Reithinger Richard, Espinoza Juan Canales, Courtenay Orin, Davies Clive R
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom.
J Clin Microbiol. 2003 Apr;41(4):1486-93. doi: 10.1128/JCM.41.4.1486-1493.2003.
Several studies have suggested that the PCR could be used in epidemiological mass-screening surveys to detect Leishmania (Viannia) spp. infection in human and animal hosts. Dogs from an area of Leishmania braziliensis and Leishmania peruviana endemicity were screened for American cutaneous leishmaniasis (ACL) infection by established PCR-based and enzyme-linked immunosorbent antibody test (ELISA) protocols. PCR detected Leishmania (Viannia) infection in a total of 90 of 1,066 (8.4%) dogs: 32 of 368 (8.7%), 65 of 769 (8.5%), and 7 of 42 (16.7%) dogs were PCR positive by testing of whole blood, buffy coat, and bone marrow aspirates, respectively. ELISA detected infection in 221 of 1,059 (20.9%) tested dogs. The high prevalence of Leishmania (Viannia) detected by PCR and ELISA in both asymptomatic (7.5 and 19.2%, respectively) and symptomatic (32 and 62.5%, respectively) dogs is further circumstantial evidence for their suspected role as reservoir hosts of ACL. However, the low sensitivity of PCR (31%) compared to ELISA (81%) indicates that PCR cannot be used for mass screening of samples in ACL epidemiological studies. Unless more-sensitive PCR protocols were to be developed, its use should be restricted to the diagnosis of active (canine and human) cases and to the parasitological monitoring of patients after chemotherapy.
多项研究表明,聚合酶链反应(PCR)可用于流行病学大规模筛查调查,以检测人和动物宿主中的利什曼原虫(维扬亚属)感染。采用既定的基于PCR和酶联免疫吸附抗体检测(ELISA)方案,对来自巴西利什曼原虫和秘鲁利什曼原虫流行地区的犬只进行美洲皮肤利什曼病(ACL)感染筛查。PCR检测了1066只犬中的90只(8.4%)感染利什曼原虫(维扬亚属):分别通过检测全血、血沉棕黄层和骨髓穿刺液,368只犬中有32只(8.7%)、769只犬中有65只(8.5%)、42只犬中有7只(16.7%)PCR呈阳性。ELISA检测了1059只受试犬中的221只(20.9%)感染。PCR和ELISA在无症状犬(分别为7.5%和19.2%)和有症状犬(分别为32%和62.5%)中检测到的利什曼原虫(维扬亚属)高流行率,进一步间接证明了它们作为ACL储存宿主的可疑作用。然而,与ELISA(81%)相比,PCR的低灵敏度(31%)表明,PCR不能用于ACL流行病学研究中的样本大规模筛查。除非开发出更灵敏的PCR方案,否则其应用应限于诊断活动性(犬类和人类)病例以及化疗后患者的寄生虫学监测。