not for quantification

Page 71: Polymerase Chain Reaction...•PCR reaction mixture usually includes water, buffer, magnesium chloride (MgCl 2), forward and reverse primers, deoxynucleotides (dNTPs), polymerase,

The end