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Al-Rashed AS, Al Jindan R, Al Jaroodi S, Al Mohanna A, Abdelhady A, El-Badry AA. Genotypic and phylogenic analyses of cutaneous leishmaniasis in Al Ahsa, Eastern Saudi Arabia during the coronavirus disease 2019 pandemic: First cases of Leishmania tropica with the predominance of Leishmania major. Sci Rep 2022; 12:10753. [PMID: 35750705 PMCID: PMC9232512 DOI: 10.1038/s41598-022-14702-z] [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: 02/17/2022] [Accepted: 06/10/2022] [Indexed: 01/19/2023] Open
Abstract
During the coronavirus disease 2019 lockdown period, a surge in sandflies and cutaneous leishmaniasis (CL) cases was observed in Al-Ahsa, Saudi Arabia. Skin punch biopsies were obtained from 100 patients clinically diagnosed with CL in Al-Ahsa who had no travel history in the last 6 months. Impression smears were used following a three-step polymerase chain reaction (PCR) protocol using genus-specific primers targeting kDNA and ITS1. Leishmania speciation was determined by ITS1 PCR/nested PCR-restriction fragment length polymorphism and sequencing. A phylogenetic tree was constructed. The associated patient characteristics were analyzed. Using internal transcribed spacer one (ITS1)-PCR/nested PCR, 98 cases were considered true-positive CL. Leishmania major was the predominant species, and Leishmania tropica was identified in three cases. Microscopy had poor sensitivity and perfect specificity. Direct ITS1-PCR missed nine cases. Sex, residence, and treatment outcome were significantly associated with the occurrence of Leishmania; distribution of skin lesion(s) and treatment outcome were significantly associated with Leishmania genotype. This is the first time that L. tropica was identified as a cause of CL in human in Al-Ahsa, in addition to the predominant zoonotic species, L. major. We recommend using ITS1-nested PCR for negative cases by ITS1-PCR. Further exploration of Leishmania transmission dynamics in vectors and reservoir animals is essential for designing effective preventive measures.
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Affiliation(s)
- Abdullatif S Al-Rashed
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem Al Jindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Salma Al Jaroodi
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Al Mohanna
- Vector Borne and Diseases Prevention Center, Al Ahsa, Saudi Arabia
| | | | - Ayman A El-Badry
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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2
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Van der Auwera G, Davidsson L, Buffet P, Ruf MT, Gramiccia M, Varani S, Chicharro C, Bart A, Harms G, Chiodini PL, Brekke H, Robert-Gangneux F, Cortes S, Verweij JJ, Scarabello A, Karlsson Söbirk S, Guéry R, van Henten S, Di Muccio T, Carra E, van Thiel P, Vandeputte M, Gaspari V, Blum J. Surveillance of leishmaniasis cases from 15 European centres, 2014 to 2019: a retrospective analysis. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 35086613 PMCID: PMC8796293 DOI: 10.2807/1560-7917.es.2022.27.4.2002028] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Surveillance of human leishmaniasis in Europe is mostly limited to country-specific information from autochthonous infections in the southern part. As at the end of 2021, no integrated analysis has been performed for cases seen across centres in different European countries. Aim To provide a broad perspective on autochthonous and imported leishmaniasis cases in endemic and non-endemic countries in Europe. Methods We retrospectively collected records from cutaneous, mucosal and visceral leishmaniasis cases diagnosed in 15 centres between 2014 and 2019. Centres were located in 11 countries: Belgium, France, Germany, Italy, the Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and the United Kingdom. Data on country of infection, reason for travelling, infecting species, age and sex were analysed. Results We obtained diagnostic files from 1,142 cases, of which 76%, 21% and 3% had cutaneous, visceral, and mucosal disease, respectively. Of these, 68% were men, and 32% women, with the median age of 37 years (range: 0–90) at diagnosis. Visceral leishmaniasis was mainly acquired in Europe (88%; 167/190), while cutaneous leishmaniasis was primarily imported from outside Europe (77%; 575/749). Sixty-two percent of cutaneous leishmaniasis cases from outside Europe were from the Old World, and 38% from the New World. Geographic species distribution largely confirmed known epidemiology, with notable exceptions. Conclusions Our study confirms previous reports regarding geographic origin, species, and traveller subgroups importing leishmaniasis into Europe. We demonstrate the importance of pooling species typing data from many centres, even from areas where the aetiology is presumably known, to monitor changing epidemiology.
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Affiliation(s)
| | | | - Pierre Buffet
- Service des maladies infectieuses et tropicales, AP-HP, Hopital Necker, Paris, France
| | - Marie-Thérèse Ruf
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Stefania Varani
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Aldert Bart
- Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Gundel Harms
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | | | | | | | - Sofia Cortes
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Jaco J Verweij
- Microvida Laboratory for Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | | | | | | | | | | | - Elena Carra
- Istituto Zooprofilattico Sperimentale della Lombardia e dell' Emilia-Romagna 'Bruno Ubertini', Brescia, Italy
| | | | | | - Valeria Gaspari
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Johannes Blum
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
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- The members of the network are listed under Investigators
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3
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Conter CC, Mota CA, Dos Santos BA, de Souza Braga L, de Souza Terron M, Navasconi TR, Fernandes ACBS, Demarchi IG, de Castro KRR, Aristides SMA, Lonardoni MVC, Teixeira JJV, Silveira TGV. PCR primers designed for new world Leishmania: A systematic review. Exp Parasitol 2019; 207:107773. [PMID: 31605671 DOI: 10.1016/j.exppara.2019.107773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/07/2019] [Accepted: 10/07/2019] [Indexed: 01/03/2023]
Abstract
Studies of the primers that were designed to detect New World Leishmania were systematically reviewed to report the characteristics of each target, detection limit, specificity of the primers designed and diagnostic sensibility. The papers identified in the databases PubMed and Web of Science involved 50 studies. Minicircle is the most applied target in molecular research for diagnosis, due to its high sensitivity in detecting Leishmania in different clinical samples, a characteristic that can be partially attributed to the higher number of copies of the minicircle per cell. The other molecular targets shown in this review were less sensitive to diagnostic use because of the lower number of copies of the target gene per cell, but more specific for identification of the subgenus and/or species. The choice of the best target is an important step towards the result of the research. The target allows the design of primers that are specific to the genus, subgenus or a particular species and also imparts sensitivity to the method for diagnosis. The findings of this systematic review provide the advantages and disadvantages of the main molecular targets and primers designed for New World Leishmania, offering information so that the researcher can choose the PCR system best suited to their research need. This is a timely and extremely thorough review of the primers designed for New World Leishmania.
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Affiliation(s)
- Carolina Cella Conter
- Graduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil
| | - Camila Alves Mota
- Graduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil
| | | | - Laís de Souza Braga
- Graduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil
| | | | - Taísa Rocha Navasconi
- Graduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil
| | | | - Izabel Galhardo Demarchi
- Department of Clinical Analyses and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
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4
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Mousavi T, Shokohi S, Abdi J, Naserifar R, Ahmadi M, Mirzaei A. Determination of genetic diversity of Leishmania species using mini-circle kDNA, in Iran-Iraq countries border. Trop Parasitol 2018; 8:77-82. [PMID: 30693211 PMCID: PMC6329268 DOI: 10.4103/tp.tp_3_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2018] [Indexed: 11/06/2022] Open
Abstract
Background and Objective: Cutaneous leishmaniasis (CL) is one of the most important diseases worldwide, with a different range of prevalence in endemic areas. Anthroponotic and zoonotic CL are two epidemiological forms of CL, in Iran. Although Ilam Province in the west of Iran is one of the main endemic areas of the disease, there is no inclusive study to determine the genetic variations of parasite in these areas. The objective of this study was to determine the genetic diversity of Leishmania species in Ilam Province, using mini-circle kDNA gene. Materials and Methods: Direct smears were taken from skin lesions of 200 suspected cases of CL. Smears were stained, screened under light microscope. Polymerase chain reaction (PCR) was performed, using specific kinetoplast DNA primers. Data were analyzed, using the molecular bio-software. Results: All the samples were positive by direct examination. PCR results showed all cases were positive for Leishmania major. Although all isolated cases belong to a different county of Ilam province, all were positive for L. major with intra-species genetic diversity, divided into four clades in the dendrogram. Interpretation and Conclusion: This variation can affect drug resistance and controlling strategies of parasite. It is possible that different species of sand flies and rodents are the vector and reservoir of parasite, respectively; however, further studies are needed to validate this.
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Affiliation(s)
- Tahereh Mousavi
- Department of Medical Parasitology, Paramedical School, Ilam University of Medical Sciences, Ilam, Iran
| | - Sahar Shokohi
- Department of Medical Parasitology, Paramedical School, Ilam University of Medical Sciences, Ilam, Iran
| | - Jahangir Abdi
- Department of Medical Parasitology, Paramedical School, Ilam University of Medical Sciences, Ilam, Iran
| | - Razi Naserifar
- Department of Medical Parasitology, Paramedical School, Ilam University of Medical Sciences, Ilam, Iran
| | - Mahmoud Ahmadi
- Department of Medical Parasitology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asad Mirzaei
- Department of Medical Parasitology, Paramedical School, Ilam University of Medical Sciences, Ilam, Iran
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5
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Souguir-Omrani H, Chemkhi J, Fathallah-Mili A, Saadi-BenAoun Y, BelHadjAli I, Guizani I, Guerbouj S. Paraechinus aethiopicus (Ehrenberg 1832) and Atelerix algirus (Lereboullet 1842) hedgehogs: Possible reservoirs of endemic leishmaniases in Tunisia. INFECTION GENETICS AND EVOLUTION 2018; 63:219-230. [DOI: 10.1016/j.meegid.2018.05.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 05/14/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022]
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6
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Khatri ML, Di Muccio T, Fiorentino E, Gramiccia M. Ongoing outbreak of cutaneous leishmaniasis in northwestern Yemen: clinicoepidemiologic, geographic, and taxonomic study. Int J Dermatol 2017; 55:1210-1218. [PMID: 27419356 DOI: 10.1111/ijd.13310] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 01/29/2016] [Accepted: 02/03/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is widespread in Yemen but has not been fully documented. OBJECTIVES This study aimed to investigate the clinicoepidemiologic and geographic aspects of CL in northwest Yemen and the taxonomic profile of the causative Leishmania species. METHODS All CL cases diagnosed at the Dermatology Clinic of the Saudi Hospital at Hajjah during 1997-2012 were reviewed. Diagnoses were based on clinical, microscopic and, occasionally, histopathologic examinations. Leishmania species identification was carried out in 712 microscopically positive samples by multi-locus enzyme electrophoresis and polymerase chain reaction-restriction fragment length polymorphism. RESULTS During the surveillance period, 1343 cases of CL were diagnosed. Lesions per patient ranged from one to 71, but most patients had a single facial lesion, classified as representing the "dry type" in 1315 (97.9%) and "wet type" in 28 (2.1%) patients. Leishmania typing in 576 cases identified Leishmania tropica as the main species responsible (n = 529), followed by Leishmania infantum (n = 20), Leishmania donovani (n = 11), and members of the L. donovani complex (n = 8). Atypical molecular patterns were observed in eight CL cases diagnosed in areas in which the three Leishmania species were found sympatrically. CONCLUSIONS Cutaneous leishmaniasis appears to be endemic in northwest Yemen, where its incidence has recently increased abruptly. The disease presents clinically as the "dry type" and is caused mainly by L. tropica and occasionally by L. infantum, L. donovani, and L. donovani complex species. A sympatric diffusion of the three species is present in some governorates.
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Affiliation(s)
| | - Trentina Di Muccio
- Unit of Vector-borne Diseases and International Health, Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Eleonora Fiorentino
- Unit of Vector-borne Diseases and International Health, Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marina Gramiccia
- Unit of Vector-borne Diseases and International Health, Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
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7
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Van der Auwera G, Bart A, Chicharro C, Cortes S, Davidsson L, Di Muccio T, Dujardin JC, Felger I, Paglia MG, Grimm F, Harms G, Jaffe CL, Manser M, Ravel C, Robert-Gangneux F, Roelfsema J, Töz S, Verweij JJ, Chiodini PL. Comparison of Leishmania typing results obtained from 16 European clinical laboratories in 2014. ACTA ACUST UNITED AC 2017; 21:30418. [PMID: 27983510 PMCID: PMC5291127 DOI: 10.2807/1560-7917.es.2016.21.49.30418] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 07/13/2016] [Indexed: 11/20/2022]
Abstract
Leishmaniasis is endemic in southern Europe, and in other European countries cases are diagnosed in travellers who have visited affected areas both within the continent and beyond. Prompt and accurate diagnosis poses a challenge in clinical practice in Europe. Different methods exist for identification of the infecting Leishmania species. Sixteen clinical laboratories in 10 European countries, plus Israel and Turkey, conducted a study to assess their genotyping performance. DNA from 21 promastigote cultures of 13 species was analysed blindly by the routinely used typing method. Five different molecular targets were used, which were analysed with PCR-based methods. Different levels of identification were achieved, and either the Leishmania subgenus, species complex, or actual species were reported. The overall error rate of strains placed in the wrong complex or species was 8.5%. Various reasons for incorrect typing were identified. The study shows there is considerable room for improvement and standardisation of Leishmania typing. The use of well validated standard operating procedures is recommended, covering testing, interpretation, and reporting guidelines. Application of the internal transcribed spacer 1 of the rDNA array should be restricted to Old World samples, while the heat-shock protein 70 gene and the mini-exon can be applied globally.
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Affiliation(s)
| | - Aldert Bart
- Academic Medical Center, Amsterdam, The Netherlands
| | | | - Sofia Cortes
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, UNL, Lisbon, Portugal
| | | | | | - Jean-Claude Dujardin
- Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Biomedical Sciences, Antwerp University, Antwerp, Belgium
| | - Ingrid Felger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Maria Grazia Paglia
- National Institute for Infectious Diseases (INMI) Lazzaro Spallanzani, Rome, Italy
| | - Felix Grimm
- Institute of Parasitology, University of Zürich, Zürich, Switzerland
| | - Gundel Harms
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Charles L Jaffe
- Hebrew University, Hadassah Medical Centre, Jerusalem, Israel
| | - Monika Manser
- United Kingdom National External Quality Assessment Service, London, United Kingdom
| | | | | | - Jeroen Roelfsema
- National Institute for Public Health and the Environment, RIVM, Bilthoven, The Netherlands
| | - Seray Töz
- Ege University, Faculty of Medicine, Department of Parasitology, Izmir, Turkey
| | | | - Peter L Chiodini
- Hospital for Tropical Diseases, London, United Kingdom.,London School of Hygiene and Tropical Medicine, London, United Kingdom
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8
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Rugna G, Carra E, Corpus F, Calzolari M, Salvatore D, Bellini R, Di Francesco A, Franceschini E, Bruno A, Poglayen G, Varani S, Vitale F, Merialdi G. Distinct Leishmania infantum Strains Circulate in Humans and Dogs in the Emilia-Romagna Region, Northeastern Italy. Vector Borne Zoonotic Dis 2017; 17:409-415. [PMID: 28301296 DOI: 10.1089/vbz.2016.2052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Human leishmaniasis is an emerging problem in Italy and is on the increase in the Emilia-Romagna region, northeastern part of the country. Nevertheless, studies dealing with the molecular characterization of Leishmania spp. circulating in these areas are limited. In the present work, we explored the genetic polymorphism of Leishmania isolates from 28 cases of canine leishmaniasis and three cases of human visceral leishmaniasis (VL), which occurred in 2013-2014 in the Emilia-Romagna region. The characterization was carried out in comparison with nine human isolates of Leishmania from other VL endemic Italian regions and two reference strains. Nucleic acid from 31 Leishmania-positive phlebotomine sandfly pools, sampled in 2012-2013 in the Emilia-Romagna region, were also evaluated. DNA amplification and sequencing of the ribosomal internal transcribed spacer-1 and of a repetitive nuclear region on chromosome 31 were carried out for genotyping. Two size polymorphic targets were also analyzed by PCR, the cpb E/F-gene and the k26-gene. Altogether, the analysis showed the circulation of different Leishmania infantum genotypes in the Emilia-Romagna region: two genotypes found in dogs from public kennels were similar to VL isolates from other Italian regions, whereas a third genotype was detected in VL cases of the Emilia-Romagna region and in all but one of the sandfly pools. The combined molecular tools applied in this study can constitute a helpful support for parasite tracking (e.g., in outbreak investigations) and for a better understanding of the epidemiological evolution of leishmaniasis in northeastern Italy.
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Affiliation(s)
- Gianluca Rugna
- 1 Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna "Bruno Ubertini", Brescia, Italy
| | - Elena Carra
- 1 Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna "Bruno Ubertini", Brescia, Italy
| | - Francesco Corpus
- 1 Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna "Bruno Ubertini", Brescia, Italy
| | - Mattia Calzolari
- 1 Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna "Bruno Ubertini", Brescia, Italy
| | - Daniela Salvatore
- 2 Department of Veterinary Medical Sciences, University of Bologna , Ozzano Emilia, Italy
| | - Romeo Bellini
- 3 Medical and Veterinary Entomology Department, Centro Agricoltura Ambiente "G. Nicoli" IAEA Collaborating Center , Crevalcore, Italy
| | | | - Erica Franceschini
- 4 Clinic of Infectious Diseases, Azienda Ospedaliero-Universitaria , Policlinico of Modena, Modena, Italy
| | - Antonella Bruno
- 5 Fondazione IRCCS Policlinico S. Matteo , S.C. Microbiologia e Virologia, Pavia, Italy
| | - Giovanni Poglayen
- 2 Department of Veterinary Medical Sciences, University of Bologna , Ozzano Emilia, Italy
| | - Stefania Varani
- 6 Unit of Microbiology, Department of Experimental, Diagnostic, and Specialty Medicine, St. Orsola Malpighi University Hospital, University of Bologna , Bologna, Italy
| | - Fabrizio Vitale
- 7 National Reference Center for Leishmaniasis (C.Re.Na.L.) , Istituto Zooprofilattico Sperimentale della Sicilia, Palermo, Italy
| | - Giuseppe Merialdi
- 1 Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna "Bruno Ubertini", Brescia, Italy
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9
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Akhoundi M, Downing T, Votýpka J, Kuhls K, Lukeš J, Cannet A, Ravel C, Marty P, Delaunay P, Kasbari M, Granouillac B, Gradoni L, Sereno D. Leishmania infections: Molecular targets and diagnosis. Mol Aspects Med 2017; 57:1-29. [PMID: 28159546 DOI: 10.1016/j.mam.2016.11.012] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/08/2016] [Accepted: 11/28/2016] [Indexed: 12/15/2022]
Abstract
Progress in the diagnosis of leishmaniases depends on the development of effective methods and the discovery of suitable biomarkers. We propose firstly an update classification of Leishmania species and their synonymies. We demonstrate a global map highlighting the geography of known endemic Leishmania species pathogenic to humans. We summarize a complete list of techniques currently in use and discuss their advantages and limitations. The available data highlights the benefits of molecular markers in terms of their sensitivity and specificity to quantify variation from the subgeneric level to species complexes, (sub) species within complexes, and individual populations and infection foci. Each DNA-based detection method is supplied with a comprehensive description of markers and primers and proposal for a classification based on the role of each target and primer in the detection, identification and quantification of leishmaniasis infection. We outline a genome-wide map of genes informative for diagnosis that have been used for Leishmania genotyping. Furthermore, we propose a classification method based on the suitability of well-studied molecular markers for typing the 21 known Leishmania species pathogenic to humans. This can be applied to newly discovered species and to hybrid strains originating from inter-species crosses. Developing more effective and sensitive diagnostic methods and biomarkers is vital for enhancing Leishmania infection control programs.
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Affiliation(s)
- Mohammad Akhoundi
- Service de Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; MIVEGEC, UMR CNRS5290-IRD224-Université de Montpellier Centre IRD, Montpellier, France.
| | - Tim Downing
- School of Biotechnology, Dublin City University, Dublin, Ireland
| | - Jan Votýpka
- Biology Centre, Institute of Parasitology, Czech Academy of Sciences, České Budějovice, Czech Republic; Department of Parasitology, Faculty of Science, Charles University in Prague, Prague, Czech Republic
| | - Katrin Kuhls
- Division of Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, Wildau, Germany
| | - Julius Lukeš
- Biology Centre, Institute of Parasitology, Czech Academy of Sciences, České Budějovice, Czech Republic; Faculty of Sciences, University of South Bohemia, České Budějovice, Czech Republic; Canadian Institute for Advanced Research, Toronto, Canada
| | - Arnaud Cannet
- Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, Université de Nice-Sophia Antipolis, Nice, France
| | - Christophe Ravel
- French National Reference Centre on Leishmaniasis, Montpellier University, Montpellier, France
| | - Pierre Marty
- Service de Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, Université de Nice-Sophia Antipolis, Nice, France
| | - Pascal Delaunay
- Service de Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, Université de Nice-Sophia Antipolis, Nice, France; MIVEGEC, UMR CNRS5290-IRD224-Université de Montpellier Centre IRD, Montpellier, France
| | - Mohamed Kasbari
- Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail, ANSES, Laboratoire de Santé Animale, Maisons-Alfort, Cedex, France
| | - Bruno Granouillac
- IRD/UMI 233, INSERM U1175, Montpellier University, Montpellier, France; MIVEGEC, UMR CNRS5290-IRD224-Université de Montpellier Centre IRD, Montpellier, France
| | - Luigi Gradoni
- Unit of Vector-borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - Denis Sereno
- MIVEGEC, UMR CNRS5290-IRD224-Université de Montpellier Centre IRD, Montpellier, France; Intertryp UMR IRD177, Centre IRD de Montpellier, Montpellier, France
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10
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Abstract
SUMMARYLeishmaniasis and dirofilariasis are parasitic diseases of humans and dogs, worldwide, and they are often found as coinfections in endemic areas. Cases of human and canine dirofilariasis have being reported in Greece and leishmaniasis is endemic in most prefectures in humans and dogs. In most cases, dirofilariasis is established by parasitological (the modified Knott's test) and/or immunological methods, whilst for leishmaniasis molecular techniques and culture are also used. During an epidemiological study in Greece, 22·1% of the 5772 dogs studied were found positive by serology forLeishmania.Blood cultures of 165 (12·94%) of these animals producedLeishmaniapromastigotes and 26 (2·03%)Dirofilariamicrofilariae (L1), whilst only in two (0·16%) bothLeishmaniaandDirofilariaL1 appeared. The aim was to assess coinfections by the two parasites in dogs in Greece, the isolation and survival ofDirofilariamicrofilariae andLeishmaniapromastigotes using clotted blood (a fast, simple and low-cost method) and the survival potential of the two parasites in coexistence,in vitro.
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11
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Abstract
This is the first record of Leishmania detection in foxes in Greece. Spleen, lymph nodes, bone marrow and blood samples were collected from 47 red foxes (Vulpes vulpes) found dead or captured, narcotized and freed after bleeding, from November 2009 to 2011, in Fthiotida prefecture, central Greece. This is an endemic for canine leishmaniasis area with several human visceral leishmaniasis cases. The samples were tested for Leishmania infantum and Leishmania tropica by molecular methods (polymerase chain reaction (PCR) and restriction fragment length polymorphism) and serology (indirect immunofluorescent antibody test; when blood samples were available). Leishmania infantum DNA was detected in 28 animals (59·5%). PCR positivity was related to animal age, sex, weight, characteristics of the area trapped, presence of leishmaniasis symptoms and presence of endo- and ecto-parasites. The results were related to dog seropositivity obtained earlier in the area. The findings support the hypothesis that this wild canid may serve as a reservoir for Leishmania in areas where the sandfly vectors are found. In the prefectures of Larisa and Magnisia, adjacent to Fthiotida, Phlebotomus perfiliewi and Phlebotomus tobbi (known vectors of L. infantum) have been reported.
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Di Muccio T, Scalone A, Bruno A, Marangi M, Grande R, Armignacco O, Gradoni L, Gramiccia M. Epidemiology of Imported Leishmaniasis in Italy: Implications for a European Endemic Country. PLoS One 2015; 10:e0129418. [PMID: 26114938 PMCID: PMC4482607 DOI: 10.1371/journal.pone.0129418] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/09/2015] [Indexed: 02/06/2023] Open
Abstract
In the past decade, the number of imported leishmaniasis cases has increased in countries of Western Europe. The trend is associated with increasing travels, ecotourism activity, military operations and immigration. While in endemic countries leishmaniasis is usually well diagnosed, accurate patient history and parasite identification are necessary to distinguish between autochthonous and imported cases. This is particularly important, as new Leishmania species/genotypes may be introduced and transmitted by local phlebotomine vectors without appropriate surveillance, with unpredictable consequences. We report on the surveillance of imported leishmaniasis performed by the Leishmania Identification Reference Centre of Rome from 1986 through 2012, involving health care centres from 16/20 Italian regions. Suspected imported cases were analyzed and conclusions were based on clinical, epidemiological and diagnostic findings. Over the years, different parasite identification methods were employed, including MultiLocus Enzyme Electrophoresis and molecular techniques combining disease diagnosis (SSU rDNA nested-PCR) and Leishmania typing (nuclear repetitive sequence and ITS-1 PCR-RFLPs). A total of 105 imported cases were recorded (annual range: 0-20) of which 36 were visceral (VL) (16 HIV-coinfections) and 69 cutaneous (CL) cases; 85 cases (52 CL) were from the Old World and 20 (17 CL) from the New World. Eight Leishmania species were identified, of which 7 were exotic to Italy. VL importation until 1995 was associated with the spread of Mediterranean Leishmania-HIV co-infections in early 1990s. Following the introduction of HAART treatment, such cases became occasional in Italians but relatively frequent among immigrants. In contrast, a steady increase of CL cases was observed from different areas of the Old and New Worlds, that in recent years included mainly immigrants ‘visiting friends and relatives’ and Italian tourists. This positive trend likely depends on better diagnosis and reporting; however, we suspect that many CL cases remained unrecognized. Given the relatively low incidence of leishmaniasis importation, the risk of introduction of exotic parasites appears limited, although the detection of anthroponotic species requires attention.
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Affiliation(s)
- Trentina Di Muccio
- Unit of Vector-borne Diseases & International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy
| | - Aldo Scalone
- Unit of Vector-borne Diseases & International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy
| | - Antonella Bruno
- Laboratory of Parasitology, Unit of Microbiology and Virology, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimo Marangi
- Unit of Infectious Diseases, Department of Medical Sciences, Sant’Andrea Hospital, Rome, Italy
| | - Romualdo Grande
- Unit of Clinical Microbiology Virology and Bioemergencies Diagnosis, Luigi Sacco University Hospital, Milan, Italy
| | | | - Luigi Gradoni
- Unit of Vector-borne Diseases & International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy
| | - Marina Gramiccia
- Unit of Vector-borne Diseases & International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy
- * E-mail:
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Abstract
Leishmania is an infectious protozoan parasite related to African and American trypanosomes. All Leishmania species that are pathogenic to humans can cause dermal disease. When one is confronted with cutaneous leishmaniasis, identification of the causative species is relevant in both clinical and epidemiological studies, case management, and control. This review gives an overview of the currently existing and most used assays for species discrimination, with a critical appraisal of the limitations of each technique. The consensus taxonomy for the genus is outlined, including debatable species designations. Finally, a numerical literature analysis is presented that describes which methods are most used in various countries and regions in the world, and for which purposes.
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Affiliation(s)
- Gert Van der Auwera
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium
| | - Jean-Claude Dujardin
- Institute of Tropical Medicine, Department of Biomedical Sciences, Antwerp, Belgium Antwerp University, Department of Biomedical Sciences, Antwerp, Belgium
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Imani M, Dehkharghani AD, Ghelman M, Mohammadloo M. Molecular technique for detection of Leishmania infantum isolates in Iran. Trop Parasitol 2014; 4:35-7. [PMID: 24754025 PMCID: PMC3992800 DOI: 10.4103/2229-5070.129160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 03/20/2014] [Indexed: 11/08/2022] Open
Abstract
Introduction: Leishmania infantum is the causative agent of autochthonous cutaneous and visceral cases of leishmaniasis and transmitted by female sandflies. The dogs are considered the main reservoir hosts; however, there are the reports on Leishmania infection in other animals. In this study, occurrence types of L. infantum isolates have been analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Materials and Methods: In this experimental study, 77 samples were cultured and prepared for microscopic study and examined through PCR-RFLP. The samples were used for both deoxyribonucleic acid (DNA) and smear-slide preparations. The DNAs were amplified by PCR for the detection of Leishmania subgenus and PCR products were restricted with HaeIII for the species differentiation. Results: The visceral Leishmania parasites were genotyped as L. infantum. It was also determined sensitivity in PCR (100%) was higher than microscopic examination. Conclusion: PCR-RFLP technique appears to be most sensitive for the detection and differentiation of L. infantum. There exists a relationship between genetic heterogeneousness and clinical manifestation and geographical regions of this disease in human.
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Affiliation(s)
- Mohsen Imani
- Department of Molecular, Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Mohsen Ghelman
- Department of Immunolgy School of Allied Health, University of Medical Sciences, Tehran, Iran
| | - Mahnaz Mohammadloo
- Department of Molecular, Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran
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Will the introduction of Leishmania tropica MON-58, in the island of Crete, lead to the settlement and spread of this rare zymodeme? Acta Trop 2014; 132:125-30. [PMID: 24462941 DOI: 10.1016/j.actatropica.2014.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 01/06/2014] [Accepted: 01/14/2014] [Indexed: 11/21/2022]
Abstract
The rare zymodeme, Leishmania tropica MON-58, was isolated from a young Afghan refugee with a facial cutaneous lesion who had come to live in Crete early 2008. The same zymodeme variant was isolated from a local dog that had never travelled outside the island, with symptoms of visceral leishmaniasis, which stayed in the area where the patient worked during the summer months. This is the first record of L. tropica in a host, other than human, in Greece and another example of introduction of a vector borne pathogen in a focus where local vector/s can sustain it, with the risk of initiation of new transmission cycle/s.
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Ntais P, Sifaki-Pistola D, Christodoulou V, Messaritakis I, Pratlong F, Poupalos G, Antoniou M. Leishmaniases in Greece. Am J Trop Med Hyg 2013; 89:906-15. [PMID: 24062479 DOI: 10.4269/ajtmh.13-0070] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract. During the last 35 years, visceral leishmaniasis has spread in Greece with autochthonous human cases appearing in 41 of the 54 prefectures. The occurrence of the disease was mapped and related to dog seropositivity, environmental and geospatial risk factors. Average dog seropositivity was 22.1% and positive animals were found in 43 of 54 prefectures. Factors like: altitude, presence of water bodies, land use, wind speed, mean land surface temperature, mean relative humidity, and mean annual rainfall were found to affect dog seropositivity. Cases of cutaneous leishmaniasis, caused by Leishmania tropica are also increasing. Phlebotomus similis believed to be the potential vector of L. tropica in Greece, was found in areas where the disease is widespread but also where cases have never been reported implying a danger of introduction of this anthroponotic parasite to new regions.
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Affiliation(s)
- Pantelis Ntais
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; University Montpellier 1, Faculty of Medicine, Laboratory of Parasitology-Mycology, Hospital University Centre (CHRU) of Montpellier and French National Reference Centre for Leishmaniases, CNRS 5290 - IRD 224 - University Montpellier 1&2 (UMR "MIVEGEC")
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Tordini G, Giaccherini R, Pacenti L, Miracco C, Zazzi M, Zanelli G. Cutaneous leishmaniasis: usefulnessof PCR on paraffin-embedded skin biopsies as part of routine investigation. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 101:745-9. [DOI: 10.1179/136485907x229059] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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18
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Quaresma PF, Carvalho GMDL, Ramos MCDNF, Andrade Filho JD. Natural Leishmania sp. reservoirs and phlebotomine sandfly food source identification in Ibitipoca State Park, Minas Gerais, Brazil. Mem Inst Oswaldo Cruz 2013; 107:480-5. [PMID: 22666858 DOI: 10.1590/s0074-02762012000400007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 02/03/2012] [Indexed: 11/22/2022] Open
Abstract
Leishmania spp are distributed throughout the world and different species are associated with varying degrees of disease severity. However, leishmaniasis is thought to be confined to areas of the world where its insect vectors, sandflies, are present. Phlebotomine sandflies obtain blood meals from a variety of wild and domestic animals and sometimes from humans. These vectors transmit Leishmania spp, the aetiological agent of leishmaniasis. Identification of sandfly blood meals has generally been performed using serological methods, although a few studies have used molecular procedures in artificially fed insects. In this study, cytochrome b gene (cytB) polymerase chain reaction (PCR) was performed in DNA samples isolated from 38 engorged Psychodopygus lloydi and the expected 359 bp fragment was identified from all of the samples. The amplified product was digested using restriction enzymes and analysed for restriction fragment length polymorphisms (RFLPs). We identified food sources for 23 females; 34.8% yielded a primate-specific banding profile and 26.1% and 39.1% showed banding patterns specific to birds or mixed restriction profiles (rodent/marsupial, human/bird, rodent/marsupial/human), respectively. The food sources of 15 flies could not be identified. Two female P. lloydi were determined to be infected by Leishmania using internal transcribed spacer 1 and heat shock protein 70 kDa PCR-RFLP. The two female sandflies, both of which fed on rodents/marsupials, were further characterised as infected with Leishmania (Viannia) braziliensis. These results constitute an important step towards applying methodologies based on cytB amplification as a tool for identifying the food sources of female sandflies.
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Affiliation(s)
- Patrícia Flávia Quaresma
- Laboratório de Leishmanioses, Instituto René Rachou, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
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El-Beshbishy HA, Al-Ali KH, El-Badry AA. Molecular characterization of cutaneous leishmaniasis in Al-Madinah Al-Munawarah province, western Saudi Arabia. Int J Infect Dis 2012; 17:e334-8. [PMID: 23253909 DOI: 10.1016/j.ijid.2012.11.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 11/11/2012] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Leishmaniasis is a parasitic disease affecting a large number of people worldwide. In this study we carried out the molecular characterization of cutaneous leishmaniasis (CL) in Al-Madinah Al-Munawarah Province, Saudi Arabia, confirming Leishmania major and Leishmania tropica as the prevalent species using molecular techniques. METHODS One hundred and five patients with suspected CL were identified from four different localities in Al-Madinah Al-Munawarah Province and Al-Miqat Hospital, Al-Madinah, Saudi Arabia. Thirty-four of the 105 patients were selected at random for molecular investigation. RESULTS Characterization of CL species by internal transcribed spacer 1 (ITS1) PCR-restriction fragment length polymorphism (RFLP) and kinetoplast DNA (kDNA) PCR established L. major and L. tropica as the causative organisms. kDNA PCR had a sensitivity of 90.7%, whereas ITS1 PCR had a sensitivity of 70.1%, thus facilitating the diagnosis and species identification. Parasite culture alone detected 39.2% and smear alone 55.3% of the positive samples. With the exception of kDNA PCR, all other assays were 100% specific. CONCLUSIONS This study provides the first findings for the comprehensive molecular characterization of CL in Saudi Arabia.
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Affiliation(s)
- Hesham A El-Beshbishy
- Medical Laboratories Technology Department, Faculty of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawarah, PO Box 30001, Saudi Arabia.
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Usefulness of a PCR-based method in the detection and species identification of Leishmania from clinical samples. ACTA ACUST UNITED AC 2012; 60:e75-9. [DOI: 10.1016/j.patbio.2011.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 11/30/2011] [Indexed: 11/22/2022]
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Belal US, Abdel-Hafeez EH, Naoi K, Norose K. Cutaneous leishmaniasis in the Nalut District, Libyan Arab Jamahiriya: a clinico-epidemiologic study and Leishmania species identification. J Parasitol 2012; 98:1251-6. [PMID: 22551502 DOI: 10.1645/ge-3086.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cutaneous leishmaniasis (CL), an endemic disease in the littoral zones of the Mediterranean area, the Middle East, East Africa, and especially in Libya, has not been fully documented. The present study clarifies the clinico-epidemiologic profile of CL and the molecular genotyping of the Leishmania spp. in the Nalut district, Libya. Two hundred and twenty-three CL patients were examined at the out-patient clinics of Nalut Hospital from March 2006 to February 2007. CL was diagnosed by clinical, microscopic, culture, polymerase chain reaction (PCR), and PCR-restriction fragment length polymorphism (RFLP) analyses. The disease was observed year-round, with the highest prevalence between November and February. Fifty-nine percent of patients were younger than 20 yr. Nodulo-ulcerative lesions, indurated ulcers, papulo-ulcerative lesions, and subcutaneous nodular lesions were observed in 170, 25, 15, and 13 patients, respectively. Two hundred patients (89.7%) had dry type of lesions, whereas 23 patients (10.3%) presented a wet type of lesion. One hundred and fifty-nine (71.3%) of 223 patients were confirmed positive for CL by the presence of the amastigote form of Leishmania by stained Giemsa smear, and 170 (76.2%) were positive according to the presence of the promastigote form of Leishmania by culture in RPMI 1640 medium supplemented with 10% fetal bovine serum (FBS). PCR confirmed 203 (91.0%) positive cases. Genotyping of Leishmania spp. by RFLP analysis revealed that L. tropica was the most common species at all ages, and L . infantum was second under 20 yr of age. In summary, CL is endemic in the Nalut district, Libya; PCR was the most sensitive parasite diagnostic test, and L. tropica was the most common species.
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Affiliation(s)
- Usama S Belal
- Department of Parasitology, Faculty of Medicine, Al Jabal al Gharbi University, Nalut City, Libya
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Yehia L, Adib-Houreih M, Raslan WF, Kibbi AG, Loya A, Firooz A, Satti M, El-Sabban M, Khalifeh I. Molecular diagnosis of cutaneous leishmaniasis and species identification: analysis of 122 biopsies with varied parasite index. J Cutan Pathol 2012; 39:347-55. [DOI: 10.1111/j.1600-0560.2011.01861.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Christodoulou V, Antoniou M, Ntais P, Messaritakis I, Ivovic V, Dedet JP, Pratlong F, Dvorak V, Tselentis Y. Re-emergence of visceral and cutaneous leishmaniasis in the Greek Island of Crete. Vector Borne Zoonotic Dis 2012; 12:214-22. [PMID: 22217163 DOI: 10.1089/vbz.2011.0004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Leishmaniases are vector-borne diseases transmitted by phlebotomine sand flies. Three species of Leishmania are found in the Mediterranean basin: Leishmania infantum, the most common species responsible for both visceral (VL) and cutaneous leishmaniasis (CL); Leishmania major, found in North Africa and Middle East causing CL; Leishmania tropica with a limited presence in Europe, causing CL. During the last 25 years, Crete has become an endemic zone for L. infantum with a high number of infected dogs and an increasing number of human cases every year; in the last 4 years, the incidence has reached an average of seven VL patients per year in a population of 600,000. At the same time, CL has re-emerged in Crete due to L. tropica, with an average of three CL cases per year in the last 4 years. Isolates were typed as L. infantum MON-1 and MON-98 and L. tropica MON-300, a zymodeme not reported before. Both VL and CL have spread to the whole of the island during the last 25 years, primarily in semi-urban and urban areas with altitudes of 0-50 m. The prevailing Phlebotomus species were Phlebotomus neglectus (proven vector of L. infantum) and Phlebotomus similis (suspected vector of L. tropica).
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Affiliation(s)
- Vasiliki Christodoulou
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses, and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece
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Azmi K, Nasereddin A, Ereqat S, Schnur L, Schonian G, Abdeen Z. Methods incorporating a polymerase chain reaction and restriction fragment length polymorphism and their use as a ‘gold standard’ in diagnosing Old World cutaneous leishmaniasis. Diagn Microbiol Infect Dis 2011; 71:151-5. [DOI: 10.1016/j.diagmicrobio.2011.06.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Revised: 05/21/2011] [Accepted: 06/06/2011] [Indexed: 11/28/2022]
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Gramiccia M. Recent advances in leishmaniosis in pet animals: Epidemiology, diagnostics and anti-vectorial prophylaxis. Vet Parasitol 2011; 181:23-30. [DOI: 10.1016/j.vetpar.2011.04.019] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Diagnosis of Indian visceral leishmaniasis by nucleic acid detection using PCR. PLoS One 2011; 6:e19304. [PMID: 21559398 PMCID: PMC3084819 DOI: 10.1371/journal.pone.0019304] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 03/27/2011] [Indexed: 11/19/2022] Open
Abstract
Background PCR based diagnosis for Visceral Leishmaniasis (VL), despite numerous published primers, remains far from being applied in the field. The present study was planned to design a Leishmania specific diagnostic assay and to evaluate its sensitivity and specificity on a sample size, which to the best of our knowledge is the largest ever screened in one study. Methods Leishmania specific primers were developed using 18S rRNA gene and their sensitivity was evaluated on 500 parasitologically confirmed patients with VL and 25 Post Kala-azar Dermal Leishmaniasis (PKDL) patients. Specificity was calculated on 250 healthy endemic controls, 250 healthy non endemic controls and 250 non leishmanial diseases like malaria. Results Our PCR assay had a sensitivity of 87.8% (95%CI: 84.1–89.8) using 200 µL of patient's peripheral-blood. Specificity was absolute in non-endemic healthy controls and in subjects with different diseases while in endemic controls it was 84% (95%CI: 78.9–88.0). Its overall specificity was 94.6% (95%CI-92.8–96.1). Conclusions The PCR assay developed is sensitive enough to detect the 18S rRNA gene in an amount equivalent to a single parasite or less in a one million human cell environment. The high sensitivity of this PCR diagnostic test with relatively non-invasive peripheral blood sampling method opens up the possibility of its deployment in field for the routine diagnosis of VL.
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Roelfsema JH, Nozari N, Herremans T, Kortbeek LM, Pinelli E. Evaluation and improvement of two PCR targets in molecular typing of clinical samples of Leishmania patients. Exp Parasitol 2011; 127:36-41. [DOI: 10.1016/j.exppara.2010.06.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 06/15/2010] [Accepted: 06/16/2010] [Indexed: 10/19/2022]
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Gadisa E, Kuru T, Genet A, Engers H, Aseffa A, Gedamu L. Leishmania donovani complex (Kinetoplastida, Trypanosomatidae): Comparison of deoxyribonucleic acid based techniques for typing of isolates from Ethiopia. Exp Parasitol 2010; 126:203-8. [DOI: 10.1016/j.exppara.2010.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Revised: 04/24/2010] [Accepted: 04/27/2010] [Indexed: 10/19/2022]
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Tordini G, Giaccherini R, Sammarro G, Braito A, Zanelli G. Human leishmaniasis in Tuscany: a changing pattern of visceral disease? ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2010; 104:171-4. [PMID: 20406584 DOI: 10.1179/136485910x12647085215499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- G Tordini
- Department of Molecular Biology, Siena University, Policlinico Santa Maria alle Scotte, Siena, Italy.
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Wang JY, Gao CH, Yang YT, Chen HT, Zhu XH, Lv S, Chen SB, Tong SX, Steinmann P, Ziegelbauer K, Zhou XN. An outbreak of the desert sub-type of zoonotic visceral leishmaniasis in Jiashi, Xinjiang Uygur Autonomous Region, People's Republic of China. Parasitol Int 2010; 59:331-7. [PMID: 20434585 DOI: 10.1016/j.parint.2010.04.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Revised: 04/11/2010] [Accepted: 04/14/2010] [Indexed: 12/24/2022]
Abstract
Few outbreaks of the desert sub-type of zoonotic visceral leishmaniasis (VL) have been described worldwide. In 2008, the incidence rate of VL in Jiashi County, Xinjiang Uygur Autonomous Region in the western part of the People's Republic of China, increased more than twenty-folds compared to the average annual incidence rate. The majority of the cases (96.6%) occurred among <2 year-old infants. For the first time in the desert area of Xinjiang, the parasites were isolated from bone marrow aspirates, using the NNN medium culture approach. The genetic analysis of the ITS-1 nucleotide sequence indicated that three isolates from eastern Jiashi County were genetically closely related and belonged to the Leishmaniainfantum group. However, they differed from an isolate from Kashi city which was classified as a member of the Leishmaniadonovani group.
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Affiliation(s)
- Jun-Yun Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China.
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Mazeris A, Soteriadou K, Dedet JP, Haralambous C, Tsatsaris A, Moschandreas J, Messaritakis I, Christodoulou V, Papadopoulos B, Ivovic V, Pratlong F, Loucaides F, Antoniou M. Leishmaniases and the Cyprus paradox. Am J Trop Med Hyg 2010; 82:441-8. [PMID: 20207870 DOI: 10.4269/ajtmh.2010.09-0282] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In Cyprus, leishmaniasis has been considered exclusively a veterinary problem. It was prevalent before 1945, and until its recent reemergence, it was nearly eradicated by 1996 as a consequence of the destruction of reservoir hosts and vectors. A survey carried out to provide an unbiased estimate of current transmission rates in dogs and humans showed a 9-fold increase in dog seroprevalence (reaching 14.9%) compared with 10 years ago. However, no human cases caused by Leishmania infantum were detected, although L. donovani cases were reported recently. The 62 strains isolated from dogs were typed as L. infantum MON-1 (98.4%), which is the predominating zymodeme in the Mediterranean region, and MON-98 (1.6%). The Phlebotomus species P. tobbi (vector of L. infantum in Cyprus), P. galilaeus, and P. papatasi were the predominant species captured. Two transmission cycles seem to run in parallel in Cyprus: in dogs with L. infantum and in humans with L. donovani.
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Cutaneous leishmaniasis in North-Western Yemen: A clinicoepidemiologic study and Leishmania species identification by polymerase chain reaction–restriction fragment length polymorphism analysis. J Am Acad Dermatol 2009; 61:e15-21. [DOI: 10.1016/j.jaad.2009.04.047] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2008] [Revised: 03/13/2009] [Accepted: 04/20/2009] [Indexed: 11/23/2022]
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Gavgani ASM, Ghazanchaei A, Karimi P, Mohit H, Davies CR. Practical approach for typing strains of Leishmania infantum by enzyme polymorphism: a cross sectional study in Northwest of Iran. Pak J Biol Sci 2009; 10:4505-9. [PMID: 19093520 DOI: 10.3923/pjbs.2007.4505.4509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In present study, All samples collected from Kalybar and Ahar districts in Northwest of Iran from 12 patients (bone marrow aspirates), 26 dogs (spleenic and hepatic aspirates) and more than 100 sand flies between years 2004-2006. All patients were clinically diagnosed to have visceral leishmaniasis. Serological profiles of all sera samples from both human and dogs were in accordance with leishmaniasis (DAT). Isoenzyme profiles of these isolates were compared with those of reference using 12 enzyme systems. L. infuntum MON-1 is the only zymodeme present in all samples of dogs, sand flies and human. The enzymatic polymorphism is compared to that of neighboring countries (Azarbaijan, Iraq and Turkey etc.) and we concluded that the Visceral Leishmaniasis (VL) focus in northwest of Iran is evidently Mediterranean focus of zoonotic VL, which extends from Portugal and Morocco to Pakistan and the central Asian republics. Domestic doges act as the reservoir host, where Phlebotomus kandellakii and Perfiliewi ariasi are vectors.
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Affiliation(s)
- A S Mazloumi Gavgani
- Department of Medical Parasitology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Hemophagocytic lymphohistiocytosis associated with Epstein Barr virus and Leishmania donovani coinfection in a child from Cyprus. J Pediatr Hematol Oncol 2008; 30:704-7. [PMID: 18776766 DOI: 10.1097/mph.0b013e31816916f6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We present a case of a 9-month-old girl from Cyprus with hemophagocytic lymphohistiocytosis associated with Epstein Barr virus and Leishmania donovani coinfection. Treatment with liposomal amphotericin B resulted in a dramatic resolution of clinical and laboratory abnormalities. To our knowledge, this is the first reported case of a coinfection-associated hemophagocytic lymphohistiocytosis and the first clinical report of visceral leishmaniasis infection in Europe by L. donovani.
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Stark D, van Hal S, Lee R, Marriott D, Harkness J. Leishmaniasis, an emerging imported infection: report of 20 cases from Australia. J Travel Med 2008; 15:351-4. [PMID: 19006509 DOI: 10.1111/j.1708-8305.2008.00223.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Leishmaniasis is a protozoan infection rarely reported in Australia. However, with the advent of increased international tourism and migration of refugees from endemic regions, leishmaniasis has emerged as an increasingly imported infection. We report 20 cases (17 cutaneous, 2 visceral, and 1 post-kala-azar dermal leishmaniasis). These data highlight the range of species causing leishmaniasis imported in Australia and demonstrate the importance of species identification in determining proper treatment.
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Affiliation(s)
- Damien Stark
- Division of Microbiology, SydPath, St. Vincent's Hospital, Darlinghurst, Australia.
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Naturally InfectedLutzomyiaSand Flies in aLeishmania-Endemic Area of Brazil. Vector Borne Zoonotic Dis 2008; 8:407-14. [DOI: 10.1089/vbz.2007.0180] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Identification of Leishmania parasites in clinical samples obtained from cutaneous leishmaniasis patients using PCR-RFLP technique in endemic region, Sanliurfa province, in Turkey. Parasitol Res 2008; 103:583-6. [PMID: 18509680 DOI: 10.1007/s00436-008-1013-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Accepted: 04/18/2008] [Indexed: 10/22/2022]
Abstract
Antroponotic cutaneous leishmaniasis (ACL) is an endemic disease and one of the major health problems in Sanliurfa province located in the southeastern region of Turkey. Leishmania tropica is confirmed as the causative agent of ACL in this region. In Sanliurfa city alone, the recorded total cases of ACL were 6,817 between 2001 and 2006. We aimed to determine the effectiveness of a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for identification and differentiation of the Leishmania parasite in comparison to direct microscopic examination of clinical samples. The lesion exudates were collected from 51 ACL suspected patients and used for smear-slide preparations and DNA isolation. The isolated DNA was amplified by PCR, including primers selected on repetitive DNA for identification of a Leishmania subgenus, and the amplified DNA was restricted by HaeIII restriction endonuclease. The PCR-RFLP results showed that only L. tropica exists in this province. It is also determined that the positivity rate with PCR was higher (96%) than by microscopic examination (64%) in the diagnosis of ACL. Our results indicate that the PCR-RFLP method is more sensitive and specific for the detection and differentiation of agents of ACL in this area.
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Yébenes M, Cruz I, Cañavate C, Gilaberte M, Baena V, Pujol RM. Nodular lymphangitic subcutaneous dissemination after intralesional antimonial treatment for localized cutaneous leishmaniasis. Clin Exp Dermatol 2008; 33:142-4. [DOI: 10.1111/j.1365-2230.2007.02575.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Agteresch HJ, van 't Veer MB, Cornelissen JJ, Sluiters JF. Visceral leishmaniasis after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2007; 40:391-3. [PMID: 17572716 DOI: 10.1038/sj.bmt.1705728] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Antinori S, Calattini S, Longhi E, Bestetti G, Piolini R, Magni C, Orlando G, Gramiccia M, Acquaviva V, Foschi A, Corvasce S, Colomba C, Titone L, Parravicini C, Cascio A, Corbellino M. Clinical use of polymerase chain reaction performed on peripheral blood and bone marrow samples for the diagnosis and monitoring of visceral leishmaniasis in HIV-infected and HIV-uninfected patients: a single-center, 8-year experience in Italy and review of the literature. Clin Infect Dis 2007; 44:1602-10. [PMID: 17516404 DOI: 10.1086/518167] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 03/06/2007] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND To overcome some of the limitations of conventional microbiologic techniques, polymerase chain reaction (PCR)-based assays are proposed as useful tools for the diagnosis of visceral leishmaniasis. PATIENTS AND METHODS A comparative study using conventional microbiologic techniques (i.e., serologic testing, microscopic examination, and culture) and a Leishmania species-specific PCR assay, using peripheral blood and bone marrow aspirate samples as templates, was conducted during an 8-year period. The study cohort consisted of 594 Italian immunocompetent (adult and pediatric) and immunocompromised (adult) patients experiencing febrile syndromes associated with hematologic alterations and/or hepatosplenomegaly. Identification of the infecting protozoa at the species level was directly obtained by PCR of peripheral blood samples, followed by restriction fragment-length polymorphism analysis of the amplified products, and the results were compared with those of isoenzyme typing of Leishmania species strains from patients, which were isolated in vitro. RESULTS Sixty-eight patients (11.4%) had a confirmed diagnosis of visceral leishmaniasis. Eleven cases were observed in human immunodeficiency virus (HIV)-uninfected adults, 20 cases were observed in HIV-infected adults, and the remaining 37 cases were diagnosed in HIV-uninfected children. In the diagnosis of primary visceral leishmaniasis, the sensitivities of the Leishmania species-specific PCR were 95.7% for bone marrow aspirate samples and 98.5% for peripheral blood samples versus sensitivities of 76.2%, 85.5%, and 90.2% for bone marrow aspirate isolation, serologic testing, and microscopic examination of bone marrow biopsy specimens, respectively. None of 229 healthy blood donors or 25 patients with imported malaria who were used as negative control subjects had PCR results positive for Leishmania species in peripheral blood samples (i.e., specificity of Leishmania species-specific PCR, 100%). PCR and restriction fragment-length polymorphism analysis for Leishmania species identification revealed 100% concordance with isoenzyme typing in the 19 patients for whom the latter data were available. CONCLUSIONS PCR assay is a highly sensitive and specific tool for the diagnosis of visceral leishmaniasis in both immunocompetent and immunocompromised patients and can be reliably used for rapid parasite identification at the species level.
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Affiliation(s)
- Spinello Antinori
- Dipartimento di Scienze Cliniche L. Sacco, Sezione di Malattie Infettive e Tropicali, Università di Milano, Milan, Italy.
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Maroli M, Pennisi MG, Di Muccio T, Khoury C, Gradoni L, Gramiccia M. Infection of sandflies by a cat naturally infected with Leishmania infantum. Vet Parasitol 2007; 145:357-60. [PMID: 17174035 DOI: 10.1016/j.vetpar.2006.11.009] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2006] [Revised: 11/09/2006] [Accepted: 11/14/2006] [Indexed: 10/23/2022]
Abstract
Despite the recent reports of feline leishmaniosis from Southern Europe, cats are still regarded as unusual Leishmania hosts. A cat found chronically infected with Leishmania was submitted to xenodiagnosis. After being sedated, the animal was exposed to the bite of 100 laboratory-reared Phlebotomus perniciosus in a fine net cage for 90 min. Four out of 19 blood-fed sandflies (21%) showed motile promastigotes at the dissection. Parasites cultured from cat's lymph node and an infected fly were identical at PCR-RFLP genotyping and identified as Leishmania infantum MON-1, the main zymodeme responsible for human and canine leishmaniosis in Southern Europe. This is the first evidence of transmissibility of feline parasites to a proven vector, suggesting that cats may represent an additional domestic reservoir for L. infantum.
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Affiliation(s)
- Michele Maroli
- Unit of Vector-borne Diseases and International Health, MIPI Department, Istituto Superiore di Sanità, Rome, Italy.
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Leishmania infantum leishmaniasis in corticosteroid--treated patients. BMC Infect Dis 2006; 6:177. [PMID: 17176478 PMCID: PMC1764017 DOI: 10.1186/1471-2334-6-177] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2006] [Accepted: 12/18/2006] [Indexed: 11/23/2022] Open
Abstract
Background The number of leishmaniasis cases associated with immunosuppression has increased regularly over the past 20 years. Immunosuppression related to HIV infection, immunosuppressive treatment, organ transplantation, and neoplastic diseases increases the risk for Leishmania-infected people to develop visceral illness. Case presentation Three cases of Leishmania infantum leishmaniasis in corticosteroid (CS)-treated patients are reported: an isolated lingual leishmaniasis in a farmer treated with CS for asthma, a severe visceral leishmaniasis associated with cutaneous lesions in a woman with myasthenia gravis, and a visceral involvement after cutaneous leishmaniasis in a man receiving CS. Conclusion Physicians should recognise CS-treated patients as a population likely to be immunesuppressed. In immunodeficiency conditions, unusual forms of leishmaniasis can develop and foster the risk of a diagnostic delay and of poor response to therapy.
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Genetu A, Gadisa E, Aseffa A, Barr S, Lakew M, Jirata D, Kuru T, Kidane D, Hunegnaw M, Gedamu L. Leishmania aethiopica: Strain identification and characterization of superoxide dismutase-B genes. Exp Parasitol 2006; 113:221-6. [PMID: 16516199 DOI: 10.1016/j.exppara.2006.01.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2005] [Revised: 01/12/2006] [Accepted: 01/13/2006] [Indexed: 10/24/2022]
Abstract
This study was performed to characterize the genes that code for superoxide dismutase (SOD) in Leishmania aethiopica. It involved three main steps: specimen collection and parasite isolation, species identification, and molecular characterization of the SOD genes. Out of 20 skin slit specimens cultured and processed from suspected cutaneous leishmaniasis patients enrolled in the study, five (25%) were found to be positive for motile promastigotes. Isoenzyme electrophoresis and PCR-RFLP results confirmed that the isolates were L. aethiopica. Superoxide dismutase-B (SODB) genes were identified from L. aethiopica for the first time. Iron superoxide dismutase-B genes amplified from promastigotes of L. aethiopica (LaeFeSODB) were similar in size to the SODB genes of other Leishmania species. Nucleotide sequences of LaeFeSODB1 showed 95.4, 93.5, and 97.3% identity with L. donovani SODB1 (LdFeSODB1) L. major SODB1 (LmFeSODB1) and L. tropica SODB1 (LtrFeSODB1), respectively. Similarly, LaeFeSODB2 showed 95.9 and 94.1 and 97.6% identity with LdFeSODB2 and LmFeSODB2 and LtrFeSODB2, respectively. On the other hand, predicted amino acid sequence comparison indicated that LaeFeSODB1 had 91.3, 89.8, and 93.9% identity with LdFeSODB1, LmFeSODB1, and LtrFeSODB1, respectively. The difference in nucleic acid sequence of LaeFeSODB from that of LmFeSODB and LtrFeSODB can be utilized to develop specific molecular methods that help differentiate these species in places where there is an overlap in the distribution of these species. In addition, the data provide information about the situation of L. aethiopica with respect to SODB genes.
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Affiliation(s)
- Abebe Genetu
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia.
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Böer A, Blödorn-Schlicht N, Wiebels D, Steinkraus V, Falk TM. Unusual histopathological features of cutaneous leishmaniasis identified by polymerase chain reaction specific for Leishmania
on paraffin-embedded skin biopsies. Br J Dermatol 2006; 155:815-9. [PMID: 16965433 DOI: 10.1111/j.1365-2133.2006.07365.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is rare in Northern Europe and may be overlooked because colleagues have little experience with it. OBJECTIVES To identify manifestations of CL that may escape diagnosis. METHODS Correlation of clinical diagnosis and histopathological findings in 28 biopsy specimens taken from 19 patients with CL confirmed by polymerase chain reaction (PCR) specific for Leishmania. RESULTS In only one patient was the clinical diagnosis CL; other diagnoses included: malignant epithelial neoplasms (5), follicular cyst (2), atypical mycobacteriosis (1), sarcoidosis (2) and lymphoma (1). Lesions were single (15) or few (4) nodules predominantly situated on the extremities or face (16). Histopathological findings were diagnostic of CL in only 10 cases. In nine cases Leishmania was not identified microscopically; histopathological diagnoses were: granulomatous dermatitis (6), lupoid rosacea (1), foreign body granuloma (1) and granuloma annulare (1). Unaltered epidermis (9), nodular infiltrates (5), numerous multinucleated histiocytes (3), palisaded granulomas with fibrinoid centres (2), sarcoidal granulomas (4) and elastophagocytosis (1) misled the histopathologists in these cases. CONCLUSIONS CL seems often to be misdiagnosed clinically in countries where it is not endemic. Histopathologically, CL may be misinterpreted as sarcoidosis, foreign body granuloma, lupoid rosacea and granuloma annulare, especially when Leishmania is not seen microscopically. We suggest that in Northern Europe, PCR for Leishmania-specific DNA should be performed routinely in any granulomatous dermatitis presenting as a single or few nodules on the extremities or face, even when a diagnosis of CL was not considered by the referring clinician.
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Affiliation(s)
- A Böer
- Dermatologikum Hamburg, Stephansplatz 5, 20354 Hamburg, Germany.
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Stark D, Pett S, Marriott D, Harkness J. Post-kala-azar dermal leishmaniasis due to Leishmania infantum in a human immunodeficiency virus type 1-infected patient. J Clin Microbiol 2006; 44:1178-80. [PMID: 16517925 PMCID: PMC1393159 DOI: 10.1128/jcm.44.3.1178-1180.2006] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report the first case of post-kala-azar dermal leishmaniasis due to Leishmania infantum in a human immunodeficiency virus type 1-infected patient in Australia. Molecular characterization of the isolate was performed using PCR restriction fragment length polymorphism targeting both repetitive sequences from Leishmania nuclear DNA and repetitive kinetoplast DNA minicircles for species differentiation.
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Affiliation(s)
- D Stark
- Department of Microbiology, St. Vincent's Hospital, Darlinghurst 2010 NSW, Sydney, Australia.
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Saridomichelakis MN, Mylonakis ME, Leontides LS, Billinis C, Koutinas AF, Galatos AD, Gouletsou P, Diakou A, Kontos VI. Periodic administration of allopurinol is not effective for the prevention of canine leishmaniosis (Leishmania infantum) in the endemic areas. Vet Parasitol 2005; 130:199-205. [PMID: 15905034 DOI: 10.1016/j.vetpar.2005.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2005] [Revised: 04/13/2005] [Accepted: 04/13/2005] [Indexed: 10/25/2022]
Abstract
A total of 95 clinically healthy and seronegative for Leishmania infantum dogs, residing an area highly endemic for canine leishmaniosis (CL) and living an outdoor life-style, were split into positive and negative groups, and then were randomly assigned to receive allopurinol (n=51; 20 mg/kg once daily), or placebo (n=44) for 1 week per month, from April to November. Forty per cent (38/95) of these dogs were not reexamined and retested at the end of the trial for reasons unrelated to CL. None of the remaining 57 dogs exhibited the symptomatic form of the disease at the end of the 1-year follow-up period. Of the 15 allopurinol-treated dogs that were non-infected (negative PCR and tissue smear microscopy) at the beginning of the trial, 6 (40% P=0.03) became PCR-positive, of which 3 became also seropositive, at the end of the observation period. In contrast, only 1 of 7 (14.3%) placebo-treated non-infected dogs became PCR positive at the same time point. Of the 19 allopurinol-treated dogs that were infected (PCR-positive) at the beginning of the trial, 18 (94.7%) remained PCR-positive and one (5.3%) seroconverted, at the end of the observation period. Of the 16 initially infected and placebo-treated dogs, 14 (87.5%) remained PCR positive, of which one (6.7%) also turned positive by tissue smear microscopy. Therefore, it is concluded that the use of allopurinol, at the daily dose of 20mg/kg, for 1 week per month, during the period of sandfly activity, does not prevent the infection of non-infected dogs by L. infantum, and, also, does not help in the elimination of the parasite from dogs with asymptomatic infections.
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Affiliation(s)
- Manolis N Saridomichelakis
- Clinic of Companion Animal Medicine, School of Veterinary Medicine, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., GR-54627 Thessaloniki, Greece.
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Casolari C, Guaraldi G, Pecorari M, Tamassia G, Cappi C, Fabio G, Cesinaro AM, Piolini R, Rumpianesi F, Presutti L. A rare case of localized mucosal leishmaniasis due to Leishmania infantum in an immunocompetent italian host. Eur J Epidemiol 2005; 20:559-61. [PMID: 16121766 DOI: 10.1007/s10654-005-1249-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The case of authoctonous isolated laryngeal leishmaniasis due to L. infantum in an italian immunocompetent host is reported. It is highlighed the need to consider mucosal leishmaniasis in the differential diagnosis of laryngeal tumors. Rapid nested-PCR technique and enzyme restriction analysis were useful for diagnosis and species identification directly from bioptic samples.
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Deniau M, Cañavate C, Faraut-Gambarelli F, Marty P. The biological diagnosis of leishmaniasis in HIV-infected patients. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2004; 97 Suppl 1:115-33. [PMID: 14678639 DOI: 10.1179/000349803225002598] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This review emphasises the particular difficulties encountered in confirming a suspected case of cutaneous or visceral leishmaniasis when that case is co-infected with HIV. HIV infection appears to have a more profound impact on the development of visceral leishmaniasis than on the evolution of the purely cutaneous disease. The various techniques available for immunological, parasitological and molecular diagnosis are presented and evaluated. The value of serodiagnosis for the detection of antileishmanial antibodies is in part dependent on the antigens used. Western blots may have a use not only in diagnosis but also in predicting the cases of HIV infection that are at most risk of developing symptomatic leishmaniasis. The presence of leishmanial parasites may still only be demonstrated incontrovertibly by the microscopical examination of smears or the culture of blood or biopsy samples. The use of cultures not only permits diagnosis but also detailed study of the parasites. The potential use of PCR in diagnosis is explored and related to other possible tests. A recommended, standardized procedure for the diagnosis of leishmaniasis in HIV-infected patients is presented.
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Affiliation(s)
- M Deniau
- Service de Parasitologie-Mycologie, UMR BIPAR 956, Hôpital Henri Mondor, Avenue du Général de Lattre de Tassigny, 94010 Créteil, France.
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49
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Catone G, Marino G, Poglayen G, Gramiccia M, Ludovisi A, Zanghì A. Canine transmissible venereal tumour parasitized by Leishmania infantum. Vet Res Commun 2003; 27:549-53. [PMID: 14609266 DOI: 10.1023/a:1026047725012] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- G Catone
- Dipartimento di Chirurgia, Fisiopatologia e Clinica della Riproduzione degli Animali domestici, Polo Universitario Annunziata, 98168 Messina, Italy
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50
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Nimri LF, Schallig HDFH. Application of riboprinting for the identification of isolates of cutaneous Leishmania spp. Parasitology 2003; 127:201-5. [PMID: 12964822 DOI: 10.1017/s0031182003003548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Riboprinting is one of several molecular methods that can generate comparative data independently of the complexity of the organism's morphology. Restriction fragment length polymorphism (RFLP) profiles derived from digestion of polymerase chain reaction (PCR) products of the ribosomal 18S from Leishmania spp. yields a typical 'riboprint' profile that can vary intraspecifically. A selection of 76 stocks of L. major and L. tropica, isolated from patients with cutaneous leishmaniasis, was analysed by riboprinting to assess divergence within and between species. L. major and L. tropica could be easily differentiated from each other. Analysis of PCR-RFLP profiles indicated that stocks of Leishmania spp. could be broadly partitioned into 2 species corresponding to L. major and L. tropica. To test if ribosomal 18S sequences were homogeneous within each species, several isolates of each of the Leishmania spp. were digested. Interpretation of the riboprint profiles of the 18S independently amplified by PCR, there would appear to be one restriction pattern present within cach Leishmania spp. Homogeneity within copies of the ribosomal 18S within a single genome has, therefore, been demonstrated. The species designation established by riboprinting results were in agreement with the zymodeme analysis of the same isolates. The restriction patterns produced were simple, reproducible and easy to interpret.
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Affiliation(s)
- L F Nimri
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
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