A Comprehensive Evaluation of a Loop-Mediated Isothermal Amplification Assay for the Diagnosis of Pulmonary Tuberculosis in Children Using Bronchoalveolar Lavage Fluid

Abstract

Objective Using TB-LAMP for diagnosing pediatric PTB, however, still requires systematic evaluation. Here, we evaluated TB-LAMP performance alone and in combination with conventional assays for diagnosing PTB in Chinese children, using mycobacterial culture or CCRS (the composite clinical reference standard) as references. Design or Methods BALF samples were collected at Shenyang Tenth People’s Hospital from 251 children susceptible to TB infection with indications for fiberoptic bronchoscopy. Results When mycobacterial culture was the reference, TB-LAMP used alongside smear microscopy doubled sensitivity for detecting pediatric PTB compared with smear microscopy alone (82.5% vs 40.0%). When CCRS was the reference, AFB microscopy, MTB culture, and TB-LAMP had sensitivities of 16.5%, 30.1%, and 51.1%, respectively, and specificities of 98.2%, 100.0%, and 99.1%. Combining MTB culture with TB-LAMP gave a sensitivity of 61.1% and specificity of 96.6%. TB-LAMP identified 39.3% and 43.2% of cases with negative MTB culture or AFB microscopy results. Conclusion TB-LAMP using BALF samples provided faster results, allowing early and accurate PTB diagnosis. Our findings provide insights for optimizing diagnostic algorithms for pediatric PTB.

Evaluation of nucleotide MALDI-TOF MS on bronchoalveolar lavage fluid for pulmonary Tuberculosis: experience from a tertiary hospital in southwestern China

“…BALF is the most common used respiratory sample type for the diagnosis of PTB besides sputum, which is also preferred by clinicians due to its closer proximity to the lesion. Multiple studies have reported the capability of different molecular tests to diagnose PTB in BALFs, such as Xpert MTB/RIF assay, SAT-TB, LAMP, next-generation metagenome sequencing, nanopore sequencing, etc., with sensitivities raging from 45.18-94.4% [21][22][23][24][25][26] . The comparatively lower results of the Xpert MTB/RIF assay in our study than those previously studies may be related to several factors, including study site, sample source, and the operator, suggesting that we need to improve the level of testing within our hospital.…”

Investigation into the application of remimazolamin conjunction with low-dose propofolfor pediatricfiberoptic bronchoscopy

“…In contrast, propofol is renowned for its rapid onset and short duration of action. It facilitates swift induction and recovery from anesthesia, making it suitable for procedures requiring promptcompletion [11][12][13] . Yet, propofol can induce significant cardiovascular and respiratory depression, especially in pediatric patients 14 .…”