Rodríguez OY, Rodríguez GI, Zamora MY, Rodríguez SJE, Valdés LY, Echevarria PE, Obregón FAM, Verdasquera CD, Fernández MC

Language: Spanish
References: 26
Page: 211-222
PDF size: 161.85 Kb.

ABSTRACT

Introduction: leptospirosis is an important re-emerging zoonosis worldwide, with an associated mortality ranging 15-25 %. Post-mortem diagnosis of the disease is painstaking. Different molecular methods for diagnosis of leptospirosis have been implemented. In Cuba, the National Reference Laboratory for Letospires of "Pedro Kourí" Institute of Tropical Medicine (LNRL-IPK) performs laboratory diagnosis of fatal cases suspected of leptospirosis.
Objective: to diagnose leptospirosis in fresh tissue samples from dead people by using a molecular method.
Methods: of 50 deceased individuals- 3 in 2008, 7 in 2009, 15 in 2010 and 25 of 2011- from different Cuban regions, 171 samples of fresh tissues of different organs were studied. A singleplex polymerase chain reaction that amplifies lipl32 gene fragment was used. Additionally, a serological diagnosis of leptospirosis was performed in 9 cases.
Results: the laboratory confirmed 32 % of cases as positive (16/50). Of these, 2 (66.7 %) in 2008, 2 (28.6 %) in 2009, 1 (6.7 %) in 2010 and 11 (44 %) in 2011. The positivity rate of the different sample was 25 % in the lung (12/48), 25.6 % in the liver (11/43), 22.5 % in the kidneys (9/40), 6.3 % in the brain (1/16), 7.1 % in the heart (1/14), 12.5 % in the spleen (1/8) and 50 % in the muscles (1/2). Of the nine cases that underwent serology, three were positive by PCR and negative by serological testing, whereas one case was found positive in the serology but negative in the PCR. The overall agreement coefficient between serology and PCR was 55.5 % (5/9).
Conclusions: polymerase chain reaction, as a molecular tool for diagnosis of leptospirosis at the LNRL-IPK, has allowed making post-mortem confirmation of that disease in Cuba. It is recommended to continue shipping serum samples from fatal cases to the LNRL-IPK for confirmation, which will allow a better interpretation of the results by using serology.

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