Manisa Celal Bayar Üniversitesi Tıp Fakültesi, Tıbbi Parazitoloji Anabilim Dalı, Manisa, Türkiye
Manisa Celal Bayar Üniversitesi Tıp Fakültesi, Dermatoloji Anabilim Dalı, Manisa, Türkiye
Turkiye Parazitol Derg. 2022 Sep 12;46(3):249-252. doi: 10.4274/tpd.galenos.2022.27247.
Laboratory diagnosis of leishmaniasis is based on culture, microscopic examination, serological and molecular methods. The gold standard method is to see amastigotes in microscopic examination and to grow promastigotes in Novy, MacNeal, Nicolle (NNN) medium. NNN medium is frequently used for culture all over the world. In our study, it was aimed to investigate whether the use of RPMI-1640 medium is an appropriate method in cases where the gold standard NNN medium is not available for the diagnosis of cutaneous leishmaniasis (CL). Smears were prepared from the needle aspiration fluid sample from the patient who applied to Manisa Celal Bayar University Faculty of Medicine and had lesions suspicious of CL, and were stained with Giemsa for the presence of amastigotes. The samples taken were directly inoculated into RPMI-1640 broth and incubated at 26 °C for the presence of promastigotes. On consecutive days after incubation, it was checked for promastigote growth. Genotyping of the grown isolate was performed with primers and probes specific to the internal transcribed spacer-1 (ITS-1) gene region with the help of real-time polymerase chain reaction. The amastigote form was observed in the microscopic examination of the needle aspiration fluid sample smear preparations taken from the patient. On the other hand, promastigote growth was observed in RPMI-1640 broth from the 3rd day. In addition, the isolate obtained from the CL patient was determined to be Leishmania tropica as a result of the species determination made by genotyping. It is thought that this study is important in terms of suggesting an alternative medium for the diagnosis of leishmaniasis in laboratories where the gold standard NNN medium is easily accessible. RPMI-1640 medium, which is easily obtained and prepared in parasitology laboratories, can help in the diagnosis of the disease and treatment follow-up, Leishmania spp. isolation and drug resistance studies.
利什曼病的实验室诊断基于培养、显微镜检查、血清学和分子方法。金标准方法是在显微镜下观察无鞭毛体并在 Novy、MacNeal、Nicolle (NNN) 培养基中培养前鞭毛体。NNN 培养基在世界各地广泛用于培养。在我们的研究中,旨在研究在无法获得金标准 NNN 培养基的情况下,使用 RPMI-1640 培养基是否是诊断皮肤利什曼病 (CL) 的合适方法。从向马尼亚 Celal Bayar 大学医学院就诊且疑似 CL 病变的患者的针吸液样本中制备涂片,并使用吉姆萨染色检查有无无鞭毛体。直接将采集的样本接种到 RPMI-1640 肉汤中,并在 26°C 孵育以检测前鞭毛体。孵育后连续每天检查前鞭毛体生长情况。使用针对内部转录间隔区-1 (ITS-1) 基因区域的引物和探针,借助实时聚合酶链反应对生长的分离株进行基因分型。从患者的针吸液样本涂片制备物的显微镜检查中观察到无鞭毛体形式。另一方面,从第 3 天开始在 RPMI-1640 肉汤中观察到前鞭毛体生长。此外,通过基因分型确定从 CL 患者获得的分离株为热带利什曼原虫。该研究在建议在容易获得金标准 NNN 培养基的实验室中诊断利什曼病的替代培养基方面具有重要意义。RPMI-1640 培养基易于在寄生虫学实验室获得和制备,可有助于疾病诊断和治疗随访、利什曼原虫的分离和耐药性研究。
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