Molecular typing of Leishmania infantum isolates from a leishmaniasis outbreak in Madrid, Spain, 2009 to 2012

Abstract

Leishmaniasis is endemic in southwest Europe. Recent data point to the spread and (re-)emergence of this disease in previously endemic and non-endemic European countries. A recent example is the urban community outbreak of cutaneous and visceral leishmaniasis in the southwest of Madrid autonomous community, Spain, which began on 1 July 2009. A total of 446 cases associated to this outbreak were reported up to 31 December 2012. We show molecular typing data for 73 Leishmania infantum isolates obtained from January 2008 to July 2012 from different areas of Madrid, including those affected by the outbreak. Seven different genotypes were identified by combining data from two targets: the ribosomal internal transcribed spacers (ITS)-1 and-2 and the haspb (k26) gene. The results contribute to a better understanding of the parasite population circulating in the region, and indicate that most of the outbreak-associated isolates (22/31) were infected by parasites with the same combined genotype. Additional data from 82 L. infantum isolates typed as either MON-1 or MON-24 by isoenzyme analysis indicate that far from concluding that the outbreak was caused by a 'new' emerging genotype, further molecular typing-based surveillance studies are required to better understand the epidemiology of leishmaniasis in the region.

Atypical presentation in adults in the largest community outbreak of leishmaniasis in Europe (Fuenlabrada, Spain)

“…The epidemiologic features and control measures of this outbreak have been reported by Arce et al [10]. As peculiarities of the outbreak, a genotype of L. infantum was found (genotype L-920 or L-962, ITS LOMBARDI) [11], and a new reservoir, the hare, was identified [12]. Despite reaching a peak incidence in 2011, the outbreak as of this writing in 2014 remains active.…”

Visceral Leishmaniasis and HIV Coinfection in the Mediterranean Region

“…Currently, leishmaniasis is spreading northwards in endemic regions, outbreaks are occurring in endemic areas, and foci of the disease are appearing in previously nonendemic European countries [96], [97]. Thus, awareness about leishmaniasis should be increased among health professionals [98].…”

Species Typing in Dermal Leishmaniasis

“…We have optimized PCRs for sensitivity and specificity, which makes the target applicable in various settings (66, 67, 191, 194-196, 201, 202). On top of this, several leading labs have developed supplementary hsp70 assays (9,197,200). Confining oneself to one target allows an appreciation of what it can and-at least as importantly-cannot do.…”

“…Fraga et al (191) studied Leishmania evolution based on hsp70. Because many studies have illustrated the value of the heat shock protein 70 gene for species discrimination, it has been used by various researchers (9,22,64,192,193).…”

“…Strategies include histone 2B RFLP analysis (184); sequencing and RFLP analysis of N-acetylglucosamine-1-phosphate transferase (181,224); PCR and RFLP analysis of hydrophilic acylated surface protein B, also known as K26 (9,225); glycosomal glyceraldehyde 3-phosphate dehydrogenase sequencing (24); meta2 RFLP analysis (226); chitinase sequencing (27); sequence analysis of DNA and RNA polymerase genes (227); pteridine reductase 1 sequencing (228); ␤-tubulin analysis (229); heat shock protein 20 sequencing (230); and sequence analysis of a calmodulin intergenic spacer (231).…”