DETECTION OF LEPTOSPIRES IN URINE BY PCR FOR EARLY DIAGNOSIS OF LEPTOSPIROSIS
DETECTION OF LEPTOSPIRES IN URINE BY PCR FOR EARLY DIAGNOSIS OF LEPTOSPIROSIS
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DOI：
10.1128/jcm.32.8.1894-1898.1994
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发表时间：
1994-08-01
影响因子：
9.4
通讯作者：
TERPSTRA, WJ
中科院分区：
文献类型：
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作者：
BAL, AE;GRAVEKAMP, C;TERPSTRA, WJ
我们测试了患者的尿液样本，在当前钩端螺旋体病的不同阶段，并在此之后，以确定是否使用PCR检测尿液中的钩端螺旋体可以是一个有价值的替代培养。DNA提取和随后的PCR应用于15个新鲜排尿样本的程序被证明是两倍的敏感性培养。总的来说，我们能够在大约90%（29个中的26个）的尿液样本中检测到钩端螺旋体。尿液和血清样本，从七个病人，前八天的疾病。虽然一般认为钩端螺旋体尿症大约在患病的第二周开始，但我们能够在所有这些早期尿液样本中检测到钩端螺旋体。7份血清标本中仅2份PCR检测结果为阳性，提示尿液PCR检测对钩体病的早期诊断比血清PCR检测更有效。6名在患病时接受抗生素治疗的患者的尿液样本经PCR检测呈阳性，这意味着尽管接受了治疗，患者的尿液中仍有钩端螺旋体脱落。其中一些样本甚至是在感染数年后采集的，这表明尿液中钩端螺旋体的脱落可能比通常假设的持续时间长得多。我们的结论是，检测尿液中的钩端螺旋体与PCR是一个有前途的方法，钩端螺旋体病的早期诊断，也可能是有用的，在研究长期脱落。
We tested urine samples from patients at different stages of current leptospirosis and thereafter to determine whether use of the PCR for detection of leptospires in urine can be a valuable alternative to culturing. The procedure of DNA extraction and subsequent PCR applied to 15 freshly voided urine samples proved to be twice as sensitive as culturing. Overall, we were able to detect leptospires in approximately 90% (26 of 29) of the urine samples. Urine and serum samples were obtained from seven patients, before the eighth day of illness. Although it is generally assumed that leptospiruria starts approximately in the second week of illness, we were able to detect leptospires in all of these early urine samples. In contrast, only two of seven corresponding serum samples gave positive PCR results, which suggests that PCR analysis of urine can be more successful for early diagnosis of leptospirosis than PCR analysis of serum. Urine samples from six patients who had been treated with antibiotics at the time of illness were positive by PCR, implying that the patients were still shedding leptospires in their urine despite treatment. Some of these samples were even taken years after the infection, indicating that shedding of leptospires in urine may last much longer than is generally assumed. We conclude that detection of leptospires in urine with PCR is a promising approach for early diagnosis of leptospirosis and may also be useful in studying long-term shedding.