Bumbrah Gurvinder Singh, Jain Sarika, Singh Shweta, Fatima Zeeshan, Hameed Saif
Department of Forensic Sciences, Amity School of Applied Sciences, Amity University Haryana, Gurugram, 122413 Manesar India.
Department of Mathematics, Amity School of Applied Sciences, Amity University Haryana, Gurugram, 122413 Manesar India.
Curr Fungal Infect Rep. 2023 May 1:1-11. doi: 10.1007/s12281-023-00466-0.
Human fungal infections particularly caused by and have emerged as major public health burden. Long turnaround time and poor sensitivity of the conventional diagnostics are the major impediments for faster diagnosis of human fungal pathogens.
To overcome these issues, molecular-based diagnostics have been developed. They offer enhanced sensitivity but require sophisticated infrastructure, skilled manpower, and remained expensive. In that context, loop-mediated isothermal amplification (LAMP) assay represents a promising alternative that facilitates visual read outs. However, to eradicate fungal infections, all forms of fungi must be accurately detected. Thus, a need for alternative testing methodologies is imperative that should be rapid, accurate and facilitate widespread adoption. Therefore, the aim of the present study is to conduct a meta-analysis to assess the diagnostic efficiency of LAMP in the detection of a panel of human fungal pathogens following PRISMA guidelines using scientific databases viz. PubMed, Google Scholar, Science Direct, Scopus, BioRxiv, and MedRxiv.
From various studies reported on the diagnosis of fungi, only 9 articles were identified as eligible to meet the criteria of LAMP based diagnosis. Through this meta-analysis, it was found that most of the studies were conducted in China and Japan with sputum and blood as the most common specimens to be used for LAMP assay. The collected data underlined that ITS gene and fluorescence-based detections ranked as the most used target and method. The pooled sensitivity values of meta-analysis ranged between 0.71 and 1.0 and forest plot and SROC (summary receiver operating characteristic) curve revealed a pooled specificity values between 0.13 and 1.0 with the confidence interval of 95%, respectively. The accuracy and precision rates of eligible studies mostly varied between 70 to 100% and 68 to 100%, respectively. A quality assessment based on QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) of bias and applicability was conducted which depicted low risk of bias and applicability concerns. Together, LAMP technology could be considered as a feasible alternative to current diagnostics considering high fungal burden for rapid testing in low resource regions.
由[具体真菌名称1]和[具体真菌名称2]引起的人类真菌感染已成为主要的公共卫生负担。传统诊断方法周转时间长且灵敏度低，是快速诊断人类真菌病原体的主要障碍。
为克服这些问题，已开发出基于分子的诊断方法。它们具有更高的灵敏度，但需要复杂的基础设施、技术熟练的人力，且成本仍然很高。在这种情况下，环介导等温扩增（LAMP）检测法是一种很有前景的替代方法，它便于进行可视化读数。然而，要根除真菌感染，必须准确检测所有形式的真菌。因此，迫切需要快速、准确且便于广泛应用的替代检测方法。因此，本研究的目的是按照PRISMA指南，使用科学数据库，即PubMed、谷歌学术、科学Direct、Scopus、BioRxiv和MedRxiv，进行一项荟萃分析，以评估LAMP在检测一组人类真菌病原体中的诊断效率。
从已报道的各种真菌诊断研究中，仅9篇文章被确定符合基于LAMP诊断的标准。通过这项荟萃分析发现，大多数研究在中国和日本进行，痰液和血液是LAMP检测中最常用的标本。收集的数据表明，ITS基因和基于荧光的检测分别是最常用的靶标和方法。荟萃分析的合并灵敏度值在0.71至1.0之间，森林图和SROC（汇总受试者工作特征）曲线显示合并特异性值在0.13至1.0之间，置信区间为95%。符合条件的研究的准确率和精密度率大多分别在70%至100%和68%至100%之间。基于QUADAS - 2（诊断准确性研究质量评估）对偏倚和适用性进行了质量评估，结果显示偏倚风险和适用性问题较低。总体而言，考虑到在资源匮乏地区快速检测时真菌负担较高，LAMP技术可被视为当前诊断方法的一种可行替代方法。
