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.	蒙光义, 王冬晓, 彭评志, 等. 抗菌药物使用强度对嗜麦芽窄食单胞菌耐药率的影响. 中国感染控制杂志, 2019, 18(3): 262-266.
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1. 张迪, 钱晓君, 褚水莲, 等. 2002—2016年中国呼吸系统疾病死亡率及其变化趋势. 中华医学杂志, 2020, 100(24): 1895-1900.
2. 刘又宁, 曹彬, 王辉, 等. 中国九城市成人医院获得性肺炎微生物学与临床特点调查. 中华结核和呼吸杂志, 2012, 35(10): 739-746.
3. 中华医学会呼吸病学分会. 肺部感染性疾病支气管肺泡灌洗病原体检测中国专家共识(2017年版). 中华结核和呼吸杂志, 2017, 40(8): 578-583.
4. 中国研究型医院学会呼吸病学专业委员会, 成人呼吸系统感染性疾病病原学诊断专家意见编写组. 成人呼吸系统感染性疾病病原学诊断专家意见. 中华结核和呼吸杂志, 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. 季伟, 陈慧中. 亟待提高对急性呼吸道感染多病原学联合检测重要性的认识. 中华预防医学杂志, 2011, 45(3): 197-199.
7. 闵新珍, 黄汉鹏, 戴春晖, 等. 呼吸机相关性肺炎的影响因素及预防对策研究. 中华医院感染学杂志, 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, 陈飘飘, 应斌武. 基于环介导等温扩增技术的即时检测在检验医学中的应用. 中华检验医学杂志, 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. 徐真谛, 杨小生. 呼吸道苛养菌的分离培养以及耐药性研究. 数理医药学杂志, 2019, 32(3): 430-431.
15. 李辉腾, 郭旭光, 陈瑞娟, 等. 荧光环介导恒温扩增技术检测嗜肺军团菌方法的建立. 国际检验医学杂志, 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. 全国细菌耐药监测网. 全国细菌耐药监测网2014—2019年临床分离非发酵革兰阴性杆菌耐药性变迁. 中国感染控制杂志, 2021, 20(1): 69-75.
18. 蒙光义, 王冬晓, 彭评志, 等. 抗菌药物使用强度对嗜麦芽窄食单胞菌耐药率的影响. 中国感染控制杂志, 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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