环介导等温扩增法作为斯里兰卡杜氏利什曼原虫感染的一种灵敏诊断工具。
Loop-mediated isothermal amplification assay as a sensitive diagnostic tool for Leishmania donovani infections in Sri Lanka.
作者信息
Kothalawala H S, Karunaweera N D
机构信息
Department of Parasitology, Faculty of Medicine, University of Colombo, Sri Lanka.
出版信息
Ceylon Med J. 2016 Jun;61(2):68-70. doi: 10.4038/cmj.v61i2.8286.
INTRODUCTION
Cutaneous leishmaniasis (CL) in Sri Lanka is caused by Leishmania donovani MON 37. Confirmation of diagnosis is done through microscopy, either directly or after in vitro culture. Molecular diagnostic methods are sensitive, but require well established laboratories. Loop mediated isothermal amplification assay (LAMP) is rapid, specific for parasite speciesspecific DNA amplification, and requires only basic laboratory equipment. The aim of the study was to determine the potential utility of LAMP to diagnose leishmaniasis.
METHODS
Thirty one patients clinically diagnosed as CL were enrolled in the study. Light microscopy, a widely used and universally accepted method was used as the reference standard for confirmation of diagnosis.
RESULTS
LAMP was positive for 19/23 microscopically positive patients, yielding a sensitivity of 82.6%. Specificity of the LAMP assay was 100% and the positive and negative predictive values were 100% and 66% respectively. The average time taken for the LAMP assay was 1 hour and 40 minutes and the cost per sample was about SLR 2 000, which was approximately half the time and cost of a nested PCR (polymerase chain reaction).
CONCLUSIONS
LAMP could be considered a potentially useful diagnostic tool for leishmaniasis.
引言
斯里兰卡的皮肤利什曼病（CL）由杜氏利什曼原虫MON 37引起。诊断通过显微镜检查进行确认，可直接检查或在体外培养后检查。分子诊断方法灵敏，但需要设备完善的实验室。环介导等温扩增检测法（LAMP）快速，对寄生虫物种特异性DNA扩增具有特异性，且仅需基本的实验室设备。本研究的目的是确定LAMP在诊断利什曼病方面的潜在效用。
方法
31例临床诊断为CL的患者纳入本研究。光学显微镜检查作为广泛使用且被普遍接受的方法，用作诊断确认的参考标准。
结果
LAMP检测对23例显微镜检查呈阳性的患者中的19例呈阳性，灵敏度为82.6%。LAMP检测的特异性为100%，阳性预测值和阴性预测值分别为100%和66%。LAMP检测平均耗时1小时40分钟，每个样本成本约为2000斯里兰卡卢比，大约是巢式聚合酶链反应（PCR）时间和成本的一半。
结论
LAMP可被视为利什曼病一种潜在有用的诊断工具。
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