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基于 LAMP 的检测方法可以纠正由血清学检测漏诊的假结核耶尔森菌感染。

LAMP-based assay can rectify the diagnosis of Yersinia pseudotuberculosis infections otherwise missed by serology.

机构信息

1​Department of Pediatrics, Kawasaki Medical School, Japan.

2​Bacteriology Section, Okayama Prefectural Institute for Environmental Science and Public Health, Japan.

出版信息

J Med Microbiol. 2019 Feb;68(2):143-147. doi: 10.1099/jmm.0.000868. Epub 2019 Jan 16.

Abstract

BACKGROUND

Despite being a well-known but seldom encountered zoonotic pathogen, diagnosis of Yersinia pseudotuberculosis is not necessarily easy. Infected patients occasionally present with various symptoms resembling Kawasaki disease; thus discriminating the two in the acute phase is challenging. In addition to bacterial culture and serology, novel detection methods based on loop-mediated isothermal amplification (LAMP) are reported in the literature. However, the clinical utility of LAMP-based methods in comparison with the other methods is scarcely documented in the literature.

AIM

To clarify the clinical utility of a LAMP-based method in the diagnosis of Yersinia pseudotuberculosis infection.

METHODOLOGY

Inpatients admitted due to suspected Yersinia pseudotuberculosis infection during April 2008 through March 2015 were enrolled. Results of the LAMP-based method as well as culture and serology were collected and compared.

RESULTS

Among 16 eligible cases, serology proved positive in 13 (81.3 %) cases, LAMP in eight (50 %) cases, and bacterial culture in four (25 %) cases. No significant difference among the three methods could be proved statistically. Although serology was the most sensitive method, it is known to miss cases such as young patients, whereas LAMP could complement all three cases missed by serology. Furthermore, LAMP can return the test result within a few hours from specimen receipt, whereas serology and bacterial culture requires days to weeks of time.

CONCLUSION

Although second to serology in sensitivity, the LAMP-based method proved its utility in making rapid diagnosis, and serving a complementary role to serology.

摘要

背景

尽管耶尔森菌属假结核亚种是一种广为人知但很少见的人畜共患病病原体,但诊断并不一定容易。感染患者偶尔会出现各种类似川崎病的症状;因此,在急性期区分两者具有挑战性。除了细菌培养和血清学外,文献中还报道了基于环介导等温扩增(LAMP)的新型检测方法。然而,基于 LAMP 的方法与其他方法相比在临床上的应用在文献中鲜有记载。

目的

阐明基于 LAMP 的方法在诊断耶尔森菌属假结核亚种感染中的临床应用价值。

方法

纳入 2008 年 4 月至 2015 年 3 月因疑似耶尔森菌属假结核亚种感染而住院的患者。收集并比较了基于 LAMP 的方法以及培养和血清学的结果。

结果

在 16 例符合条件的病例中,血清学检测结果阳性的有 13 例(81.3%),LAMP 阳性的有 8 例(50%),细菌培养阳性的有 4 例(25%)。三种方法之间无统计学差异。虽然血清学是最敏感的方法,但它已知会漏诊年轻患者等病例,而 LAMP 可以补充血清学漏诊的所有 3 例病例。此外,LAMP 可以在收到标本后的几个小时内返回检测结果,而血清学和细菌培养需要数天到数周的时间。

结论

虽然 LAMP 法的敏感性次于血清学,但它在快速诊断方面具有实用性,并能对血清学起到补充作用。

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