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Lindner AK, Moreno-del Castillo MC, Wintel M, Equihua Martinez G, Richter J, Kurth F, Pfäfflin F, Zoller T, Gertler M, Georgi S, Nürnberg M, Hülso C, Bernhard J, Kotsias SK, Seigerschmidt A, van Loon W, Mockenhaupt F, Kampmann B, Harms G. American Cutaneous Leishmaniasis: Imported cases in Berlin 2000-2023. PLoS Negl Trop Dis 2024; 18:e0012323. [PMID: 39008517 PMCID: PMC11271916 DOI: 10.1371/journal.pntd.0012323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 07/25/2024] [Accepted: 06/26/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND American Cutaneous Leishmaniasis (ACL) shows variable response to therapy, but data on species-specific treatment efficacy is scarce. We describe the clinical characteristics and outcome of patients with ACL imported to a tertiary centre in Germany and determine whether species-specific therapy according to the 2014 "LeishMan" group recommendations is associated with cure. METHODS A retrospective chart review was conducted at the Charité Institute of International Health in Berlin. We analysed data on PCR-confirmed ACL cases collected between 2000 and 2023. Systemic therapy included liposomal amphotericin B, miltefosine, pentavalent antimony, ketoconazole or itraconazole. Localized therapy included perilesional pentavalent antimony or paromomycin ointment. Cure was defined as re-epithelialization of ulcers or disappearance of papular-nodular lesions after 3 months of treatment. Logistic regression models were used to quantify the effect of species-specific systemic therapy on the outcome. RESULTS 75 cases were analysed. Most patients were male (62%), median age was 35 years, no patient had a history of immunosuppression. The most common reason for travel was tourism (60%), the most common destination was Costa Rica (28%), the median duration of illness was 8 weeks, and most patients presented with ulcers (87%). Lesions were complex in 43%. The most common Leishmania (L.) species was L. braziliensis (28%), followed by L. panamensis (21%). 51/73 (70%) patients were cured after initial therapy and 17/21 (81%) after secondary therapy. Cure after systemic therapy was more frequent when species-specific treatment recommendations were followed (33/45; 73%), compared to when not followed, (6/17; 35%, P = 0.008). This association was independent of age, sex, previous therapy, complex lesions, and Leishmania species (adjusted OR, 5.06; 95% CI, 1.22-24.16). CONCLUSIONS ACL is a rare, imported disease in Germany. Complex lesions were common, challenging successful therapy. This study highlights the importance of identifying the parasite species and suggests that a species-specific approach to treatment leads to better outcomes.
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Affiliation(s)
- Andreas K. Lindner
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Maria Cristina Moreno-del Castillo
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Mia Wintel
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Gabriela Equihua Martinez
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Joachim Richter
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Florian Kurth
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases, Respiratory and Critical Care Medicine, Berlin, Germany
| | - Frieder Pfäfflin
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases, Respiratory and Critical Care Medicine, Berlin, Germany
| | - Thomas Zoller
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases, Respiratory and Critical Care Medicine, Berlin, Germany
| | - Maximilian Gertler
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Susanne Georgi
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Michael Nürnberg
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Claudia Hülso
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Julian Bernhard
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Sarah Konopelska Kotsias
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Antonio Seigerschmidt
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Welmoed van Loon
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Frank Mockenhaupt
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Beate Kampmann
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
| | - Gundel Harms
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
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2
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Poloni A, Giacomelli A, Corbellino M, Grande R, Nebuloni M, Rizzardini G, Ridolfo AL, Antinori S. Delayed diagnosis among patients with visceral leishmaniasis. Intern Emerg Med 2023; 18:2293-2300. [PMID: 37768484 DOI: 10.1007/s11739-023-03430-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
We aimed to estimate the diagnostic latency of patients with visceral leishmaniasis (VL). A monocentric retrospective observational study was conducted including all confirmed cases of VL diagnosed from January 2005 to March 2022. Epidemiological and clinical characteristics of patients with VL were collected. The diagnostic latency was defined as the number of days between the first contact with a health-care provider for signs and/or symptoms referable to VL and the laboratory diagnosis of leishmaniasis. Twenty-four cases of VL were included in the study, mostly male (75%) and Italians (79.2%), with a median age of 40 years [Inter Quartile Range (IQR 30-48)]. Fourteen (58.3%) VL cases were people living with HIV (PLWH) and 4 (16.6%) subjects were on immunosuppressive therapy. For VL the median diagnostic latency was 54 days (IQR 28-162). The shorter diagnostic latency was observed in PLWH [31 days (IQR 20-47)] followed by immunocompetent patients [160 days (IQR 133-247)] and those on immunosuppressive therapy [329 days (IQR 200-678)]. Twelve patients (50%) reported at least one medical encounter before the diagnosis of VL and 6 patients received a wrong therapy. Diagnostic delay in VL was significant in patients under immune suppressive treatment.
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Affiliation(s)
- Andrea Poloni
- III Infectious Diseases Unit, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
- Department of Biomedical and Clinical Sciences, Università degli studi di Milano, Milan, Italy
| | - Andrea Giacomelli
- III Infectious Diseases Unit, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, 20157, Milan, Italy.
| | - Mario Corbellino
- III Infectious Diseases Unit, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
| | | | - Manuela Nebuloni
- Department of Biomedical and Clinical Sciences, Università degli studi di Milano, Milan, Italy
- Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Anna Lisa Ridolfo
- III Infectious Diseases Unit, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
| | - Spinello Antinori
- III Infectious Diseases Unit, III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
- Department of Biomedical and Clinical Sciences, Università degli studi di Milano, Milan, Italy
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3
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Vandeputte M, van Henten S, van Griensven J, Bottieau E. Which trial do we need? A collaborative platform trial for cutaneous leishmaniasis amongst international travellers. Clin Microbiol Infect 2023; 29:1237-1240. [PMID: 37230249 DOI: 10.1016/j.cmi.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Martin Vandeputte
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Infection Medicine, University of Edinburgh, Edinburgh, UK.
| | - Saskia van Henten
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Poloni A, Giacomelli A, Corbellino M, Grande R, Nebuloni M, Rizzardini G, Ridolfo AL, Antinori S. Delayed diagnosis among patients with cutaneous and mucocutaneous leishmaniasis. Travel Med Infect Dis 2023; 55:102637. [PMID: 37634674 DOI: 10.1016/j.tmaid.2023.102637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023]
Affiliation(s)
- Andrea Poloni
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | | | - Manuela Nebuloni
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy; Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Giuliano Rizzardini
- I Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy; III Infectious Diseases Unit, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy.
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5
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Monzote L, González D, Blanco O, Fraga J, Capó V, Herrera A, Montalvo AM. Imported cases of cutaneous leishmaniasis in Cuba, 2017: role of human movement. Trop Dis Travel Med Vaccines 2022; 8:15. [PMID: 35773710 PMCID: PMC9248147 DOI: 10.1186/s40794-022-00171-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Leishmaniasis is a vector-borne disease caused by several species from genus Leishmania. An increase in the number of cases related to human movement has been informed in the last years. Due to the increase of suspicious leishmaniasis cases arriving in Cuba during 2017, a general analysis is presented herein. Methods Clinical samples were collected from 5 patients suspicious of leishmaniasis, received from January to December 2017 at the Institute of Tropical Medicine Pedro Kourí, Cuba. Skin lesion samples were analyzed using different diagnostic assays: direct smear, histological examination, and molecular analysis for species identification. Epidemiological and demographic data were requested from each case and analyzed. Treatment and follow up of patient was also performed. Results Five cases were confirmed as Leishmania infection according to microscopic observation and molecular methods results. PCR-18S, PCR-N/RFLP and PCR-F/RFLP identified the following species: L. panamensis (2 cases), L. braziliensis (1 case), L.panamensis/L.guyanensis (1 case), L. mexicana complex (1 case). In treated patients, drugs were well tolerated, cure were documented and no relapse have been currently reported (3 years later). Conclusions Clinical characteristics, demographic data, and epidemiological features of infection for each case evidence the potential risk related with travel to endemic areas of leishmaniasis. Keyworks Cutaneous leishmaniasis, Epidemiology, Imported cases.
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Establish an allele-specific real-time PCR for Leishmania species identification. Infect Dis Poverty 2022; 11:60. [PMID: 35655325 PMCID: PMC9164491 DOI: 10.1186/s40249-022-00992-y] [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: 03/02/2022] [Accepted: 05/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Leishmaniasis is a serious neglected tropical disease that may lead to life-threatening outcome, which species are closely related to clinical diagnosis and patient management. The current Leishmania species determination method is not appropriate for clinical application. New Leishmania species identification tool is needed using clinical samples directly without isolation and cultivation of parasites. Methods A probe-based allele-specific real-time PCR assay was established for Leishmania species identification between Leishmania donovani and L. infantum for visceral leishmaniasis (VL) and among L. major, L. tropica and L. donovani/L. infantum for cutaneous leishmaniasis (CL), targeting hypoxanthine-guanine phosphoribosyl transferase (HGPRT) and spermidine synthase (SPDSYN) gene with their species-specific single nucleotide polymorphisms (SNPs). The limit of detection of this assay was evaluated based on 8 repeated tests with intra-assay standard deviation < 0.5 and inter-assay coefficients of variability < 5%. The specificity of this assay was tested with DNA samples obtained from Plasmodium falciparum, Toxoplasma gondii, Brucella melitensis and Orientia tsutsugamushi. Total 42 clinical specimens were used to evaluate the ability of this assay for Leishmania species identification. The phylogenetic tree was constructed using HGPRT and SPDSYN gene fragments to validate the performance of this assay. Results This new method was able to detect 3 and 12 parasites/reaction for VL and CL respectively, and exhibited no cross-reaction with P. falciparum, T. gondii, B. melitensis, O. tsutsugamushi and non-target species of Leishmania. Twenty-two samples from VL patients were identified as L. donovani (n = 3) and L. infantum (n = 19), and 20 specimens from CL patients were identified as L. major (n = 20), providing an agreement of 100% compared with sequencing results. For further validation, 29 sequences of HGPRT fragment from nine Leishmania species and 22 sequences from VL patients were used for phylogenetic analysis, which agreed with the results of this new method. Similar results were obtained with 43 sequences of SPDSYN fragment from 18 Leishmania species and 20 sequences from CL patients. Conclusions Our assay provides a rapid and accurate tool for Leishmania species identification which is applicable for species-adapted therapeutic schedule and patient management. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00992-y.
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7
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Lemieux A, Lagacé F, Billick K, Ndao M, Yansouni CP, Semret M, Libman MD, Barkati S. Cutaneous leishmaniasis in travellers and migrants: a 10-year case series in a Canadian reference centre for tropical diseases. CMAJ Open 2022; 10:E546-E553. [PMID: 35728837 PMCID: PMC9343123 DOI: 10.9778/cmajo.20210238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis is increasingly encountered in returned travellers and migrants to nonendemic countries. We sought to describe the clinical characteristics and treatment outcomes of cases of cutaneous leishmaniasis diagnosed at our reference centre over a 10-year period. METHODS This case series included all laboratory-confirmed cases of cutaneous leishmaniasis in travellers and migrants for whom complete clinical data were available, diagnosed between January 2008 and October 2018 at the J.D. MacLean Centre for Tropical Diseases in Montréal. We examined the number of cases each year. We used descriptive statistics to summarize variables (e.g., demographic characteristics, travel history, clinical presentation, diagnostic methods, treatments, adverse events) extracted from the patients' electronic medical records. The primary outcome for evaluating clinical response to treatment was defined as the complete re-epithelialization of the wound surface at 1 year. RESULTS We identified 48 patients who received diagnoses of cutaneous leishmaniasis in the 10-year study period, including 33 exposed in the Americas and 15 exposed in other regions (median age 43.5 [range 1-75] yr); 28 [58%] males). The annual number of cases increased from 9 in 2008/09 to 16 in 2017/18. The median time from onset to diagnosis was 89 (IQR 58-134) days. Liposomal amphotericin B was the most commonly used initial treatment (20 [53%] patients). Thirty-five patients completed their follow-up, and 11 had successful response to 1 course of liposomal amphotericin B. Adverse events (including acute kidney injury, increased pancreatic enzymes and fatigue) were reported in 6 (30%) patients. Clinical cure was achieved within 1 year for 32 (91%) of the 35 patients who completed follow-up. INTERPRETATION This study showed an increase in the number of cases of cutaneous leishmaniasis seen in our centre over the study period, likely because of increased travel and migration. This diagnosis should be considered in travellers and migrants with a chronic cutaneous lesion.
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Affiliation(s)
- Alexandre Lemieux
- Department of Medicine (Lemieux), Division of Dermatology, Centre Hospitalier de l'Université de Montréal; Department of Medicine (Lagacé, Billick), Division of Dermatology, McGill University Health Centre; J.D. MacLean Centre for Tropical Diseases at McGill University (Billick, Ndao, Yansouni, Semret, Libman, Barkati); National Reference Centre for Parasitology (Ndao), Research Institute of the McGill University Health Centre; Department of Medicine (Yansouni, Semret, Libman, Barkati), Division of Infectious Diseases, McGill University Health Centre, Montréal, Que
| | - François Lagacé
- Department of Medicine (Lemieux), Division of Dermatology, Centre Hospitalier de l'Université de Montréal; Department of Medicine (Lagacé, Billick), Division of Dermatology, McGill University Health Centre; J.D. MacLean Centre for Tropical Diseases at McGill University (Billick, Ndao, Yansouni, Semret, Libman, Barkati); National Reference Centre for Parasitology (Ndao), Research Institute of the McGill University Health Centre; Department of Medicine (Yansouni, Semret, Libman, Barkati), Division of Infectious Diseases, McGill University Health Centre, Montréal, Que
| | - Kendall Billick
- Department of Medicine (Lemieux), Division of Dermatology, Centre Hospitalier de l'Université de Montréal; Department of Medicine (Lagacé, Billick), Division of Dermatology, McGill University Health Centre; J.D. MacLean Centre for Tropical Diseases at McGill University (Billick, Ndao, Yansouni, Semret, Libman, Barkati); National Reference Centre for Parasitology (Ndao), Research Institute of the McGill University Health Centre; Department of Medicine (Yansouni, Semret, Libman, Barkati), Division of Infectious Diseases, McGill University Health Centre, Montréal, Que
| | - Momar Ndao
- Department of Medicine (Lemieux), Division of Dermatology, Centre Hospitalier de l'Université de Montréal; Department of Medicine (Lagacé, Billick), Division of Dermatology, McGill University Health Centre; J.D. MacLean Centre for Tropical Diseases at McGill University (Billick, Ndao, Yansouni, Semret, Libman, Barkati); National Reference Centre for Parasitology (Ndao), Research Institute of the McGill University Health Centre; Department of Medicine (Yansouni, Semret, Libman, Barkati), Division of Infectious Diseases, McGill University Health Centre, Montréal, Que
| | - Cédric P Yansouni
- Department of Medicine (Lemieux), Division of Dermatology, Centre Hospitalier de l'Université de Montréal; Department of Medicine (Lagacé, Billick), Division of Dermatology, McGill University Health Centre; J.D. MacLean Centre for Tropical Diseases at McGill University (Billick, Ndao, Yansouni, Semret, Libman, Barkati); National Reference Centre for Parasitology (Ndao), Research Institute of the McGill University Health Centre; Department of Medicine (Yansouni, Semret, Libman, Barkati), Division of Infectious Diseases, McGill University Health Centre, Montréal, Que
| | - Makeda Semret
- Department of Medicine (Lemieux), Division of Dermatology, Centre Hospitalier de l'Université de Montréal; Department of Medicine (Lagacé, Billick), Division of Dermatology, McGill University Health Centre; J.D. MacLean Centre for Tropical Diseases at McGill University (Billick, Ndao, Yansouni, Semret, Libman, Barkati); National Reference Centre for Parasitology (Ndao), Research Institute of the McGill University Health Centre; Department of Medicine (Yansouni, Semret, Libman, Barkati), Division of Infectious Diseases, McGill University Health Centre, Montréal, Que
| | - Michael D Libman
- Department of Medicine (Lemieux), Division of Dermatology, Centre Hospitalier de l'Université de Montréal; Department of Medicine (Lagacé, Billick), Division of Dermatology, McGill University Health Centre; J.D. MacLean Centre for Tropical Diseases at McGill University (Billick, Ndao, Yansouni, Semret, Libman, Barkati); National Reference Centre for Parasitology (Ndao), Research Institute of the McGill University Health Centre; Department of Medicine (Yansouni, Semret, Libman, Barkati), Division of Infectious Diseases, McGill University Health Centre, Montréal, Que
| | - Sapha Barkati
- Department of Medicine (Lemieux), Division of Dermatology, Centre Hospitalier de l'Université de Montréal; Department of Medicine (Lagacé, Billick), Division of Dermatology, McGill University Health Centre; J.D. MacLean Centre for Tropical Diseases at McGill University (Billick, Ndao, Yansouni, Semret, Libman, Barkati); National Reference Centre for Parasitology (Ndao), Research Institute of the McGill University Health Centre; Department of Medicine (Yansouni, Semret, Libman, Barkati), Division of Infectious Diseases, McGill University Health Centre, Montréal, Que.
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Mostmans Y, Van Gysel J, Vanden Nest H, Mervillie K, Richert B, Clevenbergh P. Intralesional injections of meglumine antimoniate to treat complex facial leishmania infantum acquired in Spain: a case report. J Eur Acad Dermatol Venereol 2022; 36:e548-e550. [PMID: 35181939 DOI: 10.1111/jdv.18019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/06/2022] [Accepted: 02/09/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Yora Mostmans
- Department of Immunology-Allergology, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium.,Department of Dermatology, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Julie Van Gysel
- Department of Immunology-Allergology, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium.,Department of Dermatology, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium
| | | | - K Mervillie
- Department of Pathology, Centraal Laboratorium Antwerpen, Antwerpen, Belgium
| | - B Richert
- Department of Dermatology, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium
| | - P Clevenbergh
- Department of Infectiology, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgium
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9
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Fernández-Arévalo A, Ballart C, Muñoz-Basagoiti J, Basarte L, Lobato G, Arnau A, Abras A, Tebar S, Llovet T, Lami P, Pratlong F, Alsina M, Roe E, Puig L, Muñoz C, Gállego M. Autochthonous and imported tegumentary leishmaniasis in Catalonia (Spain): Aetiological evolution in the last four decades and usefulness of different typing approaches based on biochemical, molecular and proteomic markers. Transbound Emerg Dis 2021; 69:1404-1418. [PMID: 33864706 DOI: 10.1111/tbed.14107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/22/2021] [Accepted: 04/11/2021] [Indexed: 02/07/2023]
Abstract
Leishmaniasis is a transmissible disease caused by Leishmania protozoa. Spain is endemic for both visceral and cutaneous leishmaniasis, the autochthonous aetiological agent being Leishmania infantum. Around the world, the L. donovani complex is associated with visceral symptoms, while any species of the Leishmania or Viannia subgenera affecting human can produce tegumentary forms. In a context of growing numbers of imported cases, associated with globalisation, the aim of this study was to analyse the aetiological evolution of human tegumentary leishmaniasis in a region of Spain (Catalonia). Fifty-six Leishmania strains, isolated from 1981 to 2018, were analysed using MLEE, gene sequencing (hsp70, rpoIILS, fh and ITS2) and MALDI-TOF. The utility of these different analytical methods was compared. The results showed an increase in leishmaniasis over the two last decades, particularly imported cases, which represented 39% of all cases studied. Leishmania infantum, L. major, L. tropica, L. braziliensis, L. guyanensis and L. panamensis were identified. The combination of molecular and enzymatic methods allowed the identification of 29 different strain types (A to AC). Strain diversity was higher in L. (Viannia), whilst the different L. major types were relatable with geo-temporal data. Among the autochthonous cases, type C prevailed throughout the studied period (39%). Minor types generally appeared within a short time interval. While all the techniques provided identical identification at the species complex level, MALDI-TOF and rpoIILS or fh sequencing would be the most suitable identification tools for clinical practice, and the tandem hsp70-ITS2 could substitute MLEE in the epidemiological field.
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Affiliation(s)
- Anna Fernández-Arévalo
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Cristina Ballart
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Jordana Muñoz-Basagoiti
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Leire Basarte
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Gonzalo Lobato
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Albert Arnau
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain
| | - Alba Abras
- Laboratori d'Ictiologia Genètica, Departament de Biologia, Universitat de Girona, Girona, Spain
| | - Silvia Tebar
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
| | - Teresa Llovet
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Patrick Lami
- National Reference Centre for Leishmaniasis, University Hospital Centre of Montpellier, University of Montpellier, Montpellier, France
| | - Francine Pratlong
- National Reference Centre for Leishmaniasis, University Hospital Centre of Montpellier, University of Montpellier, Montpellier, France
| | - Mercè Alsina
- Servei de Dermatologia, Hospital Clínic de Barcelona & Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Esther Roe
- Servei de Dermatologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lluís Puig
- Servei de Dermatologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carme Muñoz
- Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.,Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Barcelona, Spain.,Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Montserrat Gállego
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
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