在内脏利什曼病患者接触者的无症状个体外周血中检测杜氏利什曼原虫。
Detection of Leishmania donovani in peripheral blood of asymptomatic individuals in contact with patients with visceral leishmaniasis.
作者信息
Banu Sultana S, Meyer Wieland, Ahmed Be-Nazir, Kim Rady, Lee Rogan
机构信息
Parasitology Department, Centre for Infectious Diseases and Microbiology Laboratory Services (CIDMLS), ICPMR, Westmead Hospital, NSW, Australia Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Marie Bashir Institute, Westmead Institute for Medical Research, NSW, Australia Discipline of Medicine, Sydney Medical School, University of Sydney, NSW, Australia Communicable Disease Control Unit, Directorate General of Health Services, Mohakhali, Dhaka, Bangladesh.
Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Marie Bashir Institute, Westmead Institute for Medical Research, NSW, Australia Discipline of Medicine, Sydney Medical School, University of Sydney, NSW, Australia.
出版信息
Trans R Soc Trop Med Hyg. 2016 May;110(5):286-93. doi: 10.1093/trstmh/trw027.
BACKGROUND
The majority of individuals infected with Leishmania donovani complex remain asymptomatic. They may act as transmission reservoirs for visceral leishmaniasis (VL). We investigated sero-prevalence of L. donovani complex amongst those closely associated with patients with VL and whether these sero-reactive individuals had Leishmania parasites in their peripheral blood. Other risk factors were also investigated.
METHODS
A total of 257 individuals in contact with patients with VL were tested for anti-Leishmania antibodies by rK39 immunochromatographic test (rK39 ICT), ELISA using promastigote antigen (p-ELISA) and indirect fluorescent antibody test (IFAT). Buffy coats of rK39 ICT positive individuals were cultured; sero-reactive buffy coats were tested for Leishmania DNA by ITS1 PCR. DNA obtained from culture was sequenced to confirm Leishmania species. Risk factors were evaluated for each sero-positive sample.
RESULTS
The results showed 29.2% (75/257) prevalence by serological tests: 14.4% (37/257) were positive by rK39 ICT, 25.3% (65/257) by p-ELISA, 18.3% (47/257) by IFAT and 10.9% (28/257) by all three serological methods. Ten percent (3/30) of cultures were positive for Leishmania promastigotes. Only 3% (2/74) sero-reactive buffy coats were positive for DNA; sequence analysis revealed L. donovani species. Significant risk factors were age, working as farmers, domestic animals in household and proximity to animal shelters.
CONCLUSIONS
Asymptomatic family members of patients with VL can carry live L. donovani in peripheral blood and may act as potential reservoirs.
GENBANK ACCESSION NUMBER
BankIt1863680 Leishmania KT921417 (DNA sequences of the ribosomal ITS1 region of L. donovani).
背景
大多数感染杜氏利什曼原虫复合体的个体无症状。他们可能成为内脏利什曼病（VL）的传播储存宿主。我们调查了与VL患者密切接触者中杜氏利什曼原虫复合体的血清流行率，以及这些血清反应阳性个体的外周血中是否存在利什曼原虫寄生虫。还调查了其他风险因素。
方法
对总共257名与VL患者有接触的个体进行检测，采用rK39免疫层析试验（rK39 ICT）、使用前鞭毛体抗原的酶联免疫吸附测定（p-ELISA）和间接荧光抗体试验（IFAT）检测抗利什曼原虫抗体。对rK39 ICT阳性个体的血沉棕黄层进行培养；对血清反应阳性的血沉棕黄层进行ITS1聚合酶链反应检测利什曼原虫DNA。对从培养物中获得的DNA进行测序以确认利什曼原虫种类。对每个血清阳性样本评估风险因素。
结果
血清学检测结果显示患病率为29.2%（75/257）：rK39 ICT阳性率为14.4%（37/257），p-ELISA阳性率为25.3%（65/257），IFAT阳性率为18.3%（47/257），三种血清学方法均阳性率为10.9%（28/257）。10%（3/30）的培养物利什曼原虫前鞭毛体呈阳性。仅3%（2/74）血清反应阳性的血沉棕黄层DNA呈阳性；序列分析显示为杜氏利什曼原虫。显著的风险因素为年龄、从事农民工作、家中饲养家畜以及靠近动物庇护所。
结论
VL患者的无症状家庭成员外周血中可携带活的杜氏利什曼原虫，可能作为潜在的储存宿主。
基因库登录号
BankIt1863680利什曼原虫KT921417（杜氏利什曼原虫核糖体ITS1区域的DNA序列）
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