Micro-Colony Forming Unit Assay for Efficacy Evaluation of Vaccines Against Tuberculosis

Summary

The determination of colony-forming units (CFU) is the gold-standard technique for quantifying bacteria, including Mycobacterium tuberculosis which can take weeks to form visible colonies. Here we describe a micro-CFU for CFU determination with increased time efficiency, reduced lab space and reagent cost, and scalability to medium and high throughput experiments.

Abstract

Tuberculosis (TB), the leading cause of death worldwide by an infectious agent, killed 1.6 million people in 2022, only being surpassed by COVID-19 during the 2019-2021 pandemic. The disease is caused by the bacterium Mycobacterium tuberculosis (M.tb). The Mycobacterium bovis strain Bacillus Calmette-Guérin (BCG), the only TB vaccine, is the oldest licensed vaccine in the world, still in use. Currently, there are 12 vaccines in clinical trials and dozens of vaccines under pre-clinical development. The method of choice used to assess the efficacy of TB vaccines in pre-clinical studies is the enumeration of bacterial colonies by the colony-forming units (CFU) assay. This time-consuming assay takes 4 to 6 weeks to conclude, requires substantial laboratory and incubator space, has high reagent costs, and is prone to contamination. Here we describe an optimized method for colony enumeration, the micro-CFU (mCFU), that offers a simple and rapid solution to analyze M.tb vaccine efficacy results. The mCFU assay requires tenfold fewer reagents, reduces the incubation period threefold, taking 1 to 2 weeks to conclude, reduces lab space and reagent cost, and minimizes the health and safety risks associated with working with large numbers of M.tb. Moreover, to evaluate the efficacy of a TB vaccine, samples may be obtained from a variety of sources, including tissues from vaccinated animals infected with Mycobacteria. We also describe an optimized method to produce a unicellular, uniform, and high-quality mycobacterial culture for infection studies. Finally, we propose that these methods should be universally adopted for pre-clinical studies of vaccine efficacy determination, ultimately leading to time reduction in the development of vaccines against TB.

Introduction

Tuberculosis (TB) is the leading cause of death worldwide by a single infectious agent, bacterium Mycobacterium tuberculosis (M.tb), killing more people than any other pathogen. In 2021, TB was responsible for 1.6 million deaths and was surpassed by COVID-19 during the 2019-2021 pandemic¹. Moreover, according to the World Health Organization´s global TB report of 2022, the COVID-19 pandemic was responsible for an increase in new TB cases. The WHO also reports large drops in the number of people diagnosed with TB during this period, which could increase further the number of TB cases¹.

Protocol

NOTE: The protocol described here is for BCG but can be applied to any Mycobacteria. BCG can be used as a surrogate bacterium for TB experiments when BSL3 facilities are not available²². The following procedures using BCG should be performed under a biosafety level 2 (BSL2) laboratory and follow the appropriate biosafety guidelines and good laboratory practices for the manipulation of hazard group 2 microorganisms.

1. Culture media preparation

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Discussion

TB is an important public health problem with increasing importance, particularly in low and middle-income countries. The disruption of healthcare settings to diagnose and treat TB during the COVID-19 pandemic caused a negative impact on the incidence of new cases¹. In addition, the multi-drug and extensively-drug resistant M.tb strains, and the co-infection of M.tb and HIV must be urgently addressed to control this epidemic^1,3.......

Materials

Name	Company	Catalog Number	Comments
96-well plates	VWR	734-2781
DSLR 15-55 mm lens	Nikon	AF-P DX NIKKOR 18-55mm f/3.5-5.6G VR
DSLR camera	Nikon	D3400
DSLR macro lens	Sigma	MACRO 105mm F2.8 EX DG OS HSM
Fetal calf serum	Gibco	10270106
Fiji Software		https://fiji.sc/	Fiji is an open-source software supported by several laboratories, institutions, and individuals. All the required plugins are included.
Igepal CA-630	Sigma-Aldrich	18896
L-glutamine	Gibco	25030-081
Middlebrook 7H10	BD	262710
Middlebrook 7H9	BD	271310
Multichannel pipette (0.5 - 10 µl)	Gilson	FA10013
Multichannel pipette (20 - 200 µl)	Gilson	FA10011
Mycobacterium bovis BCG	American Type Culture Collection	ATCC35734	strain TMC 1011 [BCG Pasteur]
OADC enrichment	BD	211886
Phosphate buffered saline (PBS)	NZYTech	MB25201
RPMI 1640 medium	Gibco	21875091
Sodium pyruvate	Gibco	11360-070
Spectrophotometer UV-6300PC	VWR	634-6041
Square Petri dish 120 x 120 mm	Corning	BP124-05
Tyloxapol	Sigma-Aldrich	T8761
Ultrasound bath Elma P 30 H	VWR	142-0051