Background/Purpose: Loop-mediated Isothermal Amplification (LAMP) is a promising nucleic-acid amplification assay. Prompt and accurate diagnosis of Osteoarticular tuberculosis (OATB) is required for early treatment, better patient outcomes and to prevent further joint destruction.The objective of the present study was to evaluate the LAMP test using IS6110 and MPB64 targets specific for Mycobacterium tuberculosis complex for rapid diagnosis of OATB. Comparison of results of IS6110 LAMP, MPB64 LAMP test with IS6110 PCR, culture and AFB smear

Methods:

LAMP  assay using six pairs of primers (each  for IS6110 and MPB64 ) specific for Mycobacterium tuberculosis were performed on synovial fluid/pus samples of 90 patients(10 confirmed,  80 suspected ) of  OATB  and 30 non tuberculosis controls subjects.

Results:

Overall LAMP test (using any of two targets) had sensitivity and specificity of 100% for confirmed OATB cases. In 80 clinically diagnosed but unconfirmed OATB cases LAMP was positive in 71/80 (88.75%) cases. Senstivity of IS6110 LAMP, MPB64 LAMP and IS6110 PCR in clinically unconfirmed OATB cases was 81.75% (65/80),  86.25% (69/80) and 72.5%( 58/80) respectively.  The overall sensitivity of microscopy, culture, IS6110 PCR, IS6110LAMP, MPB64 LAMP and LAMP test ( if any of the targets were used ) were 3.33%, 11.1%, 73.33%, 83.33%, 87.77% and 90%  respectively. Specificity of all the tests were100%.There were 4 cases which were missed by IS6110 LAMP assay and 2 cases were missed by MPB64 LAMP assay.

Conclusion:

LAMP assay using two targets is promising technique for rapid diagnosis of OATB in 60 minutes.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/multi-targeted-loop-mediated-isothermal-amplification-for-rapid-diagnosis-of-osteoarticular-tuberculosis-in-60-minutes-experience-from-north-india/