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Title: Diagnostic accuracy of real-time PCR assays targeting 16S rRNA and lipl32 genes for human leptospirosis in Thailand: A case-control study
Authors: Janjira Thaipadunpanit
Wirongrong Chierakul
Vanaporn Wuthiekanun
Direk Limmathurotsakul
Premjit Amornchai
Siriphan Boonslip
Lee D. Smythe
Roongrueng Limpaiboon
Alex R. Hoffmaster
Nicholas P.J. Day
Sharon J. Peacock
Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Queensland Health
Udon Thani Regional Hospital
National Center for Emerging and Zoonotic Infectious Diseases
Nuffield Department of Clinical Medicine
University of Cambridge
Keywords: Agricultural and Biological Sciences;Biochemistry, Genetics and Molecular Biology
Issue Date: 7-Feb-2011
Citation: PLoS ONE. Vol.6, No.1 (2011)
Abstract: Background: Rapid PCR-based tests for the diagnosis of leptospirosis can provide information that contributes towards early patient management, but these have not been adopted in Thailand. Here, we compare the diagnostic sensitivity and specificity of two real-time PCR assays targeting rrs or lipL32 for the diagnosis of leptospirosis in northeast Thailand. Methods/Principal Findings: A case-control study of 266 patients (133 cases of leptospirosis and 133 controls) was constructed to evaluate the diagnostic sensitivity and specificity (DSe & DSp) of both PCR assays. The median duration of illness prior to admission of cases was 4 days (IQR 2-5 days; range 1-12 days). DSe and DSp were determined using positive culture and/or microscopic agglutination test (MAT) as the gold standard. The DSe was higher for the rrs assay than the lipL32 assay (56%, (95% CI 47-64%) versus 43%, (95% CI 34-52%), p < 0.001). No cases were positive for the lipL32 assay alone. There was borderline evidence to suggest that the DSp of the rrs assay was lower than the lipL32 assay (90% (95% CI 83-94%) versus 93%, (95%CI 88-97%), p = 0.06). Nine controls gave positive reactions for both assays and 5 controls gave a positive reaction for the rrs assay alone. The DSe of the rrs and lipL32 assays were high in the subgroup of 39 patients who were culture positive for Leptospira spp. (95% and 87%, respectively, p = 0.25). Conclusions/Significance: Early detection of Leptospira using PCR is possible for more than half of patients presenting with leptospirosis and could contribute to individual patient care.
ISSN: 19326203
Appears in Collections:Scopus 2011-2015

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