Dual-mode visual detection strategies of viable pathogens for point-of-care testing.

Here, we introduce a power-free foldable poly(methyl methacrylate) (PMMA) microdevice fully integrating DNA extraction, amplification, and visual detection, realized in novel dual modes - colorimetric and aggregate formation - using 4-Aminoantipyrine (4-AP) for monitoring pathogens. The microdevice contains two parts: reaction and detection zones. A sealing film was utilized to connect the two zones and make the device foldable. The FTA card was deposited in the reaction zone for DNA extraction, followed by loop-mediated isothermal amplification (LAMP) at 65 °C for 45 min. When the detection zone is folded toward the reaction zone, paper discs modified with 4-AP placed in the detection zone are delivered to the reaction zone. Specifically, in the presence of LAMP amplicons, 4-AP is oxidized into antipyrine red or generates aggregates by interacting with copper sulfate, forming copper hybrid nanostructure (Cu-hNs). In the absence of LAMP amplicons, 4-AP is not oxidized and maintains yellow color or fails to form aggregates. Furthermore, we introduced the ethidium homodimer-1 (EthD-1) to identify viable bacteria. EthD-1 penetrated the compromised membranes of nonviable cells and prevented further DNA amplification by intercalating with the DNA. In this way, only samples containing viable cells displayed color change or formed aggregates upon reaction with 4-AP. Using this method, SARS-CoV-2 RNA and Enterococcus faecium were identified by naked eye, with the limit of detection of 103 copies/µL and 102 CFU/mL, respectively, within 60 min. The introduced microdevice can be used for rapidly monitoring viable pathogens and controlling outbreaks of infectious disease in resource-limited settings.

Fabrication of a fully integrated paper microdevice for point-of-care testing of infectious disease using Safranin O dye coupled with loop-mediated isothermal amplification.

In this study, we introduce a paper microdevice fully integrating DNA extraction, loop-mediated isothermal amplification (LAMP), and Safranin O-based colorimetric detection of two major infectious pathogens, namely SARS-CoV-2 and Enterococcus faecium. The paper microdevice is composed of two parts: sample and reaction chambers. A sealing film acted as a bottom layer to allow foldable motion for transferring DNA from sample chamber to reaction chamber in a seamless manner. An FTA card was employed in the sample chamber for DNA extraction and purification from bacteria-spiked milk. After LAMP reaction at 65 °C for 30 min, a novel aggregation-based DNA detection was obtained by Safranin O polymerization in the reaction chamber. Specifically, Safranin O underwent polymerization by addition of oxidant to form Safranin O oligomers. The electrostatic interaction between the positively charged Safranin O oligomers and the negatively charged DNA comprising LAMP amplicons resulted in the aggregation with a dark red color. Meanwhile, in the absence of LAMP amplicons, Safranin O oligomers were well dispersed and displayed their original red color. By using Safranin O-based detection, SARS-CoV-2 and E. faecium were successfully identified by naked eye within 60 min, and the limits of detection were 10-4 ng/µL and 102 CFU/mL, respectively. These results indicate that a fully integrated paper microdevice plays an important role in sample-in-answer-out format in the genetic analyses of infectious disease and serves as a rapid tool for controlling the spread of diseases.

Ultraviolet-induced in situ gold nanoparticles for point-of-care testing of infectious diseases in loop-mediated isothermal amplification.

The present study investigated ultraviolet-induced in situ gold nanoparticles (AuNPs) coupled with loop-mediated isothermal amplification (LAMP) for the point-of-care testing (POCT) of two major infectious pathogens, namely, Coronavirus (COVID-19) and Enterococcus faecium (E. faecium spp.). In the process, gold ions in a gold chloride (HAuCl4) solution were reduced using trisodium citrate (Na3Ct), a reducing agent, and upon UV illumination, red-colored AuNPs were produced in the presence of LAMP amplicons. The nitrogenous bases of the target deoxyribonucleic acid (DNA) acted as a physical support for capturing gold ions dissolved in the sample. The high affinity of gold with the nitrogenous bases enabled facile detection within 10 min, and the detection limit of COVID-19 plasmid DNA was as low as 42 fg µL-1. To ensure POCT, we designed a portable device that contained arrays of reagent chambers and detection chambers. In the portable device, colorimetric reagents such as HAuCl4 and Na3Ct were contained in the reagent chambers; these reagents were subsequently transferred to the detection chambers where LAMP amplicons were present and thus allowed convenient sample delivery and multiplex detection. Owing to the high sensitivity of the in situ AuNPs, simplicity of portable device fabrication, and rapid colorimetric detection, we strongly believe that the fabricated portable device could serve as a kit for rapid POCT for instantaneous detection of infectious diseases, and could be readily usable at the bedside.