Clinical application of loop-mediated isothermal amplification chip in pathogen detection for patients with acute exacerbation of chronic obstructive pulmonary disease_West China Medical Journal

Authors：

TAO Jianxia , YE Fei , LI Xiaohan ,  KANG Mei

Department of Laboratory Medicine, West China Hospital, Sichuan University; Clinical Laboratory Medicine Research Center, West China Hospital, Sichuan University; Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

KANG Mei, Email: kangmei@sina.com

Keywords：

Acute exacerbation of chronic obstructive pulmonary disease; loop-mediated isothermal amplification chip; pathogen detection; bacterial culture

DOI：

10.7507/1002-0179.202507280

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Objective To evaluate the clinical value of loop-mediated isothermal amplification chip (LAMP) in pathogen detection for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods We retrospectively analyzed qualified lower respiratory tract specimens from AECOPD patients treated at West China Hospital of Sichuan University between February 2021 and December 2022. Both LAMP and conventional culture methods were performed simultaneously to compare their positive detection rates, pathogen profiles, and diagnostic consistency (Kappa test). Subgroup analysis was further performed based on the site of infection [community acquired pneumonia (CAP) vs. hospital acquired pneumonia (HAP)]. Results A total of 159 patients were included. Among the 159 specimens, the overall positive rate of LAMP was significantly higher than that of the culture method [36.5% (58/159) vs. 30.2% (48/159)]. Significant differences in positive rates were observed for Acinetobacter baumannii (13.8% vs. 11.3%) and Pseudomonas aeruginosa (9.4% vs. 7.5%). The LAMP chip method detected mixed infections in 13 cases and additionally identified 6 cases of Mycobacterium tuberculosis complex. Consistency analysis between the two methods for respiratory pathogen detection showed statistically significant agreement for Escherichia coli, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, and Haemophilus influenzae (P<0.05). In the CAP subgroup, only the LAMP method exclusively detected Mycobacterium tuberculosis complex (5.6%), Streptococcus pneumoniae (2.8%), Staphylococcus aureus (0.9%), and Escherichia coli (1.9%). In the HAP subgroup, only the LAMP method exclusively detected MRSA (3.8%). Significant differences in positive rates between the two methods for multiple pathogens were observed in both CAP and HAP groups (P<0.05). Conclusions For pathogen detection in AECOPD patients, the LAMP method offers rapid (only 2 hours), simple and efficient testing, particularly valuable for mixed infection screening. It shows advantages in detecting fastidious pathogens in community-acquired pneumonia, and providing guiding significance for early precise anti-infective therapy.

Citation： TAO Jianxia, YE Fei, LI Xiaohan, KANG Mei. Clinical application of loop-mediated isothermal amplification chip in pathogen detection for patients with acute exacerbation of chronic obstructive pulmonary disease. West China Medical Journal, 2026, 41(4): 581-586. doi: 10.7507/1002-0179.202507280 Copy

1.	中華醫學會呼吸病學分會慢性阻塞性肺疾病學組, 中國醫師協會呼吸醫師分會慢性阻塞性肺疾病工作委員會. 慢性阻塞性肺疾病診治指南(2021 年修訂版). 中華結核和呼吸雜志, 2021, 44(3): 170-205.
2.	Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med, 2008, 359(22): 2355-2365.
3.	Li Y, Xie L, Xin S, et al. Values of procalcitonin and C-reactive proteins in the diagnosis and treatment of chronic obstructive pulmonary disease having concomitant bacterial infection. PakJ Med Sci, 2017, 33(3): 566-569.
4.	許俊. 慢性阻塞性肺疾病急性加重期與慢性阻塞性肺疾病并發社區獲得性肺炎患者的臨床對比. 醫學信息, 2018, 31(22):118-120.
5.	羅德云, 陳菊屏. NLR 聯合降鈣素原對 COPD 急性加重期細菌感染患者預后價值探討. 天津醫藥, 2019, 47(10): 1054-1057.
6.	常春, 姚婉貞, 陳亞紅, 等. 血清降鈣素原對慢性阻塞性肺疾病加重期患者下呼吸道細菌感染的診斷價值//中華醫學會第七次全國呼吸病學術會議暨學習班論文匯編. 北京, 2006. 北京: 中華醫學會呼吸病學分會.
7.	Yu AC, Vatcher G, Yue X, et al. Nucleic acid-based diagnostics for infectious diseases in public health affairs. Front Med, 2012, 6(2): 173-186.
8.	Hou J, Wu H, Zeng X, et al. Clinical evaluation of the loop-mediated isothermal amplification assay for the detection of common lower respiratory pathogens in patients with respiratory symptoms. Medicine (Baltimore), 2018, 97(51): e13660.
9.	Kubota R, Jenkins DM. Real-time duplex applications of loop-mediated AMPlification (LAMP) by assimilating probes. Int J Mol Sci, 2015, 16(3): 4786-4799.
10.	田苗, 王鵬新, 嚴泰來, 等. Kappa 系數的修正及在干旱預測精度及一致性評價中的應用. 農業工程學報, 2012, 28(24): 1-7.
11.	Wang C , Xu J , Yang L , et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
12.	Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2095-2128.
13.	Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PloS Med, 2006, 3(11): e442.
14.	Notomi T, Okayama H, Masubuchi H, et al. Loop-mediated isothermal amplification of DNA. Nucleic Acids Res, 2000, 28(12): E63.
15.	Yan L, Zhou J, Zheng Y, et al. Isothermal amplified detection of DNA and RNA. Mol BioSyst, 2014, 10(5): 970-1003.
16.	李美, 陳飄飄, 應斌武. 基于環介導等溫擴增技術的即時檢測在檢驗醫學中的應用. 中華檢驗醫學雜志, 2021, 44(9): 776-780.
17.	顧錦, 郭會, 周圍, 等. 環介導等溫擴增技術在下呼吸道感染常見病原體檢測中的應用. 臨床檢驗雜志, 2021, 39(1): 12-16.
18.	張勇, 付傳發, 寇英華, 等. 不同年齡人群慢性阻塞性肺疾病急性加重期病原菌分布及耐藥性研究. 臨床肺科雜志, 2017, 22(10): 1847-1850.
19.	查軍. AECOPD 致病菌分布與耐藥性研究. 臨床醫藥文獻電子雜志, 2017, 4(76): 14872-14873.
20.	唐睿珠, 羅正瓊, 徐秋月, 等. 呼吸道病原體核酸恒溫擴增芯片十三聯檢在下呼吸道感染常見病原體基因中的檢測. 昆明醫科大學學報, 2017, 38(1): 8-12.
21.	衛清, 李荷楠, 彭秋生, 等. 環介導恒溫擴增技術在呼吸道感染常見細菌臨床檢測中的應用評價. 微生物學通報, 2022, 49(5): 1811-1822.
22.	徐曉娜, 孫昕, 王莉莉, 等. LAMP 法和傳統培養法檢測下呼吸道感染常見病原體的比較研究. 安徽醫學, 2021, 42(7): 802-805.
23.	王詠紅, 郭雅潔, 陳玉瑩, 等. 恒溫擴增芯片法在兒童下呼吸道感染性疾病中的應用價值評估. 中國循證兒科雜志, 2018, 13(3): 176-179.

1. 中華醫學會呼吸病學分會慢性阻塞性肺疾病學組, 中國醫師協會呼吸醫師分會慢性阻塞性肺疾病工作委員會. 慢性阻塞性肺疾病診治指南(2021 年修訂版). 中華結核和呼吸雜志, 2021, 44(3): 170-205.
2. Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med, 2008, 359(22): 2355-2365.
3. Li Y, Xie L, Xin S, et al. Values of procalcitonin and C-reactive proteins in the diagnosis and treatment of chronic obstructive pulmonary disease having concomitant bacterial infection. PakJ Med Sci, 2017, 33(3): 566-569.
4. 許俊. 慢性阻塞性肺疾病急性加重期與慢性阻塞性肺疾病并發社區獲得性肺炎患者的臨床對比. 醫學信息, 2018, 31(22):118-120.
5. 羅德云, 陳菊屏. NLR 聯合降鈣素原對 COPD 急性加重期細菌感染患者預后價值探討. 天津醫藥, 2019, 47(10): 1054-1057.
6. 常春, 姚婉貞, 陳亞紅, 等. 血清降鈣素原對慢性阻塞性肺疾病加重期患者下呼吸道細菌感染的診斷價值//中華醫學會第七次全國呼吸病學術會議暨學習班論文匯編. 北京, 2006. 北京: 中華醫學會呼吸病學分會.
7. Yu AC, Vatcher G, Yue X, et al. Nucleic acid-based diagnostics for infectious diseases in public health affairs. Front Med, 2012, 6(2): 173-186.
8. Hou J, Wu H, Zeng X, et al. Clinical evaluation of the loop-mediated isothermal amplification assay for the detection of common lower respiratory pathogens in patients with respiratory symptoms. Medicine (Baltimore), 2018, 97(51): e13660.
9. Kubota R, Jenkins DM. Real-time duplex applications of loop-mediated AMPlification (LAMP) by assimilating probes. Int J Mol Sci, 2015, 16(3): 4786-4799.
10. 田苗, 王鵬新, 嚴泰來, 等. Kappa 系數的修正及在干旱預測精度及一致性評價中的應用. 農業工程學報, 2012, 28(24): 1-7.
11. Wang C , Xu J , Yang L , et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
12. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2095-2128.
13. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PloS Med, 2006, 3(11): e442.
14. Notomi T, Okayama H, Masubuchi H, et al. Loop-mediated isothermal amplification of DNA. Nucleic Acids Res, 2000, 28(12): E63.
15. Yan L, Zhou J, Zheng Y, et al. Isothermal amplified detection of DNA and RNA. Mol BioSyst, 2014, 10(5): 970-1003.
16. 李美, 陳飄飄, 應斌武. 基于環介導等溫擴增技術的即時檢測在檢驗醫學中的應用. 中華檢驗醫學雜志, 2021, 44(9): 776-780.
17. 顧錦, 郭會, 周圍, 等. 環介導等溫擴增技術在下呼吸道感染常見病原體檢測中的應用. 臨床檢驗雜志, 2021, 39(1): 12-16.
18. 張勇, 付傳發, 寇英華, 等. 不同年齡人群慢性阻塞性肺疾病急性加重期病原菌分布及耐藥性研究. 臨床肺科雜志, 2017, 22(10): 1847-1850.
19. 查軍. AECOPD 致病菌分布與耐藥性研究. 臨床醫藥文獻電子雜志, 2017, 4(76): 14872-14873.
20. 唐睿珠, 羅正瓊, 徐秋月, 等. 呼吸道病原體核酸恒溫擴增芯片十三聯檢在下呼吸道感染常見病原體基因中的檢測. 昆明醫科大學學報, 2017, 38(1): 8-12.
21. 衛清, 李荷楠, 彭秋生, 等. 環介導恒溫擴增技術在呼吸道感染常見細菌臨床檢測中的應用評價. 微生物學通報, 2022, 49(5): 1811-1822.
22. 徐曉娜, 孫昕, 王莉莉, 等. LAMP 法和傳統培養法檢測下呼吸道感染常見病原體的比較研究. 安徽醫學, 2021, 42(7): 802-805.
23. 王詠紅, 郭雅潔, 陳玉瑩, 等. 恒溫擴增芯片法在兒童下呼吸道感染性疾病中的應用價值評估. 中國循證兒科雜志, 2018, 13(3): 176-179.

West China Medical Journal

Clinical application of loop-mediated isothermal amplification chip in pathogen detection for patients with acute exacerbation of chronic obstructive pulmonary disease

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