LAMP在下呼吸道感染病原菌快速检测中的临床应用

Clinical application of LAMP in rapid detection of pathogens in lower respiratory tract infections

目的利用环介导等温扩增检测(loop mediated isothermal amplification,LAMP)即呼吸道病原菌核酸联合检测法(13联)分析痰标本病原菌的检出情况,为临床诊疗提供病原学循证依据。方法选取2022年1月至12月铜仁市人民医院收治的1642例下呼吸道感染患者作为研究对象,采集痰标本/肺泡灌洗液进行LAMP(13联)检测,分析呼吸道病原菌检出情况及其与性别、年龄、季节的关系。结果13种呼吸道病原菌的总体检出率男性明显高于女性(P<0.01)。在不同年龄组中,3~6岁患者流感嗜血杆菌和肺炎链球菌的检出率、6~18岁患者肺炎支原体的检出率、>60岁患者耐甲氧西林葡萄球菌、嗜麦芽窄食单胞菌和肺炎克雷伯菌的检出率均明显高于其他组(P<0.05)。在不同季节组中,肺炎链球菌和肺炎衣原体好发于春季,肺炎支原体在秋节感染率最高,差异均具有统计学意义(P<0.05)。结论LAMP可快速检测出病原菌,为下呼吸道感染的预防及临床诊疗提供病原学依据。

Objective Loop mediated isothermal amplification(LAMP)was used to detect the distribution of pathogens in sputum samples,namely combined nucleic acid detection of respiratory pathogens(13 pairs),so as to provide provide reference for clinical accurate diagnosis and treatment.Methods A total of 1642 patients with lower respiratory tract infection admitted to Tongren City People’s Hospital from January to December in 2022 were selected.Each patient collected sputum specimens/bronchoalveolar for detection by using LAMP(13 pairs).The detection of pathogenic bacteria in respiratory tract and the relationship with sex,age and season were analyzed.Results The overall detection rate of 13 respiratory pathogens was significantly higher in males than in females(P<0.01);In different age groups,the detection rates of Haemophilus influenzae and Streptococcus pneumoniae in patients aged 3-6,Mycoplasma pneumoniae in patients aged 6-18,and methicillin-resistant Staphylococcus aureus,Streptococcus maltophilus,and Klebsiella pneumoniae in patients aged over 60 were significantly higher than those in other groups(P<0.05);In different seasonal groups,Streptococcus pneumoniae and Chlamydia pneumoniae were more prevalent in spring,while Mycoplasma pneumoniae had the highest infection rate in autumn,and the differences were statistically significant(P<0.05).Conclusion LAMP can be used to detect the pathogen rapidly and provide the basis for clinical diagnosis and treatment.