| [PMID]: | 28915243 |
| [Au] Autor: | Riediger IN; Stoddard RA; Ribeiro GS; Nakatani SM; Moreira SDR; Skraba I; Biondo AW; Reis MG; Hoffmaster AR; Vinetz JM; Ko AI; Wunder EA |
| [Ad] Endereço: | Molecular Biology Section, Central Laboratory of the State of Paraná, Curitiba, Paraná Brazil. |
| [Ti] Título: | Rapid, actionable diagnosis of urban epidemic leptospirosis using a pathogenic Leptospira lipL32-based real-time PCR assay. |
| [So] Source: | PLoS Negl Trop Dis;11(9):e0005940, 2017 Sep. |
| [Is] ISSN: | 1935-2735 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | BACKGROUND: With a conservatively estimated 1 million cases of leptospirosis worldwide and a 5-10% fatality rate, the rapid diagnosis of leptospirosis leading to effective clinical and public health decision making is of high importance, and yet remains a challenge. METHODOLOGY: Based on parallel, population-based studies in two leptospirosis-endemic regions in Brazil, a real-time PCR assay which detects lipL32, a gene specifically present in pathogenic Leptospira, was assessed for the diagnostic effectiveness and accuracy. Patients identified by active hospital-based surveillance in Salvador and Curitiba during large urban leptospirosis epidemics were tested. Real-time PCR reactions were performed with DNA-extracted samples obtained from 127 confirmed and 23 unconfirmed cases suspected of leptospirosis, 122 patients with an acute febrile illness other than leptospirosis, and 60 healthy blood donors. PRINCIPAL FINDINGS: The PCR assay had a limit of detection of 280 Leptospira genomic equivalents/mL. Sensitivity for confirmed cases was 61% for whole blood and 29% for serum samples. Sensitivity was higher (86%) for samples collected within the first 6 days after onset of illness compared to those collected after 7 days (34%). The real-time PCR assay was able to detect leptospiral DNA in blood from 56% of serological non-confirmed cases. The overall specificity of the assay was 99%. CONCLUSIONS: These findings indicate that real-time PCR may be a reliable tool for early diagnosis of leptospirosis, which is decisive for clinical management of severe and life-threatening cases and for public health decision making. |
| [Mh] Termos MeSH primário: |
Proteínas da Membrana Bacteriana Externa/genética
Epidemias
Leptospira/isolamento & purificação
Leptospirose/diagnóstico
Leptospirose/epidemiologia
Lipoproteínas/genética
Reação em Cadeia da Polimerase em Tempo Real/métodos
|
| [Mh] Termos MeSH secundário: |
Adulto
Brasil/epidemiologia
DNA Bacteriano/genética
DNA Bacteriano/isolamento & purificação
Feminino
Seres Humanos
Leptospira/genética
Leptospirose/sangue
Leptospirose/microbiologia
Masculino
Meia-Idade
RNA Ribossômico 16S/genética
Sensibilidade e Especificidade
|
| [Pt] Tipo de publicação: | JOURNAL ARTICLE |
[Nm] Nome de substância:
| 0 (Bacterial Outer Membrane Proteins); 0 (DNA, Bacterial); 0 (LipL32 protein, Leptospira); 0 (Lipoproteins); 0 (RNA, Ribosomal, 16S) |
| [Em] Mês de entrada: | 1710 |
| [Cu] Atualização por classe: | 171023 |
[Lr] Data última revisão:
| 171023 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 170916 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1371/journal.pntd.0005940 |
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