Department of Pediatrics, Konan Kosei Hospital.
Jpn J Infect Dis. 2013;66(6):539-42. doi: 10.7883/yoken.66.539.
Rapid diagnosis of Mycoplasma pneumoniae pneumonia is required for timely treatment with effective antibiotics; however, PCR-based methods are often too expensive and technologically intensive for general use in clinical practice. In this study, the efficacy of the loop-mediated isothermal amplification (LAMP) assay for diagnosis of M. pneumoniae pneumonia in clinical practice was prospectively evaluated. From July 2011 to March 2012, 531 children hospitalized for community-acquired pneumonia were enrolled. In all patients, throat swabs were obtained on admission for the detection of M. pneumoniae DNA, and paired serum samples were obtained to assay M. pneumoniae particle agglutination (PA) antibody titers. M. pneumoniae pneumonia was diagnosed by either a positive LAMP assay or an increase of 4-fold or greater in the PA titer. Overall, 271 children (51.0% of the patients with pneumonia) were diagnosed with M. pneumoniae pneumonia. Among these, 258 (95.2%) and 248 (91.5%) were identified by the LAMP assay and serological tests, respectively. When the results of serological tests were considered as standard, the sensitivity, specificity, and positive and negative predictive values of the LAMP assay were 94.8%, 91.9%, and 91.1% and 95.2%, respectively. The median duration of pharyngeal carriage, as measured by the LAMP assay, was 9.5 days. Thus, the LAMP assay is useful in the rapid diagnosis of M. pneumoniae pneumonia.
快速诊断肺炎支原体感染对于及时使用有效抗生素进行治疗至关重要；然而，基于 PCR 的方法在临床实践中通常过于昂贵且技术要求高，难以广泛应用。本研究前瞻性评估了环介导等温扩增（LAMP）检测法在临床实践中诊断肺炎支原体肺炎的效果。2011 年 7 月至 2012 年 3 月，我们共纳入了 531 例因社区获得性肺炎住院的患儿。所有患者入院时均采集咽拭子进行肺炎支原体 DNA 检测，同时采集配对血清样本检测肺炎支原体颗粒凝集（PA）抗体滴度。通过 LAMP 检测或 PA 滴度升高 4 倍或以上来诊断肺炎支原体肺炎。总体而言，271 例患儿（肺炎患儿的 51.0%）被诊断为肺炎支原体肺炎。其中，258 例（95.2%）和 248 例（91.5%）患儿分别通过 LAMP 检测和血清学检测得到确诊。以血清学检测结果为标准时，LAMP 检测的敏感性、特异性、阳性预测值和阴性预测值分别为 94.8%、91.9%、91.1%和 95.2%。通过 LAMP 检测测得的咽拭子中位携带时间为 9.5 天。因此，LAMP 检测法可用于快速诊断肺炎支原体肺炎。
