「バークホルデリア」ファージターミナーゼ遺伝子を標的とするマルチプレックスPCRを用いたメライド病のファージベース診断アッセイ

Conventional diagnostic approaches involve identifying the bacterial pathogen from patient samples, which can delay results and miss low-bacteremia cases. Herein, we demonstrate that Burkholderia phages circulating in patient blood can serve as a powerful diagnostic biomarker. Building on this, a multiplex PCR targeting the Burkholderia pseudomallei phage terminase gene was developed to improve melioidosis diagnosis. The assay provided 97.2% sensitivity and 100% specificity, with results obtainable within 6 h. The strength of this PCR assay is the amplification of four different multicopy Burkholderia phage terminase genes from serum samples, resulting in increased sensitivity under low-bacteremia conditions. To our knowledge, this study reports a phage-based PCR assay that detects phage DNA directly from melioidosis patients' blood, representing a shift from molecular pathogen-based to phage-based diagnostics. This approach not only improves sensitivity but also opens avenues for integrating phage biology into the diagnostic landscape of infectious diseases.