Lloyd Aaron, Pasupuleti Vinay, Thota Priyaleela, Pant Chaitanya, Rolston David D K, Hernandez Adrian V, Benites-Zapata Vicente A, Fraser Thomas G, Donskey Curtis J, Deshpande Abhishek
Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Department of Gastroenterology, University of Kansas Medical Center, Kansas City, KS, USA.
Diagn Microbiol Infect Dis. 2015 May;82(1):4-10. doi: 10.1016/j.diagmicrobio.2015.02.007. Epub 2015 Feb 23.
Loop-mediated isothermal DNA amplification (LAMP) is currently used as standalone diagnostic test for C. difficile infection (CDI). We assessed the diagnostic accuracy of LAMP for the diagnosis of CDI. We searched 5 databases to identify studies that compared LAMP with culture cytotoxicity neutralization assay or anaerobic toxigenic culture (TC) of C. difficile. We used the random-effects model to calculate pooled sensitivities, specificities, diagnostic odds ratios, and their 95% confidence intervals (CIs). The search of the databases yielded 16 studies (6979 samples) that met inclusion criteria. When TC was used as the gold standard (6572 samples), bivariate analysis yielded a mean sensitivity of 0.95 (95% CI, 0.93-0.97; I(2)=67.4) and a mean specificity of 0.99 (95% CI, 0.96-1.00; I(2)=97.0). LAMP is a useful diagnostic tool with high sensitivity and specificity for detecting CDI. The results should, however, be interpreted only in the presence of clinical suspicion and symptoms of CDI.
环介导等温DNA扩增技术（LAMP）目前用作艰难梭菌感染（CDI）的独立诊断检测方法。我们评估了LAMP诊断CDI的诊断准确性。我们检索了5个数据库，以确定将LAMP与艰难梭菌培养细胞毒性中和试验或厌氧产毒培养（TC）进行比较的研究。我们使用随机效应模型计算合并敏感性、特异性、诊断比值比及其95%置信区间（CI）。对数据库的检索产生了16项符合纳入标准的研究（6979个样本）。当将TC用作金标准（6572个样本）时，双变量分析得出平均敏感性为0.95（95%CI，0.93-0.97；I(2)=67.4），平均特异性为0.99（95%CI，0.96-1.00；I(2)=97.0）。LAMP是一种用于检测CDI的具有高敏感性和特异性的有用诊断工具。然而，结果应仅在存在CDI临床怀疑和症状的情况下进行解释。
