Combined PCR and MAT improves the early diagnosis of the biphasic illness leptospirosis
The diagnosis of leptospirosis remains a challenge due to its non-specific symptoms and the biphasic nature of the illness. A comprehensive diagnosis that includes both molecular (polymerase chain reaction (PCR)) and serology is vital for early detection of leptospirosis and to avoid misdiagnosis. H...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485768/?tool=EBI |
| _version_ | 1819265219351805952 |
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| author | Noraini Philip Norliza Bahtiar Affendy Siti Norbaya Masri Muhamad Yazli Yuhana Leslie Thian Lung Than Zamberi Sekawi Vasantha Kumari Neela Kalimuthusamy Natarajaseenivasan |
| author_facet | Noraini Philip Norliza Bahtiar Affendy Siti Norbaya Masri Muhamad Yazli Yuhana Leslie Thian Lung Than Zamberi Sekawi Vasantha Kumari Neela Kalimuthusamy Natarajaseenivasan |
| author_sort | Noraini Philip |
| collection | DOAJ |
| description | The diagnosis of leptospirosis remains a challenge due to its non-specific symptoms and the biphasic nature of the illness. A comprehensive diagnosis that includes both molecular (polymerase chain reaction (PCR)) and serology is vital for early detection of leptospirosis and to avoid misdiagnosis. However, not all samples could be subjected to both tests (serology and molecular) due to budget limitation, infrastructure, and technical expertise at least in resource-limited countries. We evaluated the usefulness of testing the clinically suspected leptospirosis cases with both techniques on all samples collected from the patients on the day of admission. Among the 165 patient’s blood/serum samples tested (from three hospitals in Central Malaysia), 43 (26%) showed positivity by microscopic agglutination test (MAT), 63 (38%) by PCR, while 14 (8%) were positive by both MAT and PCR. For PCR, we tested two molecular targets (lipL32 by qPCR and 16S rDNA or rrs by nested PCR) and detected lipL32 in 47 (29%) and rrs gene in 63 (38%) patients. The use of more than one target gene for PCR increased the detection rates. Hence, a highly sensitive multiplex PCR targeting more than one diagnostic marker is recommended for the early detection of Leptospira in suspected patients. When the frequencies for positivity detected either by MAT or PCR combined, leptospirosis was diagnosed in a total of 92 (56%) patients, a higher frequency compared to when samples were only tested by a single method (MAT or PCR). The results from this study suggest the inclusion of both serology and molecular methods for every first sample irrespective of the days post-onset of symptoms (DPO) collected from patients for early diagnosis of leptospirosis. |
| first_indexed | 2024-12-23T20:41:54Z |
| format | Article |
| id | doaj.art-097a0d2c0dee4dc497d4c1543291fc5b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-23T20:41:54Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-097a0d2c0dee4dc497d4c1543291fc5b2022-12-21T17:31:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01159Combined PCR and MAT improves the early diagnosis of the biphasic illness leptospirosisNoraini PhilipNorliza Bahtiar AffendySiti Norbaya MasriMuhamad Yazli YuhanaLeslie Thian Lung ThanZamberi SekawiVasantha Kumari NeelaKalimuthusamy NatarajaseenivasanThe diagnosis of leptospirosis remains a challenge due to its non-specific symptoms and the biphasic nature of the illness. A comprehensive diagnosis that includes both molecular (polymerase chain reaction (PCR)) and serology is vital for early detection of leptospirosis and to avoid misdiagnosis. However, not all samples could be subjected to both tests (serology and molecular) due to budget limitation, infrastructure, and technical expertise at least in resource-limited countries. We evaluated the usefulness of testing the clinically suspected leptospirosis cases with both techniques on all samples collected from the patients on the day of admission. Among the 165 patient’s blood/serum samples tested (from three hospitals in Central Malaysia), 43 (26%) showed positivity by microscopic agglutination test (MAT), 63 (38%) by PCR, while 14 (8%) were positive by both MAT and PCR. For PCR, we tested two molecular targets (lipL32 by qPCR and 16S rDNA or rrs by nested PCR) and detected lipL32 in 47 (29%) and rrs gene in 63 (38%) patients. The use of more than one target gene for PCR increased the detection rates. Hence, a highly sensitive multiplex PCR targeting more than one diagnostic marker is recommended for the early detection of Leptospira in suspected patients. When the frequencies for positivity detected either by MAT or PCR combined, leptospirosis was diagnosed in a total of 92 (56%) patients, a higher frequency compared to when samples were only tested by a single method (MAT or PCR). The results from this study suggest the inclusion of both serology and molecular methods for every first sample irrespective of the days post-onset of symptoms (DPO) collected from patients for early diagnosis of leptospirosis.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485768/?tool=EBI |
| spellingShingle | Noraini Philip Norliza Bahtiar Affendy Siti Norbaya Masri Muhamad Yazli Yuhana Leslie Thian Lung Than Zamberi Sekawi Vasantha Kumari Neela Kalimuthusamy Natarajaseenivasan Combined PCR and MAT improves the early diagnosis of the biphasic illness leptospirosis PLoS ONE |
| title | Combined PCR and MAT improves the early diagnosis of the biphasic illness leptospirosis |
| title_full | Combined PCR and MAT improves the early diagnosis of the biphasic illness leptospirosis |
| title_fullStr | Combined PCR and MAT improves the early diagnosis of the biphasic illness leptospirosis |
| title_full_unstemmed | Combined PCR and MAT improves the early diagnosis of the biphasic illness leptospirosis |
| title_short | Combined PCR and MAT improves the early diagnosis of the biphasic illness leptospirosis |
| title_sort | combined pcr and mat improves the early diagnosis of the biphasic illness leptospirosis |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485768/?tool=EBI |
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