Polymorphism-specific PCR enhances the diagnostic performance of American tegumentary leishmaniasis and allows the rapid identification of Leishmania species from Argentina

BMC Infectious Diseases

Research Article

Tatsuyuki Mimori¹  Fabricio M Locatelli²  Masataka Korenaga²  Yoshihisa Hashiguchi³  Ayako Tomatani⁴  Taketoshi Taniguchi⁴  Julio R Nasser⁵  S Pamela Cajal⁵  María C Mora⁶  Miguel A Basombrío⁶  Luis A Parada⁶  Paola A Barroso⁷  Jorge D Marco⁷ 

[1] Department of Microbiology, School of Health Sciences, Kumamoto University, Kumamoto, Japan;Department of Parasitology, Kochi Medical School, Kochi University, Nankoku, Japan;Department of Parasitology, Kochi Medical School, Kochi University, Nankoku, Japan;Prometeo Proyecto, Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador;Division of Molecular Biology, Science Research Center, Kochi University, Nankoku, Japan;Instituto de Investigaciones en Enfermedades Tropicales, Sede Regional Orán, Universidad Nacional de Salta, San Ramón de la Nueva Orán, Salta, Argentina;Instituto de Patología Experimental, Facultad de Ciencias de la Salud, Universidad Nacional de Salta / Consejo Nacional de Investigaciones Científicas y Técnicas, Salta, Argentina;Instituto de Patología Experimental, Facultad de Ciencias de la Salud, Universidad Nacional de Salta / Consejo Nacional de Investigaciones Científicas y Técnicas, Salta, Argentina;Department of Parasitology, Kochi Medical School, Kochi University, Nankoku, Japan;

关键词: Leishmaniasis;    Tegumentary leishmaniasis;    Leishmania braziliensis;    Leishmania guyanensis;    Leishmania panamensis;    PS-PCR;    Diagnosis;    Argentina;    Species identification;    Leishmania;   

DOI  :  10.1186/1471-2334-12-191

 received in 2012-06-15, accepted in 2012-08-08,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe diagnosis of the leishmaniases poses enormous challenges in Argentina. The Polymorphism-Specific PCR (PS-PCR) designed and validated in our laboratories has been proven effective for typifying the Leishmania genus from cultured material. Here we evaluated the performance of this method in the diagnosis of American tegumentary leishmaniasis (ATL) and the rapid identification of Leishmania spp. directly from clinical specimens.MethodsA total of 63 patients from northwestern Argentina, with cutaneous or mucocutaneous lesions, underwent an ATL diagnosis protocol which included clinical examination, Leishmanin skin test, and microscopic examination of dermal smears. In addition, we performed PS-PCR on DNA directly extracted from the specimens scraped from the lesions.ResultsOut of the 63 patients, 44 were classified as ATL cases and 19 as non-ATL cases. The diagnostic sensitivity of the microscopic analysis of dermal smears and PS-PCR individually were 70.5% and 81%, respectively. When performing both tests in parallel, this parameter increased significantly to 97.6% (p = 0.0018). The specificities, on the other hand, were 100%, 84.2%, and 83.3% for the combination, respectively (p > 0.05). Using the PS-PCR analysis we successfully identified the Leishmania spp. in 31 out of the 44 ATL cases. Twenty-eight (90.3%) cases were caused by L. (V.) braziliensis, two (6.5%) by L. (V.) guyanensis, and one (3.2%) by L. (V.) panamensis.ConclusionsThe efficacy of the ATL diagnosis was significantly improved by combining the dermal smear examination with a PS-PCR analysis. Our strategy allowed us to reach the diagnosis of ATL with high accuracy regarding the species of the etiological agent in 70.5% of the cases. Moreover, we diagnosed two cases of the disseminated cutaneous form caused by L. (V.) braziliensis and a cutaneous case due to L. (V.) panamensis infection, both findings reported for the first time in Argentina.

【 授权许可】

CC BY   
© Marco et al.; licensee BioMed Central Ltd. 2012