Author | Riediger, Irina Nastassja | |
Author | Stoddard, Robyn A. | |
Author | Ribeiro, Guilherme de Sousa | |
Author | Nakatani, Sueli M. | |
Author | Moreira, Suzana D. R. | |
Author | Skraba, Irene | |
Author | Biondo, Alexander Welker | |
Author | Reis, Mitermayer Galvão dos | |
Author | Hoffmaster, Alex R. | |
Author | Vinetz, Joseph M. | |
Author | Ko, Albert Icksang | |
Author | Wunder Junior, Elsio Augusto | |
Access date | 2017-11-06T17:35:22Z | |
Available date | 2017-11-06T17:35:22Z | |
Document date | 2017 | |
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. | pt_BR |
ISSN | 1935-2727 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/23053 | |
Sponsorship | National Institutes of Health [R01 TW009504, R25 TW009338, U01 AI088752, R01 AI052473 and
D43 TW00919; Coordination for the Improvement of Higher Education Personnel (CAPES) from the Brazilian Ministry of Education; National Council of Scientific and Technological Development (CNPq) | pt_BR |
Language | eng | pt_BR |
Publisher | Public Library of Science | pt_BR |
Rights | open access | pt_BR |
Subject in Portuguese | Leptospira | pt_BR |
Subject in Portuguese | Leptospirose | pt_BR |
Subject in Portuguese | Epidemia | pt_BR |
Subject in Portuguese | Reação em cadeia da polimerase em tempo real | pt_BR |
Subject in Portuguese | Lipoproteinas | pt_BR |
Subject in Portuguese | Adulto | pt_BR |
Title | Rapid, actionable diagnosis of urban epidemic leptospirosis using a pathogenic Leptospira lipL32-based real-time PCR assay | pt_BR |
Type | Article | pt_BR |
DOI | 10.1371/journal.pntd.0005940 | |
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. | pt_BR |
Affilliation | Central Laboratory of the State of Parana. Molecular Biology Section. Curitiba, PR, Brazil | pt_BR |
Affilliation | National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, Georgia, USA | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil | pt_BR |
Affilliation | Central Laboratory of the State of Parana. Molecular Biology Section. Curitiba, PR, Brazil | pt_BR |
Affilliation | Federal University of the State of Paraná. Hospital das Clínicas. Curitiba, PR, Brazil | pt_BR |
Affilliation | Central Laboratory of the State of Parana. Molecular Biology Section. Curitiba, PR, Brazil | pt_BR |
Affilliation | Federal University of the State of Paraná. Department of Veterinary Medicine. Curitiba, PR, Brazil | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil | pt_BR |
Affilliation | National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, Georgia, USA | pt_BR |
Affilliation | University of California San Diego School of Medicine. Department of Medicine. Division of Infectious Diseases. La Jolla, California, USA | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, USA | pt_BR |
Subject | Leptospira | pt_BR |
Subject | Leptospirosis | pt_BR |
Subject | Epidemics | pt_BR |
Subject | Real-Time Polymerase Chain Reaction | pt_BR |
Subject | Lipoproteins | pt_BR |
Subject | Adult | pt_BR |