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Title: Accuracy of loop-mediated isothermal amplification for diagnosis of human leptospirosis in Thailand
Authors: Piengchan Sonthayanon
Wirongrong Chierakul
Vanaporn Wuthiekanun
Janjira Thaipadungpanit
Thareerat Kalambaheti
Siriphan Boonsilp
Premjit Amornchai
Lee D. Smythe
Direk Limmathurotsakul
Nicholas P. Day
Sharon J. Peacock
Mahidol University
Organisation Mondiale de la Sante
Nuffield Department of Clinical Medicine
University of Cambridge
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Apr-2011
Citation: American Journal of Tropical Medicine and Hygiene. Vol.84, No.4 (2011), 614-620
Abstract: There is a lack of diagnostic tests for leptospirosis in technology-restricted settings. We developed loop-mediated isothermal amplification (LAMP) specific for the 16S ribosomal RNA gene (rrs) of pathogenic and intermediate group Leptospira species. The lower limit of detection was 10 genomic equivalents/reaction, and analytical specificity was high; we observed positive reactions for pathogenic/intermediate groups and negative reactions for non-pathogenic Leptospira species and other bacterial species. We evaluated this assay in Thailand by using a case-control study of 133 patients with laboratory-proven leptospirosis and 133 patients with other febrile illnesses. Using admission blood, we found that the rrs LAMP showed positive results in 58 of 133 cases (diagnostic sensitivity = 43.6, 95% confidence interval [CI] = 35.0-52.5) and in 22 of 133 controls (diagnostic specificity = 83.5, 95% CI = 76.0-89.3). Sensitivity was high for 39 patients who were culture positive for Leptospira spp. (84.6, 95% CI = 69.5-94.1). The rrs LAMP can provide an admission diagnosis in approximately half of patients with leptospirosis, but its clinical utility is reduced by a lower specificity. Copyright © 2011 by The American Society of Tropical Medicine and Hygiene.
ISSN: 00029637
Appears in Collections:Scopus 2011-2015

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