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环介导等温扩增技术在儿童下呼吸道感染诊断中的价值

The value of loop-mediated isothermal amplification in diagnosing lower respiratory tract infections in children.

作者信息

Yan Feng, Xu Shikun, Shen Meijing, Zhao Yu, Tong Huabo, Wu Kaifeng, Zha He

机构信息

Department of Clinical Laboratory, The Third Affiliated Hospital of Zunyi Medical University (Zunyi First People's Hospital), Guizhou, China.

出版信息

Pract Lab Med. 2025 Mar 8;44:e00463. doi: 10.1016/j.plabm.2025.e00463. eCollection 2025 Apr.

Abstract

OBJECTIVE

To evaluate the diagnostic value of loop-mediated isothermal amplification(LAMP) chip method (hereinafter referred to as "LAMP") in the detection of pathogens in children with lower respiratory tract infections(LRTIs).

METHODS

Sputum samples from 1723 children with LRTIs hospitalized from April 2020 to April 2021 were collected. Pathogen detection was performed using both LAMP and sputum culture method(SCM).Detection rates and consistency between the two methods were analyzed using the Chi-square test and Kappa analysis.

RESULTS

The positive detection rates of the LAMP and the SCM were 58.97 %(1016/1723) and 43.64 %(752/1723), respectively(0.001). The detection rates of (Spn)(24.26 %/13.52 %), (Sau)(13.12 %/10.39 %), (Aba)(1.33 %/0.48 %), (Sma)(0.58 %/0.12 %), and (Hin)(31.05 %/16.19 %) were significantly higher with the LAMP than with the SCM(0.05). Both methods showed that single infections were predominant among children, with positive rates of 65.06 % and 87.23 %, respectively, with Hin(49.92 %/33.69 %) being the most common pathogen.In mixed infections, the positive rates were 34.94 % and 12.77 %, respectively, with mixed infections of Hin and Spn being the most common, accounting for 48.89 % and 32.29 % of cases, respectively. There were significant differences in the detection rates of Spn, Sau, (Kpn), Sma, Hin, and (Eco) between single and mixed infections( < 0.05). The detection results of Spn, Sau, Kpn, Hin, and Eco exhibited high consistency between the two methods, while the consistency for (Pae), Aba, and Sma was lower.

CONCLUSION

The LAMP is simpler, faster, more sensitive and specific than SCM, offering a reliable laboratory diagnostic basis for clinical management of LRTIs in children.

摘要

目的

评估环介导等温扩增(LAMP)芯片法(以下简称“LAMP”)在检测儿童下呼吸道感染(LRTIs)病原体中的诊断价值。

方法

收集2020年4月至2021年4月期间住院的1723例LRTIs患儿的痰液样本。采用LAMP和痰培养法(SCM)进行病原体检测。使用卡方检验和Kappa分析对两种方法的检出率及一致性进行分析。

结果

LAMP和SCM的阳性检出率分别为58.97%(1016/1723)和43.64%(752/1723)(<0.001)。LAMP检测肺炎链球菌(Spn)(24.26%/13.52%)、金黄色葡萄球菌(Sau)(13.12%/10.39%)、鲍曼不动杆菌(Aba)(1.33%/0.48%)、嗜麦芽窄食单胞菌(Sma)(0.58%/0.12%)和流感嗜血杆菌(Hin)(31.05%/16.19%)的检出率显著高于SCM(<0.05)。两种方法均显示儿童中单一感染为主,阳性率分别为65.06%和87.23%,其中Hin(49.92%/33.69%)为最常见病原体。在混合感染中,阳性率分别为34.94%和12.77%,其中Hin和Spn混合感染最为常见,分别占病例的48.89%和32.29%。单一感染和混合感染在Spn、Sau、肺炎克雷伯菌(Kpn)、Sma、Hin和大肠埃希菌(Eco)的检出率上存在显著差异(<0.05)。Spn、Sau、Kpn、Hin和Eco的检测结果在两种方法间具有高度一致性,而铜绿假单胞菌(Pae)、Aba和Sma的一致性较低。

结论

LAMP比SCM更简便、快速、灵敏且特异,为儿童LRTIs的临床管理提供了可靠的实验室诊断依据。

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