Rapid Detection of Amoebic Liver Abscess Using Recombinase Polymerase Amplification Assay in Resource-Limited Settings

Priya Datta Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

Search for other papers by Priya Datta in
Current site
Google Scholar
PubMed
Close
,
Divya Rattan Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

Search for other papers by Divya Rattan in
Current site
Google Scholar
PubMed
Close
,
Navneet Sharma Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

Search for other papers by Navneet Sharma in
Current site
Google Scholar
PubMed
Close
,
Naveen Kalra Department of Radio-Diagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

Search for other papers by Naveen Kalra in
Current site
Google Scholar
PubMed
Close
,
Ajay Duseja Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Search for other papers by Ajay Duseja in
Current site
Google Scholar
PubMed
Close
, and
Sumeeta Khurana Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;

Search for other papers by Sumeeta Khurana in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

Amoebic liver abscess (ALA) is a significant public health concern in tropical countries. Traditional diagnostic methods, such as microscopy, have low sensitivity, and nested polymerase chain reaction (nPCR) has lengthy turnaround times. In this study, we aimed to evaluate the effectiveness of the recombinase polymerase amplification (RPA) assay for detecting Entamoeba histolytica in amoebic liver pus samples. The assay was tested on 150 clinical pus samples collected from suspected ALA patients in the emergency department of a tertiary care center located in Chandigarh, northern India. For comparison with RPA, nPCR was also performed on these samples. Of 150 samples, 79 (53%) tested positive for E. histolytica using the RPA assay, and similar (79; 53%) number of samples tested positive with nested PCR. In addition, sequences obtained through Sanger sequencing showed high similarity with other sequences in the National Center for Biotechnology Information database and were submitted to the database. Our findings highlight the potential of RPA as a valuable tool for the accurate diagnosis of ALA.

    • Supplemental Materials (PDF 254.75 KB)

Author Notes

Authors’ contributions: P. Datta: conceptualization, validation, resources, writing—review and editing, supervision, funding acquisition. D. Rattan: data curation, writing—original draft preparation, investigation, formal analysis, software. N. Sharma: conceptualization, patient enrollment, writing—review and editing. N. Kalra: provision of pus sample, data analysis, results validation. A. Duseja: patient enrollment, writing—review and editing, supervision. S. Khurana: data analysis, writing—review and editing, supervision.

Current contact information: Priya Datta, Divya Rattan, and Sumeeta Khurana, Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India, E-mails: drpriyadatta@hotmail.com, divyarattan59@gmail.com, and sumeetakhurana@hotmail.com. Navneet Sharma, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India, E-mail: navneetsharma@hotmail.com. Naveen Kalra, Department of Radio-Diagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India, E-mail: navkal2004@yahoo.com. Ajay Duseja, Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India, E-mail: ajayduseja@yahoo.co.in.

Address correspondence to Priya Datta, Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. E-mail: drpriyadatta@hotmail.com
  • 1.

    Jackson-Akers JY, Prakash V, Oliver TI, 2023. Amebic Liver Abscess. Treasure Island, FL: StatPearls Publishing.

  • 2.

    Tharmaratnam T, et al., 2020. Entamoeba histolytica and amoebic liver abscess in northern Sri Lanka: A public health problem. Trop Med Health 48: 2.

  • 3.

    Kumar R, Patel R, Priyadarshi RN, Narayan R, Maji T, Anand U, Soni JR, 2024. Amebic liver abscess: An update. World J Hepatol 16: 316.

  • 4.

    Weitzel T, Cabrera J, Rosas R, Noriega LM, Schiappacasse G, Vollrath V, Porte L, 2017. Enteric multiplex PCR panels: A new diagnostic tool for amoebic liver abscess? New Microbes New Infect 18: 50–53.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Baltrušis P, Höglund J, 2023. Digital PCR: Modern solution to parasite diagnostics and population trait genetics. Parasit Vectors 16: 143.

  • 6.

    Lobato IM, O’Sullivan CK, 2018. Recombinase polymerase amplification: Basics, applications and recent advances. Trends Analyt Chem 98: 19–35.

  • 7.

    Tan M, Liao C, Liang L, Yi X, Zhou Z, Wei G, 2022. Recent advances in recombinase polymerase amplification: Principle, advantages, disadvantages and applications. Front Cell Infect Microbiol 12: 1019071.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Lv R, Lu N, Wang J, Li Y, Qi Y, 2022. Recombinase Polymerase Amplification for Rapid Detection of Zoonotic Pathogens: An Overview. Available at: https://www.scienceopen.com/hosted-document?doi=10.15212/ZOONOSES-2022-0002. Accessed March 3, 2024.

    • PubMed
    • Export Citation
  • 9.

    Clark CG, Diamond LS, 2002. Methods for cultivation of luminal parasitic protists of clinical importance. Clin Microbiol Rev 15: 329–341.

  • 10.

    Khairnar K, Parija SC, 2008. Detection of Entamoeba histolytica DNA in the saliva of amoebic liver abscess patients who received prior treatment with metronidazole. J Health Popul Nutr 26: 418.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Nair G, Rebolledo M, White AC Jr., Crannell Z, Richards-Kortum RR, Pinilla AE, Ramírez JD, López MC, Castellanos-Gonzalez A, 2015. Detection of Entamoeba histolytica by recombinase polymerase amplification. Am J Trop Med Hyg 93: 591.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Philips SA, Manochitra K, Padukone S, Parija SC, 2018. Detection of Entamoeba Species: A comparative analysis of nested-multiplex PCR and recombinase polymerase amplification. Int J Curr Microbiol Appl Sci 7: 1803–1808.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Khairnar K, Parija SC, Palaniappan R, 2007. Diagnosis of intestinal amoebiasis by using nested polymerase chain reaction-restriction fragment length polymorphism assay. J Gastroenterol 42: 631–640.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Gadsby NJ, McHugh MP, Russell CD, Mark H, Morris AC, Laurenson IF, Hill AT, Templeton KE, 2015. Development of two real-time multiplex PCR assays for the detection and quantification of eight key bacterial pathogens in lower respiratory tract infections. Clin Microbiol Infect 21: 788.e1–788.e13.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Parija SC, Mandal J, Ponnambath DK, 2014. Laboratory methods of identification of Entamoeba histolytica and its differentiation from look-alike Entamoeba spp. Trop Parasitol 4: 90–95.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Korpe PS, Stott BR, Nazib F, Kabir M, Haque R, Herbein JF, Petri WA Jr., 2012. Evaluation of a rapid point-of-care fecal antigen detection test for Entamoeba histolytica. Am J Trop Med Hyg 86: 980–981.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Jauset-Rubio M, et al., 2016. Ultrasensitive, rapid and inexpensive detection of DNA using paper based lateral flow assay. Sci Rep 6: 37732.

  • 18.

    Crannell Z, Castellanos-Gonzalez A, Nair G, Mejia R, White AC, Richards-Kortum R, 2015. Multiplexed recombinase polymerase amplification assay to detect intestinal protozoa. Anal Chem 88: 1565–1573.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Kersting S, Rausch V, Bier FF, von Nickisch-Rosenegk M, 2014. Rapid detection of Plasmodium falciparum with isothermal recombinase polymerase amplification and lateral flow analysis. Malar J 13: 1–9.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Li TT, Wang JL, Zhang NZ, Li WH, Yan HB, Li L, Jia WZ, Fu BQ, 2019. Rapid and visual detection of Trichinella spp. using a lateral flow strip-based recombinase polymerase amplification (LF-RPA) assay. Front Cell Infect Microbiol 9: 1.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Rattaprasert P, Chavananikul C, Fungfuang W, Chavalitshewinkoon-Petmitr P, Limudomporn P, 2023. Combining isothermal recombinase polymerase amplification with lateral flow assay for diagnosis of P. cynomolgi malaria infection. PLoS Negl Trop Dis 17: e0011470.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Bharadwaj M, Bengtson M, Golverdingen M, Waling L, Dekker C, 2021. Diagnosing point-of-care diagnostics for neglected tropical diseases. PLoS Negl Trop Dis 15: e0009405.

  • 23.

    Portunato F, Bartalucci C, Vena A, Giacobbe DR, Porcile E, Montanelli P, Piol N, Centanaro M, Andorno E, Bassetti M, 2024. Amoebic liver abscess: Potential application of new diagnostic techniques for an old pathogen. Infect Dis Ther 13: 625–632.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Lai MY, Hamid MA, Jelip J, Mudin RN, Lau YL, 2023. Lateral flow recombinase polymerase amplification assays for the detection of human Plasmodium species. Am J Trop Med Hyg 108: 882–886.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Datta P, Rattan D, Sharma D, Sharma N, Kalra N, Duseja A, Angrup A, Sehgal R, 2024. Novel diagnostic approach for amoebic liver abscess using cell free (cf) DNA: A prospective study. Infect Dis 56: 259–267.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 762 762 78
Full Text Views 9 9 6
PDF Downloads 12 12 9
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save