Diagnostic accuracy of a loop-mediated isothermal PCR assay for detection of Orientia tsutsugamushi during acute Scrub Typhus infection.
There is an urgent need to develop rapid and accurate point-of-care (POC) technologies for acute scrub typhus diagnosis in low-resource, primary health care settings to guide clinical therapy.In this study we present the clinical evaluation of loop-mediated isothermal PCR assay (LAMP) in the context...
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ftdoajarticles:oai:doaj.org/article:8563e15426c24c17ad57d42872d1739e 2023-05-15T15:09:24+02:00 Diagnostic accuracy of a loop-mediated isothermal PCR assay for detection of Orientia tsutsugamushi during acute Scrub Typhus infection. Daniel H Paris Stuart D Blacksell Pruksa Nawtaisong Kemajittra Jenjaroen Achara Teeraratkul Wirongrong Chierakul Vanaporn Wuthiekanun Pacharee Kantipong Nicholas P J Day 2011-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001307 https://doaj.org/article/8563e15426c24c17ad57d42872d1739e EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3172190?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001307 https://doaj.org/article/8563e15426c24c17ad57d42872d1739e PLoS Neglected Tropical Diseases, Vol 5, Iss 9, p e1307 (2011) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2011 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001307 2022-12-31T05:31:16Z There is an urgent need to develop rapid and accurate point-of-care (POC) technologies for acute scrub typhus diagnosis in low-resource, primary health care settings to guide clinical therapy.In this study we present the clinical evaluation of loop-mediated isothermal PCR assay (LAMP) in the context of a prospective fever study, including 161 patients from scrub typhus-endemic Chiang Rai, northern Thailand. A robust reference comparator set comprising following 'scrub typhus infection criteria' (STIC) was used: a) positive cell culture isolate and/or b) an admission IgM titer ≥1∶12,800 using the 'gold standard' indirect immunofluorescence assay (IFA) and/or c) a 4-fold rising IFA IgM titer and/or d) a positive result in at least two out of three PCR assays. Compared to the STIC criteria, all PCR assays (including LAMP) demonstrated high specificity ranging from 96-99%, with sensitivities varying from 40% to 56%, similar to the antibody based rapid test, which had a sensitivity of 47% and a specificity of 95%.The diagnostic accuracy of the LAMP assay was similar to realtime and nested conventional PCR assays, but superior to the antibody-based rapid test in the early disease course. The combination of DNA- and antibody-based detection methods increased sensitivity with minimal reduction of specificity, and expanded the timeframe of adequate diagnostic coverage throughout the acute phase of scrub typhus. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Chiang ENVELOPE(162.650,162.650,-77.967,-77.967) PLoS Neglected Tropical Diseases 5 9 e1307 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Daniel H Paris Stuart D Blacksell Pruksa Nawtaisong Kemajittra Jenjaroen Achara Teeraratkul Wirongrong Chierakul Vanaporn Wuthiekanun Pacharee Kantipong Nicholas P J Day Diagnostic accuracy of a loop-mediated isothermal PCR assay for detection of Orientia tsutsugamushi during acute Scrub Typhus infection. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
There is an urgent need to develop rapid and accurate point-of-care (POC) technologies for acute scrub typhus diagnosis in low-resource, primary health care settings to guide clinical therapy.In this study we present the clinical evaluation of loop-mediated isothermal PCR assay (LAMP) in the context of a prospective fever study, including 161 patients from scrub typhus-endemic Chiang Rai, northern Thailand. A robust reference comparator set comprising following 'scrub typhus infection criteria' (STIC) was used: a) positive cell culture isolate and/or b) an admission IgM titer ≥1∶12,800 using the 'gold standard' indirect immunofluorescence assay (IFA) and/or c) a 4-fold rising IFA IgM titer and/or d) a positive result in at least two out of three PCR assays. Compared to the STIC criteria, all PCR assays (including LAMP) demonstrated high specificity ranging from 96-99%, with sensitivities varying from 40% to 56%, similar to the antibody based rapid test, which had a sensitivity of 47% and a specificity of 95%.The diagnostic accuracy of the LAMP assay was similar to realtime and nested conventional PCR assays, but superior to the antibody-based rapid test in the early disease course. The combination of DNA- and antibody-based detection methods increased sensitivity with minimal reduction of specificity, and expanded the timeframe of adequate diagnostic coverage throughout the acute phase of scrub typhus. |
format |
Article in Journal/Newspaper |
author |
Daniel H Paris Stuart D Blacksell Pruksa Nawtaisong Kemajittra Jenjaroen Achara Teeraratkul Wirongrong Chierakul Vanaporn Wuthiekanun Pacharee Kantipong Nicholas P J Day |
author_facet |
Daniel H Paris Stuart D Blacksell Pruksa Nawtaisong Kemajittra Jenjaroen Achara Teeraratkul Wirongrong Chierakul Vanaporn Wuthiekanun Pacharee Kantipong Nicholas P J Day |
author_sort |
Daniel H Paris |
title |
Diagnostic accuracy of a loop-mediated isothermal PCR assay for detection of Orientia tsutsugamushi during acute Scrub Typhus infection. |
title_short |
Diagnostic accuracy of a loop-mediated isothermal PCR assay for detection of Orientia tsutsugamushi during acute Scrub Typhus infection. |
title_full |
Diagnostic accuracy of a loop-mediated isothermal PCR assay for detection of Orientia tsutsugamushi during acute Scrub Typhus infection. |
title_fullStr |
Diagnostic accuracy of a loop-mediated isothermal PCR assay for detection of Orientia tsutsugamushi during acute Scrub Typhus infection. |
title_full_unstemmed |
Diagnostic accuracy of a loop-mediated isothermal PCR assay for detection of Orientia tsutsugamushi during acute Scrub Typhus infection. |
title_sort |
diagnostic accuracy of a loop-mediated isothermal pcr assay for detection of orientia tsutsugamushi during acute scrub typhus infection. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2011 |
url |
https://doi.org/10.1371/journal.pntd.0001307 https://doaj.org/article/8563e15426c24c17ad57d42872d1739e |
long_lat |
ENVELOPE(162.650,162.650,-77.967,-77.967) |
geographic |
Arctic Chiang |
geographic_facet |
Arctic Chiang |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 5, Iss 9, p e1307 (2011) |
op_relation |
http://europepmc.org/articles/PMC3172190?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001307 https://doaj.org/article/8563e15426c24c17ad57d42872d1739e |
op_doi |
https://doi.org/10.1371/journal.pntd.0001307 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
5 |
container_issue |
9 |
container_start_page |
e1307 |
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1766340603142995968 |