Multiplexed pathogen identification via bead-based isothermal amplification in a low-cost microfluidic device - Summary:
Treatment decisions for respiratory infections, diarrheal diseases, sepsis, and urinary tract infections (UTIs)
are tied to the identification and differentiation of the many possible infection-causing pathogen(s). Nucleic acids
(NAs) are effective biomarkers for pathogen identification, but detecting nucleic acid sequences typically requires
some variation of the polymerase chain reaction (PCR), necessitating complex instrumentation and trained staff
that are only found in centralized laboratories. The long-term goal of the proposed project is to develop a point-
of-care (POC)-compatible microfluidic device for DNA amplification and detection of 9 different UTI-causing
pathogens. The proposed project will focus on developing the amplification and detection components, which in
future efforts will be integrated with sample preparation. In the herein proposed system, the user will add
extracted DNA to a disposable cartridge, external instruments will actuate fluid handling, thermal control, and
imaging, and the results will be available 1 hr later. This method will use isothermal nucleic acid amplification,
which is more suitable for POC settings than PCR because it requires no thermocycling, resulting in less
expensive and more robust systems. However, isothermal nucleic acid amplification is usually not suitable for
higher order multiplexing (> 2 or 3 NA sequences). To achieve high-order multiplexing, the proposed method will
combine the advantages of spatial multiplexing, where the sample is divided into and amplified within distinct
compartments, and color-based multiplexing, where color of a unique oligonucleotide detection probe is used to
identify an amplified sequence. However, we will circumvent the limitations of these two approaches, such as
loss of sensitivity in spatial multiplexing due to sample dilution, and limited filter space to differentiate excitation
and emission of multiple fluorophores in color multiplexing. We will use clonal isothermal nucleic acid
amplification inside a water-in-oil emulsion with fluorescently encoded microbeads, followed by detection in a
microchannel. In Aim 1, we will establish the required processes to generate the droplet-bead emulsions and
isothermally amplify NAs within each droplet, resulting in amplicons bound to the microbeads, followed by
breaking open the emulsion, and isolating the beads for imaging. In Aim 2, we will design and fabricate a
microfluidic device appropriate for use at the point-of-care to execute the processes developed in Aim 1. In Aim
3, we will test the device with extracted DNA from UTI pathogens to validate the device's accuracy in identifying
the correct pathogen. In future work, we will create a small compact instrument (< 1 ft3) that autonomously
actuates the fluid handling, thermal control, and imaging components in an integrated user friendly format with
the microfluidic device developed here. This device will also be coupled with upstream sample preparation and
we will test the entire sample-to-answer process with actual clinical UTI samples.