Ciurariu Elena, Prodan-Barbulescu Catalin, Mateescu Diana-Maria, Tutac Paul, Sorop Virgiliu-Bogdan, Susan Monica, Varga Norberth-Istvan
Department of Functional Sciences, Physiology, Centre of Immuno-Physiology and Biotechnologies (CIFBIOTEH), "Victor Babeş" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania.
Department I-Discipline of Anatomy and Embryology, Faculty of Medicine, "Victor Babeş" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania.
Microorganisms. 2025 Mar 15;13(3):667. doi: 10.3390/microorganisms13030667.
Leptospirosis is a zoonotic disease with a varied clinical presentation that can mimic other infectious diseases, posing diagnostic challenges. While the Microscopic Agglutination Test (MAT) remains the gold standard for serological diagnosis, its limitations have led to increasing interest in polymerase chain reaction (PCR) as a rapid and sensitive diagnostic tool. This systematic review evaluates the role and clinical applications of PCR for diagnosing human leptospirosis. We analyzed the sensitivity and specificity of PCR, compared its performance with other diagnostic tests, and assessed the comparative utility of blood and urine samples for PCR testing. Our findings demonstrate that PCR has a high sensitivity and specificity, particularly in the early stages of the disease. Combining PCR with serological tests like MAT can maximize the diagnostic accuracy across different stages of illness. We recommend that PCR be considered a first-line diagnostic test for suspected leptospirosis, especially when rapid diagnosis is crucial. Further research is needed to standardize PCR protocols and explore its potential in differentiating species and serotypes. By leveraging the strengths of PCR and combining it with other diagnostic methods, we can significantly improve the diagnosis and management of leptospirosis.
钩端螺旋体病是一种人畜共患病，临床表现多样，可类似其他传染病，给诊断带来挑战。虽然显微镜凝集试验（MAT）仍是血清学诊断的金标准，但其局限性使得人们对聚合酶链反应（PCR）作为一种快速且灵敏的诊断工具越来越感兴趣。本系统评价评估了PCR在诊断人类钩端螺旋体病中的作用及临床应用。我们分析了PCR的敏感性和特异性，将其性能与其他诊断试验进行比较，并评估了血液和尿液样本用于PCR检测的相对效用。我们的研究结果表明，PCR具有高敏感性和特异性，尤其是在疾病早期。将PCR与MAT等血清学试验相结合可在疾病的不同阶段最大限度地提高诊断准确性。我们建议将PCR视为疑似钩端螺旋体病的一线诊断试验，尤其是在快速诊断至关重要时。需要进一步研究以规范PCR方案，并探索其在区分菌种和血清型方面的潜力。通过利用PCR的优势并将其与其他诊断方法相结合，我们可以显著改善钩端螺旋体病的诊断和管理。
