Reliability of direct varicella zoster virus loop-mediated isothermal amplification method for rapid diagnosis of breakthrough varicella
Reliability of direct varicella zoster virus loop-mediated isothermal amplification method for rapid diagnosis of breakthrough varicella
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DOI：
10.1016/j.jcv.2019.07.009
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发表时间：
2019-10-01
影响因子：
8.8
通讯作者：
Yamaguchi, Nobuyuki
中科院分区：
文献类型：
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作者：
Higashimoto, Yuki;Kawamura, Yoshiki;Yamaguchi, Nobuyuki
背景：由于突破性水痘（BV）患者症状较轻，临床诊断较困难。在疫苗覆盖率较高的地区，由于水痘病毒偶尔发生，因此需要进行即时检测以控制水痘爆发。在本研究中，评估了水痘带状疱疹病毒（VZV）环介导等温扩增（LAMP）用于快速诊断 BV 的可靠性。研究设计：分析了从疑似水痘患者收集的总共 328 份拭子样本。对于水痘的实验室诊断，使用从拭子样本中提取的 DNA 进行 VZV 实时 PCR。未提取DNA的拭子样本用于VZV-LAMP（direct-LAMP）。结果：实时PCR诊断出VZV感染285例，其中自然水痘105例，BV 180例。在 285 例病例中，通过直接 LAMP 检测到了 250 例（87.8%）VZV DNA。 BV 患者的发热情况和持续时间、皮疹次数和水痘带状疱疹病毒 DNA 载量均显着低于自然水痘患者。 direct-LAMP诊断水痘和BV的敏感性分别为93.3%和84.4%。结论：Direct-LAMP与实时PCR相比具有成本低、简便、快速等优点，被认为可用于BV的快速诊断。
Background: Since patients with breakthrough varicella (BV) have mild symptoms, clinical diagnosis is difficult. In high vaccine coverage area, as BV occurs sporadically, point of care test is required for controlling varicella outbreak. In this study, the reliability of varicella zoster virus (VZV)-loop mediated isothermal amplification (LAMP) was evaluated for the rapid diagnosis of BV.Study design: A total of 328 swab samples collected from patients with suspected varicella were analyzed. For the laboratory diagnosis of varicella, VZV real-time PCR was carried out using DNA extracted from swab samples. Swab samples without DNA extraction were used for VZV-LAMP(direct-LAMP).Results: VZV infection was diagnosed by real-time PCR in 285 cases, including 105 natural varicella cases and 180 BV cases. VZV DNA was detected in 250 (87.8%) of the 285 cases by direct-LAMP. The presence and duration of fever, number of skin eruptions, and VZV DNA load were significantly lower in BV than natural varicella. The sensitivity of direct-LAMP for the diagnosis of varicella and BV was 93.3% and 84.4%, respectively.Conclusions: Direct LAMP was considered to be useful for rapid diagnosis of BV as it has several advantages such as low cost, ease and rapidity, as compared to real time PCR.