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Am. J. Trop. Med. Hyg., 77(4), 2007, pp. 636-639
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Use of kDNA-based Polymerase Chain Reaction as a Sensitive and Differentially Diagnostic Method of American Tegumentary Leishmaniasis in Disease-Endemic Areas of Northern Argentina

Alejandra Barrio*, María C. Mora, Federico Ramos, Sonia Moreno, Ruth Samson, AND Miguel A. Basombrío
Instituto de Patología Experimental, Facultad de Ciencias de la Salud, Universidad Nacional de Salta, Salta, Argentina; Hospital del Milagro, Servicio de Dermatología, Salta, Argentina

 

ABSTRACT

We evaluated the polymerase chain reaction (PCR) for the diagnosis of endemic American Tegumentary Leishmaniasis in Salta, Argentina. Diverse Leishmania species, coexistence of mycotic and varicose ulcers, and high endemicity T. cruzi, represent diagnostic challenges in the region. We performed a simplified PCR using sensitive, generic primers on samples obtained by a non-invasive method. We tested different culture types and clinical specimens with other microorganisms that induce leishmaniasis-like lesions. The PCR had a sensitivity and specificity of 100%. Forty-five patients with presumptive leishmaniasis were compared to the PCR, smears, and the Montenegro skin test (MST). In the same population, the PCR had an increased sensitivity, detecting 25 of 45 cases compared with 16 of 45 for smears and had a higher sensitivity in detecting mucocutaneous lesions. Diagnosis by PCR was supported by clinical presentation, positive MST results, compatible epidemiology, and in some cases histopathologic results or isolation of parasites by culture. These findings indicate the convenience of incorporating this PCR into diagnostic strategies for detecting leishmaniasis in northern Argentina.

Received December 1, 2006. Accepted for publication June 20, 2007.

Acknowledgments: We thank Dr. Nestor Taranto and Pamela Cajal for providing positive control samples, and Drs. Paola Zago, Alejandra Falú, and Marta Urzagasti for their support during the clinical phase of the study.

Financial support: This study was supported by the Roemmers Foundation and Consejo de Investigación, Universidad Nacional de Salta, Argentina. Miguel A. Basombrío is an International Research Scholar of the Howard Hughes Medical Institute. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.

* Address correspondence to Alejandra Barrio, Avenida del Golf 159, B° Tres Cerritos, 4400, Salta, Argentina. E-mails: barrioa{at}unsa.edu.ar and aleba05{at}yahoo.com.ar

Authors’ addresses: Alejandra Barrio, María C. Mora, Federico Ramos, and Miguel A. Basombrío, Instituto de Patología Experimental, Universidad Nacional de Salta, Avda. Bolivia 5150, 4400, Salta Argentina, Telephone: 54-38-7425-5333. Sonia Moreno and Ruth Samson, Hospital del Milagro, Servicio de Dermatología, Avda. Sarmiento 557, 4400, Salta Argentina, Telephone and Fax: 54-38-7431-7400.

Reprint requests: Alejandra Barrio, Avenida del Golf 159, B° Tres Cerritos, 4400, Salta, Argentina, E-mails: barrioa{at}unsa.edu.ar and aleba05{at}yahoo.com.ar.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.