Avaliação do teste ELISA-lgM no diagnóstico precoce da leptospirose humana

SummaryThe aim of this study was to compare the sensitivity and specificity of polymerase chain reaction (PCR) using two primer pairs and combined with blood culture, immunoglobulin M enzyme-linked immunosorbent assay (IgM ELISA), microscopic agglutination test (MAT) and slide agglutination test (SAT) in the diagnosis of human leptospirosis. We analysed 124 serum samples: 60 from patients with confirmed leptospirosis, 20 from patients with other diseases and 44 from healthy individuals. Analysing the first serum sample collected during the first 3-8 days of disease, the sensitivities of the four tests MAT, IgM ELISA, SAT and PCR were, respectively, 69.0%, 79.3%, 72.4% and 62%. In subsequent samples, those same sensitivities were, respectively, 95.4%, 100%, 100% and 72.7% in samples collected from days 9 to 14 and 88.9%, 88.9%, 77.8% and 44.4% in those collected from days 15 to 42. The most specific method (at 100%) was PCR and the least specific (at 89.1%) was IgM ELISA. Although we found PCR to be less sensitive than the serological tests over the course of the disease, our data indicate that PCR was the most sensitive in those initial serum samples presenting no specific antibodies detectable by any of the serological methods tested. We also recommend that PCR can be used in combination with serological tests as we found that this improves the sensitivity of the diagnosis of leptospirosis in the first phase of the disease (93.1-96.5%).

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“…As described previously (Camargo et al. 1992), the antigen utilized in IgM ELISA was prepared according to the method described by Adler et al.…”

Section: Methodsmentioning

confidence: 99%

Polymerase chain reaction in comparison with serological tests for early diagnosis of human leptospirosis

Fonseca

Freitas

Romero

et al. 2006

Tropical Med Int Health

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“…Immunoglobulin C (IgC) and IgM enzymelinked immunosorbent assay (ELISA) tests have shown excellent results, which are, at least, similar to those of microagglutination, 14,20,29 with the advantage of being a much simpler technique that may be performed at laboratories not specialized in Leptospira. The IgM ELISA reaction is positive from the fifth day onward, and virtually defines the diagnosis when symptoms are compatible.…”

Section: Laboratory Diagnosismentioning

confidence: 98%

“…The pathogenesis of lung lesions is the same as that of the other hemorrhagic manifestations of the disease. At autopsy, the lungs may show only scattered petechiae and ecchymoses throughout the parenchyma and pleural surface, 28 but in some cases more extensive areas of hemorrhage and edema may occur [28][29][30] ( Figs. 2A, B).…”

Section: Pathogenesis and Pathologymentioning

confidence: 99%

Leptospirosis

Bethlem¹,

Lemle²,

Pereira³

1991

Semin Respir Crit Care Med

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“…Additionally, it is very difficult to analyze the false positives and false negatives with this method of diagnosis (41). However, microscopy can be coupled with silver stains such as warthin starry stain or immunostaining with specific antibodies but it is not advantageous in early infections (42,43).…”

Section: Microscopymentioning

confidence: 99%

Recent advances in the diagnosis of leptospirosis

et al. 2020

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their benefit over the traditional standard diagnosis kits in terms of cost, sensitivity, specificity and time. LEPTOSPIRA: THE CAUSATIVE ORGANISMLeptospira is the genus belonging to the order spirochetes, family leptospiracea with the body diameter and length of 0.1 µm and 6-20 µm respectively is comprised of several pathogenic and saprophytic species ( 9). The genus is characterized by the morphological features such as flexibility, spirally shaped (distinctive hooked ends) and the presence of two periplasmic polar inserted internal flagella for motility (10). The cell wall of the bacteria is composed of lipopolysaccharide (LPS) which is homologous to other gram-negative bacteria. The data about heritability of leptospirosis is not still clear but in leptospira the variation in the structural lipopolysaccharide (sugar composition and orientation) is associated with identification of over 200 serovars of the leptospira. Leptospires are classified clinically and genotypically. Clinically, leptospires are classified into pathogenic (parasitic and infectious) and non-pathogenic strains (Saprophytic and non-infectious), whereas genotypic classification relates to the different species based on the phenotypic relationship. Overall, non-pathogenic strains are known to occur in free-living state including L.

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Avaliação do teste ELISA-lgM no diagnóstico precoce da leptospirose humana

Cited by 6 publications

References 3 publications

Polymerase chain reaction in comparison with serological tests for early diagnosis of human leptospirosis

Polymerase chain reaction in comparison with serological tests for early diagnosis of human leptospirosis

Leptospirosis

Recent advances in the diagnosis of leptospirosis

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