Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Indian J Tuberc. 2020 Oct;67(4):479-482. doi: 10.1016/j.ijtb.2020.07.019. Epub 2020 Jul 21.
The present study was conceived to evaluate multi-targeted loop mediated amplification (MLAMP) for the rapid diagnosis of extrapulmonary tuberculosis (EPTB).
A total of 700 patients were included who were classified into 2 groups: Group 1 (n = 400) included a 100 culture confirmed EPTB patients and 300 culture negative, suspected EPTB patients. Group 2 (n = 300) included negative controls from non-tubercular patients. All samples were subjected to Ziehl-Neelsen microscopy, solid culture on Lowenstein Jensen media, Polymerase chain reaction (PCR) targeting IS6110 gene and LAMP targeting both IS6110 and MPB64 individually and as MLAMP. The overall sensitivity of microscopy, culture, IS6110 PCR, IS6110 LAMP, MPB64 LAMP and the MLAMP assay were 12%, 25%, 72.5%, 80% and 86.6% respectively and the specificity of all the tests was 100%.
MLAMP is a rapid robust tool for the diagnosis of EPTB and utilizing two targets for M. tuberculosis can improve the overall sensitivity and increase the yield of detection from extrapulmonary samples. The rapidity, ease of performance and low cost make MLAMP an excellent alternative in low-income, resource limited settings.
本研究旨在评估多靶点环介导扩增（MLAMP）在肺部外结核（EPTB）快速诊断中的应用。
共纳入 700 例患者，分为 2 组：第 1 组（n=400）包括 100 例经培养证实的 EPTB 患者和 300 例培养阴性、疑似 EPTB 患者。第 2 组（n=300）为非结核患者的阴性对照。所有样本均进行齐-尼氏染色镜检、Lowenstein Jensen 固体培养基培养、IS6110 基因聚合酶链反应（PCR）、分别针对 IS6110 和 MPB64 的 LAMP 以及 MLAMP。显微镜检查、培养、IS6110 PCR、IS6110 LAMP、MPB64 LAMP 和 MLAMP 检测的总灵敏度分别为 12%、25%、72.5%、80%和 86.6%，所有检测的特异性均为 100%。
MLAMP 是一种快速、可靠的 EPTB 诊断工具，利用两个结核分枝杆菌靶标可以提高整体灵敏度，增加肺部外样本的检测产量。其快速、易于操作和低成本使其成为资源有限的低收入环境中的理想选择。
