EasyScreen™ Sample Processing Kit (Automated Platforms) User Guide A method for nucleic acid extraction from microorganisms for use with compatible EasyScreen™ IVD Kits For in vitro Diagnostic Use REF SP001 VER 1.0 The Whipps Consultancy Limited 272 Bath Street, Glasgow G2 4JR Table of Contents 1. Introduction 1.Introduction ...............................................................................3 Gastroenteritis is a widespread clinical problem causing worldwide morbidity and mortality. Gastroenteritis can be caused by a wide range of infectious agents including viral, bacterial and protozoa. It has been estimated that foodborne gastroenteritis alone causes 76 million episodes of illness, 325,000 hospitalisations, and 5,000 deaths each year in the United States alone1. 1.1 Intended Use..................................................................................... 4 2. Notice To Customers.................................................................5 2.1 Important Information ........................................................................ 5 2.2 Summary and Explanation of the Test ............................................... 6 2.3 Principle of the Procedure ................................................................. 6 2.4 Limitations ........................................................................................ 8 2.5 Warnings and Handling Precautions ................................................ 11 2.6 Specimen collection, handling, storage and stability ........................ 12 2.7 Contents of the EasyScreen™ Sample Processing Kit..................... 13 2.8 Materials and Equipment Required (Not Supplied)............................ 13 3.Methods ..................................................................................14 3.1 Reagent Preparation........................................................................ 14 3.2 Protocol........................................................................................... 14 3.3 Quality Control ................................................................................ 16 3.4 Performance Characteristics............................................................ 16 In developed countries the mortality due to gastrointestinal infections is low but morbidity and economic consequences can be high2. Conversely in developing countries, gastroenteritis is the second most common cause of morbidity and mortality causing the death of about 2 million children less than 5 years of age each year3. Rapid, simple and accurate diagnostic methods are required to ease the burden on testing laboratories and provide better patient diagnosis and care. Mead PS, et al. Food-related illness and death in the United States. Emerg Infect Dis. 1999;5:607–24. 1 van Maarseveen NM, Wessels E, de Brouwer CS, Vossen A, and Claas E. Diagnosis of viral gastroenteritis by simultaneous detection of Adenovirus group F, Astrovirus, Rotavirus group A, Norovirus genogroups I and II and Sapovirus in two internally controlled multiplex real-time PCR assays. J Clin. Virol. 2010:49:205-210. 2 3 World Health Organization. Children’s environmental health. Available at http://www.who.int/ceh/en/ 4.Warranty ..................................................................................24 5.Troubleshooting ......................................................................24 2 3 1.1 Intended Use The EasyScreen™ Sample Processing Kit (Automated Platforms) ( REF SP001) is an accessory designed to rapidly isolate nucleic acids (DNA and RNA) from stool samples via an automated purification system. The nucleic acids are converted into 3base™ sequences prior to purification and are compatible with our range of real-time multiplex PCR (mPCR) assays for a wide range of gastrointestinal pathogens including bacteria, protozoan and viral targets. This accessory kit includes all reagents required to take a sample from the specimen, lyse any microorganisms and convert the nucleic acids to a 3base™ form for use with the EasyScreen™ range of real-time PCR based IVDs. The accessory is to be used in hospital and pathology laboratories or similar by trained personnel. This accessory kit does not produce any results, but is a necessary requirement for the following kits: CDD001: EasyScreen™ C. difficile Detection Kit: A screening test for the detection of (i) toxigenic C. difficile (targets both tcdA and tcdB), (ii) an endogenous extraction control (EC), and (iii) an internal positive control (IPC) for detection of inhibitors. CDD002: EasyScreen™ C. difficile Reflex Kit: A screening test for the detection of hypervirulent C. difficile incl. 027 & 078 via (i) tcdC gene deletion at position 117 and (ii) binary toxin gene (iii) gyrA gene mutation (fluroquinolone resistance) and (iv) an internal positive control (IPC) for detection of inhibitors. EB001: EasyScreen™ Enteric Bacteria Detection Kit: A screening test for the detection of (i) Salmonella spp., (ii) Shigella spp., (iii) Campylobacter spp., (iv) Yersinia enterocolitica, (v) toxigenic C. difficile, (vi) Listeria monocytogenes, (vii) an endogenous extraction control (EC), and (viii) an internal positive control (IPC) for detection of inhibitors. 4 EP001: EasyScreen™ Enteric Parasite Detection Kit: A screening test for the detection of (i) Entameoba complex, (ii) Dientameoba fragilis, (iii) Cryptosporidium, (iv) Giardia intestinalis, (v) Blastocyctis hominis, (vi) an endogenous extraction control (EC), and (vii) an internal positive control (IPC) for detection of inhibitors. EV001: EasyScreen™ Enteric Virus Detection Kit: A screening test for the detection of (i) Norovirus I/II, (ii) Astrovirus, (iii) Rotavirus (iv) Adenovirus, (v) Sapovirus, and (vi) an internal positive control (IPC) for detection of inhibitors and (vii) endogenous extraction control (EC). Coming Soon: DEC001: EasyScreen™ Diarrheagenic Escherichia coli Detection Kit: For the detection of (i) Enterohaemorrhagic E. coli (including O104 strain) (ii) Enterotoxigenic E. coli (iii) Enteroinvasive E. coli (iv) Enteropathogenic E. coli (v) Enteroaggregative E. coli directly from faecal samples and (vi) endogenous extraction control (EC). ID001: EasyScreen™ Influenza Detection Kit For the detection of (i) Influenza A, (ii) Influenza B, (iii) Influenza A-H3 (with extraction control) MTB001: EasyScreen™ M. tuberculosis Detection Kit For the rapid detection of M. tuberculosis comprising (i) the 65 kDa heat shock protein (mycobacterial universal), (ii) IS6110, (iii) 16S rDNA M. tuberculosis region (with an extraction control). 2. Notice To Customers 2.1 Important Information The EasyScreen™ Sample Processing Kit is authorised as an accessory kit for use with the EasyScreen™ range of IVD kits. To discuss licensing of the 3base™ technology for other applications, contact Human Genetic Signatures Pty Ltd at: [email protected] 5 2.2 Summary and Explanation of the Test A stool specimen from a patient suspected of having gasteroenteritis (usually liquid or soft stool) is collected and transported to the testing laboratory. A sterile dry swab is dipped into the stool material and processed with the EasyScreen™ Sample Processing Kit ( REF SP001), which lyses and converts the nucleic acids to a 3base™ form. Alternatively, a cultured sample of bacteria may be processed with the EasyScreen™ Sample Processing Kit ( REF SP001). An aliquot of the eluate is then added to the PCR reagents supplied with the EasyScreen™ IVD Kit of choice, as listed in section 1.1. All EasyScreen™ IVD Kits are designed to include an internal positive control (IPC), to detect any specimens that may contain PCR inhibitors and an Extraction Control (EC), which amplifies and detects the 16s rDNA sequence of any bacteria present in the stool sample to assure that the sample has been prepared correctly. Both of these controls also confirm the integrity of the PCR reagents and the extraction method. 2.3 Principle of the Procedure The EasyScreen™ Sample Processing Kits ( REF SP001 or REF SP002) lyse any microorganisms present and convert all Cytosine bases to Uracil (detected as Thymine after PCR amplification) to create 3base™ DNA and RNA. The 3base™ nucleic acids have a reduced complexity compared to the genome comprised of the native 4 bases. This complexity reduction results in genomes that are more similar to each other, enabling the design of primers and probes that contain less mismatches, are more homologous, produce better amplification and importantly have less cross-reactivity when multiple strains of the same organism are present (see Figure 1). 6 Figure 1a. Example of the 3base™ mechanism. The example sequences below show the increase in homology from 75% (“Before”) to 95% (“After”) via the 3base™ conversion where all C bases are detected as T bases. Before After Seq 1 GAT G G C GA T A TG GT T G A C AC GAT G G T G ATA T G G T T GATA T Seq 2 GAT G G T GACA TG GTA G A T AC GAT G G T G ATA T G G T A GATA T Seq 3 GAT G G T GA T A TG GTGG A C AC GAT G G T G ATA T G G TG GATA T Seq 4 GAT G G T GA T A TG GTA G A T A T GAT G G T G ATA T G G T A GATA T Seq 5 GAT G G T GA T A TG GTGG A C AC GAT G G T G ATA T G G TG GATA T Seq 6 GAT G G C GACA TG GT T G A T A T GAT G G T G ATA T G G T T GATA T Seq 7 GAT G G T GA T A TG GTGG A C AC GAT G G T G ATA T G G TG GATA T Seq 8 GAT G G T GACA TG GTA G A T AC GAT G G T G ATA T G G T A GATA T Seq 9 GAT G G T GA T A TG GTA G A T AC GAT G G T G ATA T G G T A GATA T Seq 10 GAT G G T GA T A TG GTGG A T AC GAT G G T G ATA T G G TG GATA T Consensus GAT G G Y GA Y A TG GTD G A Y A Y GAT G G T G ATA T G G T D GATA T 75% homology over 20 bases 95% homology over 20 bases 48 possible primer combinations 3 possible primer combinations The 3base™ conversion occurs during the 15 minute incubation at 95°C (See section 3.2). After the nucleic acids have been purified the eluate is ready to be added to the EasyScreen™ PCR reaction of choice (see Section 1.1) Figure 1b. The regular and 3base™ DNA sequence for 2 primers and 2 probes is shown. The primers and probes for the 3base™ have a more similar melting temperature (Tm) improving the efficiency of multiplex real-time PCR. Conventional Sequence Tm Primer 1 G T A C A C A CCGCCCG T CGC T CC T A CC 77°C Primer 2 G A AGGAGA AG T CG T A A C A AG 56°C Probe 1 T GA A T A A AGAGG T GA A A T T C T AGG 59°C Probe 2 G A AGGGCCGCGAGCCCCCGCGC 87°C 3base™ Sequence Tm Primer 1 G T A T A T A T T G T T T G T T G T T T T T A T T 52°C Primer 2 G A AGGAGA AG T T G T A A T A AG 50°C Probe 1 T GA A T A A AGAGG T GA A A T T T T AGG 59°C Probe 2 G A AGGG T T G T GAG T T T T T G T G T 62°C 7 2.4 Limitations a.This kit does not produce any results on its own, but is an accessory required for use with other EasyScreen™ in vitro diagnostic assays. b.This kit is not to be used for therapeutic purposes. c.Results from samples not stored properly or subjected to multiple freeze/thaw cycles should be treated with caution. See section 2.6 for more information. d.Different models of automated nucleic acid extraction instruments perform differently and these differences may affect results. This kit has been validated using a Versant Sample Preparation Kit 1.0 on a KingFisher Flex (Thermo Scientific) system. Other systems should be validated before use – please contact Genetic Signatures for recommended protocols for alternate systems. e.Potential interfering substances were assessed according to the following list. No inhibition was observed when the substance was added at the stated concentrations. 8 Contaminating substance Concentration tested* Active agent Mucin 6 mg/ml Purified mucin protein NI^ Fecal fat 6.4 mg/ml Stearic acid 10 mg/ml Palmitic acid Stearic acid Palmitic acid NI Imodium 4 mg/ml Loperamide hydrochloride NI Mylanta, double strength 5% Aluminium hydroxide 80mg/ml Magnesium hydroxide 80 mg/ml Simethicone 6 mg/ml NI Vancomycin hydrochloride 13.8 mg/ml Rectinol/ haemarrhoid cream 9 mg/ml Metranidazole 15 mg/ml NI Barium sulphate 7.8 mg/ml NI Blood 20-40% v/v NI Summer’s eve™ Feminine Lubricating Jelly 50 mg/ml NI KY gel 60 mg/ml Chlorhexidine gluconate Methyl benzoate NI Vagisil feminine itching cream 60 mg/ml Benzocaine 50 mg/g Resorcinol 20 mg/g NI Vaseline white petroleum jelly 50 mg/ml Canesten 54 mg/ml SP001 NI Zinc oxid 200 mg Cinchocaine hydrochloride 5 mg NI NI 200 mg Clotrimazole (1% v/v) NI *Mock stool sample was prepared by adding the above substances at the above concentration, and then a swab was added and processed as per the EasyScreen™ Sample Processing Kit protocol. No inhibition was observed, with both the IPC and EC detected in each case, when samples were amplified using the ( REF CDD001 kit). Multiples of the above potential interfering substances were not tested. The IPC and the EC included in each reaction are primer limited and are designed to detect if PCR inhibition is present. ^NI - not interfering. 9 f.Incorrect test results may arise from incorrect specimen collection, handling or storage, presence of inhibitors, technical error, sample mixup or because the number of organisms in the specimen is below the analytical sensitivity of this test. This use of this test must be limited to trained personnel who strictly follow the instructions provided in this user guide. g.The methods used here detect genetic material and are not able to determine if the organism was viable or not. All positive results should be treated as presumptive positive and confirmed with traditional culture techniques if viability of the organism needs to be assessed. h.If the Extraction Control in the downstream PCR is negative the operator must repeat the extraction, which will lead to a delay in obtaining results. 2.5 Warnings and Handling Precautions It is the responsibility of all users to consult the Material Safety Data Sheet (MSDS) before using this product. The MSDS for the EasyScreen™ Sample Processing Kit is available at www.geneticsignatures.com • R eagents 1 and 2 are potential irritants. Wear gloves and avoid inhaling dust when adding Reagent 1 to the bottle containing Reagent 2. • D o not proceed with the sample preparation if the product has been damaged or opened during shipment. • This product is strictly for use by qualified laboratory and medical technicians with appropriate training in laboratory techniques and good laboratory practices. • W ear lab coats, disposable gloves and protective glasses where appropriate. • B iological samples may contain infectious agents. Handle with care. Assume all biological samples are potentially infectious and handle according to local safety and containment regulations. • A ll waste produced during use of the kit must be treated as hazardous waste. Observe local biohazard, safety and other regulations. 10 11 2.6 Specimen collection, handling, storage and stability The EasyScreen™ Sample Processing Kit is designed to work with stool specimens that have been collected in sterile tubes. Once collected, the specimens should be stored between 4°C and 25°C during transport. Specimens can be kept at room temperature (15-25°C) up to 48 hours before testing but should be tested as soon as possible after collection. For longerterm storage, the specimens may be frozen, and tests may be performed up to a maximum of 3 freeze/thaw cycles. All reagents should be stored at ambient temperature (15°C-25°C). After mixing Reagents 1 and 2, store any unused material in the dark from 15°C-25°C for up to 4 weeks. All reagents in this kit must be used by their expiry date printed on the outer label and on individual reagents. The eluted nucleic acids can be stored at -70°C for long-term storage (up to 2 months), and tests may be performed on the sample after up to a maximum of 3 freeze/thaw cycles. 2.7 Contents of the EasyScreen™ Sample Processing Kit Component Name Contents Reagent 1 5 x 5 mL Reagent 2 5 x 3.5 g Elution Solution 5 x 3.5 mL Sheathed Swabs 100 Reaction Tubes (1.5 mL) 100 Screw cap lids 100 2.8 Materials and Equipment Required (Not Supplied) • A n automated nucleic acid extraction system, such as: Qiagen M48, Qiagen EZ1, Qiagen QIAsymphony, Roche MagNApure 32, Thermo KingFisher Flex, bioMérieux easyMag • C ompatible reagents for use with the above platforms. Where possible we recommend using the Versant Sample Preparation 1.0 kit ( REF 10472144). Standard laboratory Equipment (not supplied) • • • • • • • 12 imer T Aerosol barrier tips (10 µL – 1000 µL) Heat block set at 95°C Hand pipettes, up to 1000 µL A centrifuge suitable for 1.5 mL tubes. An incubator set at 80°C (optional). Sterile toothpicks. 13 3. Methods If using the EasyScreen™ Sample Processing Kit for the first time, it is highly recommended that the detailed methodology in this User Guide be read in its entirety before carrying out the method. 3.1 Reagent Preparation • T ransfer the total volume of Reagent 1 to the Reagent 2 bottle and mix by gentle inversion. Place the combined reagents at 80°C, mixing occasionally, until all of the powder is completely dissolved. If an 80°C incubator is not available the reagent can be dissolved by continual shaking for 1-2 minutes. Prepare as many bottles as needed. Each combined bottle has sufficient reagent for 20 reactions. Any left over combined reagent can be stored at 15°C-25°C for up to 4 weeks. 3.2 Protocol 1.For an individual sample add 250 µL of combined reagent 1 and 2 into a 1.5 mL reaction tube and secure the cap. 2.Take one of the swabs provided and prepare the sample using one of the methods below: • F or liquid stool specimens, dip the swab into the sample, mix well and then transfer the swab to the reaction tube. Mix by swirling the swab around in the buffer several times, then cap the tube. Re-sheath the swab and discard. 14 • F or solid or semi-solid specimens first pre-wet the swab in combined reagent 1 and 2, then dip the swab into the specimen several times to obtain a representative sample, as pathogens may be non randomly distributed in the sample. Transfer the swab to the reaction tube, mix by swirling the swab around in the buffer several times, then cap the tube. Re-sheath the swab and discard. • A lternatively, if starting with cultures, it is sufficient to use a sterile toothpick to scrape off a single colony and transfer to the Reaction Tube. Mix well by twirling the toothpick in the reagent. Cap the tube. 3. Incubate the samples at 95°C for 15 minutes. 4.Centrifuge samples at 13000 x g for 1 min and transfer the supernatant to a reaction tube compatible with the automated instrument of choice. 5.Transfer the reaction tube(s) to the automated instrument of choice and follow the instrument specific instructions, eluting in 50 µL where possible. 6.Add 10% volume of Elution Solution to the eluate (i.e. Add 5 µL Elution Solution to 50 µL of eluate). The Elution Solution is coloured for easy sample tracking. The converted purified nucleic acid is now ready for PCR using any of the multiplexed kits listed in Section 1.1. Note: Customised instructions for Qiagen M48, Qiagen EZ1, Qiagen QIAsymphony, Roche MagNApure 32, Thermo KingFisher Flex and bioMérieux easyMag are available for download from www.geneticsignatures.com and it is recommended that those individual instructions be consulted before use. The remainder of the eluate can be stored at -70°C for long-term storage (2 months), and tests may be performed on the eluate after up to 3 freeze thaw cycles. 15 3.3 Quality Control 3.4.1 Analytical Sensitivity This kit is an IVD accessory and as such does not produce any measurable results on its own. Results are generated with separate IVD kits available from Genetic Signatures. It is recommended that a Negative Run Control be included every time a batch of samples is processed with the EasyScreen™ Sample Processing Kit (Automated Platforms). This negative control should be included in order to detect reagent or environmental contamination (or carry-over) by microorganisms or amplicons from a previous PCR. The negative control should be processed with the test samples. Analytical sensitivity of the EasyScreen™ Sample Processing Kit (Automated Platforms) was determined by processing a known amount of Clostridium difficile NATtrol™ External Run Control Medium (Zeptometrix REF NATCdi(NAP1)-ERCM) estimated to be 1.14x105 cfu/ml by the manufacturers). The bacteria was diluted and 5 replicates were processed with the EasyScreen™ Sample Processing Kit (Automated Platforms) and amplified with the EasyScreen™C. difficile Detection Kit ( REF CDD001). The results are summarised below. Additional internal controls are included in all IVD kits available from Genetic Signatures. These include an Extraction Control (EC), which monitors reagent failure, user error and insufficient starting material and an Internal Positive Control (IPC), which detects any PCR inhibition that may be present in the processed clinical specimen. 3.4 Performance Characteristics As the EasyScreen™ Sample Processing Kit (Automated Platforms) is an IVD accessory, it does not produce any measurable results on its own. The following information was generated using the eluate obtained with this kit, together with the EasyScreen™ C. difficile Detection Kit ( REF CDD001) and is included only as an indication of performance. Additional and specific information regarding performance characteristics is available in the User Guide of each IVD detection kit supplied by Genetic Signatures. Table 1 Analytical sensitivity summary Starting Concentration (cfu) Amount seeded into the PCR (cfu) Number detected 2000 160 5/5 1000 80 5/5 500 40 5/5 250 20 5/5 125 10 5/5 0 0 0/5 The above “starting concentrations” were processed with the EasyScreen™ Sample Processing Kit (Automated Platforms) using a Versant Sample Preparation 1.0 Reagent Kit on a KingFisher Flex robot. The sample was eluted with 50 µL of elution solution and 4 µL was added to the PCR components supplied with the EasyScreen™C. difficile Detection Kit ( REF CDD001). The kit was able to detect at least 10 cfu of C. difficile material that was prepared using the the EasyScreen™ Sample Processing Kit (Automated Platforms). 16 17 3.4.2 Clinical Sensitivity 3.4.3 Reproducibility Clinical sensitivity of the EasyScreen™ Sample Processing Kit (Automated Platforms) was assessed by inoculating different starting amounts of Zeptometrix ERCM NAP1 culture into a stool emulsion, and processed using this kit in combination with the Versant Sample Preparation 1.0 Reagent Kit on a KingFisher Flex extraction system. The stool emulsion was prepared by inoculating a C. difficile negative stool sample into combined Reagents 1 and 2. The following amounts of the positive control culture were then added to the stool emulsion 2500, 2000, 1000, 500, 250, 125, 62.5 and 31.25 cfu. Five replicates of each control culture concentration were assessed. Four microlitres of the eluate was then amplified with the EasyScreen™ C.difficile Detection kit ( REF CDD001). In order to assess the reproducibility of the EasyScreen™ Sample Processing Kit (Automated Platforms) a panel consisting of three (3) simulated specimen categories where each tube contained a negative stool sample spiked with a low amount (500 cfu), medium amount (1000 cfu) and high amount (2500 cfu) of Clostridium difficile NATtrol™ External Run Control Medium (Zeptometrix REF NATCdi(NAP1)-ERCM) DNA. The specimens were tested in five (5) replicates per run, on five (5) distinct days (consecutive or not). Results were as follows: 1 Starting Concentration (cfu) Amount seeded into the PCR (cfu) Number detected 2500 200 5/5 1000 80 5/5 500 40 5/5 250 20 5/5 125 10 5/5 62.5 5 5/5 31.25 2.5 0 Stool only The EasyScreen™ Sample Processing Kit (Automated Platforms) used in combination with the Versant Sample Preparation 1.0 Reagent Kit on a KingFisher Flex robot returned a positive result for (i) the low positive C. difficile specimen category of 100%; (ii) the medium positive C. difficile specimen category of 100%, and (iii) the high positive C. difficile specimen category of 100%. The negative specimen was negative 100% of the time. The test regime above was also performed by a different operator, on a different day, with the same result. 5/5 1 0/5 C.difficile negative stool sample was positive for 16s and IPC, and negative for tcdA/tcdB The EasyScreen™ Sample Processing Kit (Automated Platforms) was able to process material from 31.25 cfu (equivalent to 2.5 cfu per reaction) in 5/5 cases. This corresponds to 31.25 starting cfu on the swab being eluted into 50 µL of elution solution with 4 µL being seeded into the PCR. 18 19 3.4.4 Specific Performance Characteristics 4. Warranty As a test of performance characteristics, a clinical testing facility processed a total of 94 patient stool samples with the EasyScreen™ Sample Processing Kit (Automated Platforms) in combination with the Versant Sample Preparation 1.0 Reagent Kit on a KingFisher Flex robot. A total of 4 µL of the eluate was examined with the EasyScreen™ C. difficile Detection Kit ( REF CDD001) and compared against toxigenic culture. All toxigenic culture positive samples were correctly identified when processed with the EasyScreen™ Sample Processing Kit (Automated Platforms) and amplified with the EasyScreen™ C. difficile Detection Kit. In addition, 4 culture toxin negative samples were called positive for presence of toxigenic C. difficile via the EasyScreen™ C. difficile Detection Kit. These 4 samples were found to be positive by another molecular test targeting the tcdA gene. These additional 4 samples may have contained non-viable C. difficile DNA, or it may be that the molecular tests for C. difficile DNA are more sensitive than traditional culture methods, in agreement with a recent study that found multiple independent PCR positive samples that were negative using the culture toxin assay as the gold standard (Knetsch CW, Bakker D, de Boer RF, et. al. Comparison of real-time PCR techniques to cytotoxigenic culture methods for diagnosing Clostridium difficile infection. J. Clin. Microbiol. 2011;49:227-31.) The EasyScreen™ Sample Processing Kit (Automated Platforms) is warranted to perform as described in the labelling and literature when used in accordance with the supplied instructions. Human Genetic Signatures Pty Ltd’s (trading as Genetic Signatures) sole obligation and the purchaser’s exclusive remedy for breach of this warranty shall be, at the option of Human Genetic Signatures Pty Ltd, to repair or replace the products. Human Genetic Signatures Pty Ltd will not be liable for any incidental or consequential damages in connection with the EasyScreen™ Sample Processing Kit (Automated Platforms). 5. Troubleshooting Problems Possible Solutions No PCR signal was observed for any of the processed samples, in any of the channels including the positive control. Confirm that the kit is within the expiry date and all components have been stored as directed. No PCR signal was observed for any of the processed samples, including the positive control, except for the Internal Positive Control. The sample preparation has failed – check that the combined Reagent 1 and Reagent 2 was no older than 4 weeks. Make sure that all the steps in the protocols were followed. DNA was degraded during extraction - check that all pipette tips etc used during the procedure were of molecular biology quality (ie DNase free). Sample DNA was degraded before processing – check that the samples have been stored/ handled correctly. 20 21 Explanation of Symbols Symbol Meaning The device is considered to meet the essential requirements in Article 3 of Directive 98/79/EC on in vitro diagnostic medical devices Consult instructions for use In vitro diagnostic medical device Catalogue number Single use, use only once The number of reactions 25°C 15°C Temperature limitation Batch code Expiration date Name and address of the Authorised Representative in the European Commission Name and address of the manufacturer 22 EasyScreen™ Sample Processing Kit is covered by patents owned by Human Genetic Signatures Pty Ltd granted in a number of countries including AU 2005312354, CN 200580047630.3, IN 246868, ID WO0200702024, MY 142997, MX 2007/006610, NZ 555620, SG 132883, ZA 2007/06142 and US 7833942. Corresponding patent applications are pending in a number of countries and regions including EP 05813335.6. The Polymerase Chain Reaction (PCR) process is covered by U.S. Pat. Nos. 4,683,195 and 4,683,202 assigned to Hoffmann-La Roche. Patents pending in other countries. No license under these patents to use the PCR process is conveyed expressly or by implication to the purchaser by the purchase of the EasyScreen™ Sample Processing Kit. Further information on purchasing licenses to practice the PCR process can be obtained from the director of Licensing at Applied Biosystems, 850 Lincoln Centre Drive, Foster City, California 94404 or at Roche Molecular Systems, Inc., 1145 Atlantic Avenue, Alameda, California 94501. 23 Human Genetic Signatures Pty Ltd c/o Virology Research Laboratory Level 3, Clinical Sciences Building, Prince of Wales Hospital, Randwick, NSW 2031, Australia Phone: +61 2 9870 7580 Fax: +61 2 9889 4034 Email: [email protected] www.geneticsignatures.com VER 2.0 October 2012
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