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Comparison of Leishmania typing results obtained from 16 European clinical laboratories in 2014
- Gert Van der Auwera1 , Aldert Bart2 , Carmen Chicharro3 , Sofia Cortes4 , Leigh Davidsson5 , Trentina Di Muccio6 , Jean-Claude Dujardin1,7 , Ingrid Felger8,9 , Maria Grazia Paglia10 , Felix Grimm11 , Gundel Harms12 , Charles L. Jaffe13 , Monika Manser14 , Christophe Ravel15 , Florence Robert-Gangneux16 , Jeroen Roelfsema17 , Seray Töz18 , Jaco J. Verweij19 , Peter L. Chiodini20,21
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View Affiliations Hide AffiliationsAffiliations: 1 Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium 2 Academic Medical Center, Amsterdam, The Netherlands 3 Instituto de Salud Carlos III, Madrid, Spain 4 Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, UNL, Lisbon, Portugal 5 The Public Health Agency of Sweden, Stockholm, Sweden 6 Istituto Superiore di Sanità, Rome, Italy 7 Biomedical Sciences, Antwerp University, Antwerp, Belgium 8 Swiss Tropical and Public Health Institute, Basel, Switzerland 9 University of Basel, Basel, Switzerland 10 National Institute for Infectious Diseases (INMI) Lazzaro Spallanzani, Rome, Italy 11 Institute of Parasitology, University of Zürich, Zürich, Switzerland 12 Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany 13 Hebrew University, Hadassah Medical Centre, Jerusalem, Israel 14 United Kingdom National External Quality Assessment Service, London, United Kingdom 15 University of Montpellier, Montpellier, France 16 Centre Hospitalier Universitaire de Rennes, Rennes, France 17 National Institute for Public Health and the Environment, RIVM, Bilthoven, The Netherlands 18 Ege University, Faculty of Medicine, Department of Parasitology, Izmir, Turkey 19 St. Elisabeth Hospital, Tilburg, The Netherlands 20 Hospital for Tropical Diseases, London, United Kingdom 21 London School of Hygiene and Tropical Medicine, London, United KingdomGert Van der Auweragvdauwera itg.be
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Citation style for this article: Van der Auwera Gert, Bart Aldert, Chicharro Carmen, Cortes Sofia, Davidsson Leigh, Di Muccio Trentina, Dujardin Jean-Claude, Felger Ingrid, Paglia Maria Grazia, Grimm Felix, Harms Gundel, Jaffe Charles L., Manser Monika, Ravel Christophe, Robert-Gangneux Florence, Roelfsema Jeroen, Töz Seray, Verweij Jaco J., Chiodini Peter L.. Comparison of Leishmania typing results obtained from 16 European clinical laboratories in 2014. Euro Surveill. 2016;21(49):pii=30418. https://doi.org/10.2807/1560-7917.ES.2016.21.49.30418 Received: 08 Jan 2016; Accepted: 13 Jul 2016
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 Leishmania 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 Leishmania 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 Leishmania 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.
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