Gomes Ciro M, de Paula Natália A, Cesetti Mariana V, Roselino Ana Maria, Sampaio Raimunda N R
Dermatomycology Laboratory, School of Medicine, Pós-graduação em Ciências Médicas, University of Brasília (Universidade de Brasília), Brasília, Brazil.
Laboratory of Molecular Biology, Division of Dermatology, Clinical Hospital of Ribeirão Preto, Sao Paulo, Brazil.
Diagn Microbiol Infect Dis. 2014 Aug;79(4):413-8. doi: 10.1016/j.diagmicrobio.2014.05.002. Epub 2014 May 14.
The aim of this study was to evaluate the effectiveness of polymerase chain reaction (PCR) using Kinetoplastid DNA (kDNA) from nasal swabs (NSs), saliva, and oral filter paper imprints (OFPI) in diagnosing mucocutaneous leishmaniasis (ML) and cutaneous leishmaniasis (CL). Seventeen patients with ML, 19 patients with CL, and 33 controls were evaluated. In patients with ML, PCR from NS showed an 86% diagnostic accuracy (95% confidence interval [CI] = 73.81-93.05), followed by saliva 74% (95% CI = 60.45-84.13) and OFPI 68% (95% CI = 54.19-79.24). The highest sensitivity was reached by using the NS 58.82% (95% CI = 36.01-78.39), followed by saliva 23.53% (95% CI = 9.56-47.26) and OFPI 5.88% (95% CI = 1.05-26.98). The specificities of the tests were complete. The NS and OFPI were positive in 2 cases of CL. Mucous membrane samples exhibited a higher specificity compared to the Montenegro skin test and indirect immunofluorescence. NS sensitivity was higher than that of parasitological examinations.
本研究的目的是评估利用鼻拭子（NS）、唾液和口腔滤纸印记（OFPI）中的动基体DNA（kDNA）进行聚合酶链反应（PCR）在诊断黏膜皮肤利什曼病（ML）和皮肤利什曼病（CL）中的有效性。对17例ML患者、19例CL患者和33例对照进行了评估。在ML患者中，NS的PCR诊断准确率为86%（95%置信区间[CI]=73.81 - 93.05），其次是唾液74%（95%CI = 60.45 - 84.13）和OFPI 68%（95%CI = 54.19 - 79.24）。使用NS时灵敏度最高，为58.82%（95%CI = 36.01 - 78.39），其次是唾液23.53%（95%CI = 9.56 - 47.26）和OFPI 5.88%（95%CI = 1.05 - 26.98）。这些检测的特异性均为100%。NS和OFPI在2例CL患者中呈阳性。与蒙氏皮肤试验和间接免疫荧光相比，黏膜样本表现出更高的特异性。NS的灵敏度高于寄生虫学检查。
