Electrochemical real-time nucleic acid amplification: towards point-of-care quantification of pathogens

• We review current methods for electrochemical real-time nucleic acid amplification.
• Electrochemical detection rivals optical methods due to low cost and complexity.
• Initial methods were solid phase and suffered from low amplification efficiency.
• New solution phase methods achieve clinically relevant sensitivity and specificity.
• Solution phase methods can pave the road towards use in point-of-care applications.

Real-time nucleic acid amplification, whereby the amplification rate is used to quantify the initial copy number of target DNA or RNA, has proven highly effective for monitoring pathogen loads. Unfortunately, however, current optical methods are limited to centralized laboratories due to complexity, bulk and cost. In response, recent efforts aim to develop lower-cost, electrochemical real-time amplification platforms for point-of-care applications, with researchers already having developed platforms that not only perform in situ and concurrent electrochemical detection during amplification, but also deliver sensitivity and specificity potentially rivaling bench-top optical systems. This report chronicles the evolution of the different strategies, describes the current state of the art, and identifies challenges of bringing the power of real-time detection to the point-of-care.