Accuracy of loop-mediated isothermal amplification for the diagnosis of Clostridium difficile infection: a systematic review.
Loop-mediated isothermal DNA amplification (LAMP) is currently used as standalone diagnostic test for C. difficile infection (CDI). We assessed the diagnostic accuracy of LAMP for the diagnosis of CDI. We searched 5 databases to identify studies that compared LAMP with culture cytotoxicity neutralization assay or anaerobic toxigenic culture (TC) of C. difficile. We used the random-effects model to calculate pooled sensitivities, specificities, diagnostic odds ratios, and their 95% confidence intervals (CIs). The search of the databases yielded 16 studies (6979 samples) that met inclusion criteria. When TC was used as the gold standard (6572 samples), bivariate analysis yielded a mean sensitivity of 0.95 (95% CI, 0.93-0.97; I(2)=67.4) and a mean specificity of 0.99 (95% CI, 0.96-1.00; I(2)=97.0). LAMP is a useful diagnostic tool with high sensitivity and specificity for detecting CDI. The results should, however, be interpreted only in the presence of clinical suspicion and symptoms of CDI.
Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Aaron
A
Lloyd
Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Vinay
V
Pasupuleti
Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Priyaleela
P
Thota
Department of Gastroenterology, University of Kansas Medical Center, Kansas City, KS, USA.
Chaitanya
C
Pant
Department of Internal Medicine, Geisinger Medical Center, Danville, PA, USA.
David D K
DD
Rolston
Health Outcomes and Clinical Epidemiology Section, Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Postgraduate and Medical Schools, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.
Adrian V
AV
Hernandez
Faculty of Human Medicine, Postgraduate Section, Universidad de San Martin de Porres, Lima, Peru.
Vicente A
VA
Benites-Zapata
Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
Thomas G
TG
Fraser
Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, USA; Geriatric Research Education and Clinical Center, Cleveland VA Medical Center, Cleveland, OH, USA.
Curtis J
CJ
Donskey
Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA; Medicine Institute Center for Value Based Care Research, Cleveland Clinic, Cleveland, OH, USA. Electronic address: abhishekdp@gmail.com.
Abhishek
A
Deshpande
D016360:Clostridioides difficile / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000175:diagnosis* / Q000382:microbiology; D003967:Diarrhea / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D012680:Sensitivity and Specificity
C. difficile; CDI; Diagnostic accuracy; LAMP; Sensitivity; Specificity