Brown P D, Gravekamp C, Carrington D G, van de Kemp H, Hartskeerl R A, Edwards C N, Everard C O, Terpstra W J, Levett P N
University of the West Indies, Faculty of Medical Sciences, Barbados.
J Med Microbiol. 1995 Aug;43(2):110-4. doi: 10.1099/00222615-43-2-110.
Early diagnosis of leptospirosis is important because severe leptospiral infection can run a fulminant course. The polymerase chain reaction (PCR) was evaluated for the detection of leptospires in clinical samples from patients with acute leptospiral infection. Blood and urine samples from 71 patients with leptospirosis were examined by PCR, culture or serology. Samples from 44 (62%) patients with the diagnosis of leptospirosis were positive by PCR as compared to 34 (48%) by culture. The presence of leptospires was demonstrated by PCR in 13 patients before the development of antibodies, as well as in two patients who were seronegative during their illness and at autopsy. Samples from 16 patients without leptospirosis were seronegative and culture negative, and also negative by PCR. We conclude that PCR is a rapid, sensitive and specific means of diagnosing leptospiral infection, especially during the first few days of the disease.
钩端螺旋体病的早期诊断很重要，因为严重的钩端螺旋体感染可能呈暴发性病程。对聚合酶链反应（PCR）检测急性钩端螺旋体感染患者临床样本中钩端螺旋体的情况进行了评估。采用PCR、培养或血清学方法检测了71例钩端螺旋体病患者的血液和尿液样本。诊断为钩端螺旋体病的44例（62%）患者样本经PCR检测呈阳性，相比之下，培养法检测阳性的有34例（48%）。在13例患者出现抗体之前，PCR检测到了钩端螺旋体的存在，另外在2例患者患病期间及尸检时血清学检测呈阴性的情况下，PCR也检测到了钩端螺旋体。16例非钩端螺旋体病患者的样本血清学检测呈阴性、培养结果为阴性，PCR检测也为阴性。我们得出结论，PCR是诊断钩端螺旋体感染的一种快速、灵敏且特异的方法，尤其是在疾病的最初几天。
