1887
Research article Open Access
Like 0

Abstract

Leishmaniasis is endemic in southern Europe, and in other European countries cases are diagnosed in travellers who have visited affected areas both within the continent and beyond. Prompt and accurate diagnosis poses a challenge in clinical practice in Europe. Different methods exist for identification of the infecting species. Sixteen clinical laboratories in 10 European countries, plus Israel and Turkey, conducted a study to assess their genotyping performance. DNA from 21 promastigote cultures of 13 species was analysed blindly by the routinely used typing method. Five different molecular targets were used, which were analysed with PCR-based methods. Different levels of identification were achieved, and either the subgenus, species complex, or actual species were reported. The overall error rate of strains placed in the wrong complex or species was 8.5%. Various reasons for incorrect typing were identified. The study shows there is considerable room for improvement and standardisation of typing. The use of well validated standard operating procedures is recommended, covering testing, interpretation, and reporting guidelines. Application of the internal transcribed spacer 1 of the rDNA array should be restricted to Old World samples, while the heat-shock protein 70 gene and the mini-exon can be applied globally.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2016.21.49.30418
2016-12-08
2024-03-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.49.30418
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/21/49/eurosurv-21-30418-2.html?itemId=/content/10.2807/1560-7917.ES.2016.21.49.30418&mimeType=html&fmt=ahah

References

  1. Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, et al. , WHO Leishmaniasis Control Team. Leishmaniasis worldwide and global estimates of its incidence. PLoS One. 2012;7(5):e35671.  https://doi.org/10.1371/journal.pone.0035671  PMID: 22693548 
  2. World Health Organization. Control of the leishmaniasis: report of a meeting of the WHO Expert Committee on the Control of Leishmaniases, Geneva, 22-26 March 2010. Geneva, Switzerland: World Health Organization; 2010.
  3. Boelaert M, Sundar S. Leishmaniasis. In: Farrar J, Hotez P, Junghanss T, Kang G, Lalloo D, White N, eds. Manson's Tropical Diseases. 23 ed. Philadelphia: Elsevier Saunders, 2013. p. 631-51.
  4. Blum J, Buffet P, Visser L, Harms G, Bailey MS, Caumes E, et al. LeishMan recommendations for treatment of cutaneous and mucosal leishmaniasis in travelers, 2014. J Travel Med. 2014;21(2):116-29.  https://doi.org/10.1111/jtm.12089  PMID: 24745041 
  5. Blum J, Lockwood DN, Visser L, Harms G, Bailey MS, Caumes E, et al. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis. Int Health. 2012;4(3):153-63.  https://doi.org/10.1016/j.inhe.2012.06.004  PMID: 24029394 
  6. Bailey MS, Green AD, Ellis CJ, O’Dempsey TJ, Beeching NJ, Lockwood DN, et al. Clinical guidelines for the management of cutaneous leishmaniasis in British military personnel. J R Army Med Corps. 2005;151(2):73-80.  https://doi.org/10.1136/jramc-151-02-03  PMID: 16097110 
  7. Lawn SD, Whetham J, Chiodini PL, Kanagalingam J, Watson J, Behrens RH, et al. New world mucosal and cutaneous leishmaniasis: an emerging health problem among British travellers. QJM. 2004;97(12):781-8.  https://doi.org/10.1093/qjmed/hch127  PMID: 15569809 
  8. Akhoundi M, Kuhls K, Cannet A, Votýpka J, Marty P, Delaunay P, et al. A historical overview of the classification, evolution, and dispersion of Leishmania parasites and sandflies. PLoS Negl Trop Dis. 2016;10(3):e0004349.  https://doi.org/10.1371/journal.pntd.0004349  PMID: 26937644 
  9. Van der Auwera G, Dujardin JC. Species typing in dermal leishmaniasis. Clin Microbiol Rev. 2015;28(2):265-94.  https://doi.org/10.1128/CMR.00104-14  PMID: 25672782 
  10. Rioux JA, Lanotte G, Serres E, Pratlong F, Bastien P, Perieres J. Taxonomy of Leishmania. Use of isoenzymes. Suggestions for a new classification. Ann Parasitol Hum Comp. 1990;65(3):111-25.  https://doi.org/10.1051/parasite/1990653111  PMID: 2080829 
  11. El Baidouri F, Diancourt L, Berry V, Chevenet F, Pratlong F, Marty P, et al. Genetic structure and evolution of the Leishmania genus in Africa and Eurasia: what does MLSA tell us. PLoS Negl Trop Dis. 2013;7(6):e2255.  https://doi.org/10.1371/journal.pntd.0002255  PMID: 23785530 
  12. Odiwuor S, Veland N, Maes I, Arévalo J, Dujardin JC, Van der Auwera G. Evolution of the Leishmania braziliensis species complex from amplified fragment length polymorphisms, and clinical implications. Infect Genet Evol. 2012;12(8):1994-2002.  https://doi.org/10.1016/j.meegid.2012.03.028  PMID: 22516226 
  13. Schönian G, Nasereddin A, Dinse N, Schweynoch C, Schallig HD, Presber W, et al. PCR diagnosis and characterization of Leishmania in local and imported clinical samples. Diagn Microbiol Infect Dis. 2003;47(1):349-58.  https://doi.org/10.1016/S0732-8893(03)00093-2  PMID: 12967749 
  14. Mauricio IL, Stothard JR, Miles MA. Leishmania donovani complex: genotyping with the ribosomal internal transcribed spacer and the mini-exon. Parasitology. 2004;128(Pt 3):263-7.  https://doi.org/10.1017/S0031182003004578  PMID: 15074875 
  15. Van der Auwera G, Ravel C, Verweij JJ, Bart A, Schönian G, Felger I. Evaluation of four single-locus markers for Leishmania species discrimination by sequencing. J Clin Microbiol. 2014;52(4):1098-104.  https://doi.org/10.1128/JCM.02936-13  PMID: 24452158 
  16. Van der Auwera G, Maes I, De Doncker S, Ravel C, Cnops L, Van Esbroeck M, et al. Heat-shock protein 70 gene sequencing for Leishmania species typing in European tropical infectious disease clinics. Euro Surveill. 2013;18(30):20543.  https://doi.org/10.2807/1560-7917.ES2013.18.30.20543  PMID: 23929181 
  17. Montalvo AM, Fraga J, Maes I, Dujardin JC, Van der Auwera G. Three new sensitive and specific heat-shock protein 70 PCRs for global Leishmania species identification. Eur J Clin Microbiol Infect Dis. 2012;31(7):1453-61.  https://doi.org/10.1007/s10096-011-1463-z  PMID: 22083340 
  18. Fraga J, Montalvo AM, Maes L, Dujardin JC, Van der Auwera G. HindII and SduI digests of heat-shock protein 70 PCR for Leishmania typing. Diagn Microbiol Infect Dis. 2013;77(3):245-7.  https://doi.org/10.1016/j.diagmicrobio.2013.07.023  PMID: 24050933 
  19. Marfurt J, Nasereddin A, Niederwieser I, Jaffe CL, Beck HP, Felger I. Identification and differentiation of Leishmania species in clinical samples by PCR amplification of the miniexon sequence and subsequent restriction fragment length polymorphism analysis. J Clin Microbiol. 2003;41(7):3147-53.  https://doi.org/10.1128/JCM.41.7.3147-3153.2003  PMID: 12843055 
  20. Roelfsema JH, Nozari N, Herremans T, Kortbeek LM, Pinelli E. Evaluation and improvement of two PCR targets in molecular typing of clinical samples of Leishmania patients. Exp Parasitol. 2011;127(1):36-41.  https://doi.org/10.1016/j.exppara.2010.06.024  PMID: 20599989 
  21. Marfurt J, Niederwieser I, Makia ND, Beck HP, Felger I. Diagnostic genotyping of Old and New World Leishmania species by PCR-RFLP. Diagn Microbiol Infect Dis. 2003;46(2):115-24.  https://doi.org/10.1016/S0732-8893(03)00040-3  PMID: 12812715 
  22. Bart A, van Thiel PP, de Vries HJ, Hodiamont CJ, Van Gool T. Imported leishmaniasis in the Netherlands from 2005 to 2012: epidemiology, diagnostic techniques and sequence-based species typing from 195 patients. Euro Surveill. 2013;18(30):20544.  https://doi.org/10.2807/1560-7917.ES2013.18.30.20544  PMID: 23929178 
  23. Cortes S, Rolão N, Ramada J, Campino L. PCR as a rapid and sensitive tool in the diagnosis of human and canine leishmaniasis using Leishmania donovani s.l.-specific kinetoplastid primers. Trans R Soc Trop Med Hyg. 2004;98(1):12-7.  https://doi.org/10.1016/S0035-9203(03)00002-6  PMID: 14702834 
  24. de Bruijn MH, Barker DC. Diagnosis of New World leishmaniasis: specific detection of species of the Leishmania braziliensis complex by amplification of kinetoplast DNA. Acta Trop. 1992;52(1):45-58.  https://doi.org/10.1016/0001-706X(92)90006-J  PMID: 1359760 
  25. Noyes HA, Reyburn H, Bailey JW, Smith D. A nested-PCR-based schizodeme method for identifying Leishmania kinetoplast minicircle classes directly from clinical samples and its application to the study of the epidemiology of Leishmania tropica in Pakistan. J Clin Microbiol. 1998;36(10):2877-81. PMID: 9738037 
  26. Minodier P, Piarroux R, Gambarelli F, Joblet C, Dumon H. Rapid identification of causative species in patients with Old World leishmaniasis. J Clin Microbiol. 1997;35(10):2551-5. PMID: 9316906 
  27. Schönian G, Mauricio I, Cupolillo E. Is it time to revise the nomenclature of Leishmania? Trends Parasitol. 2010;26(10):466-9.  https://doi.org/10.1016/j.pt.2010.06.013  PMID: 20609626 
  28. Tamura K, Peterson D, Peterson N, Stecher G, Nei M, Kumar S. MEGA5: molecular evolutionary genetics analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Mol Biol Evol. 2011;28(10):2731-9.  https://doi.org/10.1093/molbev/msr121  PMID: 21546353 
  29. Institute of Tropical Medicine (ITG). Leishmania Typing Results, 2014. Table S1. Antwerp: ITG. [Accessed 29 Nov 2016]. Available from: www.itg.be/leishmaniatyping
  30. Zhang CY, Lu XJ, Du XQ, Jian J, Shu L, Ma Y. Phylogenetic and evolutionary analysis of Chinese Leishmania isolates based on multilocus sequence typing. PLoS One. 2013;8(4):e63124.  https://doi.org/10.1371/journal.pone.0063124  PMID: 23646184 
  31. Piarroux R, Fontes M, Perasso R, Gambarelli F, Joblet C, Dumon H, et al. Phylogenetic relationships between Old World Leishmania strains revealed by analysis of a repetitive DNA sequence. Mol Biochem Parasitol. 1995;73(1-2):249-52.  https://doi.org/10.1016/0166-6851(95)00097-K  PMID: 8577334 
  32. Desbois N, Pratlong F, Quist D, Dedet JP. Leishmania (Leishmania) martiniquensis n. sp. (Kinetoplastida: Trypanosomatidae), description of the parasite responsible for cutaneous leishmaniasis in Martinique Island (French West Indies). Parasite. 2014;21:12.  https://doi.org/10.1051/parasite/2014011  PMID: 24626346 
  33. Shaw J, Pratlong F, Floeter-Winter L, Ishikawa E, El Baidouri F, Ravel C, et al. Characterization of Leishmania (Leishmania) waltoni n.sp. (Kinetoplastida: Trypanosomatidae), the Parasite Responsible for Diffuse Cutaneous Leishmaniasis in the Dominican Republic. Am J Trop Med Hyg. 2015;93(3):552-8.  https://doi.org/10.4269/ajtmh.14-0774  PMID: 26149864 
/content/10.2807/1560-7917.ES.2016.21.49.30418
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error