Simplified Loop-Mediated Isothermal Amplification-Based Method for Point-of-Care Detection of Streptococcus pneumoniae in Low-Resource Settings

According to the data from the World Health Organization, acute lower respiratory tract infections, such as pneumonia, are the leading causes of death in low- and middle-income countries, where the burden is highest. Adequate treatment of pneumonia requires accurate diagnosis; however, current diagnostic methods do not allow for rapid differentiation of viral and bacterial cause of pneumonia. Therefore, many patients are empirically treated, which leads to the inappropriate use of antibiotics and the acceleration of the emergence of antimicrobial resistance. We aimed to develop a fast and reliable detection method that is fit for purpose in low-resource settings to identify the most common pathogen causing pneumonia, namely Streptococcus pneumoniae. In this study, we developed, optimized, and validated a loop-mediated isothermal amplification (LAMP) method with simplified sample processing to detect S. pneumoniae in clinical swab samples. When tested on clinical samples, the simplified LAMP method demonstrated performance to that of the established PCR detection method. However, the LAMP approach does not require an expensive thermal cycler and allows for sensitive detection with a short turnaround time. Moreover, we engineered a simple, affordable device that, together with the method, can be implemented in low- and middle-income countries for point-of-care applications.