title: Diagnostic potential of multi-targeted LAMP (loop-mediated isothermal amplification) for osteoarticular tuberculosis.
abstract: Delay in diagnosing osteoarticular tuberculosis (OATB) contributes significantly to morbidity by causing disfiguration and neurological sequelae. The delay caused by conventional culture and the expertise and expense involved in other nucleic acid based tests, make LAMP (loop-mediated isothermal amplification) assay a favorable middle path. We evaluated LAMP assay using IS6110 and MPB64 for rapid diagnosis of OATB by comparing with IS6110 PCR and culture. LAMP assay was performed on 140 synovial fluid and pus samples (10 culture-positive proven cases, 80 culture-negative probable cases, and 50 negative controls) using three set of primer pairs each for IS6110 and MPB64. LAMP assay, using two-target approach, had an overall sensitivity and specificity of 90% and 100% in detecting OATB. Sensitivity of IS6110 PCR, IS6110 LAMP, and MPB64 LAMP was 80%, 100%, and 100%, respectively, for confirmed cases and 72.5%, 81.75%, and 86.25%, respectively, for probable cases. Six additional cases were picked using two-target approach. LAMP assay utilizing IS6110 and MPB64 is a cost-effective technique for an early and reliable diagnosis of OATB. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:361-365, 2017.
authors.affiliation: Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Kusum
authors.initials: K
authors.lastname: Sharma
authors.affiliation: Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Megha
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Nitya
authors.initials: N
authors.lastname: Batra
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Aman
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Mandeep Singh
authors.initials: MS
authors.lastname: Dhillon
mesh_terms: D016022:Case-Control Studies; D006801:Humans; D021141:Nucleic Acid Amplification Techniques; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis*
keywords: IS6110; MPB64; Mycobacterium tuberculosis; nucleic acid amplification