Journal article
The Utility of Blood Culture Fluid for the Molecular Diagnosis of Leptospira: A Prospective Evaluation
American Journal of Tropical Medicine and Hygiene, Vol.94(4), pp.736-740
2016
Abstract
Leptospirosis is an important zoonosis worldwide, with infections occurring after exposure to contaminated water. Despite being a global problem, laboratory diagnosis remains difficult with culture results taking up to 3 months, serology being retrospective by nature, and polymerase chain reaction showing limited sensitivity. Leptospira have been shown to survive and multiply in blood culture media, and we hypothesized that extracting DNA from incubated blood culture fluid (BCF), followed by quantitative real-time polymerase chain reaction (qPCR) could improve the accuracy and speed of leptospira diagnosis. We assessed this retrospectively, using preincubated BCF of Leptospira spp. positive (N = 109) and negative (N = 63) febrile patients in Vientiane, Lao PDR. The final method showed promising sensitivities of 66% (95% confidence interval [CI]: 55-76) and 59% (95% CI: 49-68) compared with direct or direct and indirect testing combined, as the respective reference standards (specificities > 95%). Despite these promising diagnostic parameters, a subsequent prospective evaluation in a Lao hospital population (N = 352) showed that the sensitivity was very low (∼30%) compared with qPCR on venous blood samples. The disappointingly low sensitivity does suggest that venous blood samples are preferable for the clinical microbiology laboratory, although BCF might be an alternative if leptospirosis is only suspected postadmission after antibiotics have been used.
Details
- Title
- The Utility of Blood Culture Fluid for the Molecular Diagnosis of Leptospira: A Prospective Evaluation
- Authors
- Sabine Dittrich (Author) - Mahosot Hospital, LaoWilliam E Rudgard (Author) - Mahosot Hospital, LaoKate L Woods (Author) - Mahosot Hospital, LaoJoy Silisouk (Author) - Mahosot Hospital, LaoWeerawat Phuklia (Author) - Mahosot Hospital, LaoViengmon Davong (Author) - Mahosot Hospital, LaoManivanh Vongsouvath (Author) - Mahosot Hospital, LaoKoukeo Phommasone (Author) - Mahosot Hospital, LaoSayaphet Rattanavong (Author) - Mahosot Hospital, LaoMichael Knappik (Author) - Mahosot Hospital, LaoScott B Craig (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringSteven L Weier (Author) - Mahosot Hospital, LaoSuhella M Tulsiani (Author) - University of Copenhagen, DenmarkDavid A B Dance (Author) - University of Oxford, United KingdomPaul N Newton (Author) - Mahosot Hospital, Lao
- Publication details
- American Journal of Tropical Medicine and Hygiene, Vol.94(4), pp.736-740
- Publisher
- American Society of Tropical Medicine and Hygiene
- Date published
- 2016
- DOI
- 10.4269/ajtmh.15-0674
- ISSN
- 0002-9637
- Copyright note
- Copyright © 2016 The American Society of Tropical Medicine and Hygiene. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Organisation Unit
- School of Science and Engineering - Legacy; University of the Sunshine Coast, Queensland
- Language
- English
- Record Identifier
- 99449284602621
- Output Type
- Journal article
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