Clinical application the loop-mediated isothermal amplification assay for the identification of pathogens in lower respiratory tract infections

doi:10.3877/cma.j.issn.1674-6902.2022.04.005

Abstract

Abstract:

Objective

To more accurately evaluate the performance of loop-mediated isothermal amplification (LAMP) assay for the identification of pathogens in lower respiratory tract infections(LRTIs).

Methods

The pathogen identification results of 1092 bronchoalveolar lavage fluid (BALF) samples from presumptive LRTI patients admitted to the Tangdu Hospital from January 2018 to September 2018 were analyzed retrospectively. Taking the bacterial culture as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of LAMP for detecting 8 common lower respiratory tract infection pathogens were calculated.

Results

The sensitivity of LAMP for detecting 8 pathogens were quite different, with the highest sensitivity to Staphylococcus aureus (100%) and the lowest sensitivity to Escherichia coli (40%). The specificity of LAMP for detecting 8 pathogens were higher than 94%. The positive predictive value of the LAMP test results for 8 pathogens were lower than 65%, the negative predictive value were higher than 98%, the positive likelihood were higher than 13. The negative likelihood ratio of the LAMP test results for 8 pathogens were quite different, with the lowest negative likelihood ratio to Staphylococcus aureus (0.00) and the highest negative likelihood ratio to Escherichia coli (0.60).

Conclusion

The LAMP has high accuracy in detecting pathogens of lower respiratory tract infections, which is helpful for early diagnosis and precise treatment of lower respiratory tract infections.

Key words: Lower respiratory infections, Loop-mediated isothermal amplification assay, Pathogens, Bacterial culture

Yanyan Qiao, Luyao Han, Zaiqiang Wang, Yanzhen Feng, Chan Li, Yujuan Li, Faguang Jin, Enqing Fu. Clinical application the loop-mediated isothermal amplification assay for the identification of pathogens in lower respiratory tract infections[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(04): 477-480.

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病原体	LAMP		细菌培养
病原体	阳性	阳性率	阳性	阳性率
肺炎链球菌	59	5.40	12	1.10
金黄色葡萄球菌	17	1.56	3	0.27
大肠埃希菌	10	0.92	5	0.46
肺炎克雷伯菌	38	3.48	7	0.64
铜绿假单胞菌	40	3.66	30	2.75
鲍曼不动杆菌	60	5.49	51	4.67
嗜麦芽窄食单胞菌	24	2.20	11	1.01
流感嗜血杆菌	63	5.77	7	0.64

病原体	LAMP		细菌培养
病原体	阳性	阳性率	阳性	阳性率
肺炎链球菌	59	5.40	12	1.10
金黄色葡萄球菌	17	1.56	3	0.27
大肠埃希菌	10	0.92	5	0.46
肺炎克雷伯菌	38	3.48	7	0.64
铜绿假单胞菌	40	3.66	30	2.75
鲍曼不动杆菌	60	5.49	51	4.67
嗜麦芽窄食单胞菌	24	2.20	11	1.01
流感嗜血杆菌	63	5.77	7	0.64

病原体	LAMP	培养法		灵敏度(%)	特异度(%)	阳性预测值(%)	阴性预测值(%)	阳性似然比	阴性似然比
病原体	LAMP	阳性	阴性	灵敏度(%)	特异度(%)	阳性预测值(%)	阴性预测值(%)	阳性似然比	阴性似然比
肺炎链球菌	阳性	10	49	83.33	95.46	16.95	99.81	18.37	0.17
	阴性	2	1 031
金黄色葡萄球菌	阳性	3	14	100.00	98.71	17.65	100.00	77.79	0.00
	阴性	0	1 075
大肠埃希菌	阳性	2	8	40.00	99.26	20.00	99.72	54.35	0.60
	阴性	3	1 079
肺炎克雷伯菌	阳性	6	32	85.71	97.05	15.79	99.91	29.06	0.15
	阴性	1	1 053
铜绿假单胞菌	阳性	26	14	86.67	98.68	65.00	99.62	65.74	0.14
	阴性	4	1 048
鲍曼不动杆菌	阳性	39	21	76.47	97.98	65.00	98.84	37.91	0.24
	阴性	12	1 020
嗜麦芽窄食单胞菌	阳性	7	17	63.64	98.43	29.17	99.63	40.47	0.37
	阴性	4	1 064
流感嗜血杆菌	阳性	5	58	71.43	94.65	7.94	99.81	13.36	0.30
	阴性	2	1 027

病原体	LAMP	培养法		灵敏度(%)	特异度(%)	阳性预测值(%)	阴性预测值(%)	阳性似然比	阴性似然比
病原体	LAMP	阳性	阴性	灵敏度(%)	特异度(%)	阳性预测值(%)	阴性预测值(%)	阳性似然比	阴性似然比
肺炎链球菌	阳性	10	49	83.33	95.46	16.95	99.81	18.37	0.17
	阴性	2	1 031
金黄色葡萄球菌	阳性	3	14	100.00	98.71	17.65	100.00	77.79	0.00
	阴性	0	1 075
大肠埃希菌	阳性	2	8	40.00	99.26	20.00	99.72	54.35	0.60
	阴性	3	1 079
肺炎克雷伯菌	阳性	6	32	85.71	97.05	15.79	99.91	29.06	0.15
	阴性	1	1 053
铜绿假单胞菌	阳性	26	14	86.67	98.68	65.00	99.62	65.74	0.14
	阴性	4	1 048
鲍曼不动杆菌	阳性	39	21	76.47	97.98	65.00	98.84	37.91	0.24
	阴性	12	1 020
嗜麦芽窄食单胞菌	阳性	7	17	63.64	98.43	29.17	99.63	40.47	0.37
	阴性	4	1 064
流感嗜血杆菌	阳性	5	58	71.43	94.65	7.94	99.81	13.36	0.30
	阴性	2	1 027

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