Polymerase chain reaction (PCR)-based
diagnostic testing is the
gold standard method for pathogen identification (ID) with recent
developments enabling automated PCR tests for point-of-care (POC)
use. However, multiplexed identification of several pathogens in PCR
assays typically requires optics for an equivalent number of fluorescence
channels, increasing instrumentation’s complexity and cost.
In this study, we first developed ratiometric PCR that surpassed one
target per color barrier to allow multiplexed identification while
minimizing optical components for affordable POC use. We realized
it by amplifying pathogenic targets with fluorescently labeled hydrolysis
probes with a specific ratio of red-to-green fluorophores for each
bacterial species. We then coupled ratiometric PCR and automated magnetic
beads-based sample preparation within a thermoplastic cartridge and
a portable droplet magnetofluidic platform. We named the integrated
workflow POC-ratioPCR. We demonstrated that the POC-ratioPCR could
detect one out of six bacterial targets related to urinary tract infections
(UTIs) in a single reaction using only two-color channels. We further
evaluated POC-ratioPCR using mock bacterial urine samples spiked with
good agreement. The POC-ratioPCR presents a simple and effective method
for enabling broad-based POC PCR identification of pathogens directly
from crude biosamples with low optical instrumentation complexity.