Diagnostic Accuracy of Loop-Mediated Isothermal DNA Amplification (LAMP) Assay for Detection of Clostridium difficile Infection (CDI): a Meta-Analysis
Methods: We searched MEDLINE and 4 other databases to identify diagnostic accuracy studies that compared LAMP with cell culture cytotoxicity neutralization assay (CCCNA) or anaerobic toxigenic culture (TC) of C. difficilefrom database inception to 2013. Screening for inclusion, data extraction, and quality assessment were carried out independently by 2 investigators and disagreements resolved. Data in the tables, figures, or text were independently extracted by 2 authors. We used the Mantel-Haenszel (MH) random effects model to calculate summary receiver operating characteristic curves, diagnostic odds ratios and their 95% CIs.
Results: A search of the databases yielded 16 studies (6,798 samples) that met the inclusion criteria. When TC was used as the gold standard (n= 14), the pooled sensitivity was 0.95 (95% CI, 0.93-0.96; I2 = 37.7); specificity, 0.98 (95% CI, 0.97-0.98; I2 = 94); and diagnostic odds ratio, 1180 (95% CI, 537-2592; I2 = 62.2). With CCCNA as a gold standard (n=3), the pooled sensitivity was 0.90 (95% CI, 0.82-0.95; I2 = 64.8); specificity, 0.95 (95% CI, 0.92-0.97; I2 = 94.8); and diagnostic odds ratio, 346 (95% CI, 95-1255; I2= 0).
Conclusion: LAMP appears to have high diagnostic accuracy for identifying CDI. Although there was high heterogeneity among the studies, this meta-analysis suggests that LAMP is a useful diagnostic tool with high sensitivity and specificity for detecting CDI.
C. Pant, None
V. Pasupuleti, None
A. V. Hernandez, None
C. J. Donskey, None
A. Deshpande, None
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