APPLICABILITY OF kDNA-PCR FOR ROUTINE DIAGNOSIS OF AMERICAN TEGUMENTARY LEISHMANIASIS IN A TERTIARY REFERENCE HOSPITAL

Abstract

SUMMARYThis study evaluated the applicability of kDNA-PCR as a prospective routine diagnosis method for American tegumentary leishmaniasis (ATL) in patients from the Instituto de Infectologia Emílio Ribas (IIER), a reference center for infectious diseases in São Paulo - SP, Brazil. The kDNA-PCR method detected Leishmania DNA in 87.5% (112/128) of the clinically suspected ATL patients, while the traditional methods demonstrated the following percentages of positivity: 62.8% (49/78) for the Montenegro skin test, 61.8% (47/76) for direct investigation, and 19.3% (22/114) for in vitro culture. The molecular method was able to confirm the disease in samples considered negative or inconclusive by traditional laboratory methods, contributing to the final clinical diagnosis and therapy of ATL in this hospital. Thus, we strongly recommend the inclusion of kDNA-PCR amplification as an alternative diagnostic method for ATL, suggesting a new algorithm routine to be followed to help the diagnosis and treatment of ATL in IIER.

Efficacy and Safety of Liposomal Amphotericin B for the Treatment of Mucosal Leishmaniasis from the New World: A Retrospective Study

“…21 The side effects include liver failure, pancreatitis, constitutional symptoms, and abnormal electrocardiographic findings (T wave inversion; QTc interval prolonged), which can affect 10-30% of individuals treated. [21][22][23][24] These effects limit the use of antimonials in patients with previous comorbidities and advanced age. Amphotericin B deoxycholate, liposomal amphotericin, azole drugs, miltefosine, and pentamidine are recommended as a second-line therapeutic option and in cases of therapeutic failure with antimonials, according to the Pan American Health Organization guidelines.…”

Identification of Species Causing Cutaneous Leishmaniasis by PCR in Chahbahar, Iran

“…The parasite's kDNA and circular DNA were good targets for molecular diagnostic studies and identification of the species due to having thousands of variable and conserved copies. On the other hand, this region has many taxonomic applications due to its high number of copies and repetitive sequences in the parasite genome (20). Similar to some studies, the present study used kDNA (present in a unique organelle called kinetoplast) that is both specific and highly sensitive for diagnosis.…”

Molecular Detection of Suspected Leishmania Isolates Using Polymerase Chain Reaction

“…The later L5.8SR/ LITSV targeting ribosomal internal transcribed spacer 2 separating the genes coding for 5.8S rRNA and large subunit rRNA gene. [17,18], genomic DNA, splice leader mini-exon [19], telomeric repeats [20], rRNA gene [21] and gp63 [22].…”