Comparative Evaluation of the Loop-Mediated Isothermal Amplification Assay for Detecting Pulmonary Tuberculosis

Ann Lab Med. 2018 Mar;38(2):119-124. doi: 10.3343/alm.2018.38.2.119.

Abstract

Background: Early detection of tuberculosis (TB) is challenging in resource-poor settings because of limited accessibility to molecular diagnostics. The aim of this study was to evaluate the performance of the loop-mediated isothermal amplification kit (TB-LAMP) for TB diagnosis compared with conventional and molecular tests.

Methods: A total of 290 consecutive sputum samples were collected from May till September, 2015. All samples were processed using the N-Acetyl-L-cysteine (NALC) NaOH method and tested by smear microscopy, solid and liquid culture, real-time PCR, and TB-LAMP.

Results: The sensitivity of TB-LAMP for smear-positive and smear-negative samples with culture positivity was 92.0% and 58.8%, respectively. TB-LAMP was positive in 14.9% of TB culture-negative samples; however, all those samples were also positive by real-time PCR. In addition, none of the samples positive for nontuberculous mycobacteria by culture were positive by TB-LAMP. The overall agreement between TB-LAMP and real-time PCR was good; however, the concordance rate was significantly lower for real-time PCR positive samples with Ct values of 30-35.

Conclusions: TB-LAMP could replace smear microscopy and increase TB diagnostic capacity when Xpert MTB/RIF is not feasible because of poor infrastructure.

Keywords: Real-time PCR; Sensitivity; Specificity; TB-LAMP; Tuberculosis.

Publication types

  • Comparative Study

MeSH terms

  • Culture Techniques
  • DNA, Bacterial / genetics
  • DNA, Bacterial / metabolism
  • Humans
  • Mycobacterium / genetics
  • Mycobacterium / isolation & purification
  • Nontuberculous Mycobacteria / genetics
  • Nontuberculous Mycobacteria / isolation & purification
  • Nucleic Acid Amplification Techniques / methods*
  • Real-Time Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Sputum / microbiology
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / microbiology

Substances

  • DNA, Bacterial