Experimental Aspects: Diagnostics and Therapeutics. The contribution of a multiple PCR assay for the diagnosis of American Tegumentary Leishmaniasis and the rapid identification of Leishmania species involved

MARCO, JORGE DIEGO; MIMORI, TATSUYUKI; BARROSO, PAOLA ANDREA; KORENAGA, MASATAKA; TOMOTANI, AYAKO; CALVOPIÑA, MANUEL; MORA, MARÍA CELIA; CAJAL, SILVANA PAMELA; NASSER, JULIO; TANIGUCHI, TAKETOSHI; BASOMBRÍO, MIGUEL ANGEL; HASHIGUCHI, YOSHIHISA

Studies on New and Old World Leishmaniasis and their transmission, with particular reference to Ecuador, Peru, Argentina and Pakistan

Kyowa Printing & Co. Ltd.

Lugar: Kochi, Japan; Año: 2007; p. 96 - 103

The performance of a modified polymorphism-specific-PCR (MPS-PCR) in the diagnosis of American tegumentary leishmaniasis (ATL) and direct Leishmania species identification was tested. This technique was done on boiled dermal scraping specimens taken from lesions of 63 patients with suspected ATL in Salta, Argentina. Forty-four of them were previously diagnosed as “ATL cases” and 19 as “no ATL cases” based on the combination of smear specimens, leishmanin skin test, and their clinical records. The sensitivities of MPS-PCR, smear and the MPS-PCR – smears together were 81 %, 70.5 % and 97.6 % (P < 0.05) and their specificities were 84.2 %, 100 % (defined) and 83.3 % respectively (P > 0.05). From nine patients with mucocutaneous leishmaniasis (MCL), eight were detected by MPS-PCR, but only two of them by the smears (p < 0.05). Out of 31 species-identified cases in this study, 28 were L. (V.) braziliensis (90.3 %); the remaining two, L. (V.) guyanensis (6.5 %), and one showed L. (V.) panamensis (3.2 %). The clinical forms associated with L. (V.) braziliensis revealed MCL, single (SCL), multiple (MultCL), and disseminated cutaneous leishmaniasis; L. (V.) guyanensis, MultCL; and L. (V.) panamensis, SCL. The MPS-PCR significantly improved the quality of the diagnosis of ATL, especially in MCL cases (the most sever clinical form of ATL), using non-invasive sampling methods. Besides, it also allowed the rapid Leishmania spp. identification in 70.5 % of the ATL cases. Thus, other techniques are required to confirm the L. (V.) panamensis, since this species was not reported previously in the country.