Use of nanotechnology for infectious disease diagnostics: application in drug resistant tuberculosis.

BACKGROUND: The increased transmission of multidrug-resistant (MDR) tuberculosis (TB) poses a challenge to tuberculosis prevention and control in Sri Lanka. Isoniazid (INH) is a key element of the first line anti tuberculosis treatment regimen. Resistance to INH may lead to development of MDR TB. Therefore, early detection of INH resistance is important to curb spread of resistance. Due to the limited availability of rapid molecular methods for detection of drug resistance in Sri Lanka, this study was aimed at developing a simple and rapid gold nanoparticle (AuNP) based lateral flow strip for the simultaneous detection of the most common INH resistance mutation (katG S315 T, 78.6%) and Mycobacterium tuberculosis (MTb). METHODS: Lateral flow strip was designed on an inert plastic backing layer containing a sample pad, nitrocellulose membrane and an absorption pad. Biotin labeled 4 capture probes which separately conjugated with streptavidin were immobilized on the nitrocellulose. The test sample was prepared by multiplex PCR using primers to amplify codon 315 region of the katG gene and MTb specific IS6110 region. The two detection probes complementary to the 5' end of each amplified fragment was conjugated with gold nanoparticles (20 nm) and coupled with the above amplified PCR products were applied on the sample pad. The hybridization of the amplified target regions to the respective capture probes takes place when the sample moves towards the absorption pad. Positive hybridization is indicated by red colour lines. RESULTS: The three immobilized capture probes on the strip (for the detection of TB, katG wild type and mutation) were 100 and 96.6% specific and 100 and 92.1% sensitive respectively. CONCLUSION: The AuNP based lateral flow assay was capable of differentiating the specific mutation and the wild type along with MTb identification within 3 h.

RFLP clusters of rifampicin resistant and susceptible Mycobacterium tuberculosis strains in Western province of Sri Lanka.

INTRODUCTION: Continuous studies on genetic diversity of Mycobacterium tuberculosis could enhance the awareness on transmission, control and prevention of tuberculosis (TB). In this study, we investigated current genetic diversity of TB and rifampicin resistant TB by, Restriction Fragment Length Polymorphism (RFLP) based on fingerprinting of the IS6110 insertion sequence, in the Western province of Sri Lanka, the famous touristic destination with the highest TB burden in the country. METHODOLOGY: Genomic DNA extracted from susceptible and rifampicin resistant TB strains (confirmed for rpoB gene point mutations) were digested with PvuII restriction enzyme, electrophoresed and subjected to Southern transfer. The blots were hybridised with IS6110 probe and visualized using a chemiluminescence detection. RESULTS: The number of copies of IS6110 per isolate varied from 1 to 14. The dendrogram revealed a total of 68 distinct strains among 77 TB isolates and they belonged to nine clusters. Both rifampicin resistant and susceptible strains were distributed in all clusters. This evaluation revealed the absence of genetically identical or strong relatedness between susceptible and resistant isolates. However, clonal expansion was detected in transmission of both TB and rifampicin resistant TB. In addition, the resistant isolates having the novel mutation had no clonal relatedness. CONCLUSION: This is the first observational study regarding clonal expansion of TB in Sri Lanka. Thus, further investigation on genotypes, clonal expansion and transmission of drug resistance using additional markers would be useful for controlling TB.