LAMP检测对人类真菌病原体的诊断效力:系统综述和荟萃分析。

IF 2.3 Q3 INFECTIOUS DISEASES Current Fungal Infection Reports Pub Date : 2023-05-01 DOI:10.1007/s12281-023-00466-0
Gurvinder Singh Bumbrah, Sarika Jain, Shweta Singh, Zeeshan Fatima, Saif Hameed
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引用次数: 1

摘要

目的:人类真菌感染,特别是由念珠菌和曲霉菌引起的真菌感染已成为主要的公共卫生负担。常规诊断的周转时间长和灵敏度低是快速诊断人类真菌病原体的主要障碍。最近的发现:为了克服这些问题,已经开发了基于分子的诊断方法。它们提高了灵敏度,但需要复杂的基础设施和熟练的人力,而且成本高昂。在这种情况下,环介导的等温扩增(LAMP)分析代表了一种有前途的替代方法,有助于视觉读出。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、准确并促进广泛采用的替代测试方法。因此,本研究的目的是根据PRISMA指南,使用PubMed、Google Scholar、Science Direct、Scopus、BioRxiv和MedRxiv等科学数据库,进行荟萃分析,以评估LAMP在检测一组人类真菌病原体方面的诊断效率,只有9篇文章符合LAMP诊断标准。通过荟萃分析发现,大多数研究是在中国和日本进行的,痰和血液是LAMP测定最常见的样本。收集的数据强调,基于ITS基因和荧光的检测是最常用的目标和方法。荟萃分析的合并敏感性值在0.71和1.0之间,森林图和SROC(总结受试者操作特征)曲线显示合并特异性值分别在0.13和1.0之间且置信区间为95%。合格研究的准确率和准确率分别在70%至100%和68%至100%之间。基于QUADAS-2(诊断准确性研究的质量评估)对偏倚和适用性进行了质量评估,该评估描述了偏倚和应用性问题的低风险。总之,LAMP技术可以被认为是当前诊断的可行替代方案,考虑到在低资源地区进行快速检测的高真菌负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Diagnostic Efficacy of LAMP Assay for Human Fungal Pathogens: a Systematic Review and Meta-analysis.

Purpose: Human fungal infections particularly caused by Candida and Aspergillus 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.

Recent findings: 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.

Summary: 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.

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来源期刊
Current Fungal Infection Reports
Current Fungal Infection Reports INFECTIOUS DISEASES-
CiteScore
3.10
自引率
7.10%
发文量
20
期刊介绍: This journal intends to provide clear, insightful, balanced contributions that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of fungal infections. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as advances in diagnosis, current and emerging management approaches, and genomics and pathogenesis. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. Commentaries from well-known figures in the field are also provided, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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