■人类真菌感染,特别是由念珠菌和曲霉引起的,已成为主要的公共卫生负担。常规诊断的长周转时间和差的灵敏度是更快诊断人类真菌病原体的主要障碍。
■为了克服这些问题,已经开发了基于分子的诊断。它们提供增强的灵敏度,但需要复杂的基础设施,熟练的人力,并且仍然昂贵。在这种情况下,环介导等温扩增(LAMP)分析代表了一种有希望的替代方法,可以促进视觉读出。然而,为了根除真菌感染,必须准确检测所有形式的真菌。因此,迫切需要快速的替代测试方法,准确,便于广泛采用。因此,本研究的目的是使用科学数据库进行荟萃分析,以评估LAMP在根据PRISMA指南检测一组人类真菌病原体中的诊断效率。PubMed,谷歌学者,科学直接,Scopus,BioRxiv,还有MedRxiv.
■从各种关于真菌诊断的研究报告来看,只有9篇文章被鉴定为符合基于LAMP的诊断标准.通过这个荟萃分析,发现大多数研究是在中国和日本进行的,痰和血液是最常用的LAMP检测标本。收集的数据强调ITS基因和基于荧光的检测被列为最常用的靶标和方法。荟萃分析的合并敏感性值介于0.71和1.0之间,森林地块和SROC(受试者工作特征摘要)曲线显示出合并特异性值介于0.13和1.0之间,置信区间为95%,分别。符合条件的研究的准确率和准确率大多在70%至100%和68%至100%之间变化,分别。进行了基于QUADAS-2(诊断准确性研究质量评估)的偏倚和适用性的质量评估,该评估描述了低偏倚风险和适用性问题。一起,LAMP技术可以被认为是当前诊断的可行替代方案,考虑到高真菌负担,可以在低资源地区进行快速测试。
UNASSIGNED: Human fungal infections particularly caused by Candida and Aspergillus have emerged as major public health burden. Long turnaround time and poor sensitivity of the conventional diagnostics are the major impediments for faster diagnosis of human fungal pathogens.
UNASSIGNED: To overcome these issues, molecular-based diagnostics have been developed. They offer enhanced sensitivity but require sophisticated infrastructure, skilled manpower, and remained expensive. In that context, loop-mediated isothermal amplification (
LAMP) assay represents a promising alternative that facilitates visual read outs. However, to eradicate fungal infections, all forms of fungi must be accurately detected. Thus, a need for alternative testing methodologies is imperative that should be rapid, accurate and facilitate widespread adoption. Therefore, the aim of the present study is to conduct a meta-analysis to assess the diagnostic efficiency of
LAMP in the detection of a panel of human fungal pathogens following PRISMA guidelines using scientific databases viz. PubMed, Google Scholar, Science Direct, Scopus, BioRxiv, and MedRxiv.
UNASSIGNED: From various studies reported on the diagnosis of fungi, only 9 articles were identified as eligible to meet the criteria of
LAMP based diagnosis. Through this meta-analysis, it was found that most of the studies were conducted in China and Japan with sputum and blood as the most common specimens to be used for
LAMP assay. The collected data underlined that ITS gene and fluorescence-based detections ranked as the most used target and method. The pooled sensitivity values of meta-analysis ranged between 0.71 and 1.0 and forest plot and SROC (summary receiver operating characteristic) curve revealed a pooled specificity values between 0.13 and 1.0 with the confidence interval of 95%, respectively. The accuracy and precision rates of eligible studies mostly varied between 70 to 100% and 68 to 100%, respectively. A quality assessment based on QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) of bias and applicability was conducted which depicted low risk of bias and applicability concerns. Together,
LAMP technology could be considered as a feasible alternative to current diagnostics considering high fungal burden for rapid testing in low resource regions.