Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, United States of America.
Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia, Brazil.
PLoS Negl Trop Dis. 2018 Apr 6;12(4):e0006415. doi: 10.1371/journal.pntd.0006415. eCollection 2018 Apr.
Leptospirosis is an important zoonotic disease that causes considerable morbidity and mortality globally, primarily in residents of urban slums. While contact with contaminated water plays a critical role in the transmission of leptospirosis, little is known about the distribution and abundance of pathogenic Leptospira spp. in soil and the potential contribution of this source to human infection.
METHODS/PRINCIPAL FINDINGS: We collected soil samples (n = 70) from three sites within an urban slum community endemic for leptospirosis in Salvador, Brazil. Using qPCR of Leptospira genes lipl32 and 16S rRNA, we quantified the pathogenic Leptospira load in each soil sample. lipl32 qPCR detected pathogenic Leptospira in 22 (31%) of 70 samples, though the median concentration among positive samples was low (median = 6 GEq/g; range: 4-4.31×102 GEq/g). We also observed heterogeneity in the distribution of pathogenic Leptospira at the fine spatial scale. However, when using 16S rRNA qPCR, we detected a higher proportion of Leptospira-positive samples (86%) and higher bacterial concentrations (median: 4.16×102 GEq/g; range: 4-2.58×104 GEq/g). Sequencing of the qPCR amplicons and qPCR analysis with all type Leptospira species revealed that the 16S rRNA qPCR detected not only pathogenic Leptospira but also intermediate species, although both methods excluded saprophytic Leptospira. No significant associations were identified between the presence of pathogenic Leptospira DNA and environmental characteristics (vegetation, rat activity, distance to an open sewer or a house, or soil clay content), though samples with higher soil moisture content showed higher prevalences.
CONCLUSION/SIGNIFICANCE: This is the first study to successfully quantify the burden of pathogenic Leptospira in soil from an endemic region. Our results support the hypothesis that soil may be an under-recognized environmental reservoir contributing to transmission of pathogenic Leptospira in urban slums. Consequently, the role of soil should be considered when planning interventions aimed to reduce the burden of leptospirosis in these communities.
钩端螺旋体病是一种重要的人畜共患疾病,在全球范围内造成了相当高的发病率和死亡率,主要发生在城市贫民窟的居民中。虽然接触受污染的水在钩端螺旋体病的传播中起着关键作用,但人们对土壤中致病性钩端螺旋体的分布和丰度知之甚少,也不清楚这种来源对人类感染的潜在贡献。
方法/主要发现:我们从巴西萨尔瓦多一个流行钩端螺旋体病的城市贫民窟的三个地点采集了土壤样本(n=70)。使用钩端螺旋体基因 lipl32 和 16S rRNA 的 qPCR,我们定量了每个土壤样本中的致病性钩端螺旋体负荷。lipl32 qPCR 在 70 个样本中的 22 个(31%)样本中检测到致病性钩端螺旋体,但阳性样本中的中位数浓度较低(中位数=6 GEq/g;范围:4-4.31×102 GEq/g)。我们还观察到在精细的空间尺度上,致病性钩端螺旋体的分布存在异质性。然而,当使用 16S rRNA qPCR 时,我们检测到更高比例的钩端螺旋体阳性样本(86%)和更高的细菌浓度(中位数:4.16×102 GEq/g;范围:4-2.58×104 GEq/g)。qPCR 扩增子的测序和所有类型钩端螺旋体的 qPCR 分析表明,16S rRNA qPCR 不仅检测到致病性钩端螺旋体,还检测到中间物种,尽管这两种方法都排除了腐生钩端螺旋体。虽然土壤湿度较高的样本显示出更高的流行率,但我们未发现致病性钩端螺旋体 DNA 的存在与环境特征(植被、老鼠活动、距开放污水管或房屋的距离或土壤粘含量)之间存在显著关联。
结论/意义:这是第一项成功定量流行地区土壤中致病性钩端螺旋体负担的研究。我们的研究结果支持以下假设,即土壤可能是一个被低估的环境储库,有助于城市贫民窟中致病性钩端螺旋体的传播。因此,在规划旨在减少这些社区中钩端螺旋体病负担的干预措施时,应考虑土壤的作用。