Bacterial detection of lower respiratory tract samples from patients in respiratory intensive care unit by loop-mediated isothermal amplification_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

TAO Yu ¹ ,  WANG Jianmiao ^1,2

1. Department of Respiratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P. R. China;
2. Department of Infection Control, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P. R. China;

Corresponding?author：

WANG Jianmiao, Email: wangjianmiao2010@126.com

Keywords：

Loop-mediated isothermal amplification; respiratory intensive care unit; prognosis; respiratory pathogens

DOI：

10.7507/1671-6205.202105062

Video：

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Objective To compare the bacterial spectrums of respiratory intensive care unit (RICU) patients derived from traditional bacterial culture and loop-mediated isothermal amplification (LAMP) assay. To analyze the relationship between clinical factors and clinical outcome of patients. Methods Data of patients in RICU with lower respiratory tract infection from October 2018 to December 2020 was collected. The bacterial spectrums obtained by traditional culture method and LAMP-based method were compared. Clinical factors were divided into two categories and taken into analysis of variance for assessing their relevance with clinical outcomes. Those with significances in analysis of variance were taken into binary logistic regression. Results A total of 117 patients were included. The ratio of patients with positive bacterial culture results was 39.13% (n=115), and that with positive LAMP assay results was 72.65% (n=117). The ratios of patients with at least two positive results for culture and LAMP were 8.70% (n=115) and 36.75% (n=117), respectively. According to chi-squared test, mechanical ventilation (χ²=5.260, P=0.022), and patients with two or more bacteria positive for LAMP assay (χ²=8.227, P=0.004) were related to higher risk of death. Mechanical ventilation and patients with two bacteria positive for LAMP assay were included in binary logistic regression. The odds ratio for death was 4.789 in patients with two or more bacteria positive by LAMP assay (95% confidence interval 1.198 - 19.144, P=0.027). Conclusions LAMP-based method is helpful in detecting more bacteria from respiratory tract specimens of RICU patients, which will be a contributor to precision medicine. Patients with at least two bacteria positive based on LAMP assay have higher risk of death.

Citation： TAO Yu, WANG Jianmiao. Bacterial detection of lower respiratory tract samples from patients in respiratory intensive care unit by loop-mediated isothermal amplification. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(1): 25-30. doi: 10.7507/1671-6205.202105062 Copy

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18.	蒙光義, 王冬曉, 彭評志, 等. 抗菌藥物使用強度對嗜麥芽窄食單胞菌耐藥率的影響. 中國感染控制雜志, 2019, 18(3): 262-266.
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1. 張迪, 錢曉君, 褚水蓮, 等. 2002—2016年中國呼吸系統疾病死亡率及其變化趨勢. 中華醫學雜志, 2020, 100(24): 1895-1900.
2. 劉又寧, 曹彬, 王輝, 等. 中國九城市成人醫院獲得性肺炎微生物學與臨床特點調查. 中華結核和呼吸雜志, 2012, 35(10): 739-746.
3. 中華醫學會呼吸病學分會. 肺部感染性疾病支氣管肺泡灌洗病原體檢測中國專家共識(2017年版). 中華結核和呼吸雜志, 2017, 40(8): 578-583.
4. 中國研究型醫院學會呼吸病學專業委員會, 成人呼吸系統感染性疾病病原學診斷專家意見編寫組. 成人呼吸系統感染性疾病病原學診斷專家意見. 中華結核和呼吸雜志, 2020, 43(9): 757-764.
5. Notomi T, Okayama H, Masubuchi H, et al. Loop-mediated isothermal amplification of DNA. Nucleic Acids Res, 2000, 28(12): E63.
6. 季偉, 陳慧中. 亟待提高對急性呼吸道感染多病原學聯合檢測重要性的認識. 中華預防醫學雜志, 2011, 45(3): 197-199.
7. 閔新珍, 黃漢鵬, 戴春暉, 等. 呼吸機相關性肺炎的影響因素及預防對策研究. 中華醫院感染學雜志, 2018, 28(21): 3230-3233.
8. Tang X, Xiao M, Zhuo C, et al. Multi-level analysis of bacteria isolated from inpatients in respiratory departments in China. J Thorac Dis, 2018, 10(5): 2666-2675.
9. Wong YP, Othman S, Lau YL, et al. Loop-mediated isothermal amplification (LAMP): a versatile technique for detection of micro-organisms. J Appl Microbiol, 2018, 124(3): 626-643.
10. 李美, 陳飄飄, 應斌武. 基于環介導等溫擴增技術的即時檢測在檢驗醫學中的應用. 中華檢驗醫學雜志, 2021, 44(9): 776-780.
11. Hou J, Wu H, Zeng X, et al. Clinical evaluation of the loop-mediated isothermal amplification assay for the detection of common lower respiratory pathogens in patients with respiratory symptoms. Medicine (Baltimore), 2018, 97(51): e13660.
12. Phetsuksiri B, Rudeeaneksin J, Srisungngam S, et al. Comparison of loop-mediated isothermal amplification, microscopy, culture, and PCR for diagnosis of pulmonary tuberculosis. Jpn J Infect Dis, 2020, 73(4): 272-277.
13. Wang ZQ, Zang Y, Gao YJ, et al. Evaluation of bronchoalveolar lavage fluid combined with the loop-mediated isothermal amplification assay in lower respiratory tract infections. Am J Transl Res, 2020, 12(7): 4009-4016.
14. 徐真諦, 楊小生. 呼吸道苛養菌的分離培養以及耐藥性研究. 數理醫藥學雜志, 2019, 32(3): 430-431.
15. 李輝騰, 郭旭光, 陳瑞娟, 等. 熒光環介導恒溫擴增技術檢測嗜肺軍團菌方法的建立. 國際檢驗醫學雜志, 2017, 38(22): 3136-3138.
16. Gajdacs M, Urban E. Prevalence and antibiotic resistance of Stenotrophomonas maltophilia in respiratory tract samples: a 10-year epidemiological snapshot. Health Serv Res Manag Epidemiol, 2019, 6: 2333392819870774.
17. 全國細菌耐藥監測網. 全國細菌耐藥監測網2014—2019年臨床分離非發酵革蘭陰性桿菌耐藥性變遷. 中國感染控制雜志, 2021, 20(1): 69-75.
18. 蒙光義, 王冬曉, 彭評志, 等. 抗菌藥物使用強度對嗜麥芽窄食單胞菌耐藥率的影響. 中國感染控制雜志, 2019, 18(3): 262-266.
19. Han DS, Li ZY, Li R, et al. mNGS in clinical microbiology laboratories: on the road to maturity. Crit Rev Microbiol, 2019, 45(5-6): 668-685.
20. Chiu CY, Miller SA. Clinical metagenomics. Nat Rev Genet, 2019, 20(6): 341-355.

Chinese Journal of Respiratory and Critical Care Medicine

Bacterial detection of lower respiratory tract samples from patients in respiratory intensive care unit by loop-mediated isothermal amplification

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