Conditions. To determine whether the same is true of slow-growing bacterial

Conditions. To determine whether the same is true of slow-growing bacterial species, we examined 23388095 M. bovis BCG cells that had been incubated in filtered or unfiltered human serum for 30 days at 37uC. When transferred to supplemented Middlebrook 7H9 broth, these cells exhibited dramatic pre-rRNA upshift in 1 to 4 hours, a fraction of their normal 24 hour MC-LR web generation time (Figure 4). Similar results were obtained with a related strain, M. tuberculosis H37Ra (Figure S2). Separate plating experimentsSerum Acclimation Time 1948-33-0 site CoursesIn order to determine whether the results in Figure 2 depended on high cell densities and/or extended acclimation to serum, aFigure 2. Ratiometric pre-rRNA analysis of A. baumannii, S. aureus, and P. aeruginosa cells in serum. A : Analysis of cells that had been held in serum for 7 days. Nutritional stimulation was initiated by suspending cells in pre-warmed TSB, and samples taken after 0, 1, 2, and 4 hours were subjected to RT-qPCR and qPCR to quantify pre-rRNA and gDNA, respectively. The same primers were used to amplify gDNA and cDNA generated from pre-rRNA. Ratios of pre-rRNA to gDNA (P:G; bars) are means and SDs of nine ratiometric permutations from three technical replicates of each sample type. Quantity of gDNA (lines) are means and standard deviations of the three gDNA measurements. Viable cell densities of A. baumannii, S. aureus, and P. aeruginosa, respectively, in serum were 9.06108, 9.76105, and ,16102 CFU/mL. From separate gDNA standard curves consisting of five points each, qPCR efficiencies were calculated [10(21/slope) 21] to be between 0.913 and 0.959. A replicate experiment (Figure S1) yielded similar results for all three organisms. doi:10.1371/journal.pone.0054886.gViability Testing by Pre-rRNA AnalysisFigure 3. Ratiometric pre-rRNA analysis of A. baumannii (A), P. aeruginosa (B), and S. aureus (C) cells in serum over time. Three biological replicates for each organism were prepared at ,1E5 CFU/mL in serum and analyzed after 4, 24, and 168 hours of serum acclimation. At each timepoint, nutritional stimulation was initiated by suspending cells in pre-warmed TSB for 1.5 hours. Changes in pre-rRNA are expressed as means and standard deviations of the fold-increases in P:G ratio following nutritional stimulation, relative to non-stimulated control aliquots (P:G+/P:G2). The horizontal dashed line indicates the “viability 15857111 threshold” which samples with viable cells are expected to exceed. From separate gDNA standard curves consisting of five points each, qPCR efficiencies were between 1.010 and1.067. doi:10.1371/journal.pone.0054886.gindicated that both species survive serum exposure well and were viable after 30 days (data not shown). Thus, slow-growing mycobacteria in serum respond to nutritional stimulation in a similar fashion to fast-growing Gram-negative and Gram-positive bacteria.Semi-automated Pre-rRNA AnalysisThe preceding results demonstrate the biological feasibility of molecular viability testing in a complex human sample matrix. However, these samples were spiked to high cell densities ( 1E5 CFU/mL). In addition, the experiments used laborintensive manual methods described previously [18]. To better evaluate the practical feasibility of ratiometric prerRNA analysis as a diagnostic strategy, a more streamlined semiautomated approach was applied to serum samples with spiked A. baumannii cells present at lower viable cell densities ranging from 15 to 7500 CFU/mL, as determined by viabilit.Conditions. To determine whether the same is true of slow-growing bacterial species, we examined 23388095 M. bovis BCG cells that had been incubated in filtered or unfiltered human serum for 30 days at 37uC. When transferred to supplemented Middlebrook 7H9 broth, these cells exhibited dramatic pre-rRNA upshift in 1 to 4 hours, a fraction of their normal 24 hour generation time (Figure 4). Similar results were obtained with a related strain, M. tuberculosis H37Ra (Figure S2). Separate plating experimentsSerum Acclimation Time CoursesIn order to determine whether the results in Figure 2 depended on high cell densities and/or extended acclimation to serum, aFigure 2. Ratiometric pre-rRNA analysis of A. baumannii, S. aureus, and P. aeruginosa cells in serum. A : Analysis of cells that had been held in serum for 7 days. Nutritional stimulation was initiated by suspending cells in pre-warmed TSB, and samples taken after 0, 1, 2, and 4 hours were subjected to RT-qPCR and qPCR to quantify pre-rRNA and gDNA, respectively. The same primers were used to amplify gDNA and cDNA generated from pre-rRNA. Ratios of pre-rRNA to gDNA (P:G; bars) are means and SDs of nine ratiometric permutations from three technical replicates of each sample type. Quantity of gDNA (lines) are means and standard deviations of the three gDNA measurements. Viable cell densities of A. baumannii, S. aureus, and P. aeruginosa, respectively, in serum were 9.06108, 9.76105, and ,16102 CFU/mL. From separate gDNA standard curves consisting of five points each, qPCR efficiencies were calculated [10(21/slope) 21] to be between 0.913 and 0.959. A replicate experiment (Figure S1) yielded similar results for all three organisms. doi:10.1371/journal.pone.0054886.gViability Testing by Pre-rRNA AnalysisFigure 3. Ratiometric pre-rRNA analysis of A. baumannii (A), P. aeruginosa (B), and S. aureus (C) cells in serum over time. Three biological replicates for each organism were prepared at ,1E5 CFU/mL in serum and analyzed after 4, 24, and 168 hours of serum acclimation. At each timepoint, nutritional stimulation was initiated by suspending cells in pre-warmed TSB for 1.5 hours. Changes in pre-rRNA are expressed as means and standard deviations of the fold-increases in P:G ratio following nutritional stimulation, relative to non-stimulated control aliquots (P:G+/P:G2). The horizontal dashed line indicates the “viability 15857111 threshold” which samples with viable cells are expected to exceed. From separate gDNA standard curves consisting of five points each, qPCR efficiencies were between 1.010 and1.067. doi:10.1371/journal.pone.0054886.gindicated that both species survive serum exposure well and were viable after 30 days (data not shown). Thus, slow-growing mycobacteria in serum respond to nutritional stimulation in a similar fashion to fast-growing Gram-negative and Gram-positive bacteria.Semi-automated Pre-rRNA AnalysisThe preceding results demonstrate the biological feasibility of molecular viability testing in a complex human sample matrix. However, these samples were spiked to high cell densities ( 1E5 CFU/mL). In addition, the experiments used laborintensive manual methods described previously [18]. To better evaluate the practical feasibility of ratiometric prerRNA analysis as a diagnostic strategy, a more streamlined semiautomated approach was applied to serum samples with spiked A. baumannii cells present at lower viable cell densities ranging from 15 to 7500 CFU/mL, as determined by viabilit.