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学科主题: 临床医学
题名:
Etiologic Diagnosis of Lower Respiratory Tract Bacterial Infections Using Sputum Samples and Quantitative Loop-Mediated Isothermal Amplification
作者: Kang, Yu3,4; Deng, Rui3; Wang, Can5; Deng, Tao5; Peng, Peichao1,2; Cheng, Xiaoxing1,2; Wang, Guoqing6; Qian, Minping1,2; Gao, Huafang6; Han, Bei6; Chen, Yusheng7; Hu, Yinghui8; Geng, Rong9; Hu, Chengping10; Zhang, Wei11; Yang, Jingping12; Wan, Huanying13; Yu, Qin14; Wei, Liping15; Li, Jiashu16; Tian, Guizhen17; Wang, Qiuyue18; Hu, Ke19; Wang, Siqin20; Wang, Ruiqin21; Du, Juan22; He, Bei23; Ma, Jianjun24; Zhong, Xiaoning25; Mu, Lan26; Cai, Shaoxi27; Zhu, Xiangdong28; Xing, Wanli6; Yu, Jun4; Deng, Minghua1,2; Gao, Zhancheng3
刊名: PLOS ONE
发表日期: 2012-06-14
DOI: 10.1371/journal.pone.0038743
卷: 7, 期:6
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Multidisciplinary Sciences
研究领域[WOS]: Science & Technology - Other Topics
关键词[WOS]: PNEUMONIA ; ASSAY ; LAMP ; PCR ; DNA ; EXACERBATIONS ; COLONIZATION ; DISEASE ; VIRUS ; TESTS
英文摘要:

Etiologic diagnoses of lower respiratory tract infections (LRTI) have been relying primarily on bacterial cultures that often fail to return useful results in time. Although DNA-based assays are more sensitive than bacterial cultures in detecting pathogens, the molecular results are often inconsistent and challenged by doubts on false positives, such as those due to system- and environment-derived contaminations. Here we report a nationwide cohort study on 2986 suspected LRTI patients across P. R. China. We compared the performance of a DNA-based assay qLAMP (quantitative Loop-mediated isothermal AMPlification) with that of standard bacterial cultures in detecting a panel of eight common respiratory bacterial pathogens from sputum samples. Our qLAMP assay detects the panel of pathogens in 1047(69.28%) patients from 1533 qualified patients at the end. We found that the bacterial titer quantified based on qLAMP is a predictor of probability that the bacterium in the sample can be detected in culture assay. The relatedness of the two assays fits a logistic regression curve. We used a piecewise linear function to define breakpoints where latent pathogen abruptly change its competitive relationship with others in the panel. These breakpoints, where pathogens start to propagate abnormally, are used as cutoffs to eliminate the influence of contaminations from normal flora. With help of the cutoffs derived from statistical analysis, we are able to identify causative pathogens in 750 (48.92%) patients from qualified patients. In conclusion, qLAMP is a reliable method in quantifying bacterial titer. Despite the fact that there are always latent bacteria contaminated in sputum samples, we can identify causative pathogens based on cutoffs derived from statistical analysis of competitive relationship.

语种: 英语
项目资助者: Chinese Ministry of Science and Technology ; Chinese government
WOS记录号: WOS:000305347800015
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/51221
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Peking Univ, Sch Math Sci, Beijing 100871, Peoples R China
2.Peking Univ, Ctr Theoret Biol, Beijing 100871, Peoples R China
3.Capitalbio Corp, Dept Assay Dev, Beijing, Peoples R China
4.Fujian Prov Hosp, Dept Resp Med, Fuzhou, Peoples R China
5.Peking Univ, Peoples Hosp, Dept Resp & Crit Care Med, Beijing 100871, Peoples R China
6.Chinese Acad Sci, Beijing Inst Genom, Key Lab Genome Sci & Informat, Beijing, Peoples R China
7.Tsinghua Univ, Sch Med, Dept Biomed Engn, Beijing 100084, Peoples R China
8.Capital Med Univ, Beijing Childrens Hosp, Dept Resp Med, Beijing, Peoples R China
9.Capital Med Univ, Beijing Childrens Hosp, Dept Emergency Med, Beijing, Peoples R China
10.Cent S Univ, Xiangya Hosp, Dept Resp Med, Changsha, Hunan, Peoples R China
11.Nanchang Univ, Affiliated Hosp 1, Dept Resp Med, Nanchang, Peoples R China
12.Inner Mongolia Med Coll, Affiliated Hosp 3, Dept Resp & Crit Care Med, Baotou, Peoples R China
13.Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Resp Med, Shanghai 200030, Peoples R China
14.Lanzhou Univ, Hosp 1, Dept Resp Med, Lanzhou 730000, Peoples R China
15.Guangzhou Med Univ, Affiliated Hosp 3, Dept Resp Med, Guangzhou, Guangdong, Peoples R China
16.Xuzhou Med Coll, Lianyungang Peoples Hosp 1, Dept Resp Med, Lianyungang, Peoples R China
17.Mil Gen Hosp Beijing, Clin Sect 263, Dept Resp Med, Beijing, Peoples R China
18.China Med Univ, Affiliated Hosp 1, Inst Resp Dis, Shenyang, Peoples R China
19.Wuhan Univ, Renmin Hosp, Dept Resp Med, Wuhan 430072, Peoples R China
20.Henan Prov People Hosp, Dept Resp Med, Zhengzhou, Peoples R China
21.Tsinghua Univ, Affiliated Hosp 1, Dept Resp Med, Beijing 100084, Peoples R China
22.GuiYang Med Coll, Affiliated Hosp, Dept Resp Med, Guiyang, Peoples R China
23.Peking Univ, Hosp 3, Dept Resp Med, Beijing 100871, Peoples R China
24.Lanzhou Pulm Hosp, Dept Resp Med, Lanzhou, Peoples R China
25.Guangxi Med Univ, Affiliated Hosp 1, Dept Resp Med, Nanning, Peoples R China
26.Peking Univ, Space Cent Hosp, Dept Resp Med, Beijing 100871, Peoples R China
27.So Med Univ, Nanfang Hosp, Dept Resp Med, Guangzhou, Guangdong, Peoples R China
28.Univ Chicago, Dept Med, Sect Pulm & Crit Care Med MC 6076, Chicago, IL 60637 USA

Recommended Citation:
Kang, Yu,Deng, Rui,Wang, Can,et al. Etiologic Diagnosis of Lower Respiratory Tract Bacterial Infections Using Sputum Samples and Quantitative Loop-Mediated Isothermal Amplification[J]. PLOS ONE,2012,7(6).
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