RT PCR Testing

The Polymerase Chain Reaction is a technique used to analyze DNA from very minute amounts in clinical samples by a process of amplification of the DNA strands.

For RNA viruses like  SARS-CoV-2, the Reverse transcriptase-polymerase chain reaction first synthesizes cDNA (complementary DNA) from RNA by reverse transcription (RT), then amplifies the specific cDNA by the polymerase chain reaction (PCR).

 

How PCR Test is Done

The polymerase enzyme moves along the segment of DNA, reading its code and assembling a copy, repeated hundreds of thousands of times over the course of a few hours, thereby creating enough material to undergo analysis.

Since PCR was invented in 1983 by Kary Mullis while working at Cetus, one of the first biotechnology companies, PCR testing has become a preferred method of detection for many infectious organisms, including respiratory, genito-urinary, skin and wound, gastrointestinal, and even ophthalmological infections. 

PCR Testing Labs – All the Same?

In my previous article on “Respiratory Panel PCR Test – When To Order”, we learned how effective PCR testing can be even in cases of seemingly routine respiratory infections seen in an acute or urgent care setting.
 
But are all PCR Tests the same?
 
As I was researching PCR testing labs I noticed several that offer a respiratory panel pcr test DON’T INCLUDE Sars-Cov-2 in their panel!
 
Here are some common lab panels, is your lab here?
 

Quest Diagnostics Respiratory Panel PCR Test

This assay will not detect SARS-CoV-2 (COVID-19).

Influenza A
Influenza A subtype H1
Influenza A subtype H3
Influenza B
Human Parainfluenza Virus (HPIV) 1
Human Parainfluenza Virus (HPIV) 2
Human Parainfluenza Virus (HPIV) 3
Human Parainfluenza Virus (HPIV) 4
Rhinovirus/Enterovirus
Human Metapneumovirus (HMPV)
Human Respiratory Syncytial Virus (HRSV) A
Human Respiratory Syncytial Virus (HRSV) B
Adenovirus
Coronavirus 229E
Coronavirus OC43
Coronavirus NL63
Coronavirus HKU1
Human Bocavirus
Chlamydophila pneumoniae
Mycoplasma pneumoniae

Labcorp Respiratory Panel PCR Test

Adenovirus; Bordetella pertussisChlamydophila pneumoniae; coronavirus 229E; coronavirus HKU1; coronavirus NL63; coronavirus OC43; human metapneumovirus; human rhinovirus/enterovirus; influenza A; influenza A subtype H1; influenza A subtype H3; influenza A subtype H1-2009; influenza B; Mycoplasma pneumoniae; parainfluenza virus 1; parainfluenza virus 2; parainfluenza virus 3; parainfluenza virus 4; respiratory syncytial virus

Please note: This test does not detect the 2019 Novel Coronavirus (2019-nCoV).

 

Mayo Clinic Respiratory Panel PCR Test

Rapid detection of respiratory infections caused by the following:

-Adenovirus

-Coronavirus (serotypes HKU1, NL63, 229E, OC43) (NOT SARS-CoV-2)

-Human metapneumovirus

-Human rhinovirus/enterovirus

-Influenza A (H1, H1-2009, H3)

-Influenza B

-Parainfluenza virus (serotypes 1-4)

-Respiratory syncytial virus (RSV)

Bordetella pertussis

-Bordetella parapertussis

Chlamydophila pneumoniae

Mycoplasmoides pneumoniae

 

What’s the Best PCR Testing Lab?

Here is a much more comprehensive respiratory panel pcr test from HealthtrackRx/AIT labs.

Unlike most high throughput PCR labs, AIT incorporates over 20 classes of antibiotic resistance and Sars-Cov-2 in the base panel.

Most labs concentrate solely on viral testing, but do not test extensively for bacterial pneumonia causing pathogens.

AIT offers comprehensive respiratory viral and bacterial pathogen testing, when combined with the antibiotic resistance, allows for fast, targeted treatment.

 

Respiratory Pathogens

  • Acinetobacter baumanii
  • Adenovirus HAdV-B
  • Aspergillus flavus, fumigatus, niger, terreus
  • Bordetella pertussis, parapertusis, bronchiseptica
  • Candida albicans, glabrata, parapsilosis, tropicalis
  • Candida auris
  • Chlamydia tracomatis
  • Chlamydophila pneumoniae
  • Coronavirus (229E, NL63, )C43, and HKU1)
  • COVID-19 Coronavirus (SARS-CoV-2)
  • Escherichia coli
  • Enterobacter aerogenes, cloacae
  • Enterovirus A+B+C
  • Enterovirus D
  • Haemophillus influenzae
  • Varicella zoster virus (Human Herpes Virus 3)
  • Human metapneumovirus
  • Influenza virus A,B probes
  • Klesiella ‘pneumoniae’, ooxytoca
  • Legionella pneumophila
  • Moraxella catarrhalis
  • Mycoplasma pneumoniae
  • Mycobacterium avium-intracellulare, kansasii
  • Neisseria gonorrhoeae
  • Parainfluenza virus (types 1, 2, 3, 4)
  • Proteus mirabilis, vulgaris
  • Pseudomonas aeruginosa
  • Respiratory syncytial virus
  • Rhinovirus A+B+C
  • Rhizopus spp, Mucor spp.
  • Serratia marcescens
  • Staphylococcus aureus
  • Staphylococcus spp
  • Streptococcus agalactiae (Group B strep (GBS))
  • Streptococcus pneumoniae
  • Steptococcus pyogenes (Group A strep)
 
For urgent cares, AIT also offers the Respiratory Viral Panel, or “lite panel” which tests for the three treatable respiratory viruses (Sars-Cov-2, Influenza A/B and RSV) with only 1 swab needed.

 

Unique Antibiogram Gives You Individualized Prescribing Confidence

But it doesn’t stop there – you can then be more confident prescribing treatment that guided by patient individualized antibiotic sensitivities.  This is possible by detecting the patient’s own antibiotic resistance genes:

Antibiotic Resistance Genes

  • VanA, VanB (Vancomycin resistance)
  • ermB, C; mefA (Macrolide Lincosamide Streptogramin)
  • SHV, KPC Groups (Class A beta lactamase)
  • dfr (A1, A5), sul (1, 2) probes (Trimethoprim/Sulfamethoxazole resistance)
  • mecA (Methicillin gene)
  • qnrA1, qnrA2, qnrB2 (Fluoroquinolone genes)
  • tet B, tet M (Tetracycline genes)
  • IMP, NDM, VIM Groups (Class B metallo beta lactamase)
  • ACT, MIR, FOX, ACC Groups (AmpC beta lactamase)
  • OXA-48,-51 (Class D oxacillinase)
  • CTX-M1 (15), M2 (2), M9 (9), M8/25 Groups (Class A beta lactamase)

Prescribe with Confidence

As the leader in testing sensitivity and specificity, these reports include a custom-designed accurate and detailed antibiogram.

  • Support antibiotic stewardship by reducing over-utilization of broad-spectrum anti-infectives
  • Decrease the need for empiric therapy
  • Reduce unnecessary drug exposureadverse eventscost of repeat testing, and multiple treatment attempts

Respiratory Pathogens pdf

Learn more about respiratory pathogen PCR testing – download the pdf here

Real Time Polymerase Chain Reaction (RT PCR)

Real Time Polymerase Chain Reaction (PCR) infectious disease testing offers
higher accuracy and broader detection than culture.

▪ Detects the presence of infection by amplifying pathogen RNA and DNA
▪ Pathogen and antibiotic resistance information in 24 hours
▪ Increased sensitivity and specificity
▪ Unaffected by concurrent use of antibiotics
▪ Identifies polymicrobial infections

Identifying cause of infection on the first test is important especially in immunocompromised patients, including the elderly.

Here's what you need in your practice:

  • PCR testing that provides causative microbe coverage for up to 99% of syndrome-related
    microbes, some of which are not detected by traditional culture and sensitivity.
  • The test panels that offer information on the antibiotic resistance genes found in an individual sample. This information can help the clinician choose the best possible anti-infective therapy for the patient.

Get Up to 99% detection of causative bacterial, viral, fungal pathogens with sensitivity reports

Get Advanced PCR Testing For Your Practice

Your patients want an answer.  "What do I have?" 

Especially when point of care testing is not available, inconclusive, or doesn't give you an actual treatment decision, as well as for confirmation, rapid turn-around PCR testing (24-36h) will keep your patients safe, out of the hospital, and your reputation intact. 

"The urgent care mis-diagnosed me" is not something you want to see on your online reviews.

Let's get this set up in your practice: