Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/23053
Title: Rapid, actionable diagnosis of urban epidemic leptospirosis using a pathogenic Leptospira lipL32-based real-time PCR assay
Authors: Riediger, Irina Nastassja
Stoddard, Robyn A.
Ribeiro, Guilherme de Sousa
Nakatani, Sueli M.
Moreira, Suzana D. R.
Skraba, Irene
Biondo, Alexander Welker
Reis, Mitermayer Galvão dos
Hoffmaster, Alex R.
Vinetz, Joseph M.
Ko, Albert Icksang
Wunder Junior, Elsio Augusto
Affilliation: Central Laboratory of the State of Parana. Molecular Biology Section. Curitiba, PR, Brazil
National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, Georgia, USA
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil
Central Laboratory of the State of Parana. Molecular Biology Section. Curitiba, PR, Brazil
Federal University of the State of Paraná. Hospital das Clínicas. Curitiba, PR, Brazil
Central Laboratory of the State of Parana. Molecular Biology Section. Curitiba, PR, Brazil
Federal University of the State of Paraná. Department of Veterinary Medicine. Curitiba, PR, Brazil
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil
National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, Georgia, USA
University of California San Diego School of Medicine. Department of Medicine. Division of Infectious Diseases. La Jolla, California, USA
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA
Abstract: 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.
Keywords: Leptospira
Leptospirosis
Epidemics
Real-Time Polymerase Chain Reaction
Lipoproteins
Adult
keywords: Leptospira
Leptospirose
Epidemia
Reação em cadeia da polimerase em tempo real
Lipoproteinas
Adulto
Issue Date: 2017
Publisher: Public Library of Science
Citation: RIEDIGER, Irina Nastassja et al. Rapid, actionable diagnosis of urban epidemic leptospirosis using a pathogenic Leptospira lipL32-based real-time PCR assay. PLoS Neglected Tropical Diseases,p. 1-14, Sept. 2017.
DOI: 10.1371/journal.pntd.0005940
ISSN: 1935-2727
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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