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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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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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Harran E, Kuntz G, Decors A, Bourhy P, Auffret A, Bigeard C, Cherel D, Kodjo A, Le Dréan E, Lejas C, Lequeux G, Pilard MA, Pivette M, Guillois Y, Ayral F. Tracking potential Leptospira sources following human cases of leptospirosis: A One Health approach applied to an ecosystem in Brittany, France. One Health 2024; 18:100726. [PMID: 38644972 PMCID: PMC11026838 DOI: 10.1016/j.onehlt.2024.100726] [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: 10/01/2023] [Accepted: 04/04/2024] [Indexed: 04/23/2024] Open
Abstract
Pathogenic Leptospira can cause leptospirosis: a widespread, potentially fatal bacterial zoonosis whose risk is mediated by the soil and water features, animal host distributions, meaning the local ecosystem. When human cases of leptospirosis occur, it is challenging to track down their source because ecosystem-level epidemiological knowledge on Leptospira is needed. Between 2016 and 2019 in a focal riparian ecosystem, the human population experienced an outbreak and successive cases of leptospirosis attributable to L. kirschneri and L. interrogans. The epidemiological investigation was carried out using the One Health approach, as described in international health guidelines. As a first step in this process, we investigated leptospiral carriage in the main animal hosts found in the region. We sampled 143 nutrias, 17 muskrats, and 10 Norway rats using convenient trapping. DNA was extracted from their kidneys, lungs, and urine and subjected to real-time PCR (RT-PCR) targeting the Leptospira 16S rDNA and lfb1 genes. In the farms along the river's stretch of interest, we sampled serum from 439 cattle and used a microscopic agglutination test to detect the presence of antibodies against Leptospira. Urine samples were concomitantly obtained from 145 cattle and were used in two analyses: RT-PCR targeting the Leptospira 16S rDNA gene and Leptospira culturing. We found th, wt rodents were the most likely source of the L. interrogans behind the human cases. The cattle tested negative for Leptospira DNA but positive for antibodies against the serogroups implicated in the human cases. We failed to identify the potential source of the L. kirschneri responsible for several human cases of leptospirosis. Our results call for further clarification of the Leptospira maintenance community, which may comprise known maintenance hosts, such as rodents, as well as taxa not commonly considered to be maintenance hosts but that can still spread Leptospira. The resulting research network will collaboratively conduct future eco-epidemiological surveys to illuminate the leptospirosis risks faced by humans and animals within ecosystems.
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Affiliation(s)
- Elena Harran
- USC 1233-RS2GP, VetAgro Sup, Université de Lyon, Marcy L'Etoile 69280, France
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Lebanon
| | | | - Anouk Decors
- Office Français de la Biodiversité, Direction de la recherche et de l'appui scientifique, Orléans 45100, France
| | - Pascale Bourhy
- Biology of Spirochetes Unit, National Reference Center for Leptospirosis, Institut Pasteur, University of Paris Cité, Paris, France
| | | | - Clément Bigeard
- Ecole Nationale des Services Vétérinaires – France Vétérinaire Internationale, VetAgro Sup, Université de Lyon, Marcy L'Etoile 69280, France
| | | | - Angeli Kodjo
- Laboratoire des Leptospires et d'Analyses Vétérinaires, VetAgro Sup, Université de Lyon, Marcy L'Etoile 69280, France
| | | | - Cyrille Lejas
- Fédération Départementale de Gestion des Espèces exotiques envahissantes (FDGDON 35), Direction Technique, 35340 Ercé-prés-Liffré, France
| | | | - Marie-Agnès Pilard
- Agence Régionale de Santé Bretagne, Délégation Départementale d'Ille-et-Vilaine, Département Santé-Environnement, 35042 Rennes, France
| | - Mathilde Pivette
- Santé Publique France, Direction des regions, Bretagne, 94415 Saint-Maurice, France
| | - Yvonnick Guillois
- Santé Publique France, Direction des regions, Bretagne, 94415 Saint-Maurice, France
| | - Florence Ayral
- USC 1233-RS2GP, VetAgro Sup, Université de Lyon, Marcy L'Etoile 69280, France
- VetAgro Sup, Pôle EVAAS, 69280 Marcy L'Etoile, France
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4
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Garcia-Lopez M, Lurier T, Bouilloud M, Pradel J, Tatard C, Sepulveda D, Anfray G, Dussert J, Bourhy P, Charbonnel N, Djelouadji Z. Prevalence, genetic diversity and eco-epidemiology of pathogenic Leptospira species in small mammal communities in urban parks Lyon city, France. PLoS One 2024; 19:e0300523. [PMID: 38598501 PMCID: PMC11006123 DOI: 10.1371/journal.pone.0300523] [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: 10/06/2023] [Accepted: 02/28/2024] [Indexed: 04/12/2024] Open
Abstract
Rodents are recognized as the main reservoirs of Leptospira spp. Rats, in particular, serve as hosts for the widely predominant Leptospira interrogans serovar Icterohaemorrhagiae, found worldwide. Several studies have shown the importance of other reservoirs, such as mice or hedgehogs, which harbor other leptospires' serovars. Nevertheless, our knowledge of circulating Leptospira spp. in reservoirs other than rats remains limited. In this context, we proposed an eco-health approach to assess the health hazard associated with leptospires in urban green spaces, where contacts between human/small mammals and domestic animals are likely. We studied the prevalence, the diversity of circulating strains, and epidemiology of pathogenic Leptospira species in small terrestrial mammal communities (rodents and shrews), between 2020-2022, in two parks in Lyon metropolis, France. Our study showed a significant carriage of Leptospira spp. in small terrestrial mammals in these parks and unveiled a global prevalence rate of 11.4%. Significant variations of prevalence were observed among the small mammal species (from 0 to 26.1%), with Rattus norvegicus exhibiting the highest infection levels (26.1%). We also observed strong spatio-temporal variations in Leptospira spp. circulation in its reservoirs. Prevalence seems to be higher in the peri-urban park and in autumn in 2021 and 2022. This is potentially due to differences in landscape, abiotic conditions and small mammal communities' composition. Our study suggests an important public health relevance of rats and in a lesser extent of other rodents (Apodemus spp., Clethrionomys glareolus and Mus musculus) as reservoirs of L. interrogans, with rodent species carrying specific serogroups/serovars. We also emphasize the potential hazard associated between the shrew Crocidura russula and L. kirschneri. Altogether, these results improve our knowledge about the prevalence of leptospirosis in an urban environment, which is an essential prerequisite for the implementation of prevention of associated risks.
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Affiliation(s)
- Marta Garcia-Lopez
- USC 1233-RS2GP, VetAgro Sup, University of Lyon, Marcy l’Etoile, France
- Biology of Spirochetes Unit, National Reference Center for Leptospirosis, Institut Pasteur, University of Paris Cité, Paris, France
| | - Thibaut Lurier
- UMR EPIA, INRAE, VetAgro Sup, University of Clermont Auvergne, Saint-Genès-Champanelle, France
- UMR EPIA, INRAE, VetAgro Sup, University of Lyon, Marcy l’Etoile, France
| | - Marie Bouilloud
- CBGP, INRAE, CIRAD, Institut Agro, IRD, University of Montpellier, Montpellier, France
| | - Julien Pradel
- CBGP, INRAE, CIRAD, Institut Agro, IRD, University of Montpellier, Montpellier, France
| | - Caroline Tatard
- CBGP, INRAE, CIRAD, Institut Agro, IRD, University of Montpellier, Montpellier, France
| | - Diana Sepulveda
- Department of Health, Health and Environment Service, City of Lyon, Lyon, France
| | | | | | - Pascale Bourhy
- Biology of Spirochetes Unit, National Reference Center for Leptospirosis, Institut Pasteur, University of Paris Cité, Paris, France
| | - Nathalie Charbonnel
- CBGP, INRAE, CIRAD, Institut Agro, IRD, University of Montpellier, Montpellier, France
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5
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Valente M, Bramugy J, Keddie SH, Hopkins H, Bassat Q, Baerenbold O, Bradley J, Falconer J, Keogh RH, Newton PN, Picardeau M, Crump JA. Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge. BMC Infect Dis 2024; 24:168. [PMID: 38326762 PMCID: PMC10848445 DOI: 10.1186/s12879-023-08935-0] [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: 07/18/2023] [Accepted: 12/19/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Leptospirosis is an underdiagnosed infectious disease with non-specific clinical presentation that requires laboratory confirmation for diagnosis. The serologic reference standard remains the microscopic agglutination test (MAT) on paired serum samples. However, reported estimates of MAT's sensitivity vary. We evaluated the accuracy of four index tests, MAT on paired samples as well as alternative standards for leptospirosis diagnosis: MAT on single acute-phase samples, polymerase chain reaction (PCR) with the target gene Lfb1, and ELISA IgM with Leptospira fainei serovar Hurstbridge as an antigen. METHODS We performed a systematic review of studies reporting results of leptospirosis diagnostic tests. We searched eight electronic databases and selected studies that tested human blood samples and compared index tests with blood culture and/or PCR and/or MAT (comparator tests). For MAT selection criteria we defined a threshold for single acute-phase samples according to a national classification of leptospirosis endemicity. We used a Bayesian random-effect meta-analysis to estimate the sensitivity and specificity of MAT in single acute-phase and paired samples separately, and assessed risk of bias using the Quality Assessment of Studies of Diagnostic Accuracy Approach- 2 (QUADAS-2) tool. RESULTS For the MAT accuracy evaluation, 15 studies were included, 11 with single acute-phase serum, and 12 with paired sera. Two included studies used PCR targeting the Lfb1 gene, and one included study used IgM ELISA with Leptospira fainei serovar Hurstbridge as antigen. For MAT in single acute-phase samples, the pooled sensitivity and specificity were 14% (95% credible interval [CrI] 3-38%) and 86% (95% CrI 59-96%), respectively, and the predicted sensitivity and specificity were 14% (95% CrI 0-90%) and 86% (95% CrI 9-100%). Among paired MAT samples, the pooled sensitivity and specificity were 68% (95% CrI 32-92%) and 75% (95% CrI 45-93%) respectively, and the predicted sensitivity and specificity were 69% (95% CrI 2-100%) and 75% (2-100%). CONCLUSIONS Based on our analysis, the accuracy of MAT in paired samples was not high, but it remains the reference standard until a more accurate diagnostic test is developed. Future studies that include larger numbers of participants with paired samples will improve the certainty of accuracy estimates.
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Affiliation(s)
- Marta Valente
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Calle Rosselló, 171, Entresol, Barcelona, 08036, Spain.
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
| | - Justina Bramugy
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | | | - Heidi Hopkins
- London School of Hygiene & Tropical Medicine, London, UK
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Calle Rosselló, 171, Entresol, Barcelona, 08036, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Pg. Lluís Companys 23, Barcelona, 08010, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - John Bradley
- London School of Hygiene & Tropical Medicine, London, UK
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Jane Falconer
- London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth H Keogh
- London School of Hygiene & Tropical Medicine, London, UK
| | - Paul N Newton
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Mathieu Picardeau
- Biology of Spirochetes Unit, French National Reference Centre for Leptospirosis, Institut Pasteur, Université Paris Cité, Paris, F-75015, France
| | - John A Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
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Ružić-Sabljić E, Podgoršek D, Strašek Smrdel K, Celar Šturm A, Logar M, Pavlović A, Remec T, Baklan Z, Pal E, Cerar Kišek T. First Report on Leptospira Species Isolated from Patients in Slovenia. Microorganisms 2023; 11:2739. [PMID: 38004750 PMCID: PMC10672770 DOI: 10.3390/microorganisms11112739] [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: 09/11/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Leptospirosis is an important worldwide zoonosis, and it has also been reported in Slovenia. The cultivation of Leptospira from human material is difficult. Despite that, we successfully isolated 12 human Leptospira strains isolated from patients between 2002 and 2020 and used various methods for the phenotypic and genotypic characterization of the strains, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) using our own MALDI-TOF data library, melting temperature analysis of the amplified lfb1 gene, determination of Leptospira serogroups using rabbit immune sera, NotI-RFLP of the whole Leptospira genome, multilocus sequence typing (MLST) of seven housekeeping genes, and whole-genome sequencing (WGS)-based typing. We confirmed the presence of four pathogenic Leptospira species (L. kirschneri, L. interrogans, L. borgpetersenii, and L. santarosai) and three serogroups: Grippotyphosa, Icterohaemorrhagiae, and Sejroe. MALDI-TOF identified three of seven isolates at the species level and four isolates at the genus level. Serovars of 8 of the 10 strains were determined using NotI-RFLP. MLST showed that the clinical isolates belonged to sequence types ST17, ST110, and ST155. WGS confirmed the analysis of Leptospira strains using conventional methods. In addition, WGS provided better taxonomic resolution for isolate DDA 10944/10.
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Affiliation(s)
- Eva Ružić-Sabljić
- Institute of Microbiology and Immunology and Catedra for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia; (E.R.-S.); (D.P.); (K.S.S.); (A.C.Š.)
| | - Daša Podgoršek
- Institute of Microbiology and Immunology and Catedra for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia; (E.R.-S.); (D.P.); (K.S.S.); (A.C.Š.)
- Department of Pathology and Cytology, General Hospital Celje, Oblakova 5, 3000 Celje, Slovenia
| | - Katja Strašek Smrdel
- Institute of Microbiology and Immunology and Catedra for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia; (E.R.-S.); (D.P.); (K.S.S.); (A.C.Š.)
| | - Andraž Celar Šturm
- Institute of Microbiology and Immunology and Catedra for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia; (E.R.-S.); (D.P.); (K.S.S.); (A.C.Š.)
| | - Mateja Logar
- Department of Infectious Diseases, University Medical Center, Zaloška 2, 1000 Ljubljana, Slovenia;
- Catedra for Infectious Diseases and Epidemiology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Andrea Pavlović
- Department of Infectious Diseases, General Hospital Celje, Oblakova 5, 3000 Celje, Slovenia;
| | - Tatjana Remec
- Department of Infectious Diseases, General Hospital Novo Mesto, Šmihelska Cesta 1, 8000 Novo Mesto, Slovenia;
| | - Zvonko Baklan
- Department of Infectious Diseases, University Medical Center Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia;
| | - Emil Pal
- Department of Infectious Diseases, General Hospital Murska Sobota, Ulica dr. Vrbnjaka 6, 9000 Murska Sobota, Slovenia;
| | - Tjaša Cerar Kišek
- Institute of Microbiology and Immunology and Catedra for Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia; (E.R.-S.); (D.P.); (K.S.S.); (A.C.Š.)
- National Laboratory of Health, Environment and Food, Prvomajska 1, 2000 Maribor, Slovenia
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7
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Arnaout Y, Picard-Meyer E, Robardet E, Cappelle J, Cliquet F, Touzalin F, Jimenez G, Djelouadji Z. Assessment of virus and Leptospira carriage in bats in France. PLoS One 2023; 18:e0292840. [PMID: 37862301 PMCID: PMC10588846 DOI: 10.1371/journal.pone.0292840] [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: 03/21/2022] [Accepted: 09/29/2023] [Indexed: 10/22/2023] Open
Abstract
With over 1,400 species worldwide, bats represent the second largest order of mammals after rodents, and are known to host major zoonotic pathogens. Here, we estimate the presence of pathogens in autochthonous bat populations. First, we set out to check our samples for PCR amplification efficiency by assessing the occurrence of inhibited PCR reactions from different types of bat samples with amplifying the housekeeping gene β-actin. Second, we investigated the presence of five targeted pathogens in a French bat population using PCR. We targeted viral RNA of Canine distemper virus, Alphacoronavirus, Lyssavirus, Rotavirus and bacterial Leptospira DNA. To do so, we screened for these viruses in bat faecal samples as well as in oropharyngeal swab samples. The presence of Leptospira was assessed in urine, kidney, lung and faecal samples. Results showed a frequency of inhibited reactions ranging from 5 to 60% of samples, varying according to the sample itself and also suspected to vary according to sampling method and the storage buffer solution used, demonstrating the importance of the sampling and storage on the probability of obtaining negative PCR results. For pathogen assessment, rotavirus and alphacoronavirus RNA were detected in Myotis myotis, Myotis daubentonii, Myotis emarginatus and Rhinolophus ferrumequinum bats. Rotaviruses were also detected in Barbastella barbastellus. The presence of alphacoronavirus also varied seasonally, with higher frequencies in late summer and October, suggesting that juveniles potentially play an important role in the dynamics of these viruses. Leptospira DNA was detected in M. myotis and M. daubentonii colonies. The 16S rRNA sequences obtained from Leptospira positive samples showed 100% genetic identity with L. borgpetersenii. Neither canine distemper virus nor lyssavirus RNA were detected in any of the tested samples. This study is the first to show the presence of Leptospira in autochthonous French bats in addition to coronavirus and rotavirus RNA previously reported in European autochthonous bats.
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Affiliation(s)
- Youssef Arnaout
- Lyssavirus Unit, Nancy Laboratory for Rabies and Wildlife, ANSES, Malzéville, France
- USC 1233-INRAE Rongeurs Sauvages, Risque Sanitaire et Gestion des Populations, VetAgro Sup, Marcy l’Etoile, France
| | - Evelyne Picard-Meyer
- Lyssavirus Unit, Nancy Laboratory for Rabies and Wildlife, ANSES, Malzéville, France
| | - Emmanuelle Robardet
- Lyssavirus Unit, Nancy Laboratory for Rabies and Wildlife, ANSES, Malzéville, France
| | - Julien Cappelle
- UMR ASTRE, CIRAD, INRAE, Université de Montpellier, Montpellier, France
- UMR EPIA, INRAE, VetAgro Sup, Theix, France
| | - Florence Cliquet
- Lyssavirus Unit, Nancy Laboratory for Rabies and Wildlife, ANSES, Malzéville, France
| | - Frédéric Touzalin
- School of Biology and Environmental Science, Science Centre West, University College Dublin, Dublin, Ireland
| | | | - Zouheira Djelouadji
- USC 1233-INRAE Rongeurs Sauvages, Risque Sanitaire et Gestion des Populations, VetAgro Sup, Marcy l’Etoile, France
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Garcia-Lopez M, Lorioux C, Soares A, Trombert-Paolantoni S, Harran E, Ayral F, Picardeau M, Djelouadji Z, Bourhy P. Genetic diversity of Leptospira strains circulating in humans and dogs in France in 2019-2021. Front Cell Infect Microbiol 2023; 13:1236866. [PMID: 37662012 PMCID: PMC10469827 DOI: 10.3389/fcimb.2023.1236866] [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: 06/08/2023] [Accepted: 07/21/2023] [Indexed: 09/05/2023] Open
Abstract
Leptospirosis is a bacterial zoonotic disease. Humans and dogs are susceptible hosts, with similar clinical manifestations ranging from a febrile phase to multiple organ dysfunction. The incidence of leptospirosis in mainland France is relatively high, at about 1 case per 100,000 inhabitants, but our knowledge of the strains circulating in humans and dogs remains limited. We studied the polymorphism of the lfb1 gene sequences in an exhaustive database, to facilitate the identification of Leptospira strains. We identified 46 species-groups (SG) encompassing the eight pathogenic species of Leptospira. We sequenced the lfb1 gene amplification products from 170 biological samples collected from 2019 to 2021: 110 from humans and 60 from dogs. Epidemiological data, including vaccination status in dogs, were also collected. Three Leptospira species displaying considerable diversity were identified: L. interrogans, with eight lfb1 species-groups (including five new lfb1 species-groups) in humans and dogs; L. kirschneri, with two lfb1 species-groups in humans and dogs; and L. borgpetersenii, with one lfb1 species-group in humans only. The lfb1 species-group L. interrogans SG1, corresponding to serovar Icterohaemorrhagiae or Copenhageni, was frequently retrieved from both humans and dogs (n=67/110; 60.9% and n=59/60; 98.3% respectively). A high proportion of the affected dogs developed the disease despite vaccination (n=30/60; 50%). Genotyping with the polymorphic lfb1 gene is both robust and simple. This approach provided the first global picture of the Leptospira strains responsible for acute infections in mainland France, based on biological samples but without the need for culture. Identification of the Leptospira strains circulating and their changes over time will facilitate more precise epidemiological monitoring of susceptible and reservoir species. It should also facilitate the monitoring of environmental contamination, making it possible to implement preventive measures and to reduce the burden of this disease.
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Affiliation(s)
- Marta Garcia-Lopez
- Biology of Spirochetes Unit, National Reference Center for Leptospirosis, Institut Pasteur, Paris, France
- USC 1223-RS2GP, Laboratory of Leptospira and Veterinary Analysis, VetAgro Sup, University of Lyon, Marcy l’Etoile, France
| | - Celine Lorioux
- Biology of Spirochetes Unit, National Reference Center for Leptospirosis, Institut Pasteur, Paris, France
| | - Anais Soares
- Department of Infectiology, Eurofins Biomnis, Lyon, France
| | | | - Elena Harran
- USC 1223-RS2GP, Laboratory of Leptospira and Veterinary Analysis, VetAgro Sup, University of Lyon, Marcy l’Etoile, France
| | - Florence Ayral
- USC 1223-RS2GP, Laboratory of Leptospira and Veterinary Analysis, VetAgro Sup, University of Lyon, Marcy l’Etoile, France
| | - Mathieu Picardeau
- Biology of Spirochetes Unit, National Reference Center for Leptospirosis, Institut Pasteur, Paris, France
| | - Zouheira Djelouadji
- USC 1223-RS2GP, Laboratory of Leptospira and Veterinary Analysis, VetAgro Sup, University of Lyon, Marcy l’Etoile, France
| | - Pascale Bourhy
- Biology of Spirochetes Unit, National Reference Center for Leptospirosis, Institut Pasteur, Paris, France
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Natarajan S, Joseph J, Vinayagamurthy B, Estrela P. A Lateral Flow Assay for the Detection of Leptospira lipL32 Gene Using CRISPR Technology. SENSORS (BASEL, SWITZERLAND) 2023; 23:6544. [PMID: 37514838 PMCID: PMC10385553 DOI: 10.3390/s23146544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
The clinical manifestation of leptospirosis is often misdiagnosed as other febrile illnesses such as dengue. Therefore, there is an urgent need for a precise diagnostic tool at the field level to detect the pathogenic Leptospira lipL32 gene at the molecular level for prompt therapeutic decisions. Quantitative polymerase chain reaction (qPCR) is widely used as the primary diagnostic tool, but its applicability is limited by high equipment cost and the lack of availability in every hospital, especially in rural areas where leptospirosis mainly occurs. Here, we report the development of a CRISPR dFnCas9-based quantitative lateral flow immunoassay to detect the lipL32 gene. The developed assay showed superior performance regarding the lowest detectable limit of 1 fg/mL. The test is highly sensitive and selective, showing that leptospirosis diagnosis can be achieved with a low-cost lateral flow device.
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Affiliation(s)
- Satheesh Natarajan
- Healthcare Technology Innovation Centre, Indian Institute of Technology Madras, Chennai 600113, India
| | - Jayaraj Joseph
- Department of Electrical Engineering, Indian Institute of Technology Madras, Chennai 600036, India
| | - Balamurugan Vinayagamurthy
- Indian Council of Agricultural Research-National Institute of Veterinary Epidemiology and Disease Informatics (ICAR-NIVEDI), Bangalore 560064, India
| | - Pedro Estrela
- Department of Electronic and Electrical Engineering, University of Bath, Bath BA2 7AY, UK
- Centre for Bioengineering & Biomedical Technologies, University of Bath, Bath BA2 7AY, UK
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Mišić-Majerus L, Kišek TC, Ružić-Sabljić E. Leptospirosis and characterization of Leptospira isolates from patients in Koprivnica-Križevci County, Croatia from 2000-2004. Access Microbiol 2023; 5:acmi000431. [PMID: 37223056 PMCID: PMC10202403 DOI: 10.1099/acmi.0.000431] [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: 04/22/2022] [Accepted: 02/28/2023] [Indexed: 05/25/2023] Open
Abstract
Introduction Leptospirosis, caused by spirochetes of the genus Leptospira , is present in the Koprivnica-Križevci County area, Croatia. Clinical manifestation can range from asymptomatic, short-term mild, non-specific febrile disease, to severe forms with high mortality rates. Aim The aim of the study was to valuate culture in front of microscopic agglutination test (MAT) for diagnosis of infection, and to evaluate clinical and laboratory features of the disease. Moreover, we want to characterize Leptospira strains involved in infection in Koprivnica-Križevci County, Croatia. Methods We included 68 patients with clinical presentation consistent with leptospirosis collected in a 5-year period (2000-2004). Clinical samples (blood, urine and cerebrospinal fluid, CSF) were inoculated in Kolthoff's medium; species of isolated Leptospira strains was determined with Tm of real-time PCR, serogroup/serovar with MAT and NotI-RFLP analysis. Demonstration of specific antibodies in patients' sera was done using microscopic agglutination test. Results Leptospira was isolated from the blood of 14/51(27.5 %) patients and the most often identified serogroup/serovar was Icterohaemorrhagiae (8/10, 80%) followed by Grippotyphosa (10%). Regarding to species level, 8/10 isolated belonged to L. interrogans sensu stricto and one to L. kirschneri species. MAT was carried out on 51 patients with suspected leptospirosis, and was positive in 11/51(21.5 %) patients. Most of our patients presented with moderate severe symptoms, were hospitalized from August to October, and were infected mainly during the work or recreation in our county. The frequency of particular clinical features and pathological laboratory findings correlated with the severity of the clinical condition. Conclusions Leptospirosis can be confirmed microbiologically, culture and MAT contributed almost equally to the diagnosis of infection. Serovar Icterohaemorrhagiae was found as the dominant one, and L. interrogans sensu stricto as dominant species in our county. Epidemiological data shown that leptospirosis occurs seasonally, affects the rural population, and most commonly is presented with moderate severe clinical course.
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Affiliation(s)
- Ljiljana Mišić-Majerus
- Department of Infectious Diseases, General Hospital "Dr. Tomislav Bardek", Željka Selingera 1, Koprivnica, Croatia
| | - Tjaša Cerar Kišek
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, Ljubljana, Slovenia
| | - Eva Ružić-Sabljić
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, Ljubljana, Slovenia
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11
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Barnabé NNDC, Soares RR, Barros DKS, Nogueira DB, da Costa FTR, Araújo Júnior JP, Malossi CD, Ullmann LS, da Costa DF, Silva MLCR, Higino SSDS, Santos CDSAB, de Azevedo SS, Alves CJ. Bovine Leptospirosis in Caatinga Biome, Brazil: New Insights into Diagnosis and Epidemiology. Trop Med Infect Dis 2023; 8:177. [PMID: 36977178 PMCID: PMC10053506 DOI: 10.3390/tropicalmed8030177] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023] Open
Abstract
Bovine leptospirosis causes economic losses and raises public health concerns. It is possible that there are peculiarities in the epidemiology of leptospirosis in regions with a semiarid climate, such as the Caatinga biome in Brazil, where the climate is hot and dry, and the etiological agent require alternative routes of transmission. This study aimed to close knowledge gaps to the diagnosis and epidemiology of Leptospira spp. infection in cows from the Caatinga biome, Brazil. Samples of the blood, urinary tract (urine, bladder and kidney) and reproductive tract (vaginal fluid, uterus, uterine tube, ovary and placenta) were collected from 42 slaughtered cows. Diagnostic tests included were the microscopic agglutination test (MAT), polymerase chain reaction (PCR) and bacterial isolation. Anti-Leptospira spp. antibodies were found in 27 (64.3%) of the animals analyzed using MAT at a 1:50 dilution (cut-off 50), while 31 (73.8%) animals had at least one organ/fluid where the presence of Leptospira spp. DNA was identified, and 29 animals (69%) were positive at bacteriological culture. The highest sensitivity values for MAT were obtained at the cut-off point of 50. In conclusion, even under hot and dry climate conditions, it is possible that Leptospira spp. can spread through alternative routes such as venereal transmission; moreover, a cut-off of 50 is recommended for the serological diagnosis of cattle from the Caatinga biome.
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Affiliation(s)
| | - Rafael Rodrigues Soares
- Academic Unit of Veterinary Medicine (UAMV), Federal University of Campina Grande (UFCG), Patos 58708-110, Brazil
| | - Deivyson Kelvis Silva Barros
- Academic Unit of Veterinary Medicine (UAMV), Federal University of Campina Grande (UFCG), Patos 58708-110, Brazil
| | - Denise Batista Nogueira
- Faculty of Veterinary Medicine and Zootechny (FMVZ), University of São Paulo (USP), São Paulo 05508-220, Brazil
| | | | - João Pessoa Araújo Júnior
- Institute of Biosciences, Department of Microbiology and Immunology, University of the São Paulo State (UNESP), Botucatu 18618-687, Brazil
| | - Camila Dantas Malossi
- Institute of Biosciences, Department of Microbiology and Immunology, University of the São Paulo State (UNESP), Botucatu 18618-687, Brazil
| | - Leila Sabrina Ullmann
- Institute of Biosciences, Department of Microbiology and Immunology, University of the São Paulo State (UNESP), Botucatu 18618-687, Brazil
| | | | | | | | | | - Sérgio Santos de Azevedo
- Academic Unit of Veterinary Medicine (UAMV), Federal University of Campina Grande (UFCG), Patos 58708-110, Brazil
| | - Clebert José Alves
- Academic Unit of Veterinary Medicine (UAMV), Federal University of Campina Grande (UFCG), Patos 58708-110, Brazil
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Landolt NY, Chiani YT, Pujato N, Jacob P, Schmeling MF, García Effron G, Vanasco NB. Utility evaluation of two molecular methods for Leptospira spp. typing in human serum samples. Heliyon 2022; 9:e12564. [PMID: 36747527 PMCID: PMC9898289 DOI: 10.1016/j.heliyon.2022.e12564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/26/2021] [Accepted: 12/14/2022] [Indexed: 12/26/2022] Open
Abstract
Most of the available genotyping methods were applied and evaluated in Leptospira isolates and only few of them in a relevant sample size of blood specimens but not of sera. The objective of this study was to evaluate the utility of one partial 16S rRNA gene sequencing assay (16S rRNA) and an optimized. Multilocus sequence typing scheme (MLST) for Leptospira typing directly in serum samples. Confirmed leptospirosis patients (n = 228) from Argentina (2005-2016) were randomly included. Septicemic-phase serum samples (n = 228) were studied by two genotyping methods. Available immune-phase serum samples of the included patients (n = 159) were studied by MAT to compare serological and molecular results. In culture-proven cases (n = 8), genotyping results between clinical samples and isolates were compared. Typing success rate (TSR) was 21.9% for 16S rRNA and 11.4% for MLST (full allelic profile) and a positive trend in both TSR during the study period was observed. Two species (L. interrogans and L. borgpertesenii) were identified by both methods and MLST assigned 8 different STs. The probable serogroups identified by MLST were coincident with the presumptive infecting serogroups identified by MAT, but with different frequencies. The three serogroups (Canicola, Sejroe and Icterohaemorrhagiae) most frequently identified by MAT were also genotyped by MLST. Typing results via 16S rRNA and MLST in clinical samples and isolates of culture-proven cases, were consistent except for one case. Performance of partial 16S rRNA gene sequencing assay and the optimized MLST scheme directly in sera may increase and improve the knowledge about species and serogroups causing human leptospirosis, especially in countries with low rates of culture sample collection or Leptospira isolation.
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Affiliation(s)
- Noelia Yolanda Landolt
- Instituto Nacional de Enfermedades Respiratorias (INER “Dr. E. Coni”), Administración Nacional de Laboratorios e Institutos de Salud (ANLIS “Dr. C.G. Malbran”), Av. Blas Parera 8260, 3000 Santa Fe, Argentina
| | - Yosena Teresita Chiani
- Instituto Nacional de Enfermedades Respiratorias (INER “Dr. E. Coni”), Administración Nacional de Laboratorios e Institutos de Salud (ANLIS “Dr. C.G. Malbran”), Av. Blas Parera 8260, 3000 Santa Fe, Argentina
| | - Nazarena Pujato
- Instituto Nacional de Enfermedades Respiratorias (INER “Dr. E. Coni”), Administración Nacional de Laboratorios e Institutos de Salud (ANLIS “Dr. C.G. Malbran”), Av. Blas Parera 8260, 3000 Santa Fe, Argentina,Laboratorio de Leptospirosis, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, 3000 Santa Fe, Argentina
| | - Paulina Jacob
- Instituto Nacional de Enfermedades Respiratorias (INER “Dr. E. Coni”), Administración Nacional de Laboratorios e Institutos de Salud (ANLIS “Dr. C.G. Malbran”), Av. Blas Parera 8260, 3000 Santa Fe, Argentina,Laboratorio de Leptospirosis, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, 3000 Santa Fe, Argentina
| | - María Fernanda Schmeling
- Instituto Nacional de Enfermedades Respiratorias (INER “Dr. E. Coni”), Administración Nacional de Laboratorios e Institutos de Salud (ANLIS “Dr. C.G. Malbran”), Av. Blas Parera 8260, 3000 Santa Fe, Argentina
| | - Guillermo García Effron
- Laboratorio de Micología y Diagnóstico Molecular, Cátedra de Parasitología y Micología, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, 3000 Santa Fe, Argentina,Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), CCT, Santa Fe, Argentina
| | - Norma Bibiana Vanasco
- Instituto Nacional de Enfermedades Respiratorias (INER “Dr. E. Coni”), Administración Nacional de Laboratorios e Institutos de Salud (ANLIS “Dr. C.G. Malbran”), Av. Blas Parera 8260, 3000 Santa Fe, Argentina,Laboratorio de Leptospirosis, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, 3000 Santa Fe, Argentina,Corresponding author.
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13
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Carlton JM, Eapen A, Kessler A, Anvikar AR, Hoffmann A, Singh OP, Sullivan SA, Albert S, Sahu PK, Mohanty S, Wassmer SC. Advances in Basic and Translational Research as Part of the Center for the Study of Complex Malaria in India. Am J Trop Med Hyg 2022; 107:97-106. [PMID: 36228919 PMCID: PMC9662212 DOI: 10.4269/ajtmh.21-1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 07/06/2022] [Indexed: 11/07/2022] Open
Abstract
The Center for the Study of Complex Malaria in India (CSCMi) is one of 10 International Centers of Excellence in Malaria Research funded by the National Institutes of Health since 2010. The Center combines innovative research with capacity building and technology transfer to undertake studies with clinical and translational impact that will move malaria control in India toward the ultimate goal of malaria elimination/eradication. A key element of each research site in the four states of India (Tamil Nadu, Gujarat, Odisha, and Meghalaya) has been undertaking community- and clinic-based epidemiology projects to characterize the burden of malaria in the region. Demographic and clinical data and samples collected during these studies have been used in downstream projects on, for example, the widespread use of mosquito repellants, the population genomics of Plasmodium vivax, and the serological responses to P. vivax and Plasmodium falciparum antigens that reflect past or present exposure. A focus has been studying the pathogenesis of severe malaria caused by P. falciparum through magnetic resonance imaging of cerebral malaria patients. Here we provide a snapshot of some of the basic and applied research the CSCMi has undertaken over the past 12 years and indicate the further research and/or clinical and translational impact these studies have had.
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Affiliation(s)
- Jane M. Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, New York
- Department of Epidemiology, School of Global Public Health, New York University, New York, New York
- Address correspondence to Jane M. Carlton, Center for Genomics and Systems Biology, New York University, 12 Waverly Place, New York, NY 10003. E-mail:
| | - Alex Eapen
- National Institute of Malaria Research, Indian Council of Medical Research, IDVC Field Unit, National Institute of Epidemiology Campus, Chennai, Tamil Nadu, India
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, New York
| | - Anupkumar R. Anvikar
- National Institute of Biologicals, Ministry of Health and Family Welfare, Government of India, Noida, Uttar Pradesh, India
| | - Angelika Hoffmann
- University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Switzerland
| | - Om P. Singh
- National Institute of Malaria Research, Indian Council of Medical Research, Dwarka, Delhi, India
| | - Steven A. Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, New York
| | - Sandra Albert
- Indian Institute of Public Health Shillong, Shillong, Meghalaya, India
- Martin Luther Christian University, Shillong, Meghalaya, India
| | - Praveen K. Sahu
- Department of Molecular and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, India
| | - Sanjib Mohanty
- Department of Molecular and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, India
| | - Samuel C. Wassmer
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Soupé-Gilbert ME, Oedin M, Kainiu M, Girault D, Figuet O, Brescia F, Goarant C. Original Leptospira spp. in island native terrestrial mammals: a case study in Pteropus spp. bats of New Caledonia. Transbound Emerg Dis 2022; 69:e2852-e2862. [PMID: 35730517 DOI: 10.1111/tbed.14635] [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: 03/15/2022] [Revised: 05/18/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
Leptospirosis is a bacterial zoonosis that occurs in tropical and subtropical regions worldwide. Chiroptera are known to be a formidable reservoir of zoonotic pathogens, including leptospires. The epidemiology of leptospirosis in bats in the Pacific Islands is poorly known, both in terms of prevalence and in terms of the bacterial strains involved. A strong host specificity between leptospiral strains and their mammalian reservoir is recognized. This phenomenon has notably been studied recently in bat communities, providing strong evidence of coevolution. In New Caledonia, a biodiversity hotspot where leptospirosis is endemic and enzootic, Chiroptera are the only indigenous terrestrial mammals. In this study, we aimed to investigate leptospires associated with three flying fox species in New Caledonia. Kidneys and urine samples of Pteropus spp. from captures and seizures were analyzed. Among 254 flying foxes analyzed, 24 harboured pathogenic leptospires corresponding to an observed prevalence of 9.45% with 15.8% on the Main Island and 4.3% on Loyalty Islands. The analysis of the rrs gene, lfb1, MLST sequences evidenced 4 distinct clusters of undescribed strains, likely corresponding to undescribed species. All four strains belong to the Group I of pathogenic Leptospira spp., which includes Leptospira interrogans, Leptospira noguchii and Leptospira kirschneri. We detected pathogenic leptospires in all 3 Pteropus spp. studied (including 2 endemic species) with no evidence of host specificity in two co-roosting species. For a better understanding of Leptospira-host coevolution, notably to genetically characterize and evaluate the virulence of these original bat-associated leptospires, it is essential to improve isolation techniques. Flying foxes are traditionally hunted and eaten in New Caledonia, a massive cause of bat-human interactions. Our results should encourage vigilance during these contacts to limit the spillover risk of these pathogens to humans. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Malik Oedin
- Institut Agronomique Néo-Calédonien (IAC), Equipe ARBOREAL (AgricultuRe BiOdiveRsité Et vALorisation) BP
| | - Malia Kainiu
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit
| | - Dominique Girault
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit
| | - Orane Figuet
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit
| | - Fabrice Brescia
- Institut Agronomique Néo-Calédonien (IAC), Equipe ARBOREAL (AgricultuRe BiOdiveRsité Et vALorisation) BP
| | - Cyrille Goarant
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit
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15
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Molecular Diagnostic Methods For The Detection of Leptospirosis. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.2.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Leptospirosis is a widespread infectious disease caused by the spirochete Leptospira. The clinical features of leptospirosis are fever, headache, vomiting, jaundice, and the acute form of the disease is commonly called Weil’s disease. The microscopic agglutination test (MAT) is a gold standard method used to detect leptospirosis. However, it requires 14 days of time and skilled personnel to detect leptospirosis. Various molecular methods were developed for the rapid detection process, including polymerase chain reaction (PCR), multiplex PCR, nested PCR, real-time PCR, and Loop-mediated isothermal amplification (LAMP). Other immuno-based biosensor kits are readily available for the diagnosis of leptospirosis. Though these methods claim to be highly sensitive and specific, each method has its drawbacks. This review discusses the different molecular diagnostic techniques applied for the diagnosis of leptospirosis; elaborating on each method’s sensitivity, specificity, and detection time and the different samples of water, blood, and urine used.
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16
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Turmel JM, Olive C, Bigeard B, Abel S, Banydeen R, Daoud L, Fayolle PM, Cabié A. Case Report: Pulmonary Leptospirosis Misdiagnosed as COVID-19. Am J Trop Med Hyg 2022; 107:tpmd211102. [PMID: 35576944 PMCID: PMC9294685 DOI: 10.4269/ajtmh.21-1102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
We report the case of an 83-year-old woman with acute, febrile respiratory failure resulting from interstitial pneumonia that required high-flow oxygen therapy. This clinical picture, associated with the ongoing epidemiological situation, initially guided us toward a diagnosis of COVID-19. Based on SARS-CoV-2 reverse transcription-polymerase chain reaction negativity and the absence of anti-SARS-CoV-2 antibodies, a search for a differential diagnosis was conducted that led us to conclude a diagnosis of severe pulmonary leptospirosis This case highlights the need to engage in early discussions about differential diagnoses, including neglected tropical and subtropical diseases, during the COVID-19 era.
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Affiliation(s)
- Jean-Marie Turmel
- Department of Tropical and Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Claude Olive
- Bacteriology Laboratory, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Bastien Bigeard
- Department of Tropical and Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Sylvie Abel
- Department of Tropical and Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Rishika Banydeen
- Department of Clinical Research, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Laura Daoud
- Intensive Care Unit, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - Pierre-Marie Fayolle
- Intensive Care Unit, Centre Hospitalier Universitaire de Martinique, Fort de France, France
| | - André Cabié
- Department of Tropical and Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, France
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Bothammal P, Michelraj S, Venkatachalam G, Verma A, Natarajaseenivasan K. Electrochemical biosensor for serogroup specific diagnosis of leptospirosis. Bioelectrochemistry 2022; 144:108005. [PMID: 34864273 DOI: 10.1016/j.bioelechem.2021.108005] [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: 04/05/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 11/02/2022]
Abstract
A problem with the current leptospirosis diagnostic methods is the low sensitivity and specificity during the acute phase of illness. Rapid point-of-care (POC) assays with minimal sample utilization and low cost are desired in clinical practice. Here, we report for the first time lipopolysaccharide (LPS) based electrochemical biosensor that offers a rapid, highly sensitive, serogroup specific diagnosis of leptospirosis during the acute stage of infection and also to distinguish from other flu like infections. The proposed sensor is fabricated by the immobilization of LPS onto dodecanethiol (DT) modified gold electrode. Monolayer of DT is attached through covalent bond (Au-S) interaction onto the gold electrode. Thus, leptospiral antibodies from the human serum samples bind to the LPS present on self-assembled monolayer (SAM) of DT and showed a higher RCT value compared to SAM. The detection limit of the developed LPS sensor is estimated to be 100 nM. This biosensor is the first electrochemical sensing platform used for detection of LPS from Leptospira spp. This method is completely a solution-based diagnostic method and therefore it is rapid, simple, and sensitive; thus establishing a key technology towards a useful POC diagnostic strategy in serogroup level and hence an alternative to MAT.
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Affiliation(s)
- Palanisamy Bothammal
- Medical Microbiology Laboratory, Department of Microbiology, Center for Excellence in Life Sciences, Bharathidasan University, Tiruchirappalli - 620 024, Tamil Nadu, India
| | - Singarayan Michelraj
- Electrodics and Electrocatalysis (EEC) Division, CSIR - Central Electrochemical Research Institute (CSIR - CECRI), Karaikudi - 630003, Tamil Nadu, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Ganesh Venkatachalam
- Electrodics and Electrocatalysis (EEC) Division, CSIR - Central Electrochemical Research Institute (CSIR - CECRI), Karaikudi - 630003, Tamil Nadu, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
| | - Ashutosh Verma
- Lincoln Memorial University, College of Veterinary Medicine, Harrogate, TN 37752, USA.
| | - Kalimuthusamy Natarajaseenivasan
- Medical Microbiology Laboratory, Department of Microbiology, Center for Excellence in Life Sciences, Bharathidasan University, Tiruchirappalli - 620 024, Tamil Nadu, India; Department of Neural Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA.
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Going Micro in Leptospirosis Kidney Disease. Cells 2022; 11:cells11040698. [PMID: 35203344 PMCID: PMC8869946 DOI: 10.3390/cells11040698] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 02/05/2023] Open
Abstract
Leptospirosis is a zoonotic and waterborne disease worldwide. It is a neglected infectious disease caused by Leptospira spp., as well as a reemerging disease and global public health problem with respect to morbidity and mortality both in humans and animals. Leptospirosis emerges as a leading cause of acute febrile illness along with hepatorenal injury in many countries, including Thailand. While most affected persons are symptomatic in acute disease, which is always difficult to differentiate from other tropical diseases, there is growing evidence of subtle manifestations that cause unrecognized chronic symptoms. The kidney is one of the common organs affected by Leptospires. Although acute kidney injury in the spectrum of interstitial nephritis is a well-described characteristic in severe leptospirosis, chronic kidney disease from leptospirosis is widely discussed. Early recognition of severe leptospirosis leads to reduce morbidity and mortality. Thus, in this review, we highlight the spectrum of characteristics involved in leptospirosis kidney disease and the use of serologic and molecular methods, as well as the treatments of severe leptospirosis.
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Grillová L, Robinson MT, Chanthongthip A, Vincent AT, Nieves C, Oppelt J, Mariet JF, Lorioux C, Vongsouvath M, Mayxay M, Phonemeexay O, Rattanavong S, Phommasone K, Douangnouvong A, Šmajs D, Veyrier FJ, Newton PN, Picardeau M. Genetic diversity of Leptospira isolates in Lao PDR and genome analysis of an outbreak strain. PLoS Negl Trop Dis 2021; 15:e0010076. [PMID: 34962921 PMCID: PMC8746763 DOI: 10.1371/journal.pntd.0010076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/10/2022] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Although Southeast Asia is one of the most leptospirosis afflicted regions, little is known about the diversity and molecular epidemiology of the causative agents of this widespread and emerging zoonotic disease. Methodology/Principal findings We used whole genome sequencing to examine genetic variation in 75 Leptospira strains isolated from patients in the Lao PDR (Laos) between 2006 and 2017. Eleven serogroups from 4 Leptospira species and 43 cgMLST-defined clonal groups (CGs) were identified. The most prevalent CG was CG272 (n = 18, 26.8%), composed of L. interrogans serogroup Autumnalis isolates. This genotype was recovered throughout the 12-year period and was associated with deaths, and with a large outbreak in neighbouring Thailand. Genome analysis reveals that the CG272 strains form a highly clonal group of strains that have, for yet unknown reasons, recently spread in Laos and Thailand. Additionally, accessory genes clearly discriminate CG272 strains from the other Leptospira strains. Conclusions/Significance The present study reveals a high diversity of Leptospira genotypes in Laos, thus extending our current knowledge of the pan- and core-genomes of these life-threatening pathogens. Our results demonstrate that the CG272 strains belong to a unique clonal group, which probably evolved through clonal expansion following niche adaptation. Additional epidemiological studies are required to better evaluate the spread of this genotype in Southeast Asia. To further investigate the key factors driving the virulence and spread of these pathogens, more intense genomic surveillance is needed, combining detailed clinical and epidemiological data. Pathogenic Leptospira are the causative agents for leptospirosis, a neglected and emerging zoonosis occurring worldwide. In this study, we investigated the genetic diversity of Leptospira strains isolated from patients over a 12-year period in Lao PDR. Our genome analysis revealed a high diversity of Leptospira genotypes in this endemic country for leptospirosis, including a group of clonal strains which was responsible for a large outbreak in neighboring Thailand. Further progress in our understanding of the epidemiology of Leptospira circulating genotypes should contribute to the implementation of prevention and intervention measures to reduce the risk of leptospirosis transmission.
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Affiliation(s)
- Linda Grillová
- Biology of Spirochetes Unit, Institut Pasteur, Paris, France
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Matthew T. Robinson
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Anisone Chanthongthip
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Antony T. Vincent
- INRS-Centre Armand-Frappier Santé-Biotechnologie, Bacterial Symbionts Evolution, Laval, Canada
| | - Cecilia Nieves
- INRS-Centre Armand-Frappier Santé-Biotechnologie, Bacterial Symbionts Evolution, Laval, Canada
| | - Jan Oppelt
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America
| | | | - Céline Lorioux
- Biology of Spirochetes Unit, Institut Pasteur, Paris, France
| | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | - Ooyanong Phonemeexay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Sayaphet Rattanavong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Koukeo Phommasone
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Anousone Douangnouvong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - David Šmajs
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Frédéric J. Veyrier
- INRS-Centre Armand-Frappier Santé-Biotechnologie, Bacterial Symbionts Evolution, Laval, Canada
| | - Paul N. Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mathieu Picardeau
- Biology of Spirochetes Unit, Institut Pasteur, Paris, France
- * E-mail:
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20
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Rajamani M, Maile A, Sugunan AP, Vijayachari P. Truenat TM - micro real-time-polymerase chain reaction for rapid diagnosis of leptospirosis at minimal resource settings. Indian J Med Res 2021; 154:115-120. [PMID: 34782537 PMCID: PMC8715686 DOI: 10.4103/ijmr.ijmr_2539_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background & objectives: The biological spectrum of leptospirosis ranges from acute undifferentiated febrile illness to severe fatal syndrome or a combination of syndromes. Diagnosis on clinical grounds alone is difficult and depends on laboratory support. However, no confirmatory tests are available, which is rapid and can be performed with minimum facilities available. The objectives of this study were to evaluate the diagnostic utility, accuracy and reproducibility of a rapid real time-PCR based method (Truenat™) for early diagnosis of leptospirosis, and its usage in low resource settings. Methods: The Truenat™ test was performed using plasma sample collected from confirmed patients and controls. DNA was extracted from plasma samples and the reaction was performed as per the manufacturer’s instructions. Leptospiral isolates were also used to assess the performance using different serovars. Results: Evaluation of the Truenat™ test with RT-PCR as the gold standard showed that Truenat™ had a sensitivity of 97.4 per cent and a specificity of 98.6 per cent. The overall agreement with RT-PCR was 98.2 per cent. Interpretation & conclusions: Our results showed that the test would be a useful tool for early diagnosis of leptospirosis in settings with minimal facilities and the test results could be obtained within an hour. This indicates that a specific therapy can be instituted during the early phase of the disease even at peripheral healthcare facilities as well during the outbreaks.
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Affiliation(s)
- M Rajamani
- ICMR-Regional Medical Research Centre, WHO Collaborating Centre for Diagnosis, Research, Reference & Training in Leptospirosis, Port Blair, Andaman & Nicobar Islands, India
| | - Anwesh Maile
- ICMR-Regional Medical Research Centre, WHO Collaborating Centre for Diagnosis, Research, Reference & Training in Leptospirosis, Port Blair, Andaman & Nicobar Islands, India
| | - A P Sugunan
- ICMR-Regional Medical Research Centre, WHO Collaborating Centre for Diagnosis, Research, Reference & Training in Leptospirosis, Port Blair, Andaman & Nicobar Islands, India
| | - P Vijayachari
- ICMR-Regional Medical Research Centre, WHO Collaborating Centre for Diagnosis, Research, Reference & Training in Leptospirosis, Port Blair, Andaman & Nicobar Islands, India
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21
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Quantitative Real-Time PCR Assays for the Detection of Pathogenic Leptospira Species in Urine and Blood Samples in Canine Vaccine Clinical Studies: a Rapid Alternative to Classical Culture Methods. J Clin Microbiol 2021; 59:e0300620. [PMID: 33853840 PMCID: PMC8218769 DOI: 10.1128/jcm.03006-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Leptospirosis is a vaccine-preventable bacterial zoonotic disease caused by pathogenic Leptospira species. The efficacy of Leptospira canine vaccines is assessed by challenging vaccinated and control dogs with virulent serovars of Leptospira, followed by detection of Leptospira in blood and urine. We assessed the consistency between results obtained for urine and blood samples from clinical studies with species-specific real-time quantitative PCR (qPCR) targeting the lipL32 gene and those obtained with the reference culture method. The specificity of the qPCR assay was confirmed by negative results for nonpathogenic Leptospira and for several canine viruses, bacteria, and parasites. The results from the two methods were compared using McNemar’s test, kappa coefficient (κ), and percentage of agreement analyses. The results for numbers of positive and negative dogs were similar, with no false-negative results with the qPCR assay. For both blood and urine, there was strong agreement between the culture method and qPCR results (κ = 0.68 [95% confidence interval (CI), 0.62 to 0.74] and κ = 0.65 [95% CI, 0.59 to 0.71], respectively). However, there was a statistically significant difference between blood samples (P < 0.001) and urine samples (P = 0.028). The negative percentage agreements were 97% and 84% and the positive percentage agreements were 68% and 83% for blood and urine samples, respectively. Although the cell culture method is the recommended gold standard, our results show that qPCR assay is a valid alternative method for the rapid and specific detection of pathogenic Leptospira spp. in urine and blood samples during vaccine efficacy studies, without loss of sensitivity.
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Naidoo K, Moseley M, McCarthy K, Chingonzoh R, Lawrence C, Setshedi GM, Frean J, Rossouw J. Fatal Rodentborne Leptospirosis in Prison Inmates, South Africa, 2015. Emerg Infect Dis 2021; 26:1033-1035. [PMID: 32310070 PMCID: PMC7181914 DOI: 10.3201/eid2605.191132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Leptospirosis is a neglected zoonotic disease. In 2015, leptospirosis was diagnosed in 2 prison inmates in South Africa. Using real-time PCR and DNA sequencing, we identified Leptospira interrogans serogroup Icterohaemorrhagiae in rodents and water samples within the prison. Leptospirosis might be frequently underdiagnosed in South Africa.
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Gunasegar S, Neela VK. Evaluation of diagnostic accuracy of loop-mediated isothermal amplification method (LAMP) compared with polymerase chain reaction (PCR) for Leptospira spp. in clinical samples: a systematic review and meta-analysis. Diagn Microbiol Infect Dis 2021; 100:115369. [PMID: 33845305 DOI: 10.1016/j.diagmicrobio.2021.115369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/20/2021] [Accepted: 03/06/2021] [Indexed: 12/29/2022]
Abstract
Loop-mediated isothermal amplification (LAMP) test is widely used in molecular diagnostics as a point-of-care technique alternative to traditional PCR especially in resource-limited countries. LAMP has been recently used to diagnose leptospirosis. Therefore, we undertook a systematic review and meta-analysis to compare the accuracy of LAMP with PCR in the diagnosis of leptospirosis. Sixty-one studies were extracted from three international databases and analyzed throughout using the PRISMA guideline. The pooled sensitivity of LAMP and PCR technique was 0.80 (95% CI: 0.58-0.90) and 0.54 (95% CI: 0.35-0.67) respectively indicating that LAMP is more sensitive than PCR. The Q* value of LAMP and PCR-based technique is 274.61 and 397.95, respectively. Among the analyzed studies, significant heterogeneity was observed where I2 is 90.90% for LAMP-based and 86.18% for PCR-based. Our study suggests that LAMP has better diagnostic accuracy than PCR. However, future work should be carried out to reduce heterogeneity as well as to improve and develop effective intervention strategies.
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Affiliation(s)
- Shan Gunasegar
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Vasantha Kumari Neela
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
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24
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Samrot AV, Sean TC, Bhavya KS, Sahithya CS, Chan-drasekaran S, Palanisamy R, Robinson ER, Subbiah SK, Mok PL. Leptospiral Infection, Pathogenesis and Its Diagnosis-A Review. Pathogens 2021; 10:pathogens10020145. [PMID: 33535649 PMCID: PMC7912936 DOI: 10.3390/pathogens10020145] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 12/22/2022] Open
Abstract
Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly existing as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil's disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.
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Affiliation(s)
- Antony V. Samrot
- School of Bioscience, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor 42610, Malaysia;
- Correspondence: (A.V.S.); (P.L.M.)
| | - Tan Chuan Sean
- School of Bioscience, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor 42610, Malaysia;
| | - Karanam Sai Bhavya
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Chennai, Tamil Nadu 627 011, India; (K.S.B.); (C.S.S.); (S.C.); (R.P.)
| | - Chamarthy Sai Sahithya
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Chennai, Tamil Nadu 627 011, India; (K.S.B.); (C.S.S.); (S.C.); (R.P.)
| | - SaiPriya Chan-drasekaran
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Chennai, Tamil Nadu 627 011, India; (K.S.B.); (C.S.S.); (S.C.); (R.P.)
| | - Raji Palanisamy
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Chennai, Tamil Nadu 627 011, India; (K.S.B.); (C.S.S.); (S.C.); (R.P.)
| | - Emilin Renitta Robinson
- Department of Food Processing Technology, Karunya Institute of Technology and Science, Coimbatore, Tamil Nadu 641 114, India;
| | - Suresh Kumar Subbiah
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor 43400, Malaysia;
- Department of Biotechnology, Bharath Institute of Higher Education and Research (BIHER), Selaiyur, Tamil Nadu 600 073, India
- Genetics and Regenerative Medicine Research Centre, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor 43400, Malaysia
| | - Pooi Ling Mok
- Department of Biotechnology, Bharath Institute of Higher Education and Research (BIHER), Selaiyur, Tamil Nadu 600 073, India
- Genetics and Regenerative Medicine Research Centre, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor 43400, Malaysia
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor 43400, Malaysia
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka P.O. Box 2014, Aljouf Province, Saudi Arabia
- Correspondence: (A.V.S.); (P.L.M.)
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25
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Evaluation of three qPCR for the detection of pathogenic leptospires in domestic animals in Nicaragua. BIOMEDICA 2020; 40:673-681. [PMID: 33275346 PMCID: PMC7808766 DOI: 10.7705/biomedica.5170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Indexed: 11/21/2022]
Abstract
Introducción. En Nicaragua es necesario estandarizar pruebas moleculares como la PCR en tiempo real (quantitative Polymerase Chain Reaction, qPCR) que mejoren el diagnóstico de leptospirosis en humanos y animales. Objetivo. Evaluar tres qPCR para la detección de leptospiras patógenas en animales domésticos de Nicaragua. Materiales y métodos. Se diseñaron cebadores para la amplificación del gen LipL32 en SYBR Green (SYBR Green-A) y TaqMan, y en otros descritos previamente (SYBR Green-B). Las secuencias de 12 cepas obtenidas de la base de datos del National Center for Biotechnology Information (NCBI) se alinearon para la búsqueda de sondas y cebadores. La sensibilidad analítica se determinó calculando el equivalente genómico detectable, se utilizaron 18 cepas de referencia para la sensibilidad diagnóstica y 28 controles negativos para la especificidad. Los métodos se aplicaron en 129 muestras de orina de animales domésticos. Resultados. En SYBR Green-A se obtuvo un límite de detección de cuatro equivalentes genómicos; en TaqMan, la sensibilidad fue del 94,4 % (IC95% 81,1-100,0). Con SYBR Green-A, se obtuvo una sensibilidad del 77,8 % (IC95% 55,8-99,8), en tanto que con SYBR Green-B fue del 61,1 % (IC95% 35,8-86,4). En las tres pruebas se logró una especificidad del 100 % (IC95% 98,2-100,0). El 26,4 % de las muestras de animales domésticos fueron positivas con SYBR Green-A y el 6,2 % con SYBR Green-B. Conclusiones. El SYBR Green-A presentó un límite de detección bajo, en tanto que las tres técnicas evaluadas mostraron alta especificidad, en tanto que la TaqMan tuvo la mayor sensibilidad.
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Flores B, Sheleby-Elias J, Pérez-Sánchez T, Fischer R, Múzquiz J, Fuertes H, Halaihel N, Jirón W, Duttmann C. Leptospira spp in Rodents from Peridomestic Sites in Endemic Regions of Nicaragua. ECOHEALTH 2020; 17:469-476. [PMID: 33834316 PMCID: PMC9645555 DOI: 10.1007/s10393-021-01520-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
Leptospirosis is one of the most important zoonoses in tropical countries, including Nicaragua, where it is considered endemic. The aim of this study was to determine the frequency of Leptospira spp in rodents captured from peridomestic sites in leptospirosis endemic regions of Nicaragua. Using live traps, 191 rodents were captured in 2012 and 2013 between April and December. Kidney samples were collected and processed for Leptospira detection from 166 animals by direct culture and isolation. The isolates were tested by PCR for LipL32 and lfb1-F genes specific to pathogenic Leptospira species. The trapping success over all sites was 20.2%, with higher rates of success in rainy season (p < 0.05). Leptospira spp were detected in 22.3% of rodents by direct culture methods. Significant differences (p < 0.01) were found in the frequencies of Leptospira positive rodents per month as well as per region. Of the isolated Leptospira spp, 37.5% were positive for pathogenic species by PCR. The frequency of Leptospira positive rodents by isolation could be used as a predictive indicator for the risk of human leptospirosis in Nicaragua.
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Affiliation(s)
- Byron Flores
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León, UNAN-León), Edificio Central, Contiguo a la Iglesia La Merced, Apartado Postal 68, León, Nicaragua.
| | - Jessica Sheleby-Elias
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León, UNAN-León), Edificio Central, Contiguo a la Iglesia La Merced, Apartado Postal 68, León, Nicaragua
| | - Tania Pérez-Sánchez
- Department of Animal Pathology, Faculty of Veterinary Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Rebecca Fischer
- System Health Science Center, Department of Epidemiology and Biostatistics, Texas A & M University, Bryan, USA
- Section of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | - José Múzquiz
- Department of Animal Pathology, Faculty of Veterinary Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Héctor Fuertes
- Department of Animal Pathology, Faculty of Veterinary Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - Nabil Halaihel
- Department of Animal Pathology, Faculty of Veterinary Sciences, Universidad de Zaragoza, Zaragoza, Spain
| | - William Jirón
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León, UNAN-León), Edificio Central, Contiguo a la Iglesia La Merced, Apartado Postal 68, León, Nicaragua
| | - Christiane Duttmann
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León, UNAN-León), Edificio Central, Contiguo a la Iglesia La Merced, Apartado Postal 68, León, Nicaragua
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Age-specific epidemiology of human leptospirosis in New Caledonia, 2006-2016. PLoS One 2020; 15:e0242886. [PMID: 33253284 PMCID: PMC7703958 DOI: 10.1371/journal.pone.0242886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/10/2020] [Indexed: 12/02/2022] Open
Abstract
With over one million cases worldwide annually and a high fatality in symptomatic forms, human leptospirosis is a growing public health concern for the most vulnerable populations, especially in the context of global warming and unplanned urbanization. Although the Asia-Pacific region is particularly affected, accurate epidemiological data are often lacking. We conducted an eleven-year retrospective laboratory-based epidemiological survey of human leptospirosis in New Caledonia. From 2006 to 2016, 904 cases were laboratory-confirmed, including 29 fatalities, corresponding to an average annual incidence of 30.6/100,000 and a case fatality rate of 3.2%. Over the period, there was a major shift from indirect serological diagnosis by MAT to direct diagnosis by real-time PCR, a more specific and sensitive test when performed early in the course of the disease. The systematic implementation of genotyping informed on the variety of the infective strains involved, with a predominance of serogroups Icterohaemorrhagiae and Pyrogenes. The epidemiological pattern showed a marked seasonality with an annual peak in March-April. Interestingly, the seasonal peak in children of school age was significantly earlier and corresponded to school holidays, suggesting that attending school from February on could protect children from environment-borne leptospirosis.
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Moseley M, Naidoo K, Bastos A, Retief L, Frean J, Telfer S, Rossouw J. Multi-locus sequence analyses reveal a clonal L. borgpetersenii genotype in a heterogeneous invasive Rattus spp. community across the City of Johannesburg, South Africa. Parasit Vectors 2020; 13:570. [PMID: 33176846 PMCID: PMC7659165 DOI: 10.1186/s13071-020-04444-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/30/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Rattus spp. are frequently implicated as key reservoir hosts for leptospirosis, one of the most common, but neglected, bacterial zoonoses in the world. Although leptospirosis is predicted to be a significant public health threat in Africa, studies from the continent are limited. METHODS Rattus spp. (n = 171) were sampled (January-May 2016) across the City of Johannesburg, South Africa's largest inland metropole. Rattus spp. genetic diversity was evaluated by full length (1140 bp) cyt b sequencing of 42 samples. For comparison, a further 12 Rattus norvegicus samples collected in Cape Town, South Africa's largest coastal metropole, were also genotyped. Leptospira infections were identified and genotyped using real-time PCR and multi-locus (lfb1, secY and lipL41) DNA sequencing. RESULTS Five R. norvegicus haplotypes were identified across Johannesburg, four of which have not previously been detected in South Africa, and one in Cape Town. Across Johannesburg we identified a Leptospira spp. infection prevalence of 44% (75/171) and noted significant differences in the prevalence between administrative regions within the metropole. Multi-locus sequence analyses identified a clonal genotype consistent with L. borgpetersenii serogroup Javanica (serovar Ceylonica). DISCUSSION The prevalence of infection identified in this study is amongst the highest detected in Rattus spp. in similar contexts across Africa. Despite the complex invasion history suggested by the heterogeneity in R. norvegicus haplotypes identified in Johannesburg, a single L. borgpetersenii genotype was identified in all infected rodents. The lack of L. interrogans in a rodent community dominated by R. norvegicus is notable, given the widely recognised host-pathogen association between these species and evidence for L. interrogans infection in R. norvegicus in Cape Town. It is likely that environmental conditions (cold, dry winters) in Johannesburg may limit the transmission of L. interrogans. Spatial heterogeneity in prevalence suggest that local factors, such as land use, influence disease risk in the metropole. CONCLUSIONS In South Africa, as in other African countries, leptospirosis is likely underdiagnosed. The high prevalence of infection in urban rodents in Johannesburg suggest that further work is urgently needed to understand the potential public health risk posed by this neglected zoonotic pathogen.
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Affiliation(s)
- Mark Moseley
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Kovashnee Naidoo
- National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg, South Africa
| | - Armanda Bastos
- Department of Zoology and Entomology, University of Pretoria, Pretoria, South Africa
| | - Liezl Retief
- Department of Zoology and Entomology, University of Pretoria, Pretoria, South Africa
| | - John Frean
- National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg, South Africa
- Wits Research Institute for Malaria, University of the Witwatersrand, Johannesburg, South Africa
| | - Sandra Telfer
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Jennifer Rossouw
- National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg, South Africa
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Allan KJ, Maze MJ, Galloway RL, Rubach MP, Biggs HM, Halliday JEB, Cleaveland S, Saganda W, Lwezaula BF, Kazwala RR, Mmbaga BT, Maro VP, Crump JA. Molecular Detection and Typing of Pathogenic Leptospira in Febrile Patients and Phylogenetic Comparison with Leptospira Detected among Animals in Tanzania. Am J Trop Med Hyg 2020; 103:1427-1434. [PMID: 32748767 PMCID: PMC7543812 DOI: 10.4269/ajtmh.19-0703] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Molecular data are required to improve our understanding of the epidemiology of leptospirosis in Africa and to identify sources of human infection. We applied molecular methods to identify the infecting Leptospira species and genotypes among patients hospitalized with fever in Tanzania and compared these with Leptospira genotypes detected among animals in Tanzania to infer potential sources of human infection. We performed lipL32 real-time PCR to detect the presence of pathogenic Leptospira in acute-phase plasma, serum, and urine samples obtained from study participants with serologically confirmed leptospirosis and participants who had died with febrile illness. Leptospira blood culture was also performed. In positive specimens, we performed species-specific PCR and compared participant Leptospira secY sequences with Leptospira reference sequences and sequences previously obtained from animals in Tanzania. We detected Leptospira DNA in four (3.6%) of 111 participant blood samples. We detected Leptospira borgpetersenii (one participant, 25.0%), Leptospira interrogans (one participant, 25.0%), and Leptospira kirschneri (one participant, 25.0%) (one [25%] undetermined). Phylogenetic comparison of secY sequence from the L. borgpetersenii and L. kirschneri genotypes detected from participants was closely related to but distinct from genotypes detected among local livestock species. Our results indicate that a diverse range of Leptospira species is causing human infection. Although our analysis suggests a close relationship between Leptospira genotypes found in people and livestock, continued efforts are needed to obtain more Leptospira genetic material from human leptospirosis cases to help prioritize Leptospira species and genotypes for control.
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Affiliation(s)
- Kathryn J. Allan
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Michael J. Maze
- Centre for International Health, University of Otago, Dunedin, New Zealand;,Department of Medicine, University of Otago, Christchurch, New Zealand;,Address correspondence to Michael J. Maze, Department of Medicine, University of Otago, PO Box 4345, Christchurch 8140, New Zealand. E-mail:
| | - Renee L. Galloway
- Bacterial Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew P. Rubach
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina;,Duke Global Health Institute, Duke University, Durham, North Carolina;,Programme for Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Holly M. Biggs
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina
| | - Jo E. B. Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | | | | | - Rudovick R. Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania;,Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania;,Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania;,Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand;,Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina;,Duke Global Health Institute, Duke University, Durham, North Carolina
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Seven Years Leptospirosis Follow-Up in a Critical Care Unit of a French Metropolitan Hospital; Role of Real Time PCR for a Quick and Acute Diagnosis. J Clin Med 2020; 9:jcm9093011. [PMID: 32961996 PMCID: PMC7564453 DOI: 10.3390/jcm9093011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
(1) Background: Leptospirosis infection can lead to multiple organ failure, requiring hospitalization in an intensive care unit for supportive care, along with initiation of an adapted antibiotic therapy. Achieving a quick diagnosis is decisive in the management of these patients. (2) Methods: We present here a review of leptospirosis cases diagnosed in the intensive care unit of our hospital over seven years. Clinical and biological data were gathered, and we compared the differences in terms of diagnostic method. (3) Results: Molecular biology method by Polymerase Chain Reaction (PCR) allowed quick and reliable diagnosis when performed in the first days after the symptoms began. Moreover, we identified that sampling blood and urine for PCR was more efficient than performing PCR on only one type of biological sample. (4) Conclusions: Our results confirm the efficiency of PCR for the quick diagnosis of leptospirosis and suggest that testing both blood and urine early in the disease might improve diagnosis.
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Abstract
Abstract
Background
Leptospirosis, caused by pathogenic Leptospira spp., is a widespread zoonotic disease worldwide. Early diagnosis is required for proper patient management and reducing leptospirosis morbidity and mortality.
Objective
To summarize current literature regarding commonly used and new promising molecular approaches to Leptospira detection and diagnostic tests of human leptospirosis.
Method
The relevant articles in Leptospira and leptospirosis were retrieved from MEDLINE (PubMed) and Scopus.
Results
Several molecular techniques have been developed for diagnosis of human leptospirosis. Polymerase chain reaction-based techniques targeting on either lipL32 or 16S rRNA (rrs) gene are most commonly used to detect leptospiral DNA in various clinical specimens. Whole blood and urine are recommended specimens for suspected cases in the first (acute) and the second (immune) phases, respectively. Isothermal amplification with less expensive instrument is an alternative DNA detection technique that may be suitable for resource-limited laboratories.
Conclusion
Detection of leptospiral DNA in clinical specimens using molecular techniques enhances sensitivity for diagnosis of leptospirosis. The efficient and robust molecular detection especially in the early leptospiremic phase may prompt early and appropriate treatment leading to reduced morbidity and mortality of patients with leptospirosis.
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Affiliation(s)
- Teerasit Techawiwattanaboon
- Department of Microbiology, Faculty of Medicine , Chulalongkorn University , Bangkok 10330 , Thailand
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development , Chulalongkorn University , Bangkok 10330 , Thailand
| | - Kanitha Patarakul
- Department of Microbiology, Faculty of Medicine , Chulalongkorn University , Bangkok 10330 , Thailand
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development , Chulalongkorn University , Bangkok 10330 , Thailand
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Detection of New Leptospira Genotypes Infecting Symptomatic Dogs: Is a New Vaccine Formulation Needed? Pathogens 2020; 9:pathogens9060484. [PMID: 32570803 PMCID: PMC7350335 DOI: 10.3390/pathogens9060484] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/18/2022] Open
Abstract
Leptospirosis in dogs has been largely described worldwide, and epidemiological studies have been mainly based on serological data. This study aims to detect and genotype leptospires affecting symptomatic dogs in Northeast Italy between 2013 and 2019. Overall, 1631 dogs were tested using real-time PCR, and leptospires from 193 dogs were subjected to Multilocus Sequence Typing and a Multiple Loci Variable-number Tandem Repeat Analysis. Leptospires were successfully isolated from 15 symptomatic dogs. Six distinct Sequence Types (STs) were found for 135 leptospires, with 3 STs characterizing Leptospira interrogans (ST17, ST198 and ST24), 2 STs characterizing Leptospira kirschneri (ST117 and ST289) and 1 ST characterizing Leptospira borgpetersenii (ST155), revealing the circulation of the serogroups Icterohaemorrhagiae, Australis, Sejroe and Pomona. The Multiple Loci Variable-number Tandem Repeat Analysis of 17 samples did not result in any additional discrimination. Genotypes were compared with those of strains present in the historical internal database, and possible transmission chains were identified from rat, mouse, hedgehog and pig. This work highlights the importance of molecular methods in revealing and identifying circulating Leptospira strains, and it also encourages the evaluation of the ability of commercially available vaccines to reduce the disease burden among dogs.
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Kallel H, Bourhy P, Mayence C, Houcke S, Hommel D, Picardeau M, Caro V, Matheus S. First report of human Leptospira santarosai infection in French Guiana. J Infect Public Health 2020; 13:1181-1183. [PMID: 32307314 DOI: 10.1016/j.jiph.2020.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/24/2020] [Accepted: 03/28/2020] [Indexed: 11/17/2022] Open
Abstract
Leptospirosis is a zoonotic disease with worldwide distribution. In French Guiana, a French overseas department of South America, this bacterial infection is endemic with the increase of human cases since the last 5 years. Nevertheless, the epidemiological data on the circulating infecting strain remains scarce due to the lack of specific symptoms and the used diagnostic approaches. We report a severe case of leptospirosis in a 52-years-old male, working as a street cleaner, hospitalized at the Intensive Care Unit of city capital hospital of French Guiana because of hemodynamic, neurological, renal, and respiratory failure. At ICU admission, the patient was comatose, his temperature was 37.3°C, heart rate 104 beats per minute, blood pressure 84/45mmHg, and oxygen saturation 95% while under mechanical ventilation. Retrospective exploration using molecular and serological approaches from the samples allowed reporting an infection by Leptospira santarosai serogroup Sejroe serovar Hardjo. To our knowledge, this is the first human case infected with this species in French Guiana. Through these analyses, this report provides new epidemiological information about the Leptospira strains circulating in French Guiana. In particular, this emphasizes the importance of accurate diagnosis to characterize with more precision the circulating Leptospira strains in this department.
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Affiliation(s)
- Hatem Kallel
- Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana
| | - Pascale Bourhy
- Institut Pasteur, Centre National de Référence de la Leptospirose, Biology of Spirochetes Unit, Paris, France
| | - Claire Mayence
- Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana
| | - Stéphanie Houcke
- Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana
| | - Didier Hommel
- Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana
| | - Mathieu Picardeau
- Institut Pasteur, Centre National de Référence de la Leptospirose, Biology of Spirochetes Unit, Paris, France
| | - Valérie Caro
- Institut Pasteur, Environment and Infectious Risks Unit, Paris, France
| | - Séverine Matheus
- Institut Pasteur, Environment and Infectious Risks Unit, Paris, France.
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Pérez LJ, Lanka S, DeShambo VJ, Fredrickson RL, Maddox CW. A Validated Multiplex Real-Time PCR Assay for the Diagnosis of Infectious Leptospira spp.: A Novel Assay for the Detection and Differentiation of Strains From Both Pathogenic Groups I and II. Front Microbiol 2020; 11:457. [PMID: 32265882 PMCID: PMC7100377 DOI: 10.3389/fmicb.2020.00457] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/04/2020] [Indexed: 12/12/2022] Open
Abstract
Leptospirosis is recognized as the most globally widespread reemerging zoonosis and represents a serious threat for both human and animal health. Indeed, leptospirosis is linked to more than 60,000 human deaths per year and to incalculable economic burden as consequence of medical treatment costs and livestock loss. The increasing number of reports from species of pathogenic Leptospira spp. group II causing disease in both humans and animals constitutes an additional concern to the complex epidemiology of this zoonotic agent. Diagnostic methods based on qPCR have improved the diagnosis of Leptospira spp. in terms of cost, time, and reliability, but most of the validated assays fail to detect species from the pathogenic group II. Hence, the current study was aimed to develop and validate a novel multiplex qPCR to enable the specific and selective detection of the whole group of infectious Leptospira spp., including both pathogenic groups I and II and moreover, selectively discriminate between them. To fit the "fitness of purpose" for the specific detection of infectious Leptospira spp. and further discrimination between both pathogenic groups three target regions on the 16S RNA gene were selected. These targets facilitated a broad and selective spectrum for the detection of all infectious Leptospira spp. with the exclusion of all saprophytic groups and the novel clade of environmental Leptospira spp. The analytical sensitivity (ASe) showed by the new assay also enables a wide window of detection for the agent at different stages of infection since the assay was able to efficiently detect at 95% of confidence ∼5 leptospires/reaction. From the evaluation of the analytical specificity (ASp) by in silico and in vitro approaches, it was congruently revealed that the primers and probes selected only recognized the specific targets for which the assay was intended. Bayesian latent class analysis of performance of the new assay on 684 clinical samples showed values of diagnostic sensitivity of 99.8% and diagnostic specificity of 100%. Thus, from the evaluation of the analytical and diagnostic parameters, the new multiplex qPCR assay is a reliable method for the diagnosis of Leptospira spp.
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Affiliation(s)
- Lester J. Pérez
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois at Urbana–Champaign, Urbana, IL, United States
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois at Urbana–Champaign, Urbana, IL, United States
| | - Saraswathi Lanka
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois at Urbana–Champaign, Urbana, IL, United States
| | - Vanessa J. DeShambo
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois at Urbana–Champaign, Urbana, IL, United States
| | - Richard L. Fredrickson
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois at Urbana–Champaign, Urbana, IL, United States
| | - Carol W. Maddox
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana–Champaign, Urbana, IL, United States
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Lam JY, Low GKK, Chee HY. Diagnostic accuracy of genetic markers and nucleic acid techniques for the detection of Leptospira in clinical samples: A meta-analysis. PLoS Negl Trop Dis 2020; 14:e0008074. [PMID: 32049960 PMCID: PMC7041858 DOI: 10.1371/journal.pntd.0008074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/25/2020] [Accepted: 01/18/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Leptospirosis is often difficult to diagnose because of its nonspecific symptoms. The drawbacks of direct isolation and serological tests have led to the increased development of nucleic acid-based assays, which are more rapid and accurate. A meta-analysis was performed to evaluate the diagnostic accuracy of genetic markers for the detection of Leptospira in clinical samples. METHODOLOGY AND PRINCIPLE FINDINGS A literature search was performed in Scopus, PubMed, MEDLINE and non-indexed citations (via Ovid) by using suitable keyword combinations. Studies evaluating the performance of nucleic acid assays targeting leptospire genes in human or animal clinical samples against a reference test were included. Of the 1645 articles identified, 42 eligible studies involving 7414 samples were included in the analysis. The diagnostic performance of nucleic acid assays targeting the rrs, lipL32, secY and flaB genes was pooled and analyzed. Among the genetic markers analyzed, the secY gene showed the highest diagnostic accuracy measures, with a pooled sensitivity of 0.56 (95% CI: 0.50-0.63), a specificity of 0.98 (95% CI: 0.97-0.98), a diagnostic odds ratio of 46.16 (95% CI: 6.20-343.49), and an area under the curve of summary receiver operating characteristics curves of 0.94. Nevertheless, a high degree of heterogeneity was observed in this meta-analysis. Therefore, the present findings here should be interpreted with caution. CONCLUSION The diagnostic accuracies of the studies examined for each genetic marker showed a significant heterogeneity. The secY gene exhibited higher diagnostic accuracy measures compared with other genetic markers, such as lipL32, flaB, and rrs, but the difference was not significant. Thus, these genetic markers had no significant difference in diagnostic accuracy for leptospirosis. Further research into these genetic markers is warranted.
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Affiliation(s)
- Jia-Yong Lam
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Gary Kim-Kuan Low
- Clinical Research Team, Rapid Response Revival Research Ltd, Riverwood, Sydney, Australia
| | - Hui-Yee Chee
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail:
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Bierque E, Thibeaux R, Girault D, Soupé-Gilbert ME, Goarant C. A systematic review of Leptospira in water and soil environments. PLoS One 2020; 15:e0227055. [PMID: 31986154 PMCID: PMC6984726 DOI: 10.1371/journal.pone.0227055] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/10/2019] [Indexed: 01/02/2023] Open
Abstract
Background Leptospirosis, caused by pathogenic Leptospira, is a zoonosis of global distribution. This infectious disease is mainly transmitted by indirect exposure to urine of asymptomatic animals via the environment. As human cases generally occur after heavy rain, an emerging hypothesis suggests that rainfall re-suspend leptospires together with soil particles. Bacteria are then carried to surface water, where humans get exposed. It is currently assumed that pathogenic leptospires can survive in the environment but do not multiply. However, little is known on their capacity to survive in a soil and freshwater environment. Methods We conducted a systematic review on Leptospira and leptospirosis in the environment in order to collect current knowledge on the lifestyle of Leptospira in soil and water. In total, 86 scientific articles retrieved from online databases or institutional libraries were included in this study. Principals findings/significance This work identified evidence of survival of Leptospira in the environment but major gaps remain about the survival of virulent species associated with human and animal diseases. Studies providing quantitative data on Leptospira in soil and water are a very recent trend, but must be interpreted with caution because of the uncertainty in the species identification. Several studies mentioned the presence of Leptospira in soils more frequently than in waters, supporting the hypothesis of the soil habitat and dispersion of Leptospira with re-suspended soil particles during heavy rain. In a near future, the growing use of high throughput sequencing will offer new opportunities to improve our understanding of the habitat of Leptospira in the environment. This better insight into the risk of leptospirosis will allow implementing efficient control measures and prevention for the human and animal populations exposed.
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Affiliation(s)
- Emilie Bierque
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Roman Thibeaux
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Dominique Girault
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Marie-Estelle Soupé-Gilbert
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Cyrille Goarant
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
- * E-mail:
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Leptospira in livestock in Madagascar: uncultured strains, mixed infections and small mammal-livestock transmission highlight challenges in controlling and diagnosing leptospirosis in the developing world. Parasitology 2019; 146:1707-1713. [PMID: 31554531 DOI: 10.1017/s0031182019001252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In developing countries, estimates of the prevalence and diversity of Leptospira infections in livestock, an important but neglected zoonotic pathogen and cause of livestock productivity loss, are lacking. In Madagascar, abattoir sampling of cattle and pigs demonstrated a prevalence of infection of 20% in cattle and 5% in pigs by real-time PCR. In cattle, amplification and sequencing of the Leptospira-specific lfb1 gene revealed novel genotypes, mixed infections of two or more Leptospira species and evidence for potential transmission between small mammals and cattle. Sequencing of the secY gene demonstrated genetic similarities between Leptospira detected in Madagascar and, as yet, uncultured Leptospira strains identified in Tanzania, Reunion and Brazil. Detection of Leptospira DNA in the same animal was more likely in urine samples or pooled samples from four kidney lobes relative to samples collected from a single kidney lobe, suggesting an effect of sampling method on detection. In pigs, no molecular typing of positive samples was possible. Further research into the epidemiology of livestock leptospirosis in developing countries is needed to inform efforts to reduce human infections and to improve livestock productivity.
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Yang B, de Vries SG, Ahmed A, Visser BJ, Nagel IM, Spijker R, Grobusch MP, Hartskeerl RA, Goris MGA, Leeflang MMG. Nucleic acid and antigen detection tests for leptospirosis. Cochrane Database Syst Rev 2019; 8:CD011871. [PMID: 31425612 PMCID: PMC6699653 DOI: 10.1002/14651858.cd011871.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Early diagnosis of leptospirosis may contribute to the effectiveness of antimicrobial therapy and early outbreak recognition. Nucleic acid and antigen detection tests have the potential for early diagnosis of leptospirosis. With this systematic review, we assessed the sensitivity and specificity of nucleic acid and antigen detection tests. OBJECTIVES To determine the diagnostic test accuracy of nucleic acid and antigen detection tests for the diagnosis of human symptomatic leptospirosis. SEARCH METHODS We searched electronic databases including MEDLINE, Embase, the Cochrane Library, and regional databases from inception to 6 July 2018. We did not apply restrictions to language or time of publication. SELECTION CRITERIA We included diagnostic cross-sectional studies and case-control studies of tests that made use of nucleic acid and antigen detection methods in people suspected of systemic leptospirosis. As reference standards, we considered the microscopic agglutination test alone (which detects antibodies against leptospirosis) or in a composite reference standard with culturing or other serological tests. Studies were excluded when the controls were healthy individuals or when there were insufficient data to calculate sensitivity and specificity. DATA COLLECTION AND ANALYSIS At least two review authors independently extracted data from each study. We used the revised Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) to assess risk of bias. We calculated study-specific values for sensitivity and specificity with 95% confidence intervals (CI) and pooled the results in a meta-analysis when appropriate. We used the bivariate model for index tests with one positivity threshold, and we used the hierarchical summary receiver operating characteristic model for index tests with multiple positivity thresholds. As possible sources of heterogeneity, we explored: timing of index test, disease prevalence, blood sample type, primers or target genes, and the real-time polymerase chain reaction (PCR) visualisation method. These were added as covariates to the meta-regression models. MAIN RESULTS We included 41 studies evaluating nine index tests (conventional PCR (in short: PCR), real-time PCR, nested PCR, PCR performed twice, loop-mediated isothermal amplification, enzyme-linked immunosorbent assay (ELISA), dot-ELISA, immunochromatography-based lateral flow assay, and dipstick assay) with 5981 participants (1834 with and 4147 without leptospirosis). Methodological quality criteria were often not reported, and the risk of bias of the reference standard was generally considered high. The applicability of findings was limited by the frequent use of frozen samples. We conducted meta-analyses for the PCR and the real-time PCR on blood products.The pooled sensitivity of the PCR was 70% (95% CI 37% to 90%) and the pooled specificity was 95% (95% CI 75% to 99%). When studies with a high risk of bias in the reference standard domain were excluded, the pooled sensitivity was 87% (95% CI 44% to 98%) and the pooled specificity was 97% (95% CI 60% to 100%). For the real-time PCR, we estimated a summary receiver operating characteristic curve. To illustrate, a point on the curve with 85% specificity had a sensitivity of 49% (95% CI 30% to 68%). Likewise, at 90% specificity, sensitivity was 40% (95% CI 24% to 59%) and at 95% specificity, sensitivity was 29% (95% CI 15% to 49%). The median specificity of real-time PCR on blood products was 92%. We did not formally compare the diagnostic test accuracy of PCR and real-time PCR, as direct comparison studies were lacking. Three of 15 studies analysing PCR on blood products reported the timing of sample collection in the studies included in the meta-analyses (range 1 to 7 days postonset of symptoms), and nine out of 16 studies analysing real-time PCR on blood products (range 1 to 19 days postonset of symptoms). In PCR studies, specificity was lower in settings with high leptospirosis prevalence. Other investigations of heterogeneity did not identify statistically significant associations. Two studies suggested that PCR and real-time PCR may be more sensitive on blood samples collected early in the disease stage. Results of other index tests were described narratively. AUTHORS' CONCLUSIONS The validity of review findings are limited and should be interpreted with caution. There is a substantial between-study variability in the accuracy of PCR and real-time PCR, as well as a substantial variability in the prevalence of leptospirosis. Consequently, the position of PCR and real-time PCR in the clinical pathway depends on regional considerations such as disease prevalence, factors that are likely to influence accuracy, and downstream consequences of test results. There is insufficient evidence to conclude which of the nucleic acid and antigen detection tests is the most accurate. There is preliminary evidence that PCR and real-time PCR are more sensitive on blood samples collected early in the disease stage, but this needs to be confirmed in future studies.
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Affiliation(s)
- Bada Yang
- Amsterdam University Medical Centers, University of AmsterdamDepartment of Clinical Epidemiology, Biostatistics and BioinformaticsMeibergdreef 9AmsterdamNoord‐HollandNetherlands1105 AZ
| | - Sophia G de Vries
- Amsterdam University Medical Centers, location AMC, University of AmsterdamCenter of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal MedicineMeibergdreef 9AmsterdamNoord‐HollandNetherlands1105 AZ
| | - Ahmed Ahmed
- Academic Medical Centre (AMC), University of AmsterdamMedical Microbiology, OIE and National Collaborating Centre for Reference and Research on LeptospirosisMeibergdreef 39AmsterdamNetherlands1105 AZ
| | - Benjamin J Visser
- Amsterdam University Medical Centers, location AMC, University of AmsterdamCenter of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal MedicineMeibergdreef 9AmsterdamNoord‐HollandNetherlands1105 AZ
| | - Ingeborg M Nagel
- Amsterdam UMC, University of AmsterdamMedical LibraryMeibergdreef 9AmsterdamNetherlands1105 AZ
| | - René Spijker
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCochrane NetherlandsRoom Str. 6.127P.O. Box 85500UtrechtNetherlands3508 GA
- Amsterdam UMC, University of Amsterdam, Amsterdam Public HealthMedical LibraryMeibergdreef 9AmsterdamNetherlands
| | - Martin P Grobusch
- Amsterdam University Medical Centers, location AMC, University of AmsterdamCenter of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal MedicineMeibergdreef 9AmsterdamNoord‐HollandNetherlands1105 AZ
| | - Rudy A Hartskeerl
- OIE and National Collaborating Centre for Reference and Research on LeptospirosisMeibergdreef 39AmsterdamNetherlands1105 AZ
| | - Marga GA Goris
- Academic Medical Centre (AMC), University of AmsterdamMedical Microbiology, OIE and National Collaborating Centre for Reference and Research on LeptospirosisMeibergdreef 39AmsterdamNetherlands1105 AZ
| | - Mariska MG Leeflang
- Amsterdam University Medical Centers, University of AmsterdamDepartment of Clinical Epidemiology, Biostatistics and BioinformaticsMeibergdreef 9AmsterdamNoord‐HollandNetherlands1105 AZ
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Moseley M, Rahelinirina S, Rajerison M, Garin B, Piertney S, Telfer S. Mixed Leptospira Infections in a Diverse Reservoir Host Community, Madagascar, 2013-2015. Emerg Infect Dis 2019; 24:1138-1140. [PMID: 29774844 PMCID: PMC6004868 DOI: 10.3201/eid2406.180035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
We identified mixed infections of pathogenic Leptospira in small mammals across a landscape-scale study area in Madagascar by using primers targeting different Leptospira spp. Using targeted primers increased prevalence estimates and evidence for transmission between endemic and invasive hosts. Future studies should assess rodentborne transmission of Leptospira to humans.
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First Real-Time PCR in Morocco for Human Leptospirosis Using TaqMan Probes Targeting the LipL32 Gene. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2019. [DOI: 10.5812/archcid.67237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Guillebaud J, Bernardson B, Randriambolamanantsoa TH, Randrianasolo L, Randriamampionona JL, Marino CA, Rasolofo V, Randrianarivelojosia M, Vigan-Womas I, Stivaktas V, Venter M, Piola P, Héraud JM. Study on causes of fever in primary healthcare center uncovers pathogens of public health concern in Madagascar. PLoS Negl Trop Dis 2018; 12:e0006642. [PMID: 30011274 PMCID: PMC6062140 DOI: 10.1371/journal.pntd.0006642] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 07/26/2018] [Accepted: 06/28/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The increasing use of malaria diagnostic tests reveals a growing proportion of patients with fever but no malaria. Clinicians and health care workers in low-income countries have few tests to diagnose causes of fever other than malaria although several diseases share common symptoms. We propose here to assess etiologies of fever in Madagascar to ultimately improve management of febrile cases. METHODOLOGY Consenting febrile outpatients aged 6 months and older were recruited in 21 selected sentinel sites throughout Madagascar from April 2014 to September 2015. Standard clinical examinations were performed, and blood and upper respiratory specimens were taken for rapid diagnostic tests and molecular assays for 36 pathogens of interest for Madagascar in terms of public health, regardless of clinical status. PRINCIPAL FINDINGS A total of 682 febrile patients were enrolled. We detected at least one pathogen in 40.5% (276/682) of patients and 6.2% (42/682) with co-infections. Among all tested patients, 26.5% (181/682) had at least one viral infection, 17.0% (116/682) had malaria and 1.0% (7/682) presented a bacterial or a mycobacterial infection. None or very few of the highly prevalent infectious agents in Eastern Africa and Asia were detected in this study, such as zoonotic bacteria or arboviral infections. CONCLUSIONS These results raise questions about etiologies of fever in Malagasy communities. Nevertheless, we noted that viral infections and malaria still represent a significant proportion of causes of febrile illnesses. Interestingly our study allowed the detection of pathogens of public health interest such as Rift Valley Fever Virus but also the first case of laboratory-confirmed leptospirosis infection in Madagascar.
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Affiliation(s)
- Julia Guillebaud
- Virology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | - Barivola Bernardson
- Virology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
- Epidemiology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | | | | | - Jane Léa Randriamampionona
- Epidemiology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
- Direction de la Veille Sanitaire et de la Surveillance Epidémiologique, Ministry of Public Health 101, Antananarivo, Madagascar
| | | | - Voahangy Rasolofo
- Mycobacterial Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | | | - Ines Vigan-Womas
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | - Voula Stivaktas
- Emerging and Respiratory Virus Program, Centre for Viral Zoonoses, University of Pretoria, Pretoria, South Africa
| | - Marietjie Venter
- Emerging and Respiratory Virus Program, Centre for Viral Zoonoses, University of Pretoria, Pretoria, South Africa
| | - Patrice Piola
- Epidemiology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | - Jean-Michel Héraud
- Virology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
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Diagnosis of Human Leptospirosis in a Clinical Setting: Real-Time PCR High Resolution Melting Analysis for Detection of Leptospira at the Onset of Disease. Sci Rep 2018; 8:9213. [PMID: 29907838 PMCID: PMC6003994 DOI: 10.1038/s41598-018-27555-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 06/03/2018] [Indexed: 12/12/2022] Open
Abstract
Currently, direct detection of Leptospira can be done in clinical laboratories by conventional and by real-time PCR (qRT-PCR). We tested a biobank of paired samples of serum and urine from the same patient (202 patients) presenting at the hospital in an area endemic for leptospirosis using qRT-PCR followed by high resolution melting (HRM) analysis. The results were compared with those obtained by conventional nested PCR and with the serologic gold standard microscopic agglutination test (MAT). Differences were resolved by sequencing. qRT-PCR-HRM was positive for 46 of the 202 patients (22.7%, accuracy 100%) which is consistent with known prevalence of leptospirosis in the Azores. MAT results were positive for 3 of the 46 patients (6.5%). Analysis of paired samples allowed us to identify the illness point at which patients presented at the hospital: onset, dissemination or excretion. The melting curve analysis of Leptospira species revealed that 60.9% (28/46) of patients were infected with L. interrogans and 39.1% (18/46) were infected with L. borgpetersenii, both endemic to the Azores. We validated the use of qRT-PCR-HRM for diagnosis of leptospirosis and for identification of the Leptospira species at the earliest onset of infection in a clinical setting, in less than 2 hours.
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Thibeaux R, Girault D, Bierque E, Soupé-Gilbert ME, Rettinger A, Douyère A, Meyer M, Iraola G, Picardeau M, Goarant C. Biodiversity of Environmental Leptospira: Improving Identification and Revisiting the Diagnosis. Front Microbiol 2018; 9:816. [PMID: 29765361 PMCID: PMC5938396 DOI: 10.3389/fmicb.2018.00816] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/10/2018] [Indexed: 01/24/2023] Open
Abstract
Leptospirosis is an important environmental disease and a major threat to human health causing at least 1 million clinical infections annually. There has recently been a growing interest in understanding the environmental lifestyle of Leptospira. However, Leptospira isolation from complex environmental samples is difficult and time-consuming and few tools are available to identify Leptospira isolates at the species level. Here, we propose a polyphasic isolation and identification scheme, which might prove useful to recover and identify environmental isolates and select those to be submitted to whole-genome sequencing. Using this approach, we recently described 12 novel Leptospira species for which we propose names. We also show that MALDI-ToF MS allows rapid and reliable identification and provide an extensive database of Leptospira MALDI-ToF mass spectra, which will be valuable to researchers in the leptospirosis community for species identification. Lastly, we also re-evaluate some of the current techniques for the molecular diagnosis of leptospirosis taking into account the extensive and recently revealed biodiversity of Leptospira in the environment. In conclusion, we describe our method for isolating Leptospira from the environment, confirm the usefulness of mass spectrometry for species identification and propose names for 12 novel species. This also offers the opportunity to refine current molecular diagnostic tools.
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Affiliation(s)
- Roman Thibeaux
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Dominique Girault
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Emilie Bierque
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Marie-Estelle Soupé-Gilbert
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
| | - Anna Rettinger
- Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Department of Veterinary Sciences, Faculty of Veterinary Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - Anthony Douyère
- Institut des Sciences Exactes et Appliquées, Plateau MET/MEB, Université de la Nouvelle-Calédonie, Noumea, New Caledonia
| | - Michael Meyer
- Institut des Sciences Exactes et Appliquées, Plateau MET/MEB, Université de la Nouvelle-Calédonie, Noumea, New Caledonia
| | - Gregorio Iraola
- Bioinformatics Unit, Institut Pasteur Montevideo, Montevideo, Uruguay
| | - Mathieu Picardeau
- Biology of Spirochetes Unit, Institut Pasteur, National Reference Centre and WHO Collaborating Center for Leptospirosis, Paris, France
| | - Cyrille Goarant
- Leptospirosis Research and Expertise Unit, Institut Pasteur in New Caledonia, Institut Pasteur International Network, Noumea, New Caledonia
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Guernier V, Allan KJ, Goarant C. Advances and challenges in barcoding pathogenic and environmental Leptospira. Parasitology 2018; 145:595-607. [PMID: 28716157 PMCID: PMC6010154 DOI: 10.1017/s0031182017001147] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Leptospirosis is a zoonotic bacterial disease of global importance. A large spectrum of asymptomatic animal hosts can carry the infection and contribute to the burden of human disease. Environmental sources of human contamination also point to the importance of a hydrotelluric reservoir. Leptospirosis can be caused by as many as 15 different pathogenic or intermediate Leptospira species. However, classification of these bacteria remains complicated through the use of both serological and genetic classification systems that show poor correlation. With the advent of molecular techniques, DNA-based barcoding offers a conceptual framework that can be used for leptospirosis surveillance as well as source tracking. In this review, we summarize some of the current techniques, highlight significant successes and weaknesses and point to the future opportunities and challenges to successfully establish a widely applicable barcoding scheme for Leptospira.
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Affiliation(s)
- Vanina Guernier
- Australian Institute of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Townsville, QLD 4811, Australia
| | - Kathryn J. Allan
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK
| | - Cyrille Goarant
- Institut Pasteur in New Caledonia, Institut Pasteur International Network, Leptospirosis Research and Expertise Unit, Noumea, New Caledonia. 11 rue Paul Doumer, BP 61; 98845 Noumea cedex, New Caledonia
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Chávez Á, Somarriba BF, Soto A, Sheleby-Elías J, Duttmann C, Jiménez E, Pérez E, Mora B, Jirón W. [Detection of Leptospire spp. in animals and in environmental samples from peridomestic areas in NicaraguaDetecção de Leptospira spp. em animais e em amostras ambientais de áreas peridomiciliares na Nicarágua]. Rev Panam Salud Publica 2018; 42:e26. [PMID: 31093055 PMCID: PMC6385810 DOI: 10.26633/rpsp.2018.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 10/05/2017] [Indexed: 11/28/2022] Open
Abstract
Objetivo El objetivo de este estudio fue conocer las características epidemiológicas de la leptospirosis en animales domésticos y en los casos de leptospirosis humana en áreas peridomésticas en Nicaragua entre 2014 y 2016. Métodos Las muestras se extrajeron en áreas donde se confirmaron casos en humanos utilizando un muestreo no probabilístico en 10 de los 17 departamentos del país. Se incluyeron 112 muestras de orina de animales domésticos, 129 muestras de agua y 69 de tierra para aislar leptospiras en medio Ellinghausen-McCullough-Johnson-Harris (EMJH). Además, se aplicó la prueba de microaglutinación (MAT) en 263 muestras de suero de animales y 88 aislados se analizaron mediante PCR. Resultados En 32,6% (101/310) de las muestras se aislaron espiroquetas, 23,2% (26/112) se aislaron en la orina de animales domésticos, 47,3% (61/129), en las muestras de agua y 20,3 % (14/69), en las de tierra. El análisis de aislamiento mostró diferencias significativas (P < 0,05) entre los departamentos para los diferentes tipos de muestras, y el aislamiento fue más frecuente en agua que en tierra (OR = 3,49; IC95%: 1,56-7,80). El 14,1% (37/263) de los animales fueron reactores en la prueba de microaglutinación. El serogrupo más frecuente fue Icterohaemorrhagiae (40%). En el análisis con la PCR para identificar leptospiras de las especies patógenas 10,2% (9/88) de los aislamientos fueron positivos. Conclusiones Esta investigación demuestra que los animales domésticos y el ambiente desempeñan un papel importante en la aparición de brotes de la leptospirosis y confirma el comportamiento endémico de la enfermedad en Nicaragua.
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Affiliation(s)
- Álvaro Chávez
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León (UNAN-León), León, Nicaragua
| | - Byron Flores Somarriba
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León (UNAN-León), León, Nicaragua
| | - Aida Soto
- Organización Panamericana de la Salud, Managua, Nicaragua
| | - Jessica Sheleby-Elías
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León (UNAN-León), León, Nicaragua
| | - Christiane Duttmann
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León (UNAN-León), León, Nicaragua
| | | | - Eveling Pérez
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León (UNAN-León), León, Nicaragua
| | - Brenda Mora
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León (UNAN-León), León, Nicaragua
| | - William Jirón
- Centro Veterinario de Diagnóstico e Investigación (CEVEDI), Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua-León (UNAN-León), León, Nicaragua
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Mohd Ali MR, Mohd Safee AW, Ismail NH, Abu Sapian R, Mat Hussin H, Ismail N, Yean Yean C. Development and validation of pan-Leptospira Taqman qPCR for the detection of Leptospira spp. in clinical specimens. Mol Cell Probes 2018. [PMID: 29524642 DOI: 10.1016/j.mcp.2018.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Early diagnosis of leptospirosis is important for ensuring better clinical management and achieving better outcomes. Currently, serological assays suffer from inconsistent performance and are less useful for early diagnosis of leptospirosis. As an alternative, qPCR is more sensitive, specific and able to detect the presence of leptospiral DNA during the acute phase of the infection. Meanwhile, most molecular assays do not detect the non-pathogenic group of Leptospira, even though these groups may also infect humans, although less frequently and less severely. METHODS A set of primers and probe targeting rrs genes of 22 Leptospira spp. were designed and evaluated on 31 Leptospira isolates, 41 other organisms and 65 clinical samples from suspected patients. RESULTS The developed assay was able to detect as low as 20 fg Leptospira DNA per reaction (equivalent to approximately 4 copies) and showed high specificity against the tested leptospiral strains. No cross amplification was observed with the other organisms. During the evaluation of the confirmed clinical specimens, the developed assay was able to correctly identify all positive samples (n = 10/10). One amplification was observed in a negative sample (n = 1/55). The sequencing of the PCR product of the discordant sample revealed that the sequences were similar to those of L. interrogans and L. kirschneri. CONCLUSION The findings suggest that the developed Taqman qPCR assay is sensitive, specific and has potential to be applied in a larger subsequent study.
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Affiliation(s)
- Mohammad Ridhuan Mohd Ali
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia; Secretariat National Institutes of Health (NIH), Ministry of Health Malaysia, c/o Institut Pengurusan Kesihatan, Jalan Rumah Sakit Bangsar, 59000 Kuala Lumpur, Malaysia
| | - Amira Wahida Mohd Safee
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nor Hayati Ismail
- Kota Bharu Public Health Laboratory, Jalan Kuala Krai, 16010 Kota Bharu, Kelantan, Malaysia
| | - Roslinda Abu Sapian
- Secretariat National Institutes of Health (NIH), Ministry of Health Malaysia, c/o Institut Pengurusan Kesihatan, Jalan Rumah Sakit Bangsar, 59000 Kuala Lumpur, Malaysia
| | - Hani Mat Hussin
- Kota Bharu Public Health Laboratory, Jalan Kuala Krai, 16010 Kota Bharu, Kelantan, Malaysia
| | - Nabilah Ismail
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Chan Yean Yean
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia; Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
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Abstract
PURPOSE OF REVIEW The definitive diagnosis of leptospirosis, which results from infection with spirochetes of the genus Leptospira, currently relies on the use of culture, serological testing (microscopic agglutination testing), and molecular detection. The purpose of this review is to describe new molecular diagnostics for Leptospira and discuss advancements in the use of available methods. RECENT FINDINGS Efforts have been focused on improving the clinical sensitivity of Leptospira detection using molecular methods. In this review, we describe a reoptimized pathogenic species-specific real-time PCR (targeting lipL32) that has demonstrated improved sensitivity, findings by two groups that real-time reverse-transcription PCR assays targeting the 16S rrs gene can improve detection, and two new loop-mediated amplification techniques. Quantitation of leptospiremia, detection in different specimen types, and the complementary roles played by molecular detection and microscopic agglutination testing will be discussed. Finally, a protocol for Leptospira strain subtyping using variable number tandem repeat targets and high-resolution melting will be described. SUMMARY Molecular diagnostics have an established role for the diagnosis of leptospirosis and provide an actionable diagnosis in the acute setting. The use of real-time reverse-transcription PCR for testing serum/plasma and cerebrospinal fluid, when available, may improve the detection of Leptospira without decreasing clinical specificity.
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Rapid, actionable diagnosis of urban epidemic leptospirosis using a pathogenic Leptospira lipL32-based real-time PCR assay. PLoS Negl Trop Dis 2017; 11:e0005940. [PMID: 28915243 PMCID: PMC5617227 DOI: 10.1371/journal.pntd.0005940] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/27/2017] [Accepted: 09/06/2017] [Indexed: 12/31/2022] Open
Abstract
Background With a conservatively estimated 1 million cases of leptospirosis worldwide and a 5–10% fatality rate, the rapid diagnosis of leptospirosis leading to effective clinical and public health decision making is of high importance, and yet remains a challenge. Methodology Based on parallel, population-based studies in two leptospirosis-endemic regions in Brazil, a real-time PCR assay which detects lipL32, a gene specifically present in pathogenic Leptospira, was assessed for the diagnostic effectiveness and accuracy. Patients identified by active hospital-based surveillance in Salvador and Curitiba during large urban leptospirosis epidemics were tested. Real-time PCR reactions were performed with DNA-extracted samples obtained from 127 confirmed and 23 unconfirmed cases suspected of leptospirosis, 122 patients with an acute febrile illness other than leptospirosis, and 60 healthy blood donors. Principal findings The PCR assay had a limit of detection of 280 Leptospira genomic equivalents/mL. Sensitivity for confirmed cases was 61% for whole blood and 29% for serum samples. Sensitivity was higher (86%) for samples collected within the first 6 days after onset of illness compared to those collected after 7 days (34%). The real-time PCR assay was able to detect leptospiral DNA in blood from 56% of serological non-confirmed cases. The overall specificity of the assay was 99%. Conclusions These findings indicate that real-time PCR may be a reliable tool for early diagnosis of leptospirosis, which is decisive for clinical management of severe and life-threatening cases and for public health decision making. In this study, we describe the performance testing and diagnostic accuracy assessment of a previously described real-time PCR assay aiming at the validation for early diagnosis of human leptospirosis. We found that diagnostic sensitivity was higher for EDTA whole blood samples (61%) than for serum samples (29%). We demonstrated that the molecular diagnosis was optimal when performed with EDTA whole samples collected within the first 6 days with symptoms, condition in which the sensitivity was 86%. The real-time PCR assay was able to detect leptospiral DNA in EDTA whole blood from 56% of serological non-confirmed cases for whom a convalescent sample was not available. The test overall specificity was 99%. Our findings demonstrate that real-time PCR is a reliable diagnostic tool suited for early diagnosis, and its results could support early medical interventions that could have a decisive impact on clinical outcome and thus decrease both the severity and fatality of cases.
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Peláez Sánchez RG, Quintero JÁL, Pereira MM, Agudelo-Flórez P. High-Resolution Melting Curve Analysis of the 16S Ribosomal Gene to Detect and Identify Pathogenic and Saprophytic Leptospira Species in Colombian Isolates. Am J Trop Med Hyg 2017; 96:1031-1038. [PMID: 28500802 DOI: 10.4269/ajtmh.16-0312] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
AbstractIt is important to identify the circulating Leptospira agent to enhance the performance of serodiagnostic tests by incorporating specific antigens of native species, develop vaccines that take into account the species/serovars circulating in different regions, and optimize prevention and control strategies. The objectives of this study were to develop a polymerase chain reaction (PCR)-high-resolution melting (HRM) assay for differentiating between species of the genus Leptospira and to verify its usefulness in identifying unknown samples to species level. A set of primers from the initial region of the 16S ribosomal gene was designed to detect and differentiate the 22 species of Leptospira. Eleven reference strains were used as controls to establish the reference species and differential melting curves. Twenty-five Colombian Leptospira isolates were studied to evaluate the usefulness of the PCR-HRM assay in identifying unknown samples to species level. This identification was confirmed by sequencing and phylogenetic analysis of the 16S ribosomal gene. Eleven Leptospira species were successfully identified, except for Leptospira meyeri/Leptospira yanagawae because the sequences were 100% identical. The 25 isolates from humans, animals, and environmental water sources were identified as Leptospira santarosai (twelve), Leptospira interrogans (nine), and L. meyeri/L. yanagawae (four). The species verification was 100% concordant between PCR-HRM and phylogenetic analysis of the 16S ribosomal gene. The PCR-HRM assay designed in this study is a useful tool for identifying Leptospira species from isolates.
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Affiliation(s)
- Ronald G Peláez Sánchez
- School of Microbiology, Group of Primary Immunodeficiencies, University of Antioquia, Medellín, Antioquia, Colombia
| | - Juan Álvaro López Quintero
- School of Microbiology, Group of Primary Immunodeficiencies, University of Antioquia, Medellín, Antioquia, Colombia
| | - Martha María Pereira
- World Health Organization Collaborating Center for Leptospirosis, Oswaldo Cruz Institute/FIOCRUZ, Rio de Janeiro, Brazil
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Courdurie C, Le Govic Y, Bourhy P, Alexer D, Pailla K, Theodose R, Cesaire R, Rosine J, Hochedez P, Olive C. Evaluation of different serological assays for early diagnosis of leptospirosis in Martinique (French West Indies). PLoS Negl Trop Dis 2017; 11:e0005678. [PMID: 28644889 PMCID: PMC5500375 DOI: 10.1371/journal.pntd.0005678] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 07/06/2017] [Accepted: 06/04/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Leptospirosis is a potentially life-threatening but curable zoonosis whose prognosis depends on accurate and timely diagnosis. Because of its non-specific clinical presentation, laboratory testing is essential to confirm the diagnosis. Here, we aimed to assess the performance of two enzyme-linked immunosorbent assays (ELISAs) (ELISA Serion and ELISA-Hb Pasteur) and one immunodot (GenBio) using quantitative PCR (qPCR) as gold standard, instead of the traditional microscopic agglutination test, for the diagnosis of acute leptospirosis in an endemic area. METHODOLOGY/PRINCIPAL FINDINGS Between January 2011 and December 2012, a total of 122 patients were diagnosed with leptospirosis, as confirmed by qPCR at the University Hospital of Martinique. Among them, 103 had at least one serum sample available for analysis. Performance of each serological assay was evaluated according to days' post onset of symptoms (DPO) and local species diversity (which included L. santarosai, L. interrogans, L. kirschneri, L. borgpetersenii, L. noguchii, and L. kmetyi). Several thresholds were tested to optimize accuracy. When considering the manufacturer's threshold, the sensitivity of ELISA Serion, ELISA-Hb Pasteur and GenBio immunodot was 75%, 67% and 64%, while specificity was 92%, 98% and 100%, respectively. Moreover, the threshold optimization allowed a significant improvement in specificity for the ELISA Serion from 92% to 99% (p<0.05). During the first 5 DPO, sensitivities were 35%, 30% and 42% for ELISA Serion, ELISA-Hb Pasteur and GenBio immunodot, respectively. However, between 6─10 DPO, these sensitivities dramatically increased to reach 86%, 76% and 67%, respectively. Performances of the three assays were not affected by the species studied. CONCLUSIONS/SIGNIFICANCE All these serological assays showed the potential for diagnosing leptospirosis after (but not before) 6 days' post onset of symptoms. In a high prevalence setting, where highest specificities are needed, threshold optimizing should be performed for this purpose.
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Affiliation(s)
- Christophe Courdurie
- Department of Bacteriology and Hygiene, University Hospital of Fort-de-France, Martinique, French West Indies
| | - Yohann Le Govic
- Department of Bacteriology and Hygiene, University Hospital of Fort-de-France, Martinique, French West Indies
| | - Pascale Bourhy
- Department of Spirochetes Biology, Pasteur Institute, National Reference Center and WHO Collaborating Center for Leptospirosis, Paris, France
| | - Dorothee Alexer
- Department of Bacteriology and Hygiene, University Hospital of Fort-de-France, Martinique, French West Indies
| | - Karine Pailla
- Department of Bacteriology and Hygiene, University Hospital of Fort-de-France, Martinique, French West Indies
| | - Rafaelle Theodose
- Department of Bacteriology and Hygiene, University Hospital of Fort-de-France, Martinique, French West Indies
| | - Raymond Cesaire
- Department of Virology, University Hospital of Fort-de-France, Martinique, French West Indies
| | - Jacques Rosine
- Interregional Epidemiology Unit, French Institute for Public Health Surveillance, Fort-de-France, Martinique, French West Indies
| | - Patrick Hochedez
- Department of Infectious Diseases, University Hospital of Fort-de-France, Martinique, French West Indies
| | - Claude Olive
- Department of Bacteriology and Hygiene, University Hospital of Fort-de-France, Martinique, French West Indies
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