Head-to-Head Comparison of TB-LAMP, Mycobacterial Culture and Adenosine Deaminase for Diagnosis of Pleural Tuberculosis in China

  • Lei Chen Department of Laboratory Medicine, The Second People's Hospital of Weifang
  • Aiyan Wang Department of Laboratory Medicine, People's Hospital of Fangzi District
  • Juan Cheng Department of Laboratory Medicine, The Second People's Hospital of Weifang
  • Shouhua Han Department of Laboratory Medicine, The Second People's Hospital of Weifang
  • Guangfu Liu Department of Laboratory Medicine, The Second People's Hospital of Weifang
  • Zhaobao Pan Department of Laboratory Medicine, The Second People's Hospital of Weifang
DOI: https://doi.org/10.18686/aem.v12i2.382
Keywords: Pleural Tuberculosis, Diagnosis, Lamp, Adenosine Deaminase

Abstract

Objectives: The objective of the prospective single-center study was to investigate the diagnostic performance of Loop-Mediated Amplification test (TB-LAMP), mycobacterial culture and adenosine deaminase (ADA) for diagnosing pleural tuberculosis (TB) from the pleural effusions in a TB-endemic setting. Methods: We retrospectively analyzed patients suspected of having pleural TB in Weifang between March 2018 and October 2019. The PE samples were evaluated by smear microscopy, mycobacterial culture, TB-LAMP and ADA assay. Results: Overall, 170 patients with suggestive of pleural TB were retrospectively reviewed in this study, of which 125 were diagnosed as pleural TB. Among 125 pleural TB cases, 52 cases were identified by TB-LAMP, resulting in a sensitivity of 41.6%. When combing MGIT and TB-LAMP, 13 additional positive cases were detected compared to MGIT culture alone, demonstrating a sensitivity of 56.8%. The mean ADA levels were corelated with age, and the mean ADA value of <35 years group was significantly higher than that of ≥70 years group (p=0.0214). Conclusion: In conclusion, our data demonstrate the promising effectiveness of TB-LAMP in detection of MTB in concentrated PE specimens. The ADA levels are decreased with advanced age, highlighting the urgent need for confirmation of different cut-off values for various age group.

References

[1] Abrao FC, De Abreu IR, Miyake DH, Busico MA, Younes RN. Role of adenosine deaminase and the influence of age on the diagnosis of pleural tuberculosis. Int J Tuberc Lung Dis 2014;18(11):1363-9.

[2] Blakemore R, Story E, Helb D, Kop J, Banada P, Owens MR, et al. Evaluation of the analytical performance of the Xpert MTB/RIF assay. J Clin Microbiol 2010; 48(7): 2495-501.

[3] Iwamoto T, Sonobe T, Hayashi K. Loop-mediated isothermal amplification for direct detection of Mycobacterium tuberculosis complex, M. avium, and M. intracellulare in sputum samples. J Clin Microbiol 2003; 41(6): 2616-22.

[4] Keng LT, Shu CC, Chen JY, Liang SK, Lin CK, Chang LY, et al. Evaluating pleural ADA, ADA2, IFN-gamma and IGRA for diagnosing tuberculous pleurisy. J Infect 2013;67(4):294-302.

[5] Liu R, Li J, Tan Y, Shang Y, Li Y, Su B, et al. Multicenter evaluation of the acid-fast bacillus smear, mycobacterial culture, Xpert MTB/RIF assay, and adenosine deaminase for the diagnosis of tuberculous peritonitis in China. Int J Infect Dis 2020;90:119-24.

[6] Pang Y, An J, Shu W, Huo F, Chu N, Gao M, et al. Epidemiology of Extrapulmonary Tuberculosis among Inpatients, China, 2008-2017. Emerg Infect Dis 2019; 25(3):457-64.

[7] Parida M, Sannarangaiah S, Dash PK, Rao PV, Morita K. Loop mediated isothermal amplification (LAMP): a new generation of innovative gene amplification technique; perspectives in clinical diagnosis of infectious diseases. Rev Med Virol 2008;18(6):407-21.

[8] Solari L, Soto A, Van der Stuyft P. Development of a clinical prediction rule for the diagnosis of pleural tuberculosis in Peru. Int J Infect Dis 2018;69:103-7.

[9] Weyand CM, Goronzy JJ. Aging of the Immune System. Mechanisms and Therapeutic Targets. Ann Am Thorac Soc 2016;13 Suppl 5:S422-S8.

[10] World Health Organization. The use of loop-mediated isothermal amplification (TB-LAMP) for the diagnosis of pulmonary tuberculosis. Geneva: World Health Organization, 2016.

[11] World Health Organization. Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children. Policy update. Geneva: World Health Organization, 2013.
Published
2023-06-01
Issue
Vol 12, No 2 (2023)
Section
Original Research Article

Copyright (c) 2023 Lei Chen, Aiyan Wang, Juan Cheng, Shouhua Han, Guangfu Liu, Zhaobao Pan

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Authors submitting to USP journals agree to publish their manuscript under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) where authors agree to allow third parties to share their work (copy, distribute, transmit) and to adapt it, under the condition that the authors are given credit, and that in the event of reuse or distribution, the terms of this license are made clear

Authors retain copyright of their work, with first publication rights (online and print) granted to Universe Scientific Publishing or the owner of the journal in question.