The Comparison of Kinetoplastid DNA PCR and Parasitological Methods in the Diagnosis of Cutaneous Leishmaniasis Using Clinical Samples of Suspected Patients in Turkey
Makaleler > Tam Makale · 2018
Yazarlar: F. Yildiz Zeyrek, Seray TÖZ, F. Yuksel, Nevin TURGAY AKÇİÇEK, Yusuf ÖZBEL
International Journal of Infectious Diseases, Uluslararası, Wos, 2018, cilt 73, ss 317-317
DOI: 10.1016/j.ijid.2018.04.4135
Özet
Background: Visceral (VL) and cutaneous (CL) leishmaniasis are seen in Turkey endemically and CL caused by Leishmania tropica is an important public health problem in southeastern as well as other regions of Turkey. The diagnosis has been usually made by clinical view of lesion and/or parasitological using lesion aspiration smears. Histological examination does not, however, always reveal the parasite in the skin biopsy, particularly in chronic lesions. Besides this, due to CL infections caused by different species in endemic areas, diagnostic methods enabling species identification are in great need. Species identification, in the time of diagnosis, is an important procedure for helping the clinicians in the planning of treatment as well as control measures. Polymerase chain reaction (PCR) is a specific and sensitive diagnostic tool that can also identify the parasite at species level. Kinetoplastid DNA (kDNA) is one of the genetic regions that can be used for the detection of Leishmania parasites in clinical specimens. Since long time, kDNA PCR is reported as one of the most sensitive method related to species-specific variable regions in mini-circle. It has been considered as one of the ideal targets for the diagnosis of leishmaniasis. Methods & Materials: The aim of the study was to perform polymerase chain reaction (PCR) assay targeting kinetoplastid DNA (kDNA) by primers of Uni21/Lmj4 using clinical samples and compare the results with parasitological methods, smear and culture, for the diagnosis of CL. Results: The kDNA PCR, parasite culture and microscopical evaluation of stained smears on 62 specimens from suspected CL cases who referred to Cutaneous Leishmaniasis Diagnosis and Treatment Center in Şanlıurfa, Turkey were included in the study. The kDNA PCR showed the highest sensitivity among all diagnostic assays, diagnosing 35/35 (100%) of the samples, followed by the microscopy (25/35 positive, 71.4% sensitivity) and then culture (19/35 positive, 54.3% sensitivity). Culture and microscopy together improved overall sensitivity to 88.6% (31/35). Conclusion: These results suggest performing kDNA PCR besides conventional techniques is important for sensitive diagnosis of CL in species level and also important for establishing treatment regimes and designing appropriate measures in highly endemic area, Southeastern Region of Turkey.