Modi M, Sharma K, Sharma M, Sharma A, Sharma N, Sharma S, Ray P, Varma S
Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Int J Tuberc Lung Dis. 2016 May;20(5):625-30. doi: 10.5588/ijtld.15.0741.
Rapid and accurate diagnosis of tuberculous meningitis (TBM) is imperative for the optimal management of patients. Loop-mediated isothermal amplification (LAMP) is a promising nucleic-acid amplification assay, especially for resource-poor, endemic countries.
Evaluating LAMP assay using insertion sequence (IS) 6110 and MPB64 targets for the Mycobacterium tuberculosis complex (MTC) for the rapid diagnosis of TBM. Results were compared with culture and the composite reference standard.
The LAMP assay was performed using six MTC-specific primers each for IS6110 and MPB64 on the cerebrospinal fluid of 150 TBM patients (50 confirmed, 100 suspected) and 100 non-TBM control subjects.
Multitargeted LAMP had a sensitivity and specificity of 96% and 100% for confirmed (50 culture-positive) TBM cases. The sensitivity of IS6110 polymerase chain reaction (PCR), IS6110 LAMP and MPB64 LAMP for probable cases was respectively 70 (70%), 78 (78%) and 82 (82%). In a total of 150 TBM patients, the overall sensitivity of microscopy, IS6110 PCR, IS6110 LAMP, MPB64 LAMP and the multitargeted LAMP was respectively 4%, 74.6%, 82.7%, 86.7% and 88%. The specificity for all was 100%. Six cases were missed by IS6110 LAMP and two cases by MPB64 LAMP.
The LAMP assay using two targets is a promising and accurate technique for the rapid diagnosis of TBM.
对于结核性脑膜炎（TBM）患者的最佳治疗而言，快速准确的诊断至关重要。环介导等温扩增技术（LAMP）是一种很有前景的核酸扩增检测方法，尤其适用于资源匮乏的流行国家。
评估使用结核分枝杆菌复合群（MTC）的插入序列（IS）6110和MPB64靶点的LAMP检测法对TBM进行快速诊断。将结果与培养及综合参考标准进行比较。
使用针对IS6110和MPB64的六种MTC特异性引物，对150例TBM患者（50例确诊，100例疑似）的脑脊液以及100例非TBM对照受试者进行LAMP检测。
对于确诊的（50例培养阳性）TBM病例，多靶点LAMP的敏感性和特异性分别为96%和100%。对于疑似病例，IS6110聚合酶链反应（PCR）、IS6110 LAMP和MPB64 LAMP的敏感性分别为70（70%）、78（78%）和82（82%）。在总共150例TBM患者中，显微镜检查、IS6110 PCR、IS6110 LAMP、MPB64 LAMP和多靶点LAMP的总体敏感性分别为4%、74.6%、82.7%、86.7%和88%。所有方法的特异性均为100%。IS6110 LAMP漏诊6例，MPB64 LAMP漏诊2例。
使用两个靶点的LAMP检测法是一种有前景且准确的TBM快速诊断技术。
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