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Rapid, accurate, and novel diagnostic technique for respiratory pathogens: Clinical application of loop-mediated isothermal amplification assay in older patients with pneumonia, a multicenter prospective observational study

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机构: [1]Department of Geriatrics, Peking University First Hospital, Beijing, China, [2]Bio Biological Group Co., Ltd, Beijing, China, [3]School of Public Health, Peking University Health Science Center, Beijing, China, [4]Department of Clinical Laboratory , Peking University First Hospital, Beijing, China, [5]Department of Respiratory, Anhui Chest Hospital, Hefei, China, [6]Department of Respiratory, Tsinghua ChangGung Hospital, Beijing, China, [7]Department of Geriatrics, Jishuitan Hospital, Beijing, China, [8]Department of Emergency, Aerospace Center Hospital, Beijing, China, [9]Department of Emergency, Jingmei Group General Hospital, Beijing, China, [10]Department of Respiratory, Chinese People's Liberation Army General Hospital, Beijing, China, [11]Department of Neurosurgery, Shijitan Hospital, Beijing, China, [12]Department of Emergency, Peking University First Hospital, Beijing, China, [13]Department of Respiratory, Xuanwu Hospital, Beijing, China, [14]Department of Respiratory Endoscopy, Beijing Chest Hospital, Beijing, China
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关键词: loop-mediated isothermal amplification chip pneumonia clinical application diagnostic respiratory pathogens

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BackgroundLoop-mediated isothermal amplification (LAMP) is a novel nucleic acid amplification method using only one type of enzyme that can amplify DNA with high specificity, efficiency and rapidity under isothermal conditions. Chips for Complicated Infection Detection (CCID) is based on LAMP. This study translate CCID into clinical application and evaluate its diagnostic value for pneumonia. MethodsEighty one older patients with pneumonia were prospectively enrolled from January 1 to July 23, 2021, and 57 sputum/airway secretion and 35 bronchoalveolar lavage fluid samples were collected and analyzed by CCID and conventional microbiological tests (CMTs). Samples were collected, transported, monitored, and managed by a multidisciplinary team using a sample management information system. ResultsCCID turnaround time was 50 min, and the detection limit was 500 copies/reaction. The percentage of positive samples was significantly higher using CCID than CMTs, especially for Klebsiella pneumoniae (odds ratio [OR], 9.0; 95% confidence interval [CI], 1.1-70.5; p < 0.05), Enterococcus faecalis (OR, infinity; p < 0.01), Stenotrophomonas maltophilia (OR, infinity; p < 0.01), fungi (OR, 26.0; 95% CI, 3.6-190.0; p < 0.01), and viruses (CCID only; p < 0.01). In addition, the percentage of positive results was significantly higher using CCID than CMTs in patients who used antibiotics for more than 3 days (91.9% vs. 64.9%; p < 0.01). Analyzing clinical impact, 55 cases (59.8%) benefited from CCID. ConclusionCCID allows the rapid and accurate detection of pneumonia in older patients. Moreover, this technique is less affected by previous antibiotic treatment and can improve patient care.

基金:

基金编号: 2020YFC2005401] Xicheng Financial Scientific and Technological Project [XCSTS-SD2021-02] and Project funded by Baidu Fund of Peking University [2020BD045

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出版当年[2021]版:
大类 | 2 区 生物学
小类 | 2 区 微生物学
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大类 | 2 区 生物学
小类 | 3 区 微生物学
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Q1 MICROBIOLOGY
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Q2 MICROBIOLOGY

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第一作者机构: [1]Department of Geriatrics, Peking University First Hospital, Beijing, China,
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