Laboratoire de Recherche 05SP03, Laboratoire de Parasitologie, Institut Pasteur de Tunis, Tunis, Tunisia.
Am J Trop Med Hyg. 2010 Nov;83(5):1034-9. doi: 10.4269/ajtmh.2010.10-0234.
Species-specific diagnosis was performed in 66 patients with cutaneous leishmaniasis (CL) living in Tataouine focus in southeastern Tunisia. Leishmania DNA was extracted directly from dermal scrapings (n = 66) and from parasites obtained in culture (n = 12). Species were identified by using polymerase chain reaction-restriction fragment length polymorphism analysis for internal transcribed spacer region 1 and isoenzyme analysis. Leishmania tropica and L. major were identified in 31 (47%) and 35 (53%) cases respectively. Leishmania tropica CL cases were geographically scattered, and L. major CL cases were clustered. Lesions caused by L. tropica were mostly single (83.8%) and face-localized (55.8%), and lesions caused by L. major were multiple (57.1%; P < 0.001) and situated on limbs (83.7%; P < 0.001). For both species, most lesion onsets were reported during June-January. However, lesions that emerged during February-May were mainly caused by L. tropica (83.3%; P < 0.01). Moreover, the delay before seeking medical advice was higher for L. tropica infections than for L. major infections (P < 0.05).
在突尼斯东南部的 Tataouine 流行区，对 66 例皮肤利什曼病（CL）患者进行了种特异性诊断。从皮肤刮屑（n = 66）和培养中获得的寄生虫（n = 12）中直接提取利什曼原虫 DNA。通过聚合酶链反应-限制性片段长度多态性分析内部转录间隔区 1 和同工酶分析来鉴定物种。分别在 31 例（47%）和 35 例（53%）病例中鉴定出利什曼热带和利什曼原虫。利什曼热带 CL 病例在地理上分散，而利什曼原虫 CL 病例聚集。利什曼热带引起的病变大多为单发（83.8%）和面部定位（55.8%），而利什曼原虫引起的病变为多发（57.1%；P <0.001）和位于四肢（83.7%；P <0.001）。对于这两种物种，大多数病变发作报告在 6 月至 1 月期间。然而，在 2 月至 5 月期间出现的病变主要由利什曼热带引起（83.3%；P <0.01）。此外，与利什曼原虫感染相比，利什曼热带感染寻求医疗咨询的延迟更高（P <0.05）。
