分子方法在塞尔维亚归国旅行者输入性疟疾诊断中的临床意义

Clinical significance of molecular methods in the diagnosis of imported malaria in returning travelers in Serbia.

作者信息

Dakić Zorica, Ivović Vladimir, Pavlović Milorad, Lavadinović Lidija, Marković Marija, Djurković-Djaković Olgica

机构信息

Department of Microbiology, Clinical Center of Serbia, Belgrade, Serbia.

Center for Parasitic Zoonoses, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.

出版信息

Int J Infect Dis. 2014 Dec;29:24-30. doi: 10.1016/j.ijid.2014.08.013. Epub 2014 Oct 12.

DOI:10.1016/j.ijid.2014.08.013

PMID:25312981

Abstract

OBJECTIVES

The goal of this study was to assess the clinical significance of conventional and PCR-based molecular diagnosis in patients with imported malaria in Serbia.

METHODS

Giemsa microscopy, the rapid diagnostic test, and quantitative real-time PCR (qPCR) were used to detect Plasmodium species in 109 whole-blood samples from patients after their return from malaria endemic areas, including those clinically suspected for malaria (n=97) and healthy travelers (n=12) examined as part of epidemiological surveillance.

RESULTS

A total of 45 patients were diagnosed with malaria: 42 (93.3%) by microscopy and three (6.7%) additional ones by qPCR. The agreement between the results of species-specific qPCR and microscopy was 73.3%; it was as high as 90.6% for Plasmodium falciparum infections. Follow-up analysis demonstrated persistence of Plasmodium sp DNA for a mean 6 days after the disappearance of parasitemia on microscopy.

CONCLUSIONS

Due to its sensitivity and specificity, qPCR is a helpful method complementary to microscopy, particularly in cases of low parasitemia. In addition, it is superior to microscopy for species identification.

摘要