In this study, we conducted a thorough search by the application of strict screening criteria and finally included seven articles. Nine 2*2 tables on the diagnosis of Mycoplasma Pneumoniae by LAMP were carried out. The results of the quality evaluation showed that the combined sensitivity and specificity of LAMP in the diagnosis of Mycoplasma Pneumoniae were 0.90 and 0.98; the negative likelihood ratio, positive likelihood ratio and diagnostic ratio were 0.10, 31.25, and 399.32, respectively. The SROC AUC was 0.9892, which indicated high sensitivity and specificity of LAMP in the diagnosis of Mycoplasma Pneumoniae. The SROC curve was close to the upper left corner; that is, the area under the curve was extremely large. Thus, LAMP is highly accurate in the diagnosis of Mycoplasma Pneumoniae. According to the analysis of the four studies included in the analysis conducted by the STATICS software, the bias coefficient was P = 0.108 > 0.05, indicating that the probability of publication bias was subtle.
PCR and culture are widely used as the gold standard for the detection of Mycoplasma Pneumoniae, but there are some limitations to their wide clinic application. First, the MP culture separation requires a special culture medium and a long time. Furthermore, the experimental protocol is cumbersome, resulting in a low detection rate. Hence the isolation and culture are not suitable for the early clinical diagnosis of MP infection. In addition, PCR, the technique most commonly used at the early diagnosis stage in clinical practice, requires only a small amount of MP-DNA fragments and possesses high sensitivity and specificity of detection. Nevertheless, PCR has high requirements for operators, needs expensive equipment, and requires high standards on sample collection, storage, and processing. Hence, it cannot be broadly applied in major primary hospitals. On the other hand, LAMP has some potential advantages, such as high sensitivity, high specificity, a wide detection range, which is comparable to that of PCR, but is simpler in terms of equipment and instruments used. Moreover, LAMP has high throughput that is achieved fast and without dependence on specialized equipment. Meanwhile, the assay is simple to perform; only one-week training is needed even for technicians with no prior molecular analysis experience. Moreover, the result is convenient to observe, the white turbid or green fluorescence can be directly seen by naked eye. Due to the on the above advantages, Mycoplasma pneumoniae can be detected in the early stage of disease. Since the first publication of the official report on this technology by Notomi in 2000, LAMP has been widely used in many life sciences for the detection of pathogens causing diseases, such as malaria, trypanosomiasis, and babesiosis
Nonetheless, the overall clinical accuracy of LAMP for the detection of Mycoplasma Pneumoniae has to be further studied. Also, many investigations mentioned that LAMP still has some weaknesses to be overcome. First, LAMP stability is poorer than PCR. Meanwhile, LAMP had a shorter total reaction time.
Due to the limited data reported of the tested samples, the too small sample size, and the lack of comparability, no group evaluation was conducted. The sensitivity and specificity were calculated only based on the number of subjects involved. However, in clinical settings, this part of the data for laboratory tests of different samples is of substantial significance and should be more carefully considered. Hence, this analysis needs to be further improved after the increase of clinical data accumulated in the future.
In summary, LAMP is a method with high sensitivity and specificity when used for the diagnosis of Mycoplasma Pneumoniae. LAMP is a rapid, sensitive, and specific detection method that is valuable for the early clinical diagnosis of Mycoplasma Pneumoniae. Notably, it can be used to guide the overall clinical treatment and considerably contribute to the prevention of epidemic and complications. Furthermore, it can lead to a reduction in the abusive application of antibiotics; it shortens the duration of treatment, and efficiently improves the initial treatment of patients, decreasing the patient’s pain and economic burden. Along with the advancement of the LAMP technology, LAMP can probably become a primary auxiliary diagnosis choice for Mycoplasma Pneumoniae in the near future.