Satow Marcela M, Yamashiro-Kanashiro Edite H, Rocha Mussya C, Oyafuso Luiza K, Soler Rita C, Cotrim Paulo C, Lindoso José Angelo L
Instituto de Medicina Tropical de São Paulo, São PauloSP, Brazil,
Rev Inst Med Trop Sao Paulo. 2013 Nov-Dec;55(6):393-9. doi: 10.1590/S0036-46652013000600004.
This 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.
本研究评估了kDNA-PCR作为巴西圣保罗州传染病参考中心埃米利奥·里巴斯传染病研究所(IIER)患者美洲皮肤利什曼病(ATL)前瞻性常规诊断方法的适用性。kDNA-PCR方法在87.5%(112/128)临床疑似ATL患者中检测到利什曼原虫DNA,而传统方法的阳性率如下:蒙氏皮肤试验为62.8%(49/78),直接检查为61.8%(47/76),体外培养为19.3%(22/114)。该分子方法能够在传统实验室方法认为阴性或不确定的样本中确诊疾病,有助于该医院ATL的最终临床诊断和治疗。因此,我们强烈建议将kDNA-PCR扩增作为ATL的替代诊断方法,提出一种新的常规算法,以帮助IIER诊断和治疗ATL。
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