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基于 virB 基因的环介导等温扩增与实时 PCR 法在检测临床样本中的羊布鲁氏菌中的诊断价值。

Diagnostic utility of in-house loop-mediated isothermal amplification and real-time PCR targeting virB gene for direct detection of Brucella melitensis from clinical specimens.

机构信息

Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.

出版信息

J Appl Microbiol. 2019 Jul;127(1):230-236. doi: 10.1111/jam.14260.

Abstract

AIMS

In this present study, the utility of a newly developed loop-mediated isothermal amplification (LAMP) and real-time PCR assays designed to amplify the virB gene region of Brucella melitensis was evaluated from human clinical specimens.

METHODS AND RESULTS

Fifty-four culture-confirmed cases of brucellosis and 54 culture negative but clinically suspected cases of brucellosis were included in the study. Whole blood, serum and other nonblood specimens were collected and subjected to blood culture using automatic blood culture system, serological tests, LAMP assay and real-time PCR. Overall sensitivities of LAMP and real-time PCR assays were 67·5 and 68·3% respectively. For nonblood clinical specimens, we noticed a marked increase in the sensitivities of LAMP (88·9%) and real-time PCR (100%) assays.

CONCLUSIONS

Performance of LAMP and real-time PCR was not satisfactory for whole-blood specimens because of the low abundance of bacteria or DNA. On the other hand, using nonblood specimens, both the assays showed higher sensitivity and specificity which makes them a good alternative for the rapid diagnosis of human brucellosis.

SIGNIFICANCE AND IMPACT OF THE STUDY

The developed LAMP and real-time PCR assays are a specific and rapid diagnostic tool for direct and early detection of Brucella in clinical specimens.

摘要

目的

在本研究中,评估了一种新开发的环介导等温扩增(LAMP)和实时 PCR 检测方法在人临床标本中扩增布鲁氏菌 melitensis 的 virB 基因区域的效用。

方法和结果

本研究纳入了 54 例经培养证实的布氏杆菌病病例和 54 例经培养但临床疑似布氏杆菌病的病例。采集全血、血清和其他非血液标本,使用自动血液培养系统、血清学检测、LAMP 检测和实时 PCR 进行血液培养。LAMP 和实时 PCR 检测的总敏感性分别为 67.5%和 68.3%。对于非血液临床标本,我们注意到 LAMP(88.9%)和实时 PCR(100%)检测的敏感性显著提高。

结论

由于细菌或 DNA 丰度低,LAMP 和实时 PCR 检测对全血标本的性能并不令人满意。另一方面,使用非血液标本,两种检测方法均显示出更高的敏感性和特异性,使其成为快速诊断人类布鲁氏菌病的良好替代方法。

研究的意义和影响

开发的 LAMP 和实时 PCR 检测方法是一种直接和早期检测临床标本中布鲁氏菌的特异性和快速诊断工具。

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