Development of multiplex nanopore sequencing method for the detection of
multiple respiratory viruses in cases with severe acute respiratory
infections
Abstract
Background: Severe acute respiratory infection (SARI) remains
one of the leading causes of morbidity and mortality worldwide. Multiple
respiratory viral pathogens can cause this infection. Sequencing
technologies hold great promise for detecting viral pathogens. This
study aimed to develop and validate a method for the multiplex detection
of SARI-related viruses (SARS-CoV-2, Influenza A (H1N1, H3N2), Influenza
B, human respiratory syncytial virus, human adenoviruses, human
enteroviruses, and human parainfluenza viruses) using a nanopore
next-generation sequencing method. Methods: Following genome
extraction from oropharyngeal swab samples and conventional RT-PCR
assays, the libraries were barcoded and sequenced by the MinION flow
cell. The sensitivity and specificity were assessed using various serial
dilutions of samples and different primer pools, respectively. NGS data
analysis, including adaptor trimming, assembly, mapping, and the
generation of consensus sequences, was carried out using bioinformatic
tools. Finally, the protocol was validated by evaluating with known
positive samples. Results: During 12 hours of MinION
sequencing, 711,000 reads passed the quality filters
(Q-score>7). 11 out of 12 target genes were successfully
identified in clinical samples, with more than 90% coverage for most
viruses. All the viruses detected by Q30 value of more than 1%. The
detection limit was measured for SARS-CoV-2, Influenza A (H1N1, H3N2),
Influenza B, and human respiratory syncytial virus. The platform showed
99.9% specificity in detection and was validated by 20 clinical
samples. Conclusion: This study developed and validated a novel
multiplex detection method that made it possible to identify
SARI-related respiratory viruses in a clinical laboratory setting.