Toggle Main Menu Toggle Search

Open Access padlockePrints

Rapid ultra-sensitive diagnosis of Clostridium difficile infection using a SERS-based lateral flow assay

Lookup NU author(s): Julia Spoors, Dr Christopher Johnson, Dr Neil Keegan



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© The Royal Society of Chemistry. Clostridium difficile (C. diff) infection is one of the most contagious diseases associated with high morbidity and mortality rates in hospitalised patients. Accurate diagnosis can slow its spread by determining the most effective treatment. Herein, we report a novel testing platform as a proof-of-concept for the selective, sensitive, rapid and cost-effective diagnosis of C. diff infection (CDI) based on a duplex measurement. This was achieved by detecting two specific biomarkers, surface layer protein A (SlpA) and toxin B (ToxB), using a surface enhanced Raman scattering-based lateral flow assay (SERS-based LFA). The simultaneous duplex detection of SlpA with ToxB has not been described for the clinical diagnosis of CDI previously. The SlpA biomarker "AKDGSTKEDQLVDALA"was first reported by our group in 2018 as a species-specific identification tool. The second biomarker, ToxB, is the essential virulence biomarker of C. diff pathogenic strains and is required to confirm true infection pathogenicity. The proposed SERS-based LFA platform enabled rapid duplex detection of SlpA and ToxB on separate test lines using a duplex LF test strip within 20 minutes. The use of a handheld Raman spectrometer to scan test lines allowed for the highly sensitive quantitative detection of both biomarkers with a lowest observable concentration of 0.01 pg μL-1. The use of a handheld device in this SERS-based LFA instead of benchtop machine paves the way for rapid, selective, sensitive and cheap clinical evaluation of CDI at the point of care (POC) with minimal sample backlog.

Publication metadata

Author(s): Hassanain WA, Spoors J, Johnson CL, Faulds K, Keegan N, Graham D

Publication type: Article

Publication status: Published

Journal: Analyst

Year: 2021

Volume: 146

Issue: 14

Pages: 4495-4505

Print publication date: 21/07/2021

Online publication date: 21/06/2021

Acceptance date: 19/06/2021

Date deposited: 03/08/2021

ISSN (print): 0003-2654

ISSN (electronic): 1364-5528

Publisher: Royal Society of Chemistry


DOI: 10.1039/d1an00726b


Altmetrics provided by Altmetric


Funder referenceFunder name