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Table 1.

List of primer sequences.

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Table 2.

List of the equations for calculating the performance of multiplex PCR.

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Fig 1.

Optimization of singleplex and multiplex PCR.

Lane M; 100bp marker, lane 1; DNA mixture derived from Orientia (166 bp), Leptospira (243 bp), and Rickettsia (434 bp) was amplified using multiplex PCR. Lane 2–4; O. tsutsugamushi (Karp, Kato, and Gilliam strains), lane 5; negative control, lane 6–8; L. interrogans (serovar Bratislava, Pyrogenes, and Pomona), lane 9; L. biflexa serovar Patoc, lane 10; negative control, lane 11; R. typhi, and lane 12; negative control. Lane 2–12; DNA was amplified using singleplex PCR.

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Fig 2.

Specificity of multiplex PCR assay.

(A) Multiplex PCR was tested with other pathogenic microorganisms. Lane M; 100bp marker, lane 1; Positive control (Orientia, Leptospira, and Rickettsia DNA mixture), lane 2; O. tsutsugamushi (166 bp), lane 3; L. interrogans (243 bp), lane 4; R. typhi (434 bp), lane 5; E. faecalis, lane 6; S. aureus, lane 7; Salmonella spp., lane 8; K. pneumoniae, lane 9; Dengue virus I, lane 10; Dengue virus II, lane 11; Dengue virus III, lane 12; Dengue virus IV, lane 13; P. falciparum, lane 14; P. vivax, lane 15; E. coli, and lane 16; negative control. (B) Multiplex PCR was tested in masking condition. Lane M; 100bp marker, lane 1; Positive control (Orientia, Leptospira, and Rickettsia DNA mixture), lane 2; DNA mixture of O. tsutsugamushi, S. aureus, and dengue virus, lane 3; DNA mixture of L. interrogans, S. aureus, and dengue virus, lane 4; DNA mixture of R. typhi, S. aureus, and dengue virus, lane 5; negative control.

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Fig 3.

Sensitivity of multiplex PCR assay.

(A) Limit of detection of multiplex PCR with a serial dilution of Orientia, Leptospira, and Rickettia DNA mixture, and (B) limit of detection with three bacterial DNA-spiked blood sample in different concentration. In both figures: lane M; 100bp marker, lane 1; 5 ng/μl, lane 2; 0.5 ng/μl, lane 3; 50 pg/μl, lane 4; 5 pg/μl, lane 5; 0.5 pg/μl, lane 6; 50 fg/μl, lane 7; 5 fg/μl, and lane 8; negative control.

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Fig 4.

Performance of the multiplex PCR.

(A-H) showed the multiplex PCR results when tested with blood specimens from Thai patients presented with acute undifferentiated febrile illness.

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Table 3.

Comparison of multiplex PCR results and standard serological test results.

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