Publication: Accuracy of loop-mediated isothermal amplification for diagnosis of human leptospirosis in Thailand
2
Issued Date
2011-04-01
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ISSN
00029637
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2-s2.0-79958007507
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.84, No.4 (2011), 614-620
Suggested Citation
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 Accuracy of loop-mediated isothermal amplification for diagnosis of human leptospirosis in Thailand. American Journal of Tropical Medicine and Hygiene. Vol.84, No.4 (2011), 614-620. doi:10.4269/ajtmh.2011.10-0473 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/12062
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Title
Accuracy of loop-mediated isothermal amplification for diagnosis of human leptospirosis in Thailand
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.