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Author Spotlight: Advancing Rapid Detection of Respiratory Pathogens Using Microfluidic Chip
Published on: March 29, 2024
The value of loop-mediated isothermal amplification in diagnosing lower respiratory tract infections in children
Feng Yan1, Shikun Xu1, Meijing Shen1
1Department of Clinical Laboratory, The Third Affiliated Hospital of Zunyi Medical University (Zunyi First People's Hospital), Guizhou, China.
Insights
The loop-mediated isothermal amplification (LAMP) chip method offers a faster, more sensitive, and specific alternative to sputum culture for diagnosing pediatric lower respiratory tract infections (LRTIs). This advanced diagnostic tool provides a reliable basis for effective clinical management of LRTIs in children.
Area of Science:
- Molecular Diagnostics
- Microbiology
- Pediatric Infectious Diseases
Background:
- Lower respiratory tract infections (LRTIs) are a significant cause of morbidity in children.
- Accurate and rapid pathogen identification is crucial for effective treatment of pediatric LRTIs.
- Traditional sputum culture methods (SCM) can be time-consuming and lack sensitivity.
Purpose of the Study:
- To evaluate the diagnostic performance of the loop-mediated isothermal amplification (LAMP) chip method for detecting pathogens in children with LRTIs.
- To compare the detection rates and consistency of LAMP with the conventional sputum culture method (SCM).
Main Methods:
- Sputum samples were collected from 1723 hospitalized children diagnosed with LRTIs.
- Pathogen detection was performed using both the LAMP chip method and SCM.
- Detection rates and consistency between the two methods were statistically analyzed using Chi-square and Kappa analyses.
Main Results:
- LAMP demonstrated significantly higher positive detection rates (58.97%) compared to SCM (43.64%) (P<0.001).
- LAMP showed significantly higher detection rates for key pathogens including *Streptococcus pneumoniae*, *Staphylococcus aureus*, *Acinetobacter baumannii*, *Stenotrophomonas maltophilia*, and *Haemophilus influenzae*.
- While single infections predominated, LAMP identified a higher proportion of mixed infections, with notable consistency for *S. pneumoniae*, *S. aureus*, *K. pneumoniae*, *H. influenzae*, and *E. coli*.
Conclusions:
- The LAMP chip method is simpler, faster, more sensitive, and specific than SCM for diagnosing pediatric LRTIs.
- LAMP provides a reliable laboratory diagnostic basis, supporting improved clinical management of LRTIs in children.
- The findings support the adoption of LAMP as a valuable tool in the etiological diagnosis of pediatric respiratory infections.
Objective:
To evaluate the diagnostic value of loop-mediated isothermal amplification(LAMP) chip method (hereinafter referred to as "LAMP") in the detection of pathogens in children with lower respiratory tract infections(LRTIs).
Methods:
Sputum samples from 1723 children with LRTIs hospitalized from April 2020 to April 2021 were collected. Pathogen detection was performed using both LAMP and sputum culture method(SCM).Detection rates and consistency between the two methods were analyzed using the Chi-square test and Kappa analysis.
Results:
The positive detection rates of the LAMP and the SCM were 58.97 %(1016/1723) and 43.64 %(752/1723), respectively(P<0.001). The detection rates of Streptococcus pneumoniae (Spn)(24.26 %/13.52 %), Staphylococcus aureus(Sau)(13.12 %/10.39 %), Acinetobacter baumannii (Aba)(1.33 %/0.48 %), Stenotrophomonas maltophilia (Sma)(0.58 %/0.12 %), and Haemophilus influenzae(Hin)(31.05 %/16.19 %) were significantly higher with the LAMP than with the SCM(P<0.05). Both methods showed that single infections were predominant among children, with positive rates of 65.06 % and 87.23 %, respectively, with Hin(49.92 %/33.69 %) being the most common pathogen.In mixed infections, the positive rates were 34.94 % and 12.77 %, respectively, with mixed infections of Hin and Spn being the most common, accounting for 48.89 % and 32.29 % of cases, respectively. There were significant differences in the detection rates of Spn, Sau, Klebsiella pneumoniae(Kpn), Sma, Hin, and Escherichia coli(Eco) between single and mixed infections(P < 0.05). The detection results of Spn, Sau, Kpn, Hin, and Eco exhibited high consistency between the two methods, while the consistency for Pseudomonas aeruginosa(Pae), Aba, and Sma was lower.
Conclusion:
The LAMP is simpler, faster, more sensitive and specific than SCM, offering a reliable laboratory diagnostic basis for clinical management of LRTIs in children.
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