Chargui N, Bastien P, Kallel K, Haouas N, Akrout F Messaidi, Masmoudi A, Zili J, Chaker E, Othman A Dhahri Ben, Azaiez R, Crobu L, Mezhoud H, Babba H
Laboratoire de Parasitologie--Mycologie, 99-UR/08-05, Faculté de Pharmacie de Monastir, Tunisia.
Trans R Soc Trop Med Hyg. 2005 Oct;99(10):762-8. doi: 10.1016/j.trstmh.2005.06.002.
We assessed the efficiency of a PCR method in establishing the diagnosis of cutaneous leishmaniasis (CL) in Tunisian patients. Four hundred and thirty specimens collected passively from patients with cutaneous ulcers suggestive of leishmaniasis attending health centres for diagnosis were included in the study. Dermal scrapings were analysed both by parasitological (examination of Giemsa-stained smears and in vitro cultivation) methods and by a genus-specific PCR detecting a fragment of the 18S rRNA gene. Microscopy revealed amastigotes in 245 samples (57.0%) and in vitro cultivation gave positive results in 88 cases (20.5%), whereas PCR detected Leishmania in 301 samples (70%). The sensitivities inferred from our results were 99.3%, 80.8% and 29% for PCR, microscopic examination and in vitro cultivation, respectively. The different forms of CL in this country are caused by three species of Leishmania and are treated with the same protocol. Of 303 well-documented cases in our study, 99% were probably caused by Leishmania major and 1% by Leishmania infantum. The lack of species-specific diagnosis is not known to affect treatment or prognosis in Tunisia. These data support the incorporation of PCR into diagnostic strategies for CL, particularly in Tunisia.
我们评估了一种聚合酶链反应（PCR）方法在确诊突尼斯皮肤利什曼病（CL）患者中的效率。本研究纳入了从前往健康中心进行诊断、患有疑似利什曼病皮肤溃疡的患者中被动收集的430份样本。对皮肤刮片分别采用寄生虫学方法（吉姆萨染色涂片检查和体外培养）以及检测18S核糖体RNA（rRNA）基因片段的属特异性PCR进行分析。显微镜检查在245份样本（57.0%）中发现了无鞭毛体，体外培养在88例（20.5%）中得到阳性结果，而PCR在301份样本（70%）中检测到利什曼原虫。根据我们的结果推断，PCR、显微镜检查和体外培养的敏感性分别为99.3%、80.8%和29%。该国不同形式的CL由三种利什曼原虫引起，且采用相同的治疗方案。在我们研究的303例记录完整的病例中，99%可能由硕大利什曼原虫引起，1%由婴儿利什曼原虫引起。在突尼斯，尚不清楚缺乏种特异性诊断是否会影响治疗或预后。这些数据支持将PCR纳入CL的诊断策略中，尤其是在突尼斯。
