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Matiz-González JM, Ballesteros-Ballesteros JA, Hernández M, Mejorano-Fonseca JA, Cuervo C, Faccini-Martínez ÁA, Hidalgo M, Pérez-Torres J, Silva-Ramos CR. Genetic diversity of P1/pathogenic Leptospira species hosted by bats worldwide. Zoonoses Public Health 2024; 71:457-468. [PMID: 38509439 DOI: 10.1111/zph.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Bats are a diverse group of mammals that have unique features allowing them to act as reservoir hosts for several zoonotic pathogens such as Leptospira. Leptospires have been classified into pathogenic, intermediate, and saprophytic groups and more recently into clades P1, P2, S1, and S2, being all the most important pathogenic species related to leptospirosis included within the P1/pathogenic clade. Leptospira has been detected from bats in several regions worldwide; however, the diversity of leptospires harboured by bats is still unknown. AIM The aim of the present study was to determine the genetic diversity of Leptospira spp. harboured by bats worldwide. METHODS A systematic review was conducted on four databases to retrieve studies in which Leptospira was detected from bats. All studies were screened to retrieve all available Leptospira spp. 16S rRNA sequences from the GenBank database and data regarding their origin. Sequences obtained were compared with each other and reference sequences of Leptospira species and analysed through phylogenetic analysis. RESULTS A total of 418 Leptospira spp. 16S rRNA sequences isolated from 55 bat species from 14 countries were retrieved from 15 selected manuscripts. From these, 417 sequences clustered within the P1/pathogenic group, and only one sequence clustered within the P2/intermediate group. Six major clades of P1/pathogenic Leptospira spp. were identified, three of them composed exclusively of sequences obtained from bats. CONCLUSION We identified that bats harbour a great genetic diversity of Leptospira spp. that form part of the P1/pathogenic clade, some of which are closely related to leptospirosis-associated species. This finding contributes to the knowledge of the diversity of leptospires hosted by bats worldwide and reinforces the role of bats as reservoirs of P1/pathogenic Leptospira spp.
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Affiliation(s)
- J Manuel Matiz-González
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
- Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia
| | - Jesús A Ballesteros-Ballesteros
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - María Hernández
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Julián A Mejorano-Fonseca
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Claudia Cuervo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Álvaro A Faccini-Martínez
- Servicio de Infectología, Hospital Militar Central, Bogotá, Colombia
- Servicios y Asesorías en Infectología - SAI, Bogotá, Colombia
- Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Marylin Hidalgo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jairo Pérez-Torres
- Unidad de Ecología y Sistemática (UNESIS), Laboratorio de Ecología Funcional, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Carlos Ramiro Silva-Ramos
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
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Tapajóz RCDS, Santos FDS, de Oliveira NR, Maia MAC, Seixas Neto ACP, Maiocchi LDV, Souza PHFC, Oliveira TL, Dellagostin OA. Chimeric lipoproteins for leptospirosis vaccine: immunogenicity and protective potential. Appl Microbiol Biotechnol 2024; 108:424. [PMID: 39037584 PMCID: PMC11263434 DOI: 10.1007/s00253-024-13196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 07/23/2024]
Abstract
Leptospirosis, a neglected zoonotic disease, is caused by pathogenic spirochetes belonging to the genus Leptospira and has one of the highest morbidity and mortality rates worldwide. Vaccination stands out as one of the most effective preventive measures for susceptible populations. Within the outer membrane of Leptospira spp., we find the LIC12287, LIC11711, and LIC13259 lipoproteins. These are of interest due to their surface location and potential immunogenicity. Thorough examination revealed the conservation of these proteins among pathogenic Leptospira spp.; we mapped the distribution of T- and B-cell epitopes along their sequences and assessed the 3D structures of each protein. This information aided in selecting immunodominant regions for the development of a chimeric protein. Through gene synthesis, we successfully constructed a chimeric protein, which was subsequently expressed, purified, and characterized. Hamsters were immunized with the chimeric lipoprotein, formulated with adjuvants aluminum hydroxide, EMULSIGEN®-D, Sigma Adjuvant System®, and Montanide™ ISA206VG. Another group was vaccinated with an inactivated Escherichia coli bacterin expressing the chimeric protein. Following vaccination, hamsters were challenged with a virulent L. interrogans strain. Our evaluation of the humoral immune response revealed the production of IgG antibodies, detectable 28 days after the second dose, in contrast to pre-immune samples and control groups. This demonstrates the potential of the chimeric protein to elicit a robust humoral immune response; however, no protection against challenge was achieved. While this study provides valuable insights into the subject, further research is warranted to identify protective antigens that could be utilized in the development of a leptospirosis vaccine. KEY POINTS: • Several T- and B-cell epitopes were identified in all the three proteins. • Four different adjuvants were used in vaccine formulations. • Immunization stimulated significant levels of IgG2/3 in vaccinated animals.
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Affiliation(s)
| | | | | | - Mara Andrade Colares Maia
- Biotechnology Center, Technological Development Center, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Laura de Vargas Maiocchi
- Biotechnology Center, Technological Development Center, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Thaís Larré Oliveira
- Biotechnology Center, Technological Development Center, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Odir Antônio Dellagostin
- Biotechnology Center, Technological Development Center, Federal University of Pelotas, Pelotas, RS, Brazil.
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Kundu S, Shetty A, Gomes-Solecki M. Exposure to live saprophytic Leptospira before challenge with a pathogenic serovar prevents severe leptospirosis and promotes kidney homeostasis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.01.582981. [PMID: 38496604 PMCID: PMC10942337 DOI: 10.1101/2024.03.01.582981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Previous studies demonstrated that Leptospira biflexa, a saprophytic species, triggers innate immune responses in the host during early infection. This raised the question of whether these responses could suppress a subsequent challenge with pathogenic Leptospira. We inoculated C3H/HeJ mice with a single or a double dose of L. biflexa before challenge with a pathogenic serovar, L. interrogans serovar Copenhageni FioCruz (LIC). Pre-challenge exposure to L. biflexa did not prevent LIC dissemination and colonization of the kidney. However, it rescued weight loss and mouse survival thereby mitigating disease severity. Unexpectedly, there was correlation between rescue of overall health (weight gain, higher survival, lower kidney fibrosis marker ColA1) and higher shedding of LIC in urine. This stood in contrast to the L. biflexa unexposed LIC challenged control. Immune responses were dominated by increased frequency of effector T helper (CD4+) cells in spleen, as well as significant increases in serologic IgG2a. Our findings suggest that exposure to live saprophytic Leptospira primes the host to develop Th1 biased immune responses that prevent severe disease induced by a subsequent challenge with a pathogenic species. Thus, mice exposed to live saprophytic Leptospira before facing a pathogenic serovar may withstand infection with far better outcomes. Furthermore, a status of homeostasis may have been reached after kidney colonization that helps LIC complete its enzootic cycle.
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Affiliation(s)
- Suman Kundu
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Advait Shetty
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Maria Gomes-Solecki
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
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Prager KC, Danil K, Wurster E, Colegrove KM, Galloway R, Kettler N, Mani R, McDonough RF, Sahl JW, Stone NE, Wagner DM, Lloyd-Smith JO. Detection of Leptospira kirschneri in a short-beaked common dolphin (Delphinus delphis delphis) stranded off the coast of southern California, USA. BMC Vet Res 2024; 20:266. [PMID: 38902706 PMCID: PMC11188202 DOI: 10.1186/s12917-024-04111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/04/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Pathogenic Leptospira species are globally important zoonotic pathogens capable of infecting a wide range of host species. In marine mammals, reports of Leptospira have predominantly been in pinnipeds, with isolated reports of infections in cetaceans. CASE PRESENTATION On 28 June 2021, a 150.5 cm long female, short-beaked common dolphin (Delphinus delphis delphis) stranded alive on the coast of southern California and subsequently died. Gross necropsy revealed multifocal cortical pallor within the reniculi of the kidney, and lymphoplasmacytic tubulointerstitial nephritis was observed histologically. Immunohistochemistry confirmed Leptospira infection, and PCR followed by lfb1 gene amplicon sequencing suggested that the infecting organism was L.kirschneri. Leptospira DNA capture and enrichment allowed for whole-genome sequencing to be conducted. Phylogenetic analyses confirmed the causative agent was a previously undescribed, divergent lineage of L.kirschneri. CONCLUSIONS We report the first detection of pathogenic Leptospira in a short-beaked common dolphin, and the first detection in any cetacean in the northeastern Pacific Ocean. Renal lesions were consistent with leptospirosis in other host species, including marine mammals, and were the most significant lesions detected overall, suggesting leptospirosis as the likely cause of death. We identified the cause of the infection as L.kirschneri, a species detected only once before in a marine mammal - a northern elephant seal (Mirounga angustirostris) of the northeastern Pacific. These findings raise questions about the mechanism of transmission, given the obligate marine lifestyle of cetaceans (in contrast to pinnipeds, which spend time on land) and the commonly accepted view that Leptospira are quickly killed by salt water. They also raise important questions regarding the source of infection, and whether it arose from transmission among marine mammals or from terrestrial-to-marine spillover. Moving forward, surveillance and sampling must be expanded to better understand the extent to which Leptospira infections occur in the marine ecosystem and possible epidemiological linkages between and among marine and terrestrial host species. Generating Leptospira genomes from different host species will yield crucial information about possible transmission links, and our study highlights the power of new techniques such as DNA enrichment to illuminate the complex ecology of this important zoonotic pathogen.
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Affiliation(s)
- K C Prager
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Kerri Danil
- Southwest Fisheries Science Center, National Marine Fisheries Service, NOAA, La Jolla, CA, 92037, USA
| | - Elyse Wurster
- Ocean Associates Inc. Under Contract to Southwest Fisheries Science Center, National Marine Fisheries Service, NOAA, La Jolla, CA, 92037, USA
| | - Kathleen M Colegrove
- Zoological Pathology Program, University of Illinois College of Veterinary Medicine, 3300 Golf Rd, Brookfield, IL, 60513, USA
| | - Renee Galloway
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Diseases Control and Prevention, Atlanta, GA, 30333, USA
| | - Niesa Kettler
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, 48825, USA
| | - Rinosh Mani
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, 48825, USA
| | - Ryelan F McDonough
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - Jason W Sahl
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - Nathan E Stone
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - David M Wagner
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - James O Lloyd-Smith
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, CA, 90095, USA
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Silva-Caso W, Aguilar-Luis MA, Espinoza-Espíritu W, Vilcapoma-Balbin M, Del Valle LJ, Misaico-Revate E, Soto-Febres F, Pérez-Lazo G, Martins-Luna J, Perona-Fajardo F, Del Valle-Mendoza J. Leptospira spp. and Rickettsia spp. as pathogens with zoonotic potential causing acute undifferentiated febrile illness in a central-eastern region of Peru. BMC Res Notes 2024; 17:171. [PMID: 38902784 PMCID: PMC11188165 DOI: 10.1186/s13104-024-06837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
OBJETIVE this study was to determine the relationship between acute febrile illness and bacterial pathogens with zoonotic potential that cause emerging and re-emerging diseases in a central-eastern region of Peru. RESULTS Out of the 279 samples analyzed, 23 (8.2%) tested positive for infection by Rickettsia spp., while a total of 15 (5.4%) tested positive for Leptospira spp. Women had a higher frequency of infection by Rickettsia spp., with 13 cases (53.3%), while men had a higher frequency of infection by Leptospira spp., with 10 cases (66.7%). The most frequently reported general symptom was headache, with 100.0% (n = 23) of patients with Rickettsia (+) and 86.7% (n = 13) of patients with Leptospira (+) experiencing it. Arthralgia was the second most frequent symptom, reported by 95.6% (n = 22) and 60% (n = 9) of patients with Rickettsia (+) and Leptospira (+), respectively. Myalgia was reported by 91.3% (n = 21) and 66.7% (n = 10) of patients with Rickettsia (+) and Leptospira (+), respectively. Retroocular pain, low back pain, and skin rash were also present, but less frequently. Among the positives, no manifestation of bleeding was recorded, although only one positive case for Leptospira spp. presented a decrease in the number of platelets.
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Affiliation(s)
- Wilmer Silva-Caso
- School of Medicine, Research Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
- Facultad de Medicina Humana, Unidad de Post Grado, Universidad de San Martín de Porres, Lima, Peru.
| | - Miguel Angel Aguilar-Luis
- School of Medicine, Research Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | | | - Luis J Del Valle
- Centre d'Enginyeria Biotecnologica i Molecular (CEBIM), Departament d'Enginyeria Quıímica, ETSEIB, Universidad Politécnica de Catalunya (UPC), Barcelona Tech, Spain
| | | | - Fernando Soto-Febres
- Division of Infectious Diseases, Guillermo Almenara Irigoyen National Hospital-EsSalud, Lima, 15033, Peru
| | - Giancarlo Pérez-Lazo
- Division of Infectious Diseases, Guillermo Almenara Irigoyen National Hospital-EsSalud, Lima, 15033, Peru
| | - Johanna Martins-Luna
- School of Medicine, Research Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Francisco Perona-Fajardo
- School of Medicine, Research Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Juana Del Valle-Mendoza
- School of Medicine, Research Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
- Instituto de Investigación Nutricional, Lima, Peru.
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Stone NE, Hamond C, Clegg J, McDonough RF, Bourgeois RM, Ballard R, Thornton NB, Nuttall M, Hertzel H, Anderson T, Whealy RN, Timm S, Roberts AK, Barragán V, Phipatanakul W, Leibler JH, Benson H, Specht A, White R, LeCount K, Furstenau TN, Galloway RL, Hill NJ, Madison JD, Fofanov VY, Pearson T, Sahl JW, Busch JD, Weiner Z, Nally JE, Wagner DM, Rosenbaum MH. Host population structure and rare dispersal events drive leptospirosis transmission patterns among Rattus norvegicus in Boston, Massachusetts, US. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.12.598639. [PMID: 38915728 PMCID: PMC11195238 DOI: 10.1101/2024.06.12.598639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Leptospirosis (caused by pathogenic bacteria in the genus Leptospira ) is prevalent worldwide but more common in tropical and subtropical regions. Transmission can occur following direct exposure to infected urine from reservoir hosts, such as rats, or a urine-contaminated environment, which then can serve as an infection source for additional rats and other mammals, including humans. The brown rat, Rattus norvegicus , is an important reservoir of leptospirosis in urban settings. We investigated leptospirosis among brown rats in Boston, Massachusetts and hypothesized that rat dispersal in this urban setting influences the movement, persistence, and diversity of Leptospira . We analyzed DNA from 328 rat kidney samples collected from 17 sites in Boston over a seven-year period (2016-2022); 59 rats representing 12 of 17 sites were positive for Leptospira . We used 21 neutral microsatellite loci to genotype 311 rats and utilized the resulting data to investigate genetic connectivity among sampling sites. We generated whole genome sequences for 28 Leptospira isolates obtained from frozen and fresh tissue from some of the 59 Leptospira -positive rat kidneys. When isolates were not obtained, we attempted Leptospira genomic DNA capture and enrichment, which yielded 14 additional Leptospira genomes from rats. We also generated an enriched Leptospira genome from a 2018 human case in Boston. We found evidence of high genetic structure and limited dispersal among rat populations that is likely influenced by major roads and/or other unknown dispersal barriers, resulting in distinct rat population groups within the city; at certain sites these groups persisted for multiple years. We identified multiple distinct phylogenetic clades of L. interrogans among rats, with specific clades tightly linked to distinct rat populations. This pattern suggests L. interrogans persists in local rat populations and movement of leptospirosis in this urban rat community is driven by rat dispersal. Finally, our genomic analyses of the 2018 human leptospirosis case in Boston suggests a link to rats as the source. These findings will be useful for guiding rat control and human leptospirosis mitigation efforts in this and other urban settings.
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Lu X, Westman ME, Mizzi R, Griebsch C, Norris JM, Jenkins C, Ward MP. Are Pathogenic Leptospira Species Ubiquitous in Urban Recreational Parks in Sydney, Australia? Trop Med Infect Dis 2024; 9:128. [PMID: 38922040 PMCID: PMC11209362 DOI: 10.3390/tropicalmed9060128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
Leptospirosis is a zoonotic disease caused by the spirochete bacteria Leptospira spp. From December 2017 to December 2023, a total of 34 canine leptospirosis cases were reported in urban Sydney, Australia. During the same spatio-temporal frame, one locally acquired human case was also reported. As it was hypothesised that human residents and companion dogs might both be exposed to pathogenic Leptospira in community green spaces in Sydney, an environmental survey was conducted from December 2023 to January 2024 to detect the presence of pathogenic Leptospira DNA in multipurpose, recreational public parks in the council areas of the Inner West and City of Sydney, Australia. A total of 75 environmental samples were collected from 20 public parks that were easily accessible by human and canine visitors. Quantitative PCR (qPCR) testing targeting pathogenic and intermediate Leptospira spp. was performed, and differences in detection of Leptospira spp. between dog-allowed and dog-prohibited areas were statistically examined. The global Moran's Index was calculated to identify any spatial autocorrelation in the qPCR results. Pathogenic leptospires were detected in all 20 parks, either in water or soil samples (35/75 samples). Cycle threshold (Ct) values were slightly lower for water samples (Ct 28.52-39.10) compared to soil samples (Ct 33.78-39.77). The chi-squared test and Fisher's exact test results were statistically non-significant (p > 0.05 for both water and soil samples), and there was no spatial autocorrelation detected in the qPCR results (p > 0.05 for both sample types). Although further research is now required, our preliminary results indicate the presence of pathogenic Leptospira DNA and its potential ubiquity in recreational parks in Sydney.
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Affiliation(s)
- Xiao Lu
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia; (X.L.); (M.E.W.); (C.G.); (J.M.N.)
| | - Mark E. Westman
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia; (X.L.); (M.E.W.); (C.G.); (J.M.N.)
- Elizabeth Macarthur Agricultural Institute (EMAI), Woodbridge Road, Menangle, NSW 2568, Australia; (R.M.); (C.J.)
| | - Rachel Mizzi
- Elizabeth Macarthur Agricultural Institute (EMAI), Woodbridge Road, Menangle, NSW 2568, Australia; (R.M.); (C.J.)
| | - Christine Griebsch
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia; (X.L.); (M.E.W.); (C.G.); (J.M.N.)
| | - Jacqueline M. Norris
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia; (X.L.); (M.E.W.); (C.G.); (J.M.N.)
| | - Cheryl Jenkins
- Elizabeth Macarthur Agricultural Institute (EMAI), Woodbridge Road, Menangle, NSW 2568, Australia; (R.M.); (C.J.)
| | - Michael P. Ward
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia; (X.L.); (M.E.W.); (C.G.); (J.M.N.)
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Pinto GV, Senthilkumar K, Rai P, Kabekkodu SP, Karunasagar I, Kumar BK. Identification of Dominant Leptospira Serogroups among Leptospirosis Cases and Their Clinical Outcomes: A Prospective Hospital-Based Study in Mangaluru, India. Am J Trop Med Hyg 2024; 110:1230-1236. [PMID: 38579700 PMCID: PMC11154062 DOI: 10.4269/ajtmh.23-0416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 01/22/2024] [Indexed: 04/07/2024] Open
Abstract
Leptospirosis is a reemerging zoonotic disease of worldwide significance, endemic to the southern region of India, with clinical manifestations similar to other febrile illnesses; hence, it is often misdiagnosed and underreported. Inadequate information about the disease burden and the regional circulating serogroups contributes to its neglected disease status. This study aimed to identify the infecting Leptospira serogroup in the coastal region of Mangaluru and study the clinical symptoms and outcome among leptospirosis patients. Serum samples were collected from 30 patients with confirmed leptospirosis admitted to a tertiary care center in Mangaluru and screened by microscopic agglutination test (MAT) for the infecting serogroup. The clinical profile of these cases was reviewed, and data regarding epidemiological factors such as age, sex, complications, and mortality were recorded. The MAT identified a higher occurrence of serogroup Bataviae (n = 7, 43.75%) and serogroup Australis (n = 5, 31.25%) compared with other serogroups screened in this study population. Patients were aged 16 to 65 years, with a predominance of males. The clinical presentation of leptospirosis ranged from a mild febrile illness to multiorgan failure. Fever (n = 29, 96%) was the common clinical presentation, followed by myalgia, nausea, and abdominal pain. Acute kidney injury, acute respiratory distress syndrome, and multiple organ dysfunction syndrome were the common complications observed. Determining the circulating serogroup is necessary to understand the epidemiology and diversity of Leptospira serogroups among animals and humans to strategize appropriate preventive measures.
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Affiliation(s)
- Gillaine Vail Pinto
- Department of Infectious Diseases and Microbial Genomics, Nitte University Centre for Science Education and Research, Nitte (Deemed to be University), Deralakatte, Mangaluru, Karnataka, India
| | - Kuppusamy Senthilkumar
- Department of Veterinary Microbiology, Veterinary College and Research Institute, Salem, Tamil Nadu, India
| | - Praveen Rai
- Department of Infectious Diseases and Microbial Genomics, Nitte University Centre for Science Education and Research, Nitte (Deemed to be University), Deralakatte, Mangaluru, Karnataka, India
| | - Shama Prakash Kabekkodu
- Department of General Medicine, K.S. Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangaluru, Karnataka, India
| | - Indrani Karunasagar
- DST-NUTEC, Nitte University Centre for Science Education and Research, Nitte (Deemed to be University), Deralakatte, Mangaluru, Karnataka, India
| | - Ballamoole Krishna Kumar
- Department of Infectious Diseases and Microbial Genomics, Nitte University Centre for Science Education and Research, Nitte (Deemed to be University), Deralakatte, Mangaluru, Karnataka, India
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Petakh P, Oksenych V, Khovpey Y, Kamyshnyi O. Comprehensive Analysis of Antiphage Defense Mechanisms: Serovar-Specific Patterns. Antibiotics (Basel) 2024; 13:522. [PMID: 38927188 PMCID: PMC11201134 DOI: 10.3390/antibiotics13060522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 05/30/2024] [Accepted: 06/01/2024] [Indexed: 06/28/2024] Open
Abstract
Leptospirosis is a major zoonotic disease caused by pathogenic spirochetes in the genus Leptospira, affecting over a million people annually and causing approximately 60,000 deaths. Leptospira interrogans, a key causative agent, likely possesses defense systems against bacteriophages (leptophages), yet these systems are not well understood. We analyzed 402 genomes of L. interrogans using the DefenseFinder tool to identify and characterize the antiphage defense systems. We detected 24 unique systems, with CRISPR-Cas (Clustered Regularly Interspaced Short Palindromic Repeats and CRISPR-associated proteins), PrrC, Borvo, and Restriction-Modification (R-M) being the most prevalent. Notably, Cas were identified in all strains, indicating their central role in phage defense. Furthermore, there were variations in the antiphage system distribution across different serovars, suggesting unique evolutionary adaptations. For instance, Retron was found exclusively in the Canicola serovar, while prokaryotic Argonaute proteins (pAgo) were only detected in the Grippotyphosa serovar. These findings significantly enhance our understanding of Leptospira's antiphage defense mechanisms. They reveal the potential for the development of serovar-specific phage-based therapies and underscore the importance of further exploring these defense systems.
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Affiliation(s)
- Pavlo Petakh
- Department of Biochemistry and Pharmacology, Uzhhorod National University, 88000 Uzhhorod, Ukraine; (P.P.); (Y.K.)
- Department of Microbiology, Virology and Immunology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine
| | - Valentyn Oksenych
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| | - Yevheniya Khovpey
- Department of Biochemistry and Pharmacology, Uzhhorod National University, 88000 Uzhhorod, Ukraine; (P.P.); (Y.K.)
| | - Oleksandr Kamyshnyi
- Department of Microbiology, Virology and Immunology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine
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Singh S, Acharya N, Karnik M, Reddy BSK, Waghe T, Beedkar A. Leptospirosis-Associated Acute Respiratory Distress Syndrome (ARDS) in Pregnancy: A Rare Presentation. Cureus 2024; 16:e61809. [PMID: 38975427 PMCID: PMC11227288 DOI: 10.7759/cureus.61809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 06/03/2024] [Indexed: 07/09/2024] Open
Abstract
Leptospirosis, a zoonotic disease caused by spirochetes of the genus Leptospira, poses unique challenges in pregnancy due to its varied clinical presentation and potential adverse outcomes for both mother and fetus. We present a case of a 24-year-old primigravida at 35 weeks of gestation who presented with fever, dyspnea, and abdominal pain, and was ultimately diagnosed with leptospirosis complicated by acute respiratory distress syndrome (ARDS). Prompt initiation of antibiotic therapy, supportive care, and timely delivery via emergency cesarean section led to favorable maternal and neonatal outcomes. This case report underscores the importance of considering leptospirosis in pregnant patients presenting with similar symptoms, particularly in endemic regions, and highlights the critical role of multidisciplinary management in optimizing outcomes.
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Affiliation(s)
- Shivani Singh
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neema Acharya
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Megha Karnik
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bingu Shiv Kiran Reddy
- Pulmonary and Critical Care Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejal Waghe
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aishwarya Beedkar
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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11
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Rajina KR, Madhavikutty G, Philip S, Raj PJ, Gireesh CG. Evaluation of trend and mortality pattern of communicable diseases in a teaching institution in Kerala. J Family Med Prim Care 2024; 13:2348-2353. [PMID: 39027842 PMCID: PMC11254048 DOI: 10.4103/jfmpc.jfmpc_1672_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 07/20/2024] Open
Abstract
Context Even in this era of epidemiologic transition communicable disease is still a major public health problem. Surveillance and timely prevention and control activities are the key to the reduction of morbidity and mortality of communicable diseases. Identifying the trend in communicable diseases and pattern of mortality for a period of ten years will be an insight into the ongoing surveillance. Aim In this study we have analysed data from 2013 to 2022 to evaluate the trend and mortality pattern of communicable diseases in a teaching institution in Kerala. Settings and Design A retrospective record-based cross-sectional study conducted at the Department of Community Medicine, Government Medical College, Kottayam. Methods and Material All confirmed communicable disease cases reported from 2013 to 2022 were included in this study except COVID-19-positive cases. The communicable diseases were grouped as: airborne, waterborne, vector-borne, zoonosis, bloodborne diseases and others. SPSS version 20.0 software, Microsoft Word, and Excel were used in data handling and analysis. Results Total cases reported were 48124. The majority of the morbidity was due to airborne diseases (17585,37%) followed by waterborne diseases (6381, 13%). The total number of deaths reported was 1842. Airborne and zoonotic diseases together accounted for more than 50% of the mortality. Case fatality rate of zoonosis (20.2%) was the highest followed by bloodborne diseases (10.2%). Conclusions Communicable diseases still continue as a public health problem contributing to morbidity and mortality. Airborne diseases and zoonotic diseases constitute the maximum mortality.
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Affiliation(s)
- K. R. Rajina
- Department of Community Medicine, Government Medical College, Kottayam, Kerala, India
| | | | - Sairu Philip
- Department of Community Medicine, Government Medical College, Kottayam, Kerala, India
| | - P. Jasna Raj
- Department of Community Medicine, Government Medical College, Kottayam, Kerala, India
| | - C. G. Gireesh
- Department of Community Medicine, Government Medical College, Kottayam, Kerala, India
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12
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Wainaina M, Lindahl JF, Mayer-Scholl A, Ufermann CM, Domelevo Entfellner JB, Roesler U, Roesel K, Grace D, Bett B, Al Dahouk S. Molecular and serological diagnosis of multiple bacterial zoonoses in febrile outpatients in Garissa County, north-eastern Kenya. Sci Rep 2024; 14:12263. [PMID: 38806576 PMCID: PMC11133362 DOI: 10.1038/s41598-024-62714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 05/21/2024] [Indexed: 05/30/2024] Open
Abstract
Bacterial zoonoses are diseases caused by bacterial pathogens that can be naturally transmitted between humans and vertebrate animals. They are important causes of non-malarial fevers in Kenya, yet their epidemiology remains unclear. We investigated brucellosis, Q-fever and leptospirosis in the venous blood of 216 malaria-negative febrile patients recruited in two health centres (98 from Ijara and 118 from Sangailu health centres) in Garissa County in north-eastern Kenya. We determined exposure to the three zoonoses using serological (Rose Bengal test for Brucella spp., ELISA for C. burnetti and microscopic agglutination test for Leptospira spp.) and real-time PCR testing and identified risk factors for exposure. We also used non-targeted metagenomic sequencing on nine selected patients to assess the presence of other possible bacterial causes of non-malarial fevers. Considerable PCR positivity was found for Brucella (19.4%, 95% confidence intervals [CI] 14.2-25.5) and Leptospira spp. (1.7%, 95% CI 0.4-4.9), and high endpoint titres were observed against leptospiral serovar Grippotyphosa from the serological testing. Patients aged 5-17 years old had 4.02 (95% CI 1.18-13.70, p-value = 0.03) and 2.42 (95% CI 1.09-5.34, p-value = 0.03) times higher odds of infection with Brucella spp. and Coxiella burnetii than those of ages 35-80. Additionally, patients who sourced water from dams/springs, and other sources (protected wells, boreholes, bottled water, and water pans) had 2.39 (95% CI 1.22-4.68, p-value = 0.01) and 2.24 (1.15-4.35, p-value = 0.02) times higher odds of exposure to C. burnetii than those who used unprotected wells. Streptococcus and Moraxella spp. were determined using metagenomic sequencing. Brucellosis, leptospirosis, Streptococcus and Moraxella infections are potentially important causes of non-malarial fevers in Garissa. This knowledge can guide routine diagnosis, thus helping lower the disease burden and ensure better health outcomes, especially in younger populations.
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Affiliation(s)
- Martin Wainaina
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya.
- Department of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany.
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277, Berlin, Germany.
| | - Johanna F Lindahl
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, 75007, Uppsala, Sweden
- Department of Medical Biochemistry and Microbiology, Uppsala University, 75123, Uppsala, Sweden
| | - Anne Mayer-Scholl
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277, Berlin, Germany
| | - Christoph-Martin Ufermann
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277, Berlin, Germany
| | | | - Uwe Roesler
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, 14163, Berlin, Germany
| | - Kristina Roesel
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya
- Department of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany
| | - Delia Grace
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya
- Food and Markets Department, Natural Resources Institute, University of Greenwich, London, ME130NQ, UK
| | - Bernard Bett
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya
| | - Sascha Al Dahouk
- Department of Biological Safety, German Federal Institute for Risk Assessment, 12277, Berlin, Germany
- Department of Internal Medicine III, RWTH Aachen University Hospital, 52074, Aachen, Germany
- Department 1 - Infectious Diseases, Robert Koch Institute, 13353, Berlin, Germany
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13
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Eikenbary B, Devaraju P, Chakkravarthi A, Sihag KK, Nathan T, Thangaraj G, Srinivasan L, Kumar A. A molecular survey of zoonotic pathogens of public health importance in rodents/shrews and their ectoparasites trapped in Puducherry, India. Trans R Soc Trop Med Hyg 2024:trae033. [PMID: 38768316 DOI: 10.1093/trstmh/trae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/18/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Globally, India has a high zoonotic disease burden and lacks surveillance data in humans and animals. Rodents are known reservoirs for many zoonotic diseases and their synanthropic behavior poses a great public health threat. METHODS In this study, trapped rodents/shrews from randomly selected villages within Puducherry, India, and their ectoparasites were screened for zoonotic pathogens, namely, Orientia tsutsugamushi, other pathogenic rickettsiae, Leptospira spp., Cryptosporidium spp., Coxiella burnetii and methicillin-resistant Staphylococcus aureus (MRSA) using conventional PCR. A total of 58 rodents/shrews were trapped from 11 villages. The species trapped were Suncus murinus (49/58, 84.48%), Rattus rattus (8/58, 13.79%) and Rattus norvegicus (1/58, 1.72%). All ectoparasites collected were identified as mites and its infestation rate was 46.55% (27/58). RESULTS Real-time PCR targeting the 47 kDa gene of O. tsutsugamushi revealed positivity in one rodent and one shrew (3.45%) and two mite pools (7.41%). Conventional PCR targeting the 56 kDa gene revealed positivity in one shrew and two mite pools and the phylogenetic analysis of all three amplicons indicated the circulation of the Gilliam-related serotype. MRSA was detected in the alimentary tract of a shrew (1/32, 3.13%). Leptospira spp., Rickettsia, Cryptosporidium spp. and Co. burnetii tested negative. CONCLUSIONS The detection of zoonotic pathogens within reservoir hosts and vectors poses a risk of transmission to humans. This study signifies the need for zoonotic pathogen surveillance in synanthropic rodents/shrews.
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Affiliation(s)
- Brenna Eikenbary
- Department of Global Health, Georgetown University, Washington DC, 20057, USA
| | - Panneer Devaraju
- Unit of One Health, ICMR-Vector Control Research Centre (ICMR-VCRC), Puducherry 605006, India
| | | | - Krishan Kumar Sihag
- Unit of One Health, ICMR-Vector Control Research Centre (ICMR-VCRC), Puducherry 605006, India
| | - Terence Nathan
- Unit of One Health, ICMR-Vector Control Research Centre (ICMR-VCRC), Puducherry 605006, India
| | - Gowdham Thangaraj
- Unit of One Health, ICMR-Vector Control Research Centre (ICMR-VCRC), Puducherry 605006, India
| | - Lakshmy Srinivasan
- Unit of One Health, ICMR-Vector Control Research Centre (ICMR-VCRC), Puducherry 605006, India
| | - Ashwani Kumar
- ICMR-Vector Control Research Centre (ICMR-VCRC), Puducherry 605006, India
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14
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Md Lasim A, Mohd Ngesom AM, Nathan S, Abdul Razak F, Abdul Halim M, Mohd-Saleh W, Zainul Abidin K, Mohd-Taib FS. Bacterial community profiles within the water samples of leptospirosis outbreak areas. PeerJ 2024; 12:e17096. [PMID: 38699181 PMCID: PMC11064854 DOI: 10.7717/peerj.17096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/21/2024] [Indexed: 05/05/2024] Open
Abstract
Background Leptospirosis is a water-related zoonotic disease. The disease is primarily transmitted from animals to humans through pathogenic Leptospira bacteria in contaminated water and soil. Rivers have a critical role in Leptospira transmissions, while co-infection potentials with other waterborne bacteria might increase the severity and death risk of the disease. Methods The water samples evaluated in this study were collected from four recreational forest rivers, Sungai Congkak, Sungai Lopo, Hulu Perdik, and Gunung Nuang. The samples were subjected to next-generation sequencing (NGS) for the 16S rRNA and in-depth metagenomic analysis of the bacterial communities. Results The water samples recorded various bacterial diversity. The samples from the Hulu Perdik and Sungai Lopo downstream sampling sites had a more significant diversity, followed by Sungai Congkak. Conversely, the upstream samples from Gunung Nuang exhibited the lowest bacterial diversity. Proteobacteria, Firmicutes, and Acidobacteria were the dominant phyla detected in downstream areas. Potential pathogenic bacteria belonging to the genera Burkholderiales and Serratia were also identified, raising concerns about co-infection possibilities. Nevertheless, Leptospira pathogenic bacteria were absent from all sites, which is attributable to its limited persistence. The bacteria might also be washed to other locations, contributing to the reduced environmental bacterial load. Conclusion The present study established the presence of pathogenic bacteria in the river ecosystems assessed. The findings offer valuable insights for designing strategies for preventing pathogenic bacteria environmental contamination and managing leptospirosis co-infections with other human diseases. Furthermore, closely monitoring water sample compositions with diverse approaches, including sentinel programs, wastewater-based epidemiology, and clinical surveillance, enables disease transmission and outbreak early detections. The data also provides valuable information for suitable treatments and long-term strategies for combating infectious diseases.
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Affiliation(s)
- Asmalia Md Lasim
- Department of Herbal Medicine Research Centre, Insitute for Medical Research, Setia Alam, Malaysia
- Department of Biological Science and Biotechnology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | | | - Sheila Nathan
- Department of Biological Science and Biotechnology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Fatimah Abdul Razak
- Department of Biological Science and Biotechnology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Mardani Abdul Halim
- Biotechnology Research Institute, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Wardah Mohd-Saleh
- Department of Herbal Medicine Research Centre, Insitute for Medical Research, Setia Alam, Malaysia
| | - Kamaruddin Zainul Abidin
- Faculty of Applied Science, Universiti Teknologi MARA (UiTM) Cawangan Pahang, Bandar Tun Razak, Pahang, Malaysia
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15
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Petakh P, Behzadi P, Oksenych V, Kamyshnyi O. Current treatment options for leptospirosis: a mini-review. Front Microbiol 2024; 15:1403765. [PMID: 38725681 PMCID: PMC11081000 DOI: 10.3389/fmicb.2024.1403765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
Leptospirosis, one of the most common global zoonotic infections, significantly impacts global human health, infecting more than a million people and causing approximately 60,000 deaths annually. This mini-review explores effective treatment strategies for leptospirosis, considering its epidemiology, clinical manifestations, and current therapeutic approaches. Emphasis is placed on antibiotic therapy, including recommendations for mild and severe cases, as well as the role of probiotics in modulating the gut microbiota. Furthermore, novel treatment options, such as bacteriophages and newly synthesized/natural compounds, are discussed, and the findings are expected to provide insights into promising approaches for combating leptospirosis.
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Affiliation(s)
- Pavlo Petakh
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Payam Behzadi
- Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
| | - Valentyn Oksenych
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Oleksandr Kamyshnyi
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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Petakh P, Kamyshnyi O. AMR mechanisms in L. interrogans serovars: a comprehensive study. Front Cell Infect Microbiol 2024; 14:1384427. [PMID: 38681225 PMCID: PMC11045430 DOI: 10.3389/fcimb.2024.1384427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
Antimicrobial resistance (AMR) is one of the global health challenges of the 21st century. Data regarding AMR mechanisms in Leptospira interrogans, the causative agents of leptospirosis, have been relatively limited. Therefore, our study aimed to identify resistance genes and explore potential resistance mechanisms specific to particular serovars. We conducted a comprehensive analysis of 98 Leptospira strains, representing 10 common serovars, using whole-genome sequencing (WGS) FASTA files. Employing the PATRIC tool from the Bacterial and Viral Bioinformatics Resource Center (BV-BRC), we scrutinized the genomes for AMR genes. Our investigation revealed 32 genes associated with AMR, with 20 key genes consistently prevalent across most strains. Notably, we identified unique efflux pump systems in serovar Pomona, indicating distinctive resistance mechanisms in this serovar. In summary, our findings shed light on the genetic landscape of AMR in Leptospira, uncovering both common and serovar-specific resistance elements. The presence of unique efflux pump systems in serovar Pomona introduces a novel dimension to our understanding of resistance mechanisms. These insights underscore the importance of tailored intervention strategies and collaborative efforts between human and veterinary healthcare professionals, as well as environmental scientists, to address the complex dynamics of leptospirosis and its implications for antibiotic resistance.
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Affiliation(s)
- Pavlo Petakh
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Oleksandr Kamyshnyi
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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Gajdov V, Jokic G, Savic S, Zekic M, Blazic T, Rajkovic M, Petrovic T. Genotyping of Leptospira spp. in wild rats leads to first time detection of L. kirshneri serovar Mozdok in Serbia. Front Microbiol 2024; 15:1379021. [PMID: 38605707 PMCID: PMC11006980 DOI: 10.3389/fmicb.2024.1379021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction This study aimed to investigate the prevalence and molecular characterization of Leptospira species in Belgrade, Serbia, an area where this disease is underexplored. Specifically, the study sought to employ molecular and multilocus sequence typing analyses to fill the gap in understanding the diversity and distribution of Leptospira species within the region. Methods A comprehensive molecular analysis was conducted on kidney samples obtained from Norway rats (Rattus norvegicus) in the urban environment. The study utilized molecular diagnostic techniques including real-time PCR targeting the lipL32 gene and performing sequence-based typing schemes utilizing adk, icdA, lipL32, lipL41, rrs2, and secY genes. These methodologies were applied to ascertain the presence and characterize different Leptospira species and serovars, respectively. Results The findings revealed the presence of two Leptospira species and three separate serovars in the Belgrade area. This study identified the presence of L. kirschneri serovar Mozdok in Serbia for the first time, a significant discovery previously undocumented in the region. This pioneering investigation sheds light on the molecular diversity and prevalence of Leptospira species in Serbia. Discussion The study underscores the importance of employing molecular typing methods to gain insights into the epidemiology and characterization of Leptospira species. These findings significantly contribute to both local and global perspectives on leptospirosis epidemiology, providing vital insights for the development of effective control strategies and interventions. Summary In our recent study, we explored the presence and performed molecular typing of the Leptospira species, the bacteria responsible for leptospirosis, in wild rats in Serbia. This was the first time such a study was conducted in the region. Leptospirosis is a serious disease that affects both animals and humans, often transmitted through contact with water contaminated by infected animals. Our focus was on understanding which types of Leptospira were present in these animals. Excitingly, we discovered a particular strain of Leptospira, known as L. kirshneri serovar Mozdok, for the first time in Serbia. This finding is significant because it sheds light on the presence and spread of different Leptospira serovars in Serbia. It also raises awareness about the potential health risks associated with this serovar, which was previously unknown in the area. Our work fits into a broader context of disease surveillance and public health. By identifying the types of Leptospira present in a specific region, we can better understand the risks to public health and take steps to prevent and control the spread of leptospirosis. This discovery is not just important for scientists studying infectious diseases; it has real implications for public health officials, veterinarians, and anyone concerned with preventing and treating leptospirosis. Our findings highlight the need for ongoing monitoring of Leptospira in wildlife and synanthropic fauna, to protect both animal and human health.
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Affiliation(s)
- Vladimir Gajdov
- Scientific Veterinary Institute “Novi Sad”, Novi Sad, Serbia
| | - Goran Jokic
- Laboratory for Applied Zoology, Institute of Pesticides and Environmental Protection, Belgrade, Serbia
| | - Sara Savic
- Scientific Veterinary Institute “Novi Sad”, Novi Sad, Serbia
| | - Marina Zekic
- Scientific Veterinary Institute “Novi Sad”, Novi Sad, Serbia
| | - Tanja Blazic
- Laboratory for Applied Zoology, Institute of Pesticides and Environmental Protection, Belgrade, Serbia
| | - Milica Rajkovic
- Laboratory of Experimental Hematology and Stem Cells, Institute for Medical Research, Belgrade, Serbia
| | - Tamas Petrovic
- Scientific Veterinary Institute “Novi Sad”, Novi Sad, Serbia
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Win TZ, Perinpanathan T, Mukadi P, Smith C, Edwards T, Han SM, Maung HT, Brett-Major DM, Lee N. Antibiotic prophylaxis for leptospirosis. Cochrane Database Syst Rev 2024; 3:CD014959. [PMID: 38483067 PMCID: PMC10938880 DOI: 10.1002/14651858.cd014959.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
BACKGROUND Leptospirosis is a global zoonotic and waterborne disease caused by pathogenic Leptospira species. Antibiotics are used as a strategy for prevention of leptospirosis, in particular in travellers and high-risk groups. However, the clinical benefits are unknown, especially when considering possible treatment-associated adverse effects. This review assesses the use of antibiotic prophylaxis in leptospirosis and is an update of a previously published review in the Cochrane Library (2009, Issue 3). OBJECTIVES To evaluate the benefits and harms of antibiotic prophylaxis for human leptospirosis. SEARCH METHODS We identified randomised clinical trials through electronic searches of the Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE, Embase, LILACS, Science Citation Index Expanded, and other resources. We searched online clinical trial registries to identify unpublished or ongoing trials. We checked reference lists of the retrieved studies for further trials. The last date of search was 17 April 2023. SELECTION CRITERIA We included randomised clinical trials of any trial design, assessing antibiotics for prevention of leptospirosis, and with no restrictions on age, sex, occupation, or comorbidity of trial participants. We looked for trials assessing antibiotics irrespective of route of administration, dosage, and schedule versus placebo or no intervention. We also included trials assessing antibiotics versus other antibiotics using these criteria, or the same antibiotic but with another dose or schedule. DATA COLLECTION AND ANALYSIS We followed Cochrane methodology. The primary outcomes were all-cause mortality, laboratory-confirmed leptospirosis regardless of the presence of an identified clinical syndrome (inclusive of asymptomatic cases), clinical diagnosis of leptospirosis regardless of the presence of laboratory confirmation, clinical diagnosis of leptospirosis confirmed by laboratory diagnosis (exclusive of asymptomatic cases), and serious adverse events. The secondary outcomes were quality of life and the proportion of people with non-serious adverse events. We assessed the risk of bias of the included trials using the RoB 2 tool and the certainty of evidence using GRADE. We presented dichotomous outcomes as risk ratios (RR) and continuous outcomes as mean difference (MD), with their 95% confidence intervals (CI). We used a random-effects model for our main analyses and the fixed-effect model for sensitivity analyses. Our primary outcome analyses included trial data at the longest follow-up. MAIN RESULTS We identified five randomised clinical trials comprising 2593 participants that compared antibiotics (doxycycline, azithromycin, or penicillin) with placebo, or one antibiotic compared with another. Four trials assessed doxycycline with different durations, one trial assessed azithromycin, and one trial assessed penicillin. One trial had three intervention groups: doxycycline, azithromycin, and placebo. Three trials assessed pre-exposure prophylaxis, one trial assessed postexposure prophylaxis, and one did not report this clearly. Four trials recruited residents in endemic areas, and one trial recruited soldiers who experienced limited time exposure. The participants' ages in the included trials were 10 to 80 years. Follow-up ranged from one to three months. Antibiotics versus placebo Doxycycline compared with placebo may result in little to no difference in all-cause mortality (RR 0.15, 95% CI 0.01 to 2.83; 1 trial, 782 participants; low-certainty evidence). Prophylactic antibiotics may have little to no effect on laboratory-confirmed leptospirosis, but the evidence is very uncertain (RR 0.56, 95% CI 0.25 to 1.26; 5 trials, 2593 participants; very low-certainty evidence). Antibiotics may result in little to no difference in the clinical diagnosis of leptospirosis regardless of laboratory confirmation (RR 0.76, 95% CI 0.53 to 1.08; 4 trials, 1653 participants; low-certainty evidence) and the clinical diagnosis of leptospirosis with laboratory confirmation (RR 0.57, 95% CI 0.26 to 1.26; 4 trials, 1653 participants; low-certainty evidence). Antibiotics compared with placebo may increase non-serious adverse events, but the evidence is very uncertain (RR 10.13, 95% CI 2.40 to 42.71; 3 trials, 1909 participants; very low-certainty evidence). One antibiotic versus another antibiotic One trial assessed doxycycline versus azithromycin but did not report mortality. Compared to azithromycin, doxycycline may have little to no effect on laboratory-confirmed leptospirosis regardless of the presence of an identified clinical syndrome (RR 1.49, 95% CI 0.51 to 4.32; 1 trial, 137 participants), on the clinical diagnosis of leptospirosis regardless of the presence of laboratory confirmation (RR 4.18, 95% CI 0.94 to 18.66; 1 trial, 137 participants), on the clinical diagnosis of leptospirosis confirmed by laboratory diagnosis (RR 4.18, 95% CI 0.94 to 18.66; 1 trial, 137 participants), and on non-serious adverse events (RR 1.12, 95% CI 0.36 to 3.48; 1 trial, 137 participants), but the evidence is very uncertain. The certainty of evidence for all the outcomes was very low. None of the five included trials reported serious adverse events or assessed quality of life. One study is awaiting classification. Funding Four of the five trials included statements disclosing their funding/supporting sources, and the remaining trial did not include this. Three of the four trials that disclosed their supporting sources received the supply of trial drugs directly from the same pharmaceutical company, and the remaining trial received financial support from a governmental source. AUTHORS' CONCLUSIONS We do not know if antibiotics versus placebo or another antibiotic has little or have no effect on all-cause mortality or leptospirosis infection because the certainty of evidence is low or very low. We do not know if antibiotics versus placebo may increase the overall risk of non-serious adverse events because of very low-certainty evidence. We lack definitive rigorous data from randomised trials to support the use of antibiotics for the prophylaxis of leptospirosis infection. We lack trials reporting data on clinically relevant outcomes.
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Affiliation(s)
- Tin Zar Win
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Tanaraj Perinpanathan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Patrick Mukadi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Institut National de Recherche Biomedicale (INRB), Kinshasa, DRC
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Tansy Edwards
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Su Myat Han
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hsu Thinzar Maung
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - David M Brett-Major
- Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, MD, USA
| | - Nathaniel Lee
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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19
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Win TZ, Han SM, Edwards T, Maung HT, Brett-Major DM, Smith C, Lee N. Antibiotics for treatment of leptospirosis. Cochrane Database Syst Rev 2024; 3:CD014960. [PMID: 38483092 PMCID: PMC10938876 DOI: 10.1002/14651858.cd014960.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
BACKGROUND Leptospirosis is a disease transmitted from animals to humans through water, soil, or food contaminated with the urine of infected animals, caused by pathogenic Leptospira species. Antibiotics are commonly prescribed for the management of leptospirosis. Despite the widespread use of antibiotic treatment for leptospirosis, there seems to be insufficient evidence to determine its effectiveness or to recommend antibiotic use as a standard practice. This updated systematic review evaluated the available evidence regarding the use of antibiotics in treating leptospirosis, building upon a previously published Cochrane review. OBJECTIVES To evaluate the benefits and harms of antibiotics versus placebo, no intervention, or another antibiotic for the treatment of people with leptospirosis. SEARCH METHODS We identified randomised clinical trials following standard Cochrane procedures. The date of the last search was 27 March 2023. SELECTION CRITERIA We searched for randomised clinical trials of various designs that examined the use of antibiotics for treating leptospirosis. We did not impose any restrictions based on the age, sex, occupation, or comorbidities of the participants involved in the trials. Our search encompassed trials that evaluated antibiotics, regardless of the method of administration, dosage, and schedule, and compared them with placebo or no intervention, or compared different antibiotics. We included trials regardless of the outcomes reported. DATA COLLECTION AND ANALYSIS During the preparation of this review, we adhered to the Cochrane methodology and used Review Manager. The primary outcomes were all-cause mortality and serious adverse events (nosocomial infection). Our secondary outcomes were quality of life, proportion of people with adverse events considered non-serious, and days of hospitalisation. To assess the risk of bias of the included trials, we used the RoB 2 tool, and for evaluating the certainty of evidence we used GRADEpro GDT software. We presented dichotomous outcomes as risk ratios (RR) and continuous outcomes as mean differences (MD), both accompanied by their corresponding 95% confidence intervals (CI). We used the random-effects model for all our main analyses and the fixed-effect model for sensitivity analyses. For our primary outcome analyses, we included trial data from the longest follow-up period. MAIN RESULTS We identified nine randomised clinical trials comprising 1019 participants. Seven trials compared two intervention groups and two trials compared three intervention groups. Amongst the trials comparing antibiotics versus placebos, four trials assessed penicillin and one trial assessed doxycycline. In the trials comparing different antibiotics, one trial evaluated doxycycline versus azithromycin, one trial assessed penicillin versus doxycycline versus cefotaxime, and one trial evaluated ceftriaxone versus penicillin. One trial assessed penicillin with chloramphenicol and no intervention. Apart from two trials that recruited military personnel stationed in endemic areas or military personnel returning from training courses in endemic areas, the remaining trials recruited people from the general population presenting to the hospital with fever in an endemic area. The participants' ages in the included trials was 13 to 92 years. The treatment duration was seven days for penicillin, doxycycline, and cephalosporins; five days for chloramphenicol; and three days for azithromycin. The follow-up durations varied across trials, with three trials not specifying their follow-up periods. Three trials were excluded from quantitative synthesis; one reported zero events for a prespecified outcome, and two did not provide data for any prespecified outcomes. Antibiotics versus placebo or no intervention The evidence is very uncertain about the effect of penicillin versus placebo on all-cause mortality (RR 1.57, 95% CI 0.65 to 3.79; I2 = 8%; 3 trials, 367 participants; very low-certainty evidence). The evidence is very uncertain about the effect of penicillin or chloramphenicol versus placebo on adverse events considered non-serious (RR 1.05, 95% CI 0.35 to 3.17; I2 = 0%; 2 trials, 162 participants; very low-certainty evidence). None of the included trials assessed serious adverse events. Antibiotics versus another antibiotic The evidence is very uncertain about the effect of penicillin versus cephalosporin on all-cause mortality (RR 1.38, 95% CI 0.47 to 4.04; I2 = 0%; 2 trials, 348 participants; very low-certainty evidence), or versus doxycycline (RR 0.93, 95% CI 0.13 to 6.46; 1 trial, 168 participants; very low-certainty evidence). The evidence is very uncertain about the effect of cefotaxime versus doxycycline on all-cause mortality (RR 0.18, 95% CI 0.01 to 3.78; 1 trial, 169 participants; very low-certainty evidence). The evidence is very uncertain about the effect of penicillin versus doxycycline on serious adverse events (nosocomial infection) (RR 0.62, 95% CI 0.11 to 3.62; 1 trial, 168 participants; very low-certainty evidence) or versus cefotaxime (RR 1.01, 95% CI 0.15 to 7.02; 1 trial, 175 participants; very low-certainty evidence). The evidence is very uncertain about the effect of doxycycline versus cefotaxime on serious adverse events (nosocomial infection) (RR 1.01, 95% CI 0.15 to 7.02; 1 trial, 175 participants; very low-certainty evidence). The evidence is very uncertain about the effect of penicillin versus cefotaxime (RR 3.03, 95% CI 0.13 to 73.47; 1 trial, 175 participants; very low-certainty evidence), versus doxycycline (RR 2.80, 95% CI 0.12 to 67.66; 1 trial, 175 participants; very low-certainty evidence), or versus chloramphenicol on adverse events considered non-serious (RR 0.74, 95% CI 0.15 to 3.67; 1 trial, 52 participants; very low-certainty evidence). Funding Six of the nine trials included statements disclosing their funding/supporting sources and three trials did not mention funding source. Four of the six trials mentioning sources received funds from public or governmental sources or from international charitable sources, and the remaining two, in addition to public or governmental sources, received support in the form of trial drug supply directly from pharmaceutical companies. AUTHORS' CONCLUSIONS As the certainty of evidence is very low, we do not know if antibiotics provide little to no effect on all-cause mortality, serious adverse events, or adverse events considered non-serious. There is a lack of definitive rigorous data from randomised trials to support the use of antibiotics for treating leptospirosis infection, and the absence of trials reporting data on clinically relevant outcomes further adds to this limitation.
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Affiliation(s)
- Tin Zar Win
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Su Myat Han
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tansy Edwards
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hsu Thinzar Maung
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - David M Brett-Major
- Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, Maryland, USA
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Nathaniel Lee
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Wettasinghe I, Puthra S, Sugathapala HA, Mendis S. A Rare Case of Longitudinally Extensive Transverse Myelitis Following Febrile Illness: A Case Report. Cureus 2024; 16:e56316. [PMID: 38629009 PMCID: PMC11020659 DOI: 10.7759/cureus.56316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/19/2024] Open
Abstract
Longitudinally extensive transverse myelitis (LETM) is a rapidly progressing demyelinating disease affecting the spinal cord over three or more vertebral segments. Most causes are idiopathic, while others include infections, autoimmune causes, central nervous system demyelinating diseases, and post vaccination. Here, we report a 37-year-old male who presented with a fever for six days with no source of infection and complained of pain and weakness in the bilateral lower limbs eight hours after admission. Though the neurological examination of the lower limbs was normal at that time, reduced power was detected 16 hours later, with loss of proprioception and sensation of pain with a sensory level at T4 vertebrae. Then, the patient became unable to vocalize, and the chest X-ray showed an elevated left hemidiaphragm. Thirty hours after admission, the patient went into type 2 respiratory arrest and was intubated. The magnetic resonance imaging (MRI) showed a longitudinally extensive transverse myelitis extending from the C2 vertebrae to the conus medullaris. Febrile illness is common in the medical setting in Sri Lanka, but its association with LETM is unusual. Since LETM is very rare and is a rapidly progressive disease, a high degree of clinical suspicion is crucial for early diagnosis and the initiation of treatment. This case underscores the importance of early diagnosis, which would require timely MRI, and prompt treatment with intravenous (IV) glucocorticoids or plasma exchange to reduce morbidity and mortality.
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Affiliation(s)
| | - Shiran Puthra
- Internal Medicine, Colombo South Teaching Hospital, Colombo, LKA
| | | | - Suresh Mendis
- Internal Medicine, Colombo South Teaching Hospital, Colombo, LKA
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21
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Sreevalsan TV, Chandra R. Relevance of Polymerase Chain Reaction in Early Diagnosis of Leptospirosis. Indian J Crit Care Med 2024; 28:290-293. [PMID: 38477003 PMCID: PMC10926039 DOI: 10.5005/jp-journals-10071-24649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/10/2024] [Indexed: 03/14/2024] Open
Abstract
Aim and background Leptospirosis is common in India, especially in the southern states. Mortality is high among untreated cases. Diagnosis of leptospirosis remains a challenge in India as polymerase chain reaction (PCR), which is more sensitive than Immunoglobulin M (IgM) is not widely available. This study aimed to find out the difference in diagnostic yield with PCR and IgM in early leptospirosis. Materials and methods This retrospective, single-center study included 67 adults with laboratory-confirmed leptospirosis (IgM, PCR, or both) who presented within 7 days of symptom onset and were admitted to the intensive care unit (ICU). The difference in the diagnostic yield with PCR and IgM ELISA was studied. Results About 77.6% of the patients tested positive by PCR and 55.2% tested positive by IgM. There was a statistically significant difference in the detection of leptospirosis by PCR and IgM (p-value = 0.036). In the subgroup of patients who presented within 3 days of onset of symptoms, PCR positivity was 90.32% whereas IgM positivity was only 25.8%. Conclusion Our study showed that the sensitivity of leptospira PCR is significantly higher than IgM in the first week of illness. It also showed that among the subset of patients who died, a majority were detected only by PCR. Since PCR is not widely available, leptospirosis remains underdiagnosed and mortality from the same is underestimated. Polymerase chain reaction, if routinely done along with IgM for all suspected cases of leptospirosis that present within the first week of illness helps in prompt diagnosis and treatment. How to cite this article Sreevalsan TV, Chandra R. Relevance of Polymerase Chain Reaction in Early Diagnosis of Leptospirosis. Indian J Crit Care Med 2024;28(3):290-293.
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Affiliation(s)
- TV Sreevalsan
- Department of Critical Care Medicine, Lisie Hospital, Cochin, Kerala, India
| | - Rohitha Chandra
- Department of Microbiology, Lisie Hospital, Cochin, Kerala, India
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22
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Petakh P, Oksenych V, Kamyshna I, Boisak I, Lyubomirskaya K, Kamyshnyi O. Exploring the complex interplay: gut microbiome, stress, and leptospirosis. Front Microbiol 2024; 15:1345684. [PMID: 38476949 PMCID: PMC10927737 DOI: 10.3389/fmicb.2024.1345684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/30/2024] [Indexed: 03/14/2024] Open
Abstract
Leptospirosis, a re-emerging zoonotic disease, remains a significant global health concern, especially amid floods and disasters such as the Kakhovka Dam destruction. As is known, the stress that occurs in the conditions of military conflicts among civilian and military personnel significantly affects susceptibility to infectious diseases and possibly even influences their course. This review aims to explore how the gut microbiome and stress mediators (such as catecholamines and corticosteroids) might impact the leptospirosis disease course. The review opens new horizons for research by elucidating the connections between the gut microbiome, stress, and leptospirosis.
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Affiliation(s)
- Pavlo Petakh
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Valentyn Oksenych
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Iryna Kamyshna
- Department of Medical Rehabilitation, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Iryna Boisak
- Department of Childhood Diseases, Uzhhorod National University, Uzhhorod, Ukraine
| | - Katerina Lyubomirskaya
- Department of Obstetrics and Gynecology, Zaporizhzhia State Medical and Pharmaceuticals University, Zaporizhzhia, Ukraine
| | - Oleksandr Kamyshnyi
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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23
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Senavirathna I, Jayasundara D, Warnasekara J, Kappagoda C, Agampodi S. Levels of Cytokines in Leptospirosis Patients with Different Serovars and rfb Locus. J Interferon Cytokine Res 2024; 44:80-93. [PMID: 38377491 PMCID: PMC10880283 DOI: 10.1089/jir.2023.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/21/2023] [Indexed: 02/22/2024] Open
Abstract
Leptospirosis has a wide spectrum of clinical manifestations ranging from mild to severe disease. The cytokine response is considered one of the key drivers for this varying manifestation. The different cytokine response observed in patients with leptospirosis could be due to the variation of infecting serovars. Since the rfb locus codes for the lipopolysaccharide synthesis of the bacterial cell wall, which also determines the serovar, this locus may play a role in driving a specific cytokine response in the host. We investigated 12 commonly used cytokine profiles in serum samples of culture, microscopic agglutination test (MAT), or polymerase chain reaction (PCR)-positive patients with leptospirosis. The sequences of the rfb locus in culture-positive samples were generated from whole genome sequencing and serovar status was drawn from original data published. Isolated cultures were subjected to whole genome sequencing using the PacBio RS II system, and the resulting data were used to determine the species. The recovered genomic data were annotated with the Rapid Annotation using Subsystem Technology (RAST) subsystem, and the rfb locus was extracted. The cytokine analysis was carried out using the Qiagen human ELISA kit. Eighteen samples were found to be positive by culture, while the other 7 samples were positive by PCR or MAT. Infections from Leptospira interrogans serovar Autumnalis (5), Pyrogens (3), Icterohaemorrhagiae (1) Leptospira borgpetersenii (all 7 samples clustered in same clonal group with serovar status not determined), Leptospira weilii (1 with serovar status not determined), and Leptospira kirschneri serovar Grippotyphosa (1) were included in the analysis. Three patients [infected with Leptospira interrogansserovar Autumnalis (2) and Pyrogens (1)] and 2 MAT-positive patients (highest titer against serovar Bratislava of L.interrognas) were reported to have severe clinical manifestations, while the rest had mild to moderate symptoms. Although the serum cytokine concentration of patients with severe clinical manifestation was comparatively higher, a statistically significant difference was observed only for interleukin (IL)-1β (P < 0.05). IL-10/tumor necrosis factor-alpha (TNF-α) ratio was high in patients with severe complications. In general, patients infected with L. interrogans showed higher concentration of cytokines compared to L. borgpetersenii.
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Affiliation(s)
- Indika Senavirathna
- Leptospirosis Research Laboratory, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Biochemistry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Dinesha Jayasundara
- Leptospirosis Research Laboratory, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Microbiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Janith Warnasekara
- Leptospirosis Research Laboratory, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Chamila Kappagoda
- Leptospirosis Research Laboratory, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Suneth Agampodi
- International Vaccine Institute, Seoul, Republic of Korea
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, California, USA
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24
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Yalcin Y, Kamel I, Singh H. Unmasking the Enigma of Weil's Disease: A Case Report. Cureus 2024; 16:e55124. [PMID: 38420296 PMCID: PMC10900174 DOI: 10.7759/cureus.55124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 03/02/2024] Open
Abstract
We present the case of a 37-year-old male with Weil's disease, a severe form of leptospirosis, who presented without typical ecological risk factors. Initially manifesting as weakness, muscle aches, and fever, the patient rapidly deteriorated, necessitating ICU admission due to septic shock and respiratory failure. Despite initial diagnostic challenges, including normal initial imaging and inconclusive laboratory findings, a presumptive diagnosis of leptospirosis was made using Modified Faine's criteria. Empirical antibiotic treatment with doxycycline led to significant clinical improvement, highlighting the importance of early recognition and treatment in severe cases of leptospirosis. This case underscores the need for heightened clinical suspicion and the use of diagnostic scoring systems, even in atypical presentations, to facilitate timely intervention and improve patient outcomes.
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Affiliation(s)
- Yusuf Yalcin
- Internal Medicine, Carney Hospital, Tufts University School of Medicine, Boston, USA
| | - Ibrahim Kamel
- Internal Medicine, Carney Hospital, Tufts Medical Center, Boston, USA
| | - Harinder Singh
- Pulmonary and Critical Care Medicine, Carney Hospital, Tufts Medical Center, Boston, USA
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Kundu D, Dutta D, Joseph A, Jana A, Samanta P, Bhakta JN, Alreshidi MA. Safeguarding drinking water: A brief insight on characteristics, treatments and risk assessment of contamination. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:180. [PMID: 38244090 DOI: 10.1007/s10661-024-12311-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024]
Abstract
Water pollution stands as a critical worldwide concern, bearing extensive repercussions that extend to human health and the natural ecosystem. The sources of water pollution can be diverse, arising from natural processes and human activities and the pollutants may range from chemical and biological agents to physical and radiological contaminants. The contamination of water disrupts the natural functioning of the system, leading to both immediate and prolonged health problems. Various technologies and procedures, ranging from conventional to advanced, have been developed to eliminate water impurities, with the choice depending on the type and level of contamination. Assessing risks is a crucial element in guaranteeing the safety of drinking water. Till now, research is continuing the removal of contaminates for the sake of supplying safe drinking water. The study examined physical, inorganic, organic, biological and radiological contaminants in drinking water. It looked at where these contaminants come from, their characteristics, the impact they have and successful methods used in real-world situations to clean the contaminated water. Risk assessment methodologies associated with the use of unsafe drinking water as future directives are also taken into consideration in the present study for the benefit of public concern. The manuscript introduces a comprehensive study on water pollution, focusing on assessing and mitigating risks associated with physical, inorganic, organic, biological and radiological contaminants in drinking water, with a novel emphasis on future directives and sustainable solutions for public safety.
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Affiliation(s)
- Debajyoti Kundu
- Department of Environmental Science and Engineering, School of Engineering and Sciences, SRM University-AP, Amaravati, Andhra Pradesh, 522 240, India.
| | - Deblina Dutta
- Department of Environmental Science and Engineering, School of Engineering and Sciences, SRM University-AP, Amaravati, Andhra Pradesh, 522 240, India.
| | - Anuja Joseph
- School of Environmental Science and Engineering, Indian Institute of Technology Kharagpur, Kharagpur, 721 302, India
| | - Ankan Jana
- Malaviya National Institute of Technology, Jaipur, Rajasthan, 302 017, India
| | - Palas Samanta
- Department of Environmental Science, Sukanta Mahavidyalaya, University of North Bengal, Dhupguri, Jalpaiguri, 735 210, India
| | - Jatindra Nath Bhakta
- Department of Ecological Studies & International Centre for Ecological Engineering, University of Kalyani, Kalyani, West Bengal, 741 235, India
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26
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Jin Y, Lan W, Chen X, Liu W, Luo W, Chen S. A rare case of anti-DPPX encephalitis combined with neuroleptospirosis. BMC Neurol 2024; 24:34. [PMID: 38243162 PMCID: PMC10797929 DOI: 10.1186/s12883-024-03538-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/14/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Neuroleptospirosis and anti-dipeptidyl-peptidase-like protein 6 (DPPX) encephalitis are both very rare and have only been reported in the form of respective case reports. There are no reports of anti-DPPX encephalitis combined with neuroleptospirosis in the literature. We reported the first case of neuroleptospirosis combined with elevated DPPX antibodies in serum and cerebrospinal fluid (CSF). CASE PRESENTATION A previously healthy 53-year-old Chinese male farmer with a history of drinking raw stream water and flood sewage exposure was brought to the hospital due to an acute onset of neuropsychiatric symptoms. No fever or meningeal irritation signs were detected on physical examination. Routine laboratory investigations, including infection indicators, leukocyte and protein in CSF, electroencephalogram and gadolinium-enhanced magnetic resonance imaging of the brain, all revealed normal. While metagenomic next-generation sequencing (mNGS) identified the DNA genome of Leptospira interrogans in the CSF. Anti-DPPX antibody was detected both in blood and in CSF. A diagnosis of neuroleptospirosis combined with autoimmune encephalitis associated with DPPX-Ab was eventually made. He resolved completely after adequate amount of penicillin combined with immunotherapy. CONCLUSION We highlight that in patients with acute or subacute behavioral changes, even in the absence of fever, if the most recent freshwater exposure is clear, physicians should pay attention to leptospirosis. Due to the low sensitivity of routine microscopy, culture, polymerase chain reaction and antibody testing, mNGS may have more advantages in diagnosing neuroleptospirosis. As autoimmune encephalitis can be triggered by various infections, neuroleptospirosis may be one of the causes of autoimmune encephalitis. Since neuronal antibody measurements themselves are not that common in neuroleptospirosis, future studies are needed to determine whether the detection of anti-DPPX antibodies is a rare event in leptospirosis. Early identification of autoimmune encephalitis and timely administration of immunotherapy may lead to a better outcome.
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Affiliation(s)
- Yong Jin
- Department of Neurology, Huizhou Central People's Hospital, No. 41, Eling North Road, Huizhou, Guangdong Province, 516001, China
| | - Wei Lan
- Department of Neurology, Huizhou Central People's Hospital, No. 41, Eling North Road, Huizhou, Guangdong Province, 516001, China
| | - Xiaodong Chen
- Department of Neurology, Huizhou Central People's Hospital, No. 41, Eling North Road, Huizhou, Guangdong Province, 516001, China
| | - Wu Liu
- Department of Neurology, Huizhou Central People's Hospital, No. 41, Eling North Road, Huizhou, Guangdong Province, 516001, China
| | - Weiliang Luo
- Department of Neurology, Huizhou Central People's Hospital, No. 41, Eling North Road, Huizhou, Guangdong Province, 516001, China.
| | - Suqin Chen
- Department of Neurology, Huizhou Central People's Hospital, No. 41, Eling North Road, Huizhou, Guangdong Province, 516001, China.
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Soro SD, Lattard V, Kodjo A, Benoît E, Chatron N. Structural investigation of vitamin K epoxide reductase domain-containing protein in Leptospira species: a potential target for the development of new leptospirosis treatments as an alternative to antibiotics. J Biomol Struct Dyn 2024:1-13. [PMID: 38197604 DOI: 10.1080/07391102.2024.2302925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024]
Abstract
Leptospirosis is a worldwide zoonosis caused by the motile bacterium Leptospira. This disease can cause hemorrhagic symptoms, multi-visceral and renal failures, resulting in one million cases and approximately 60,000 deaths each year. The motility of Leptospira is highly involved in its virulence and is ensured by the presence of two flagella in the periplasm. Several proteins that require the formation of disulfide bridges are essential for flagellar function. In Leptospira, these redox reactions are catalysed by the vitamin K epoxide reductase domain-containing protein (VKORdcp). The aim of the present work was to study the conservation of VKORdcp among Leptospira species and its interactions with putative substrates and inhibitor. Our results evidenced the presence of ten amino acids specific to either pathogenic or saprophytic species. Furthermore, structural studies revealed a higher affinity of the enzyme for vitamin K1 quinone, compared to ubiquinone. Finally, characterisation of the binding of a potential inhibitor revealed the involvement of some VKORdcp amino acids that have not been present in the human enzyme, in particular the polar residue D114. Our study thus paves the way for the future development of Leptospira VKORdcp inhibitors, capable of blocking bacterial motility. Such molecules could therefore offer a promising therapeutic alternative to antibiotics, especially in the event of the emergence of antibiotic-resistant strains.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
| | - Virginie Lattard
- USC 1233-RS2GP, VetAgro Sup, INRAE, Université de Lyon, Marcy L'Etoile, France
| | - Angeli Kodjo
- USC 1233-RS2GP, VetAgro Sup, INRAE, Université de Lyon, Marcy L'Etoile, France
| | - Etienne Benoît
- USC 1233-RS2GP, VetAgro Sup, INRAE, Université de Lyon, Marcy L'Etoile, France
| | - Nolan Chatron
- USC 1233-RS2GP, VetAgro Sup, INRAE, Université de Lyon, Marcy L'Etoile, France
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Torres-Bustamante M, Cantillo-Barraza O, Ko AI, Wunder EA, Quintero-Vélez JC. Eco-epidemiological study of seropositivity against Rickettsia and Leptospira agents in rural areas of Urabá, Colombia. RESEARCH SQUARE 2024:rs.3.rs-3760267. [PMID: 38260656 PMCID: PMC10802693 DOI: 10.21203/rs.3.rs-3760267/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Rickettsioses and leptospirosis are infectious diseases that are often underdiagnosed due to a lack of knowledge about their epidemiology, pathophysiology, diagnosis, management, among others. Objetive to characterize the seroprevalence and seroincidence of both Rickettsia and Leptospira agents and determine the risk factors for these outcomes in rural areas of Urabá, Antioquia. Methods a secondary data analysis using information on Rickettsia and Leptospira exposure from a prior prospective study that explored sociocultural and ecological aspects of Rickettsia infection in rural Urabá, Colombia. A multinomial mixed logistic regression model was employed to analyze factors linked to seroprevalent cases of Rickettsia, Leptospira and both, along with descriptive analyses of seroincident cases. Results the concomitant seroprevalence against Rickettsiaand Leptospira was 9.38% [95%CI 6.08%-13.37%] (56/597). The factors associated with this seroprevalence were age (ORa= 1.02 [95%CI 1.007-1.03]), male gender (ORa= 3.06 [95%CI 1.75-5.37]), fever history (ORa= 1.71 [95%CI 1.06-2.77]) the presence of breeding pigs (ORa= 2.29 [95%CI 1.36-3.88]), peridomicile yucca crops(ORa= 2.5 [95%CI 1.1-5.62]), and deforestation practices(ORa= 1.74 [95%CI 1.06-2.87]). The concomitant seroincidence against Rickettsia and Leptospira was 1.09% (3/274) [95%CI 0.29%-4.05%], three cases were female, with a median age of 31.83 years-old (IQR 8.69-56.99). At the household level, all the seroincident cases had households built partially or totally with soil floors, wooden walls, and zinc roofs. Two seroincident cases described the presence of equines, canines, and domestic chickens in intra or peri-domicile. Finally, two cases were exposed to synanthropic rodents, and one case to tick infestation. Conclusion there is evidence of seroprevalent and seroincident cases of seropositivity against both Rickettsia and Leptospira in rural areas of Urabá, Colombia. These findings can help improve public health surveillance systems in preventing, detecting, and attending to the different clinical cases caused by these pathogens.
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Thielen BK, Holzbauer S, Templen B, Schafer IJ, Artus A, Galloway R, Ireland M, Femrite T, Schleiss MR. Case Report: Locally Acquired Leptospirosis in a Minnesota Boy and His Dog. Am J Trop Med Hyg 2024; 110:123-126. [PMID: 37983913 DOI: 10.4269/ajtmh.23-0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/18/2023] [Indexed: 11/22/2023] Open
Abstract
Leptospirosis affects numerous animal species, including domestic dogs, but documented transmission to humans is rare. Here, we describe epidemiologically linked cases in a 12-year-old Minnesota boy and his pet dog. While human leptospirosis is often thought of as a disease of tropical locations, this case report describes a rare documented example of local transmission in the northern United States, a region historically not perceived to be at high risk of Leptospira species transmission to humans. This case highlights an unusual presentation, with facial nerve palsy, underappreciated epidemiological risks, and diagnostic challenges of this reemerging infection.
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Affiliation(s)
- Beth K Thielen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Stacy Holzbauer
- Minnesota Department of Health, St. Paul, Minnesota
- Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Ilana J Schafer
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aileen Artus
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Renee Galloway
- Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Mark R Schleiss
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
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Zida S, Kania D, Bolloré K, Bandaogo O, Pisoni A, Dicko A, Tinto B, Traoré J, Van de Perre P, Ouédraogo HG, Tuaillon E. Leptospirosis Cases among Outpatients with Non-Malaria Fever Attending Primary Care Clinics during the Rainy Season in Bobo Dioulasso, Burkina Faso. Am J Trop Med Hyg 2024; 110:127-132. [PMID: 38011730 DOI: 10.4269/ajtmh.23-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 08/28/2023] [Indexed: 11/29/2023] Open
Abstract
Leptospirosis is presumably an important cause of non-malarial fever in West Africa. In this study, outpatients consulting in primary care clinics during the rainy season were tested for leptospirosis, and clinical characteristics associated with leptospirosis cases were explored. Patients with fever ≥ 39°C were recruited in nine primary health care centers in Bobo Dioulasso (Burkina Faso). Diagnosis of malaria was ruled out using a rapid diagnostic test (RDT; SD Bioline Malaria®). Leptospirosis cases were defined as patients who tested positive for Leptospira IgM (Leptocheck-WB RDT and Leptospira IgM ELISA assay, Panbio) or DNA in plasma (LipL32 polymerase chain reaction [PCR]). Among 350 patients, 202 tested positive for malaria and were excluded, and 148 met the eligibility criteria and were included. Among these, 26 subjects were considered to be leptospirosis cases: 23 tested positive for Leptospira IgM (15.5%) and three tested positive by PCR (2.2%). Headaches, abdominal symptoms, and myalgia were frequently reported without any difference between leptospirosis cases and negative cases. Cough was more frequently observed among subjects testing positive for leptospirosis (P = 0.02). Water exposure, presence of a skin injury, and walking barefoot were associated with a Leptospira-positive test. All leptospirosis cases recovered without sequelae. A significant portion of outpatients with non-malarial febrile illness during the rainy season in Burkina Faso had epidemiological factors associated with leptospirosis and tested positive for Leptospira. The favorable outcome of leptospirosis cases was reassuring; this could be due in particular to the young age of the patients.
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Affiliation(s)
- Sylvie Zida
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Dramane Kania
- Institut National de Santé Publique, Centre MURAZ, Bobo Dioulasso, Burkina Faso
| | - Karine Bolloré
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, Institut National de la Santé Et de la Recherche Médicale, Établissement Français du Sang, Antilles University, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Ousséni Bandaogo
- Institut National de Santé Publique, Centre MURAZ, Bobo Dioulasso, Burkina Faso
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, Institut National de la Santé Et de la Recherche Médicale, Établissement Français du Sang, Antilles University, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Amadou Dicko
- Institut National de Santé Publique, Centre MURAZ, Bobo Dioulasso, Burkina Faso
| | - Bachirou Tinto
- Institut National de Santé Publique, Centre MURAZ, Bobo Dioulasso, Burkina Faso
| | - Jacques Traoré
- Institut National de Santé Publique, Centre MURAZ, Bobo Dioulasso, Burkina Faso
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, Institut National de la Santé Et de la Recherche Médicale, Établissement Français du Sang, Antilles University, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | | | - Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, Institut National de la Santé Et de la Recherche Médicale, Établissement Français du Sang, Antilles University, Centre Hospitalier Universitaire Montpellier, Montpellier, France
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Shiddapur G, Reddy VKK, Kondapalli MP, Adapa S, Agarwal S. Leptospirosis and Dengue Coinfection-Associated Multi-Organ Dysfunction Syndrome: A Case Report. Cureus 2024; 16:e52466. [PMID: 38371008 PMCID: PMC10870101 DOI: 10.7759/cureus.52466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Dengue and leptospirosis are frequently discussed separately, with dengue causing rash and leptospirosis causing jaundice. Currently, there are more and more reports of coinfections. The comparable clinical symptoms of both infections make it challenging to distinguish between leptospirosis and dengue. Differentiating between leptospirosis and dengue is crucial since leptospirosis has a more favorable prognosis with early antibiotic therapy, whereas dengue does not have a specific treatment, although early detection is essential for close monitoring and cautious fluid management. Here, we highlight a case of dengue virus and leptospirosis coinfection in a female who presented with acute febrile illness, dyspnea, and altered sensorium, which progressed to multiorgan dysfunction syndrome, involving the neurological, respiratory, hepatic, and hematological systems.
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Affiliation(s)
- Govind Shiddapur
- General Medicine, Dr. D. Y. Patil College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Vutukuru Kalyan Kumar Reddy
- General Medicine, Dr. D. Y. Patil College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Mohith Prakash Kondapalli
- General Medicine, Dr. D. Y. Patil College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Saimounika Adapa
- General Medicine, Dr. D. Y. Patil College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Sonali Agarwal
- General Medicine, Dr. D. Y. Patil College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
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Shirzad R, Alesheikh AA, Asgharzadeh M, Hoseini B, Lotfata A. Spatio-temporal modeling of human leptospirosis prevalence using the maximum entropy model. BMC Public Health 2023; 23:2521. [PMID: 38104062 PMCID: PMC10724969 DOI: 10.1186/s12889-023-17391-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Leptospirosis, a zoonotic disease, stands as one of the prevailing health issues in some tropical areas of Iran. Over a decade, its incidence rate has been estimated at approximately 2.33 cases per 10,000 individuals. Our research focused on analyzing the spatiotemporal clustering of Leptospirosis and developing a disease prevalence model as an essential focal point for public health policymakers, urging targeted interventions and strategies. METHODS The SaTScan and Maximum Entropy (MaxEnt) modeling methods were used to find the spatiotemporal clusters of the Leptospirosis and model the disease prevalence in Iran. We incorporated nine environmental covariates by employing a spatial resolution of 1 km x 1 km, the finest resolution ever implemented for modeling Human Leptospirosis in Iran. These covariates encompassed the Digital Elevation Model (DEM), slope, displacement areas, water bodies, and land cover, monthly recorded Normalized Difference Vegetation Index (NDVI), monthly recorded precipitation, monthly recorded mean and maximum temperature, contributing significantly to our disease modeling approach. The analysis using MaxEnt yielded the Area Under the Receiver Operating Characteristic Curve (AUC) metrics for the training and test data, to evaluate the accuracy of the implemented model. RESULTS The findings reveal a highly significant primary cluster (p-value < 0.05) located in the western regions of the Gilan province, spanning from July 2013 to July 2015 (p-value < 0.05). Moreover, there were four more clusters (p-value < 0.05) identified near Someh Sara, Neka, Gorgan and Rudbar. Furthermore, the risk mapping effectively illustrates the potential expansion of the disease into the western and northwestern regions. The AUC metrics of 0.956 and 0.952 for the training and test data, respectively, underscoring the robust accuracy of the implemented model. Interestingly, among the variables considered, the influence of slope and distance from water bodies appears to be minimal. However, altitude and precipitation stand out as the primary determinants that significantly contribute to the prevalence of the disease. CONCLUSIONS The risk map generated through this study carries significant potential to enhance public awareness and inform the formulation of impactful policies to combat Leptospirosis. These maps also play a crucial role in tracking disease incidents and strategically directing interventions toward the regions most susceptible.
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Affiliation(s)
- Reza Shirzad
- Department of Geospatial Information System, Faculty of Geodesy and Geomatics Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Ali Asghar Alesheikh
- Department of Geospatial Information System, Faculty of Geodesy and Geomatics Engineering, K. N. Toosi University of Technology, Tehran, Iran.
| | - Mojtaba Asgharzadeh
- Department of Geospatial Information System, Faculty of Geodesy and Geomatics Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Benyamin Hoseini
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Aynaz Lotfata
- School Of Veterinary Medicine, Department of Pathology, Microbiology, and Immunology, University of California, Davis, USA
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Philip N, Ahmed K. Leptospirosis in Malaysia: current status, insights, and future prospects. J Physiol Anthropol 2023; 42:30. [PMID: 38087323 PMCID: PMC10714552 DOI: 10.1186/s40101-023-00347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Among zoonotic infections, leptospirosis has a worldwide distribution and high prevalence in tropical regions. It has a broad clinical presentation from mild to severe, life-threatening infection. Leptospires, the etiological agent of leptospirosis, are found in varied ecological niches and animal species, providing a significant source of human infection. This review aims to provide the current status of leptospirosis in Malaysia and the direction for future studies. The literature search for this review was performed using PubMed, Web of Sciences, and Google Scholar databases. The incidence of leptospirosis in Malaysia from 2004 to 2020 varied; however, a large number of cases occurred during floods. Leptospira has been isolated from wild and domestic animals as well as from the environment; among them, several novel species have been identified. In Malaysia, leptospirosis infection and death were mostly associated with recreational and non-recreational water activities. Despite the endemicity of leptospirosis, the public's knowledge, attitude, and practice level are relatively low in this country. More studies are needed in Malaysia to explore the extent of leptospirosis in different settings and locations.
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Affiliation(s)
- Noraini Philip
- School of Biological Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan.
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Hailat NQ, Mafrag ZA, Gharaibeh MH, Alzuheir IM. Pathological and molecular study of kidneys in apparently healthy cattle and sheep with special reference to Leptospira species in central and northern Jordan. Vet World 2023; 16:2488-2496. [PMID: 38328369 PMCID: PMC10844780 DOI: 10.14202/vetworld.2023.2488-2496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/13/2023] [Indexed: 02/09/2024] Open
Abstract
Background and Aim Renal pathological conditions can cause significant economic losses for livestock owners. This study investigated and described the gross pathology and histopathology of lesions found in the kidneys of sheep and cattle, with particular attention to the presence of Leptospira spp. Materials and Methods Three hundred and sixty kidneys from apparently healthy sheep and cattle (208 and 152, respectively) were collected from slaughterhouses in Jordan for gross and histopathological examinations, multiplex polymerase chain reaction (PCR) analysis, and gene sequencing of Leptospira spp. Results Histopathological analysis of the samples revealed the following conditions: interstitial nephritis (4.44%), glomerulonephritis (4.16%), acute tubular necrosis (17.22%), and renal congestion (4.72%). In addition, in 26.9% of the samples, hyaline material was observed in the interstitium of the cortex and medulla. The PCR results revealed that 83 (23.1%) of the 360 samples were positive for Leptospira spp. 16S rRNA, 42/152 (28%) of cattle, and 41/208 (20%) of sheep. Four samples (two sheep and two cattle) were sequenced and deposited in GenBank with accession numbers from OL701310 to OL701313. Basic Local Alignment Search Tool search and nucleotide similarities between OL701311 and OL701313 resulted in the highest similarities with different Leptospira borgpetersenii strains, whereas OL701310 showed the highest nucleotide similarity (99.2%) with the Leptospira interrogans strain. Similarly, phylogenetic analysis revealed that OL701311 to OL701313 clustered together with different serovars of L. borgpetersenii, whereas OL701310 clustered with the L. interrogans clade. Conclusion This is the first study to reveal a close association between pathogenic Leptospira spp. and kidney disorders in Jordanian cattle and sheep. These findings may help expand the current understanding of the causes and mechanisms of renal disease in cattle and sheep and contribute to developing more effective prevention and treatment programs.
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Affiliation(s)
- Nabil Q. Hailat
- Department of Veterinary Pathology and Public Health Faculty of Veterinary Medicine, Jordan University of Science and Technology, P.O. Box 3030 Irbid, 22110 Jordan
| | - Zaid A. Mafrag
- Department of Veterinary Pathology and Public Health Faculty of Veterinary Medicine, Jordan University of Science and Technology, P.O. Box 3030 Irbid, 22110 Jordan
| | - Mohammad H. Gharaibeh
- Department of Basic Veterinary Medical Science, Faculty of Veterinary Medicine, Jordan University of Science and Technology, P.O. Box 3030 Irbid, 22110 Jordan
| | - Ibrahim M. Alzuheir
- Department of Veterinary Medicine, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, P.O. Box 7 Nablus, Palestine
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Schuler EJ, Patel DT, Marconi RT. The leptospiral OmpA-like protein (Loa22) is a surface-exposed antigen that elicits bactericidal antibody against heterologous Leptospira. Vaccine X 2023; 15:100382. [PMID: 37727366 PMCID: PMC10506094 DOI: 10.1016/j.jvacx.2023.100382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/28/2023] [Accepted: 08/30/2023] [Indexed: 09/21/2023] Open
Abstract
Leptospirosis is the most widespread zoonosis, affecting over 1 million humans each year, with more than 60,000 deaths worldwide. Leptospirosis poses a significant health threat to dogs, horses, cattle, and wildlife. The disease may be self-limiting or progress to a life-threatening multi-system disorder affecting the kidneys, liver, and lungs. Currently, bacterin vaccine formulations that consist of one or more laboratory-cultivated strains are used for prevention. However, the antibody response elicited by these vaccines is directed primarily at lipopolysaccharide and is generally serovar-specific. The development of broadly protective subunit vaccines for veterinary and human applications would be a significant step forward in efforts to combat this emerging and antigenically variable pathogen. This study assessed the properties and potential utility of the Leptospira Loa22 (Leptospira OmpA-like 22 kDa protein) protein as a vaccine antigen. Loa22 is a virulence factor that is predicted to transverse the outer membrane and present its N-terminal domain on the cell surface. This report demonstrates that diverse Leptospira strains express Loa22 in vitro and that the protein is antigenic during infection in dogs. Immunoblot and size exclusion chromatography revealed that Loa22 exists in monomeric and trimeric forms. Immunization of rats with recombinant Loa22 elicited bactericidal antibodies against diverse Leptospira strains. The immunodominant bactericidal epitopes were localized within the N-terminal domain using protein-blocking bactericidal assays. This study supports the utility of Loa22, or subfragments thereof, in developing a multivalent chimeric subunit vaccine to prevent leptospirosis and sheds new light on the cellular localization of Loa22.
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Affiliation(s)
- Edward J.A. Schuler
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, 1112 E Clay St., Richmond, VA 23298, USA
| | - Dhara T. Patel
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, 1112 E Clay St., Richmond, VA 23298, USA
| | - Richard T. Marconi
- Department of Microbiology and Immunology, Virginia Commonwealth University Medical Center, 1112 E Clay St., Richmond, VA 23298, USA
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Arboleda M, Mejía-Torres M, Posada M, Restrepo N, Ríos-Tapias P, Rivera-Pedroza LA, Calle D, Sánchez-Jiménez MM, Marín K, Agudelo-Flórez P. Molecular Diagnosis as an Alternative for Public Health Surveillance of Leptospirosis in Colombia. Microorganisms 2023; 11:2759. [PMID: 38004770 PMCID: PMC10673046 DOI: 10.3390/microorganisms11112759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Leptospirosis represents a public health problem in Colombia. However, the underreporting of the disease is an unfortunate reality, with a clear trend towards a decrease in cases since 2019, when the guidelines for its confirmatory diagnosis changed with the requirement of two paired samples. The purpose of this review is to highlight the importance of leptospirosis. While the access to rapid diagnosis is available at practically all levels of care for dengue and malaria, leptospirosis-a doubly neglected disease-deserves recognition as a serious public health problem in Colombia. In this manner, it is proposed that molecular tests are a viable diagnostic alternative that can improve the targeted treatment of the patient and the timeliness of data and case reporting to SIVIGILA, and reduce the underreporting of the disease. Taking advantage of the strengthened technological infrastructure derived from the SARS-CoV-2 pandemic for molecular diagnosis in Colombia, with a network of 227 laboratories distributed throughout the national territory, with an installed capacity for PCR testing, it is proposed that molecular diagnosis can be used as an alternative for early diagnosis. This would allow case confirmation through the public health network in Colombia, and, together with the microagglutination (MAT) technique, the epidemiological surveillance of this disease in this country would be strengthened.
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Affiliation(s)
- Margarita Arboleda
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Mariana Mejía-Torres
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Maritza Posada
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Nicaela Restrepo
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Paola Ríos-Tapias
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Luis Alberto Rivera-Pedroza
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - David Calle
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Miryan M. Sánchez-Jiménez
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Katerine Marín
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
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Sharma MD, Mishra P, Ali A, Kumar P, Kapil P, Grover R, Verma R, Saini A, Kulshrestha S. Microbial Waterborne Diseases in India: Status, Interventions, and Future Perspectives. Curr Microbiol 2023; 80:400. [PMID: 37930488 DOI: 10.1007/s00284-023-03462-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/30/2023] [Indexed: 11/07/2023]
Abstract
Water plays a vital role as a natural resource since life is unsustainable without it. If water is polluted or contaminated, it results in several health issues among people. Millions of people are infected with waterborne diseases globally, and India is no exception. In the present review, we have analyzed the outbreaks of waterborne diseases that occurred in several Indian states between 2014 and 2020, identified the key infections, and provided insights into the performance of sanitation improvement programs. We noted that acute diarrheal disease (ADD), typhoid, cholera, hepatitis, and shigellosis are common waterborne diseases in India. These diseases have caused about 11,728 deaths between 2014 and 2018 out of which 10,738 deaths occurred only after 2017. The outbreaks of these diseases have been rising because of a lack of adequate sanitation, poor hygiene, and the absence of proper disposal systems. Despite various efforts by the government such as awareness campaigns, guidance on diet for infected individuals, and sanitation improvement programs, the situation is still grim. Disease hotspots and risk factors must be identified, water, sanitation, and hygiene (WASH) services must be improved, and ongoing policies must be effectively implemented to improve the situation. The efforts must be customized to the local environment. In addition, the possible effects of climate change must be projected, and strategies must be accordingly optimized.
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Affiliation(s)
- Mamta D Sharma
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Puranjan Mishra
- Institute of Bioresource and Agriculture, Hong Kong Baptist University, Hong Kong, China
| | - Aaliya Ali
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Pradeep Kumar
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Prachi Kapil
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India
| | - Rahul Grover
- Shoolini Institute of Life Sciences and Business Management, The Mall, Solan, Himachal Pradesh, India
| | - Rekha Verma
- Amity School of Law, Amity University, Noida, UP, India
| | - Anita Saini
- Shoolini Institute of Life Sciences and Business Management, The Mall, Solan, Himachal Pradesh, India
| | - Saurabh Kulshrestha
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India.
- Center for Omics and Biodiversity Research, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, India.
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Phukan H, Sarma A, Rex DAB, Christie SAD, Sabu SK, Hariharan S, Prasad TSK, Madanan MG. Physiological Temperature and Osmotic Changes Drive Dynamic Proteome Alterations in the Leptospiral Outer Membrane and Enhance Protein Export Systems. J Proteome Res 2023; 22:3447-3463. [PMID: 37877620 DOI: 10.1021/acs.jproteome.3c00295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Leptospirosis, a remerging zoonosis, has no effective vaccine or an unambiguous early diagnostic reagent. Proteins differentially expressed (DE) under pathogenic conditions will be useful candidates for antileptospiral measures. We employed a multipronged approach comprising high-resolution TMT-labeled LC-MS/MS-based proteome analysis coupled with bioinformatics on leptospiral proteins following Triton X-114 subcellular fractionation of leptospires treated under physiological temperature and osmolarity that mimic infection. Although there were significant changes in the DE proteins at the level of the entire cell, there were notable changes in proteins at the subcellular level, particularly on the outer membrane (OM), that show the significance of subcellular proteome analysis. The detergent-enriched proteins, representing outer membrane proteins (OMPs), exhibited a dynamic nature and upregulation under various physiological conditions. It was found that pathogenic proteins showed a higher proportion of upregulation compared to the nonpathogenic proteins in the OM. Further analysis identified 17 virulent proteins exclusively upregulated in the outer membrane during infection that could be useful for vaccine and diagnostic targets. The DE proteins may aid in metabolic adaptation and are enriched in pathways related to signal transduction and antibiotic biosynthesis. Many upregulated proteins belong to protein export systems such as SEC translocase, T2SSs, and T1SSs, indicating their sequential participation in protein transport to the outer leaflet of the OM. Further studies on OM-localized proteins may shed light on the pathogenesis of leptospirosis and serve as the basis for effective countermeasures.
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Affiliation(s)
- Homen Phukan
- Department of Biochemistry, ICMR - Regional Medical Research Centre, Port Blair 744103, Andaman and Nicobar Islands, India
| | - Abhijit Sarma
- Department of Biochemistry, ICMR - Regional Medical Research Centre, Port Blair 744103, Andaman and Nicobar Islands, India
| | - Devasahayam Arokia Balaya Rex
- Center for Systems Biology and Molecular Medicine, Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore 575018, India
| | | | - Sarath Kizhakkemuriyil Sabu
- Department of Biochemistry, ICMR - Regional Medical Research Centre, Port Blair 744103, Andaman and Nicobar Islands, India
| | - Suneetha Hariharan
- Department of Biochemistry, ICMR - Regional Medical Research Centre, Port Blair 744103, Andaman and Nicobar Islands, India
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Rashid H, Omoloye AK, Abualnaja SY, Oyibo SO, Akintade OO. A Fish Farmer's Encounter With Leptospirosis: A Case Report. Cureus 2023; 15:e48138. [PMID: 37929271 PMCID: PMC10620544 DOI: 10.7759/cureus.48138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 11/07/2023] Open
Abstract
Leptospirosis is a zoonotic infection primarily caused by bacteria of the genus Leptospira. This infectious disease mainly occurs through direct contact with infected animals or indirect contact via contaminated soil or water. While the incidence rate of leptospirosis in the developing world is as high as 100 cases per 100,000 population, the incidence rate in the United Kingdom is low (0.14 cases per 100,000 population). We present a 56-year-old male fish farmer who presented to the emergency department with a history of intense thigh pain and sudden inability to mobilise following a week-long period of a flu-like illness, characterised by worsening myalgia localised to the inner thighs, fever, and episodes of passing dark red urine. Initial investigations demonstrated acute renal impairment, hepatitis, thrombocytopenia, mild rhabdomyolysis and raised inflammatory markers. With a suspected diagnosis of leptospirosis after a detailed clinical history and preliminary blood tests, treatment was immediately commenced with intravenous antibiotics, intravenous rehydration and vigilant monitoring of urinary output. The patient's condition rapidly improved and the diagnosis was later confirmed by a positive Leptospira polymerase chain reaction (PCR) report and serology. We believe prompt treatment prevented deterioration in this case. The aim of this case report is to highlight the importance of a detailed clinical history, with a particular focus on occupational exposure, especially in the developed world. Additionally, a low clinical threshold for leptospirosis is imperative, as rapid clinical deterioration can happen if no immediate medical intervention is performed.
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Affiliation(s)
- Hamza Rashid
- Medicine, Peterborough City Hospital, Peterborough, GBR
| | | | | | - Samson O Oyibo
- Diabetes and Endocrinology, Peterborough City Hospital, Peterborough, GBR
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Techawiwattanaboon T, Phanchamnan E, Iadsee N, Makjaroen J, Pisitkun T, Patarakul K. Proteomic profile of naturally released extracellular vesicles secreted from Leptospira interrogans serovar Pomona in response to temperature and osmotic stresses. Sci Rep 2023; 13:18601. [PMID: 37903905 PMCID: PMC10616267 DOI: 10.1038/s41598-023-45863-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/25/2023] [Indexed: 11/01/2023] Open
Abstract
Bacterial extracellular vesicles (EVs) are generally formed by pinching off outer membrane leaflets while simultaneously releasing multiple active molecules into the external environment. In this study, we aimed to identify the protein cargo of leptospiral EVs released from intact leptospires grown under three different conditions: EMJH medium at 30 °C, temperature shifted to 37 °C, and physiologic osmolarity (EMJH medium with 120 mM NaCl). The naturally released EVs observed under transmission electron microscopy were spherical in shape with an approximate diameter of 80-100 nm. Quantitative proteomics and bioinformatic analysis indicated that the EVs were formed primarily from the outer membrane and the cytoplasm. The main functional COG categories of proteins carried in leptospiral EVs might be involved in cell growth, survival and adaptation, and pathogenicity. Relative to their abundance in EVs grown in EMJH medium at 30 °C, 39 and 69 proteins exhibited significant changes in response to the temperature shift and the osmotic change, respectively. During exposure to both stresses, Leptospira secreted several multifunctional proteins via EVs, while preserving certain virulence proteins within whole cells. Therefore, leptospiral EVs may serve as a decoy structure for host responses, whereas some virulence factors necessary for direct interaction with the host environment are reserved in leptospiral cells. This knowledge will be useful for understanding the pathogenesis of leptospirosis and developing as one of vaccine platforms against leptospirosis in the future.
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Affiliation(s)
- Teerasit Techawiwattanaboon
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development, Chulalongkorn University, Bangkok, Thailand
| | - Eakalak Phanchamnan
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development, Chulalongkorn University, Bangkok, Thailand
- Medical Microbiology, Interdisciplinary Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Nutta Iadsee
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development, Chulalongkorn University, Bangkok, Thailand
- Medical Microbiology, Interdisciplinary Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Jiradej Makjaroen
- Center of Excellence in Systems Biology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Trairak Pisitkun
- Center of Excellence in Systems Biology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kanitha Patarakul
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development, Chulalongkorn University, Bangkok, Thailand.
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Rajaonarivelo JA, Desmoulin A, Maillard O, Collet L, Baudino F, Jaffar-Bandjee MC, Blondé R, Raffray L, Tortosa P. Clinical manifestations of human leptospirosis: bacteria matter. Front Cell Infect Microbiol 2023; 13:1259599. [PMID: 37953799 PMCID: PMC10635415 DOI: 10.3389/fcimb.2023.1259599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/06/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction A high incidence of human leptospirosis is recorded on Mayotte, an oceanic island located in southwestern Indian Ocean, but the severity of the disease appears relatively mild in terms of mortality rate and admission to the intensive care unit. It has been proposed that mild leptospirosis may result from a limited virulence of some of the occurring Leptospira species to which the population is exposed. Methods Clinical and biological data of patients admitted to the Centre Hospitalier de Mayotte were collected and the infecting Leptospira species were determined through molecular typing. Results Leptospira interrogans was detected in the minority of admitted patients but most of these patients suffered from severe forms, with 50% admitted to intensive care unit and suffering from organ failures. Nineteen percent of patients infected with Leptospira borgpetersenii were admitted to the intensive care, with 13% displaying organ failures, and one patient died. Leptospira mayottensis was found in 28% of the patients and not a single severe case was observed. Discussion The distribution of Leptospira species in patients was not different from that reported 10-15 years ago and bacterial genotypes were very closely related to those previously reported. These results highlight the importance of the diversity of pathogenic Leptospira circulating on Mayotte island and are in keeping with distinct outcome of the disease depending on the infecting Leptospira. Altogether, presented data support that the infecting Leptospira species is an important driver of disease severity in humans.
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Affiliation(s)
- Jeanne Arline Rajaonarivelo
- Unité Mixte de Recherche Processus Infectieux en Milieu Insulaire Tropical (UMR PIMIT), Université de La Réunion, CNRS 9192, INSERM 1187, IRD 249, La Réunion, France
| | - Anissa Desmoulin
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire (CHU) de La Réunion Sites Sud, Réunion, France
- Service de Réanimation, Centre Hospitalier de Mayotte, Mayotte, France
| | - Olivier Maillard
- Department of Public Health and Research, Clinical Investigation Center (CIC), INSERM CIC 1410, CHU Réunion, Réunion, France
| | - Louis Collet
- Laboratoire de Microbiologie, Centre Hospitalier de Mayotte, Mayotte, France
| | - Fiona Baudino
- Unité Mixte de Recherche Processus Infectieux en Milieu Insulaire Tropical (UMR PIMIT), Université de La Réunion, CNRS 9192, INSERM 1187, IRD 249, La Réunion, France
| | | | - Renaud Blondé
- Service de Réanimation, Centre Hospitalier de Mayotte, Mayotte, France
| | - Loïc Raffray
- Unité Mixte de Recherche Processus Infectieux en Milieu Insulaire Tropical (UMR PIMIT), Université de La Réunion, CNRS 9192, INSERM 1187, IRD 249, La Réunion, France
- Service de Médecine Interne, Centre Hospitalier Universitaire Felix Guyon, Réunion, France
| | - Pablo Tortosa
- Unité Mixte de Recherche Processus Infectieux en Milieu Insulaire Tropical (UMR PIMIT), Université de La Réunion, CNRS 9192, INSERM 1187, IRD 249, La Réunion, France
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Widawati M, Dhewantara PW, Anasi R, Wahono T, Marina R, Pertiwi IP, Wibowo AA, Ruliansyah A, Riandi MU, Widiastuti D, Astuti EP. An investigation of geographical clusters of leptospirosis during the outbreak in Pangandaran, West Java, Indonesia. GEOSPATIAL HEALTH 2023; 18. [PMID: 37795863 DOI: 10.4081/gh.2023.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/10/2023] [Indexed: 10/06/2023]
Abstract
Leptospirosis is neglected in many tropical developing countries, including Indonesia. Our research on this zoonotic disease aimed to investigate epidemiological features and spatial clustering of recent leptospirosis outbreaks in Pangandaran, West Java. The study analysed data on leptospirosis notifications between September 2022 and May 2023. Global Moran I and local indicator for spatial association (LISA) were applied. Comparative analysis was performed to characterise the identified hotspots of leptospirosis relative to its neighbourhoods. A total of 172 reported leptospirosis in 40 villages from 9 sub-districts in Pangandaran District were analysed. Of these, 132 cases (76.7%) were male. The median age was 49 years (interquartile range [IQR]: 34-59 years). Severe outcomes including renal failure, lung failure, and hepatic necrosis were reported in up to 5% of the cases. A total of 30 patients died, resulting in the case fatality rate (CFR) of 17.4%. Moran's I analysis showed significant spatial autocorrelation (I=0.293; p=0.002) and LISA results identified 7 High-High clusters (hotspots) in the Southwest, with the total population at risk at 26,184 people. The hotspots had more cases among older individuals (median age: 51, IQR: 36-61 years; p<0.001), more farmers (79%, p=0.001) and more evidence of the presence of rats (p=0.02). A comprehensive One Health intervention should be targeted towards these high-risk areas to control the transmission of leptospirosis. More empirical evidence is needed to understand the role of climate, animals and sociodemographic characteristics on the transmission of leptospirosis in the area studied.
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Affiliation(s)
- Mutiara Widawati
- Vector-borne and Zoonotic Diseases Research Group, Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Bogor, West Java.
| | - Pandji Wibawa Dhewantara
- Vector-borne and Zoonotic Diseases Research Group, Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Bogor, West Java.
| | - Raras Anasi
- Health Development Policy Agency, Ministry of Health of Indonesia, Jakarta.
| | - Tri Wahono
- Vector-borne and Zoonotic Diseases Research Group, Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Bogor, West Java.
| | - Rina Marina
- Vector-borne and Zoonotic Diseases Research Group, Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Bogor, West Java.
| | - Intan Pandu Pertiwi
- Environmental Health Technology and Disease Control Agency, Ministry of Health of Indonesia, East Jakarta, DKI Jakarta.
| | - Agus Ari Wibowo
- Environmental Health Technology and Disease Control Agency, Ministry of Health of Indonesia, East Jakarta, DKI Jakarta.
| | - Andri Ruliansyah
- Pangandaran Public Health Laboratory, Ministry of Health of Indonesia, Pangandaran, West Java.
| | - Muhammad Umar Riandi
- Pangandaran Public Health Laboratory, Ministry of Health of Indonesia, Pangandaran, West Java.
| | - Dyah Widiastuti
- Vector-borne and Zoonotic Diseases Research Group, Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Bogor, West Java; School of Postgraduate Studies, Gadjah Mada University, Yogyakarta.
| | - Endang Puji Astuti
- Vector-borne and Zoonotic Diseases Research Group, Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong, Bogor, West Java.
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Hagedoorn NN, Maze MJ, Carugati M, Cash-Goldwasser S, Allan KJ, Chen K, Cossic B, Demeter E, Gallagher S, German R, Galloway RL, Habuš J, Rubach MP, Shiokawa K, Sulikhan N, Crump JA. Global distribution of Leptospira serovar isolations and detections from animal host species: a systematic review and online database. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.03.23296503. [PMID: 37873107 PMCID: PMC10593013 DOI: 10.1101/2023.10.03.23296503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objectives Leptospira, the spirochaete causing leptospirosis, can be classified into >250 antigenically distinct serovars. Although knowledge of the animal host species and geographic distribution of Leptospira serovars is critical to understand the human and animal epidemiology of leptospirosis, currently data are fragmented. We aimed to systematically review the literature on animal host species and geographic distribution of Leptospira serovars to examine associations between serovars with animal host species and regions, and to identify geographic regions in need of study. Methods Nine library databases were searched from inception through 9 March 2023 using keywords including Leptospira, animal, and a list of serovars. We sought reports of detection of Leptospira, from any animal, characterized by cross agglutinin absorption test, monoclonal antibody typing, serum factor analysis, or pulsed-field gel electrophoresis to identify the serovar. Results We included 409 reports, published from 1927 through 2022, yielding data on 154 Leptospira serovars. The reports included data from 66 (26.5%) of 249 countries. Detections were from 144 animal host species including 135 (93.8%) from the class Mammalia, 5 (3.5%) from Amphibia, 3 (2.1%) from Reptilia, and 1 (0.7%) from Arachnida. Across the animal host species, Leptospira serovars that were detected in the largest number of animal species included Grippotyphosa (n=39), Icterohaemorrhagiae (n=29), Pomona (n=28), Australis (n=25), and Ballum (n=25). Of serovars, 76 were detected in a single animal host species. We created an online database to identify animal host species for each serovar by country. Conclusions We found that many countries have few or no Leptospira serovars detected from animal host species and that many serovars were detected from a single animal species. Our study highlights the importance of efforts to identify animal host species of leptospirosis, especially in places with a high incidence of human leptospirosis. We provide an updated resource for leptospirosis researchers.
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Affiliation(s)
| | - Michael J. Maze
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Manuela Carugati
- Division of Infectious Diseases, Duke University Medical Center, Durham, United States of America
| | | | - Kathryn J. Allan
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Kevin Chen
- Infectious Diseases Department, Te Whatu Ora Hauora a Toi Bay of Plenty, New Zealand
| | - Brieuc Cossic
- College of Veterinary Medicine, Ithaca, NY, United States of America
| | - Elena Demeter
- College of Veterinary Medicine, Ithaca, NY, United States of America
| | - Sarah Gallagher
- Health Sciences Library, University of Otago, Dunedin, New Zealand
| | - Richard German
- Health Sciences Library, University of Otago, Dunedin, New Zealand
| | - Renee L. Galloway
- Bacterial Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Josipa Habuš
- Faculty of Veterinary Medicine, University of Zagreb
| | - Matthew P. Rubach
- Division of Infectious Diseases, Duke University Medical Center, Durham, United States of America
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - Kanae Shiokawa
- School of Veterinary Medicine, Ross University, St Kitts
| | - Nadezhda Sulikhan
- Federal Scientific Center of East Asia Terrestrial Biodiversity, FEB Russian Academy of Sciences, Vladivostok, Russia
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Division of Infectious Diseases, Duke University Medical Center, Durham, United States of America
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
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Ashaiba A, Arun A, Prasad KS, Tellis RC. A clinical pilot study for the detection of sphingomyelinase in leptospirosis patient's urine at tertiary care hospital. Heliyon 2023; 9:e21138. [PMID: 37916114 PMCID: PMC10616390 DOI: 10.1016/j.heliyon.2023.e21138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose Leptospirosis is a perplexing mystification for many clinicians. Clinically often underdiagnosed due to lack of a rapid, sensitive, and specific diagnostic test. Currently available diagnostic tests have their own limitations; therefore, monitoring biomarkers that contribute an essential role in pathogenesis is crucial. Herein, a pilot study was conducted to detect the presence of sphingomyelinase in urine of leptospirosis patients. Methods Blood and urine samples were collected from 140 patients having febrile illness. Samples were analyzed through culturing, dark-field microscopy, detecting anti-leptospiral antibodies by MAT, IgM ELISA, Leptocheck-WB and screening for sphingomyelinase using a sphingomyelinase assay kit. Results Out of 140 febrile illness patients, 22.14 % were tested leptospirosis, 33.57 % were dengue, 25 % scrub typhus, 18.57 % malaria and 0.71 % co-infection (dengue-leptospirosis). MAT seropositivity of 19.28 % (27/140) was confirmed with the highest agglutinant determined against serovar Icterohaemorrhagiae RGA followed by Autumnalis, Australis, and Pyrogens. IgM ELISA and Leptocheck-WB positivity was 16.42 % and 13.57 % respectively. Whereas culture and dark-field microscopy showed a sensitivity of 4.28 % and 2.1 %, respectively. Out of 31 confirmed cases of leptospirosis, sphingomyelinase was detected in the urine of 25 (80.64 %) patients, MAT positivity was seen in 87.09 % and culture positivity was seen in 12.90 % of cases. Conclusion Detection of sphingomyelinase in the urine of a leptospirosis patient and its absence in other febrile illnesses like dengue, malaria and scrub typhus establish evidence of secretion of sphingomyelinase in urine during leptospiral infection. Hence, sphingomyelinase could be used as a potential diagnostic biomarker to detect leptospirosis in a non-invasive way.
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Affiliation(s)
- A. Ashaiba
- Department of Microbiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
| | - A.B. Arun
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
- Yenepoya Institute of Arts, Science, Commerce and Management (YIASCM), Yenepoya (deemed to be) University, Mangalore, 575 002, India
| | - K. Sudhakara Prasad
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
- Nanomaterial Research Laboratory, Yenepoya Research Centre Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
| | - Rouchelle C. Tellis
- Department of Microbiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
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Kędzierska-Mieszkowska S. Sigma factors of RNA polymerase in the pathogenic spirochaete Leptospira interrogans, the causative agent of leptospirosis. FASEB J 2023; 37:e23163. [PMID: 37688587 DOI: 10.1096/fj.202300252rrr] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/13/2023] [Accepted: 08/14/2023] [Indexed: 09/11/2023]
Abstract
The aim of this review is to summarize the current knowledge on the role of σ factors in a highly invasive spirochaete Leptospira interrogans responsible for leptospirosis that affects many mammals, including humans. This disease has a significant impact on public health and the economy worldwide. In bacteria, σ factors are the key regulators of gene expression at the transcriptional level and therefore play an important role in bacterial adaptative response to different environmental stimuli. These factors form a holoenzyme with the RNA polymerase core enzyme and then direct it to specific promoters, which results in turning on selected genes. Most bacteria possess several different σ factors that enable them to maintain basal gene expression, as well as to regulate gene expression in response to specific environmental signals. Recent comparative genomics and in silico genome-wide analyses have revealed that the L. interrogans genome, consisting of two circular chromosomes, encodes a total of 14 σ factors. Among them, there is one putative housekeeping σ70 -like factor, and three types of alternative σ factors, i.e., one σ54 , one σ28 and 11 putative ECF (extracytoplasmic function) σE -type factors. Here, characteristics of these putative σ factors and their possible role in the L. interrogans gene regulation (especially in this pathogen's adaptive response to various environmental conditions, an important determinant of leptospiral virulence), are presented.
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46
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Guzmán DA, Diaz E, Sáenz C, Álvarez H, Cueva R, Zapata-Ríos G, Prado-Vivar B, Falconí M, Pearson T, Barragán V. Domestic dogs in indigenous Amazonian communities: key players in Leptospira cycling and transmission? BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.19.558554. [PMID: 37786682 PMCID: PMC10541607 DOI: 10.1101/2023.09.19.558554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Background Leptospirosis is the world's most common zoonotic disease. Mitigation and control rely on pathogen identification and understanding the roles of potential reservoirs in cycling and transmission. Underreporting and misdiagnosis obscure the magnitude of the problem and confound efforts to understand key epidemiological components. Difficulties in culturing hamper the use of serological diagnostics and delay the development of DNA detection methods. As a result, especially in complex ecosystems, we know very little about the importance of different mammalian host species in cycling and transmission to humans. Methodology/Principal Findings We sampled five indigenous Kichwa communities living in the Yasuní National Park in the Ecuadorian Amazon basin. Blood and urine samples from domestic dogs were collected to assess the exposure of these animals to Leptospira, and to identify the circulating species. Microscopic Agglutination Tests with a panel of 22 different serovars showed anti-leptospira antibodies in 36 sampled dogs (75%), and 10 serotypes were detected. Two DNA-based detection assays revealed pathogenic Leptospira DNA in 18 of 19 dog urine samples (94.7%). Amplicon sequencing and phylogenetic analysis of 16s rDNA and SecY genes from 15 urine samples revealed genetic diversity within two of three different Leptospira species: noguchii (n=7), santarosai (n=7), and interrogans (n=1). Conclusions/Significance The high prevalence of antibodies and Leptospira DNA provides strong evidence for high rates of past and current infections. Such high prevalence has not been previously reported for dogs. These dogs live in the peridomestic environment in close contact with humans, yet they are free-ranging animals that interact with wildlife. This complex web of interactions may explain the diverse types of pathogenic Leptospira observed in this study. Our results suggest that domestic dogs are likely to play an important role in the cycling and transmission of Leptospira. Future studies in areas with complex ecoepidemiology will enable better parsing of the significance of genotypic, environmental, and host characteristics.
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Affiliation(s)
- Diego A. Guzmán
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - Eduardo Diaz
- Escuela de Medicina Veterinaria, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Carolina Sáenz
- Hospital de Fauna Silvestre TUERI, Instituto de Biodiversidad Tropical IBIOTROP, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Hernán Álvarez
- Wildlife Conservation Society – Ecuador Program, Quito, Ecuador
| | - Rubén Cueva
- Wildlife Conservation Society – Ecuador Program, Quito, Ecuador
| | | | - Belén Prado-Vivar
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - Mercy Falconí
- Agencia de Regulación y Control Fito y Zoosanitario – Agrocalidad, Quito, Ecuador
| | - Talima Pearson
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Verónica Barragán
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
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47
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Prinsen G, Baker M, Benschop J, Collins-Emerson J, Douwes J, Fayaz A, Littlejohn S, Nisa S, Quin T, Yeung P. "We don't really do doctors." messages from people diagnosed with occupational leptospirosis for medical professionals on infection, hospitalisation, and long-term effects. Heliyon 2023; 9:e19303. [PMID: 37674827 PMCID: PMC10477488 DOI: 10.1016/j.heliyon.2023.e19303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023] Open
Abstract
Leptospirosis is largely an occupational disease for people working with livestock in Aotearoa New Zealand. Introduction of livestock vaccination and use of personal protective equipment has been associated with a reduction in the incidence. However, the incidence of occupational leptospirosis remains high, with significant burdens for affected families and healthcare system. For this article, a subset of thirteen participants from a nationwide leptospirosis case-control study (2019-2021) who were diagnosed with leptospirosis and worked with livestock at the time of illness were invited and agreed to a semi-structured interview. Interviewees reflected on their experiences as messages for medical professionals. The analysis of transcripts reveals widely shared experiences with infection, hospitalisation, and treatment, as well as long-term effects and recovery. Conclusions for medical professionals include that ill workers continue to have their diagnosis of leptospirosis delayed. This delay may contribute to more than half the people ill with leptospirosis hospitalised. Further, medical professionals' communication and relationship with ill people strongly colours the latter's experience, for good or for bad. Moreover, most interviewees experienced a recovery process that took several months of feeling tired, which undermined professional performance and emotional wellbeing.
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Affiliation(s)
- Gerard Prinsen
- School of People, Environment and Planning, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| | - Michael Baker
- Department of Public Health, University of Otago, Box 7343, Wellington 6242, New Zealand
| | - Jackie Benschop
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| | - Julie Collins-Emerson
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, PO Box 756, Wellington 6140, New Zealand
| | - Ahmed Fayaz
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| | - Stuart Littlejohn
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| | - Shahista Nisa
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
| | - Tanya Quin
- Goodfellow Unit, The University of Auckland, Private Bag 92-019, Auckland, New Zealand
| | - Polly Yeung
- School of Social Work, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand
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48
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Charles JC, Jayarajah U, Subasinghe D. Clinical characteristics and outcomes of patients with leptospirosis complicated with acute pancreatitis: a systematic review. J Int Med Res 2023; 51:3000605231197461. [PMID: 37776529 PMCID: PMC10542321 DOI: 10.1177/03000605231197461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 08/08/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVES Acute pancreatitis (AP) is a severe complication of leptospirosis. This review focuses on the current evidence of AP in patients with leptospirosis. METHODS Data on clinical characteristics, biochemical parameters, diagnosis, complications, critical care, fluid management, operative management, and outcomes were analyzed. This study was registered in PROSPERO (CRD42022360802). RESULTS We included 35 individual case reports and 4 case series involving 79 patients. Sex was reported for 48 (60.7%) patients; 38 (48.1%) were male and 10 (12.6%) were female. The patients' mean age was 45.13 (15-83 years). Acute kidney injury, thrombocytopenia, hypotension, and liver injury were the most common complications reported. Complete recovery was reported for 36 (45.5%) patients. Biochemical and radiological recovery was reported for 10 (12.6%) and 9 (11.3%) patients, respectively. Death was reported in 18 (22.7%) patients. CONCLUSION A high degree of clinical suspicion and different modalities of investigations are essential in the diagnosis of AP in leptospirosis. AP can be easily missed in leptospirosis because both conditions share similar clinical presentations and complications. Because of the high prevalence of acute kidney injury, judicious fluid management and close monitoring are mandatory.
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Affiliation(s)
- James C Charles
- Department of Surgery, Teaching Hospital Jaffna, Jaffna, Sri Lanka
| | - Umesh Jayarajah
- Department of Surgery, Colombo South Teaching Hospital, Dehiwala, Sri Lanka
| | - Duminda Subasinghe
- Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka
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49
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Helman SK, Tokuyama AFN, Mummah RO, Stone NE, Gamble MW, Snedden CE, Borremans B, Gomez ACR, Cox C, Nussbaum J, Tweedt I, Haake DA, Galloway RL, Monzón J, Riley SPD, Sikich JA, Brown J, Friscia A, Sahl JW, Wagner DM, Lynch JW, Prager KC, Lloyd-Smith JO. Pathogenic Leptospira are widespread in the urban wildlife of southern California. Sci Rep 2023; 13:14368. [PMID: 37658075 PMCID: PMC10474285 DOI: 10.1038/s41598-023-40322-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/08/2023] [Indexed: 09/03/2023] Open
Abstract
Leptospirosis, the most widespread zoonotic disease in the world, is broadly understudied in multi-host wildlife systems. Knowledge gaps regarding Leptospira circulation in wildlife, particularly in densely populated areas, contribute to frequent misdiagnoses in humans and domestic animals. We assessed Leptospira prevalence levels and risk factors in five target wildlife species across the greater Los Angeles region: striped skunks (Mephitis mephitis), raccoons (Procyon lotor), coyotes (Canis latrans), Virginia opossums (Didelphis virginiana), and fox squirrels (Sciurus niger). We sampled more than 960 individual animals, including over 700 from target species in the greater Los Angeles region, and an additional 266 sampled opportunistically from other California regions and species. In the five target species seroprevalences ranged from 5 to 60%, and infection prevalences ranged from 0.8 to 15.2% in all except fox squirrels (0%). Leptospira phylogenomics and patterns of serologic reactivity suggest that mainland terrestrial wildlife, particularly mesocarnivores, could be the source of repeated observed introductions of Leptospira into local marine and island ecosystems. Overall, we found evidence of widespread Leptospira exposure in wildlife across Los Angeles and surrounding regions. This indicates exposure risk for humans and domestic animals and highlights that this pathogen can circulate endemically in many wildlife species even in densely populated urban areas.
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Affiliation(s)
- Sarah K Helman
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA.
- Institute of the Environment and Sustainability, University of California, Los Angeles, CA, USA.
| | - Amanda F N Tokuyama
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Riley O Mummah
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Nathan E Stone
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Mason W Gamble
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
- Institute of the Environment and Sustainability, University of California, Los Angeles, CA, USA
| | - Celine E Snedden
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Benny Borremans
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
- Evolutionary Ecology Group, Department of Biology, University of Antwerp, Antwerp, Belgium
- Wildlife Health Ecology Research Organization, San Diego, CA, USA
| | - Ana C R Gomez
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Caitlin Cox
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Julianne Nussbaum
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Isobel Tweedt
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - David A Haake
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- The David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | | | - Javier Monzón
- Natural Science Division, Pepperdine University, Malibu, CA, USA
| | - Seth P D Riley
- Santa Monica Mountains National Recreation Area, National Park Service, Thousand Oaks, CA, USA
| | - Jeff A Sikich
- Santa Monica Mountains National Recreation Area, National Park Service, Thousand Oaks, CA, USA
| | - Justin Brown
- Santa Monica Mountains National Recreation Area, National Park Service, Thousand Oaks, CA, USA
| | - Anthony Friscia
- Department of Integrative Biology and Physiology, University of California, Los Angeles, CA, USA
| | - Jason W Sahl
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - David M Wagner
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Jessica W Lynch
- Institute for Society and Genetics, University of California, Los Angeles, CA, USA
| | - Katherine C Prager
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - James O Lloyd-Smith
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA.
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50
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Browne ES, Pereira M, Barreto A, Zeppelini CG, de Oliveira D, Costa F. Prevalence of human leptospirosis in the Americas: a systematic review and meta-analysis. Rev Panam Salud Publica 2023; 47:e126. [PMID: 37609525 PMCID: PMC10441551 DOI: 10.26633/rpsp.2023.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/06/2023] [Indexed: 08/24/2023] Open
Abstract
Objective To describe the prevalence of leptospirosis in the Americas. Methods A systematic review and meta-analysis, in the period 1930 to 2017, performed on a search of six platforms: PubMed, Web of Science, Scopus, Lilacs, Embase, and Cochrane. Results The search found 77 publications of which 53 (68%) were from the period 2000-2017. Of the 77, 62 studies were included in the analysis, from North America (11, 17%), Central America (9, 14%), and South America (42, 67%), and 22 studies were from urban areas. Leptospirosis prevalence in the 62 studies analyzed corresponded to 28% (95% CI [23, 32]). Countries with higher prevalence were United States of America (41%), Colombia (29%), and Brazil (21%). The most frequent serovars found were Icterohaemorrhagiae (43 of 77 publications, 55%), Canicola (35, 45%), Pomona (28, 36%), and Grippotyphosa (26, 33%). Conclusions There is variability of Leptospira species and serovars with heterogenous distribution throughout the Americas, with high prevalence in some countries, highlighting the need for action to control the disease.
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Affiliation(s)
- Ericka Souza Browne
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
| | - Marcos Pereira
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
| | - Ana Barreto
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
| | - Caio Graco Zeppelini
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
| | - Daiana de Oliveira
- Oswaldo Cruz FoundationSalvadorBahiaBrazilOswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Federico Costa
- Universidade Federal da BahiaCollective Health InstituteSalvadorBahiaBrazilUniversidade Federal da Bahia, Collective Health Institute, Salvador, Bahia, Brazil
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