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TessArae, LLC, Proprietary Information Using Targeted Resequencing Microarrays for Simultaneous Definitive Detection and Identification of Multiple Respiratory Pathogens. Agnieszka M. Lichanska, Clark Tibbetts, and Matthew C. Lorence TessArae, LLC, Potomac Falls, Virginia, USA

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Page 1: Presentation from Bioconference Live 2010

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Using Targeted Resequencing Microarrays forSimultaneous Definitive Detection and Identification of

Multiple Respiratory Pathogens.

Agnieszka M. Lichanska, Clark Tibbetts, andMatthew C. Lorence

TessArae, LLC, Potomac Falls, Virginia, USA

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Overview

Re-sequencing technology vs. traditional diagnostictechniques How does re-sequencing work? How are the techniques different?

Identification of new pathogens - an example: novelH1N1 flu

Additional examples of use of RPM-Flu 3.1 assay Summary

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Shift in Microbial Diagnostics

TessArray™

TessArae Inc.TessArray RPM-Flu v3.1

Respiratory PathogenPanel

P/N: 520-191

Phenotypic detectionand identification

Genotypic detectionand identification

Mainly single result per test Multiple results per one testMultiple signatures per pathogen

Detection and confirmation

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RPM Strategy

GTATGGTAGTTGGGATAATTAGCTTGATGTCATACCATCAACCCTATTAATCGAACTACA

GTATGGTAGTTGAGATAATTAGCTTGTATGGTAGTTGCGATAATTAGCTTGTATGGTAGTTGGGATAATTAGCTTGTATGGTAGTTGTGATAATTAGCTT

CATACCATCAACACTATTAATCGAACATACCATCAACCCTATTAATCGAACATACCATCAACGCTATTAATCGAACATACCATCAACTCTATTAATCGAA

Probes to interrogatecenter position of first complementary targetstrand

Probes to interrogatecenter position of secondcomplementary targetstrand

Target

25-base window of 8 transducersHemagglutinin A/Goose/Guangdong/1/96/H5N1

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RPM Strategy

GTATGGTAGTTGGGATAATTAGCTTGATGTCATACCATCAACCCTATTAATCGAACTACA

GTATGGTAGTTGGAATAATTAGCTTGGTATGGTAGTTGGCATAATTAGCTTGGTATGGTAGTTGGGATAATTAGCTTGGTATGGTAGTTGGTATAATTAGCTTG

CATACCATCAACCATATTAATCGAACCATACCATCAACCCTATTAATCGAACCATACCATCAACCGTATTAATCGAACCATACCATCAACCTTATTAATCGAAC

Hemagglutinin A/Goose/Guangdong/1/96/H5N1

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RPM Strategy

GTATGGTAGTTGGGATAATTAGCTTGATGTCATACCATCAACCCTATTAATCGAACTACA

GTATGGTAGTTGGGATAATTAGCTTGAGTATGGTAGTTGGGCTAATTAGCTTGAGTATGGTAGTTGGGGTAATTAGCTTGAGTATGGTAGTTGGGTTAATTAGCTTGA

CATACCATCAACCCAATTAATCGAACTCATACCATCAACCCCATTAATCGAACTCATACCATCAACCCGATTAATCGAACTCATACCATCAACCCTATTAATCGAACT

Hemagglutinin A/Goose/Guangdong/1/96/H5N1

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TessArray®

RPM-Flu 3.1

TessArray™

TessArae, LLCTessArray RPM-Flu v3.1

Respiratory Pathogen PanelP/N: 520-191

Coronavirus (229E)Coronavirus (OC43)Coronavirus (NL63)Coronavirus (SARS Urbani)Cytomegalovirus (HHV-5)Enteroviruses:• Coxsackievirus (5 types)• Echovirus (8 types)• Rhinovirus (27 types)Measles VirusMetapneumovirus (types A, B)Parainfluenza 1Parainfluenza 2 Parainfluenza 3Parainfluenza 4aParainfluenza 4bRSV ARSV BRubella Virus

Bordatella pertussisCorynebacterium diphtheriaeChlamydia psittaciChlamydia trachomatisChlamydophila pneumoniaeHaemophilus influenzae Klebsiella pneumoniaeLegionella pneumophilaMoraxella catarrhalisMycobacterium kansasiiMycobacterium tuberculosisMycoplasma pneumoniaeNeisseria meningitidisPseudomonas aeruginosaStaphylococcus aureusStreptococcus agalactiaeStreptococcus pneumoniaeStreptococcus pyogenes

Variola majorBacillus anthracisFrancisella tularensisYersinia pestis

Influenza A HA1Influenza A HA2Influenza A HA3Influenza A HA4Influenza A HA5Influenza A HA6Influenza A HA7Influenza A HA8Influenza A HA9 Influenza A HA10Influenza A HA11Influenza A HA12Influenza A HA13Influenza A HA14Influenza A HA15Influenza A HA16

Influenza A NA1Influenza A NA2Influenza A NA3Influenza A NA4Influenza A NA5Influenza A NA6Influenza A NA7Influenza A NA8Influenza A NA9Influenza A MtxInfluenza A NS Influenza A PB2 Influenza B HA1Influenza B HA2Influenza B NA1

Influenza B Mtx

Adenovirus B Adenovirus C Adenovirus D Adenovirus E

Simultaneous differential diagnosisof influenza-like illness

30 different types of viral andbacterial respiratory pathogens

938,032 oligonucleotide probes

117,254 nucleotides of targetedpathogen gene sequences per assay

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How the RPM Assay Works?

Control Template Live Influenza Vaccine (FluMist® 2004-2005)

Trivalent mixture of different influenza virus A/HN and B subtypes A/Canterbury/20/1999 (H1N1) A/Wyoming/3/2003 (H3N2) B/Jilin/20/2003 Hemagglutinin and Neuraminidase Genes from these Vaccine Strains

Engineered by Reassortment with Cold-Adapted Master Strains A/Ann Arbor/6/1960 (H2N2) B/Ann Arbor/1/1966 Matrix and Other Viral Genes from Master Strains

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ChipBackground

Segment

Tile AGT C

CAG

T

Translation Key:

TGGAAAATGAAAGGACTTTGGATTTCCATGACTCCAATGTGAAGAInfluenza A Virus segment 4 hemagglutinin (HA1)

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>EV70UTR:NRL_KB_FluVaccine_082206 Start=12 End=707nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnncnannnnnngnnnngnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnannnnnnnnnnnnnnnnnnnnnnnnnnnnnnnngnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnntnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnncnncnnngnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnngnnnnntnnnnnnnnnnnnnnnncncnnnnnnnnnncnnnnnnnnnnnnnnnnntnnnnnnnnnnntnngancnnnnngnnnnnnnnnnccnnnngnnnnnnnnnnnnnnnnnnggnnnnnnnnnnnncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnacnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnncnnnnnnnnnnn>FLUAHA1:NRL_KB_FluVaccine_082206 Start=12 End=1487agaagaatgtgacagngncncactctgtcaacctacttgaggacagtcacaatggaaaactatgtctactaaaaggaatagccccncnnnnnntgggtaattgcagcgttgccggatggatcttaggaaacccagaatgcgaattactgatttccaaggaatcatggtcctacattgtagaaacaccaaatcctgagaatggaacatgttacccagggtatttcgccgactatgaggaactgagggagcaattgagttcagtatcttcatttgagagattcgaaatattccccaaagaaagctcatggcccaaccacaccgtaaccggagtatcagcatcatgcncccnnnnngggaaaagcagtttttacagaaatttgctatggcngncnnnnnngaatggnnnnnnnccaaacctgagcaagtcctatgtaaacaacaaagagaaagaagtccttgtactatgggcnntncntcacccgcctaacanagggaaccaaagggccctctatcatacagaaaatgcttatgtctctgtagtgtcttcacattatagcagaagattcaccccagaaatagccaaaagacccaaagtaagagatcaggaaggaagaatcaactactactggactctgcnggaacctggggatacaataatatttgaggcaaatggaaatctaatagcgccatggtatgcttttgcactgagtagaggctttggatcaggaatcatcacctcaaatgcaccaatggatgaatgtgatgcgaagtgtcaaacacctcagggagctataaacagcagtcttcctttccagaatgtacacccagtcacaataggagagtgtccaaagtatgtcaggagtgcaaaatnaaggatggntacaggactaaggaacatcccntccattcaatccagaggtttgtttggagccattgccggtttcattgaagnnnngtggactggaatggtagatgggtggtatggttatcatcatcagaatgagcaaggatcnggnnnnnnnncagatcaaaaaagtncacaaaatgccattaacgggattacaaacaaggtgannnnnnnnnnnnagaaaatgaacactcaattcacngcngtgggcaaagaattcaacaaattggaaagaaggatggaaaacttaaataaaaaagttgatgatgggtttctagacatttggannnnnnnnncagaattgttggttctacTGGAAAATGAAAGGACTTTGGATTTCCATGACTCCAATGTGAAGAatctgtatgagaaagtaaaaagccaattaaagaataatgccaaagaaataggaaacgggtgttttgaattctatcacaagtgtaacaatgaatgcatggagagtgtgaaaaatggaacttatgactatccaaaatattccgaagaatcaaagttaaacagggagaaaattgatggagtgaaattggaatcaatgggagtctatcagattc>FLUAHA10:NRL_KB_FluVaccine_082206 Start=12 End=787nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnngnnnnnnnnnnnnnnnnnnnnnnnnnnnncnnnnnnnnnnnngnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnngnnnnncnnnnnnnnnnnnnnnnnnnnnnnnncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnntnnnncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnannnnnnnncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnncnnnnnnnnnnnnnnnnnnnnnnnnngnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnncaggaangagnannnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnggnnnnnntnnnangnaggnnggnngnnnnnnnnnnnnnnnnnnncnnnnnnnnn…

Enterovirus 70 UTRNegative

Type A Flu - HA1Positive

Type A Flu - HA10Negative

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How to Identify a Novel Pathogen?

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RPM Detection of Novel Strains

CATACCATCAACCCTATTAATCGAACTACAGCGTATGGTAGTTGGGATAATTAGCTTGATGTCG

TGGTAGTTGGGAAAATTAGCTTGATTGGTAGTTGGGACAATTAGCTTGATTGGTAGTTGGGAGAATTAGCTTGATTGGTAGTTGGGATAATTAGCTTGAT

ACCATCAACCCTATTAATCGAACTAACCATCAACCCTCTTAATCGAACTAACCATCAACCCTGTTAATCGAACTAACCATCAACCCTTTTAATCGAACTA

CATACCATCAACCCTGTTAATCGAACTACAGCGTATGGTAGTTGGGACAATTAGCTTGATGTCG

TGGTAGTTGGGAAAATTAGCTTGATTGGTAGTTGGGACAATTAGCTTGATTGGTAGTTGGGAGAATTAGCTTGATTGGTAGTTGGGATAATTAGCTTGAT

ACCATCAACCCTATTAATCGAACTAACCATCAACCCTCTTAATCGAACTAACCATCAACCCTGTTAATCGAACTAACCATCAACCCTTTTAATCGAACTA

Forwardstrandsequencevariantdetection

Reversestrandsequencevariantdetection

target

Old Strain New Strain

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Detection of Novel Strains

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Novel H1N1 Influenza Detection

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Detecting Seasonal Strains of Influenza

RPM-Detector Tiles for Seasonal A/H1N1 and Seasonal A/H3N2 Influenza Viruse s Vir u s Target Gen e Detector Tile Sequence/Strai n Leng t h Prob e s

A/H1 N 1 Hemagglutinin(A/HA1 ) A/New Caledonia/20/1999(H1N1) 1500 bp 12,000 A/H1 N 1 Neuraminidase(A/NA1) A/New Caledonia/20/1999(H1N1) 1200 bp 9,600 A/H1 N 1 Matrix(A/H1N1-M ) A/Canterbury/100/2000(H1N1) 850 bp 6,800

A/H3 N 2 Hemagglutinin(A/HA3 ) A/Canterbury /125/2005(H3N2) 1500 bp 12,000 A/H3 N 2 Neuraminidase(A/NA2) A/Canterbury /125/2005(H3N2) 1200 bp 9,600 A/H3 N 2 Matrix(A/H3N2-M ) A/Canterbury /125/2005(H3N2) 850 bp 6,800

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A Sentinel Case

April 2009: Patient presents at Washington, DC hospital Recently returned from vacation in Mexico Convalescing from recent flu-like illness Anxious about reports of novel influenza outbreak

TessArray Outcomes:

01 May 2009 - Best MatchesL20309, X90504 H influenzae outer membrane protein P5A/duck/Guanxi/2004(H5N1); A/chicken/Yogjakarta/2004(H5N1)

Very unusual result suggested patient had been infected by an avian influenza virusDatabase updated following week, new sequence records from Mexico outbreak isolates

05 May 2009 - Best MatchesL20309, X90504 H influenzae outer membrane protein P5A/California/07/2009(H1N1); A/Texas/04/2009(H1N1)

Perfect Match to New CDC Strain!From a Test Designed in 2006 With No Prior Knowledge of New Strain

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T S R A - A ML_CNMC_01_050109 (“RPM-Flu Sentinel Case”) Best Matches from VSRD Archive

Updated November 2008 Best Matches from VSRD Archive

Updated May 2009

A/chicken/Indonesia/7/2003(H5N1) A/chicken/Puebla/231-5284/98(H5N2) A/chicken/Puebla/231-5284/98 (H5N2)

A/chicken/Yogjakarta/BBVet-IX/2004(H5N1) A/duck/Guangxi/1436/2006(H5N1) A/duck/Guangxi/351/2004(H5N1) A/duck/Guangxi/3548/2005(H5N1) A/duck/Guangxi/380/2004(H5N1) A/duck/Guangxi/4016/2005(H5N1)

A/hooded vulture/Burkina Faso/2/2006(H5N1) A/mallard/Alberta/111/99(H4N6) A/mallard/Alberta/111/99(H4N6)

A/mallard/Maryland/1235/2006(H3N6) A/mallard/Maryland/1235/2006(H3N6) A/quail/Tasikmalaya/BPPV4/2004(H5N1)

A/swine/Hong Kong/1197/02(H3N2) A/swine/Hong Kong/1197/02(H3N2) A/swine/Iowa/930/01(H1N2)

A/swine/Virginia/670/1987(H1N1) A/swine/Virginia/671/1987(H1N1)

A/swine/British Columbia/28103/2005(H3N2)

A/California/04/2009(H1N1) A/California/05/2009(H1N1) A/California/06/2009(H1N1) A/California/07/2009(H1N1) A/California/08/2009(H1N1) A/California/09/2009(H1N1) A/California/10/2009(H1N1) A/California/14/2009(H1N1) A/Canada-ON/RV1527/2009(H1N1) A/New York/06/2009(H1N1) A/New York/10/2009(H1N1) A/New York/11/2009(H1N1) A/New York/15/2009(H1N1) A/New York/18/2009(H1N1) A/New York/19/2009(H1N1) A/New York/20/2009(H1N1) A/New York/22/2009(H1N1) A/Ohio/07/2009(H1N1)

A/Texas/04/2009(H1N1) A/Texas/05/2009(H1N1)

RPM detection and identification works forstrains and variantsthat share at least 80% sequence similarity toarray detector tiles

The RPM-Flu 3.1 designed for A/H5N1 in 2006 is capable to sensitively detect and differentiate the Novel A/H1N1 SOIV from Seasonal A/H1N1 and Seasonal A/H3N2 subtypes without modification

190/215 = 88%

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Avian A/H5N1 matrixgene resequencingdetector tile sequence(top sequence)

2009 Novel H1N1(A/Pensacola/INS107/2009(H1N1)) strain (middlesequence)

Sequence from a high titerstock of a 2009 Novel H1N1outbreak strain strain,A/NHRC-California/BRD_40116(H1N1)(bottom sequence)

Legend:“x” = Mismatch“|” = Match

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Seasonal H1N1 Seasonal H3N2 Novel H1N1

LoD (95%) TCID50/ml

TessArray RPM-Flu Novel A/H1N1 1,740 Seasonal A/H1N1 102 Seasonal A/H3N2 224

CDC rRT-PCR (JBAIDS) Novel A/H1N1 5,000 Seasonal A/H1N1 10 Seasonal A/H3N2 100

Analytical Sensitivity with Cultured Influenza Virus

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Analytical SensitivityCultured Influenza Virus

0/501 (0%)0/501 (0%)0/501 (0%) Clinical Negative by PCR

0/14 (0%)0/14 (0%)0/14 (0%) Water Blanks

0/24 (0%)0/24 (0%)0/24 (0%) Other High Load Pathogens

0/16 (0%)0/16 (0%)0/16 (0%) Avian A/H5N1-positive

Negative Controls

8/8 (100%)0/8 (0%)0/8 (0%) 2009 Novel A/H1N1(SOIV)

0/31 (0%)31/31 (100%)0/31 (0%) Seasonal A/H3N2

0/13 (0%)0/13 (0%)13/13 (100%) Seasonal A/H1N1

Positive Clinical Specimens

44/44 (100%)0/55 (0%)0/55 (0%) 2009 Novel A/H1N1(SOIV)

0/58 (0%)44/44 (100%)0/58 (0%) Seasonal A/H3N2

0/41 (0%)0/41 (0%)38/38 (100%) Seasonal A/H1N1

Endpoint LoD Titration

2009 NovelA/H1N1 SOIV

SeasonalA/H3N2

SeasonalA/H1N1

Controls

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Detecting Emergent Strains

A/New Caledonia/20/1999(H1N1) HemagglutininA/New Caledonia/20/1999(H1N1) NeuraminidaseA/Canterbury/100/2000(H1N1) MatrixA/Canterbury/125/2005 (H3N2) HemagglutininA/Canterbury/125/2005 (H3N2) NeuraminidaseA/Canterbury/125/2005 (H3N2) Matrix

2004-5 FluMistA/New Caledonia/20/1999(H1N1)A/New Caledonia/20/1999(H1N1)A/Ann Arbor/6/1960(H2N2)A/Wyoming/03/2003 (H3N2)A/Wyoming/03/2003 (H3N2)A/Ann Arbor/6/1960(H2N2)

2009-10 FluMistA/South Dakota/6/2007(H1N1)A/South Dakota/6/2007(H1N1)A/Ann Arbor/6/1960(H2N2)A/Uruguay/716/2007 (H3N2)A/Uruguay/716/2007 (H3N2)A/Ann Arbor/6/1960(H2N2)

What’s on the Device:

What it Told Us:

TessArray™

TessArae, LLCTessArray RPM-Flu v3.1

Respiratory Pathogen PanelP/N: 520-191

2006-7 FluZoneA/New Caledonia/20/1999(H1N1)A/New Caledonia/20/1999(H1N1)A/Puerto Rico/8/1934(H1N1)A/Wisconsin/67/2005 (H3N2)A/Wisconsin/67/2005 (H3N2)A/Puerto Rico/8/1934(H1N1)

2009-10 FluVirinA/South Dakota/6/2007(H1N1)A/South Dakota/6/2007(H1N1)A/Puerto Rico/8/1934(H1N1)A/Uruguay/716/2007 (H3N2)A/Uruguay/716/2007 (H3N2)A/Puerto Rico/8/1934(H1N1)

When Confronted With DifferentStrains the Array Still Tells UsWhat Is Present Based on theSequences of the Organisms

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A/gull/MD/1824/78H13N6

H15N9

H14N5

H7N7

H7N3

H7N1

H5N2

No AI

H7N3

H5N3

AMPV, No AI

H12N5

H11N3

H10N7

H8N4

H7N2

H4N6

H3N2

H2N8

H1N1

Match SEPRL Reference Strain

A/Turkey/Kansas/4880/80

A/Herring Gull/DE/677/88

A/turkey/MN/366767/2005

A/Blue Winged Teal/LA/240B/88

A/quail/PA/20304/98

A/turkey/CO/169118-13/02

A/quail/NJ/25254-22/95

A/chicken/NJ/4645/96

A/duck/LA/188D/87

Avian Metapneumovirus (Colorado Strain)

A/duck/Singapore/F119/97

A/chicken/Chile(F0)/176822/02

Avian Paramyxovirus I (NDV, RPM-TEI assay)

A/chicken/Mex/26654-1374/94

A/turkey/Italy/4580/99

A/chicken/Pakistan/1369-CR2/95

A/chicken/Victoria/85

A/mallard/Gurjev/263/82

A/Shearwater/W. Australia/2576/79

H13N612

Sample RPM Assay

1 H1N1

2 H2N8

3 H3N2

4 H4N6

6 H7N2

7 H8N4

9 H10N7

10 H11N3

11 H12N5

13 AMPV, No AI

14 H5N3

15 H7N3

16 No AI

17 H5N2

18 H7N1

19 H7N3

20 H7N7

21 H14N5

22 H15N9

Specimens from USDA ARS SEPRL reference archive (20 Mar 08)Avian Influenza Subtypes: Differential Diagnostics

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Reconciliation of Inter-Platform Results Discrepancies by de novo DNA Sequencing of Viral Genes from Original Specimens

Sample IDCDC-Certified

H5 (Asian) PCRIbis-T5000

ESI-MSHA RSLT (P1)Serology

TessArray®RPM-Flu v3.1

Gold StandardDNA Sequencing

2006900845 H5 H5N1 H5 H5N1 not tested

2006906089 H5 H5N1 H5 H5N1 not tested

2006900590 H5 H5N1 H5 H5N1 not tested

2006902838 H5 H5N1 H5 H5N1 not tested

2006902764 not tested H5N1 H5 H5N1 H5N1

2006905588 Flu UNKNOWN H7 H7N7 H7N7

2004909864 not tested H9N2 UNKNOWN H7N7 H7

2005912823 Flu H7N7 UNKNOWN H10N7 H10N7

2005912908 not tested H7N7 H10 H10N7 H10N7

2004900600 Flu H7N7 H10 H10N7 H10N7

2004900845 H5 H5N1 H10 H10N7 or H10N5 H10N7

2004900688 not tested H7N7 H11 H11N? H11

2005912306 Flu NEW UNKNOWN H13N6 or H13N8 H13

= Conflict with de novo sequencing results

Avian Influenza Subtypes: Differential Diagnostics

= Results concordant with de novo sequencing

Lin et al PLOS 2009

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Longitudinal Data Analysis

CT_Sick_050509 Rhinovirus

CT_Sick_042010 Parainfluenza Virus

CT_Healthy_Control_080508CT_Sick_Day4_080603 Metapneumovirus

But not the novel A/H1N1!

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MLST-like Epidemiological Analysis:Genomic diversity of Haemophilus influenzae from 50 Different Patients at MCRD San Diego

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MLST-Like Epidemiological Analysis:Clonal genomic uniformity of Adenovirus Type 4in Same 50 Patients at MCRD San Diego

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Summary

Real-time Epidemic/Pandemic Surveillance in Human and AnimalPopulations

Simultaneous Detection and Definitive Identification of Multiple Pathogens Characterization of Difficult Cases

Superior to Benchmark Platform Sensitivity and Specificity Limits of Detection ~ 102 Genome Equivalents/specimen

Zero False Positive Detection Events Immediate Identification of Known and Unknown Strains and Variants

Surveillance of Shift and Drift in Populations Same Day Results

RPM Sequence-based Detector Array Six Sigma Data Quality Basecall Error Rate ≥ 10-6

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Acknowledgements

Naval Health Research Center/Naval Respiratory Disease Laboratory, San Diego, CA

David Metzgar Chris Myers Christian HansenCDR Kevin Russell Jason Brown Larivhie Dela CruzCDR Dennis Faix Miguel Osuna David Ortiz

TessArae, LLC - Potomac Falls, VAClark Tibbetts Brian Weslowski Leah MorrisMatthew Lorence Lisa Borsuk Klaus Schafer

Naval Research Laboratory/Center for Bio/Molecular Science andEngineering - Washington, DC

Joel Schnur Anthony Malanoski Nina LongDavid Stenger Baochuan Lin Carolyn KiddZheng Wang Dzung Thach Kate Blaney