Isothermal amplification technology (IAT) for rapid diagnosis of Rickettsioses: scope, overview, existing evidence, and the way forward

• Published in: Diagnostic microbiology and infectious disease Vol. 107; no. 3; p. 116046
• Main Authors: Dixit, Rashi, Gopalan, Natarajan, Behera, Sujit Kumar
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2023
• Subjects: Animals; Humans; Isothermal amplification; Isothermal amplification technology; Mice; Orientia; Orientia tsutsugamushi; Rickettsia; Rickettsia - genetics; Rickettsia diagnosis; Rickettsia Infections - diagnosis; Rickettsia Infections - microbiology; Rickettsioses; Scrub Typhus - diagnosis; Typhus, Endemic Flea-Borne - diagnosis; Isothermal amplification technology; Rickettsioses; Rickettsia diagnosis; Rickettsia; Isothermal amplification; Orientia
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2023.116046

•Isothermal amplification technology (IAT) are rapid, affordable diagnostic tests.•They utilize a constant temperature to amplify the target DNA.•Diagnosis of Rickettsioses is challenging; can cause fatal complications if misdiagnosed.•IATs like saltatory rolling circle amplification (SRCA), RCA and HDA are yet to be optimized for Rickettsial diagnosis.•IATs in combination with CRISPR-Cas based detection can revolutionize molecular diagnostics.
Rickettsioses, a category of zoonosis primarily caused by Rickettsia and Orientia, is a huge cause of public health concern worldwide. Diseases like murine typhus, scrub typhus, Mediterranean spotted fever and rocky mountain spotted fever are major contributors of Rickettsioses globally, with peculiar distributions in south-east Asia, Africa, Arabia and the Americas. With the innovations in molecular diagnostics, Isothermal Amplification Technology is gaining popularity for its fidelity, rapidity and cost-effectiveness. Compared to commercial assays, they are easily adaptable for point-of-care (PoC) settings. Due to nonspecific presentation as an acute undifferentiated febrile illness, diagnosis of Rickettsioses poses a great challenge. Certain isothermal amplification assays have proven to be highly efficient in diagnosing vector borne diseases like dengue, malaria, and chikungunya. The purpose of this review is to provide readers the current advancements, scope, challenges, and future prospects of isothermal amplification technologies in the detection of zoonotic pathogens like Rickettsia and Orientia.