Universidad Peruana Cayetano Heredia

Non-Invasive Cytology Brush PCR for the Diagnosis and Causative Species Identification of American Cutaneous Leishmaniasis in Peru

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dc.contributor.author Valencia, B.M.
dc.contributor.author Veland, N.
dc.contributor.author Alba, M.
dc.contributor.author Adaui, V.
dc.contributor.author Arévalo Zelada, Jorge Luis
dc.contributor.author Low, D.E.
dc.contributor.author Llanos Cuentas, Elmer Alejandro
dc.contributor.author Boggild, A.K.
dc.date.accessioned 2022-01-18T19:34:40Z
dc.date.available 2022-01-18T19:34:40Z
dc.date.issued 2012
dc.identifier.uri https://hdl.handle.net/20.500.12866/11113
dc.description.abstract Background: Traditional methods of detecting Leishmania from cutaneous lesions involve invasive diagnostic procedures, such as scrapings, which cause discomfort, require technical expertise, and carry risks of invasive procedures. We compared the performance of 2 novel, molecular-based non-invasive methods for the diagnosis of cutaneous leishmaniasis (CL). Methods: Consecutive patients presenting to the Leishmania Clinic at the Hospital Nacional Cayetano Heredia were enrolled. PCR was performed on filter paper lesion impressions (FPLIs), cytology brushes, and lancets for detection of Leishmania DNA. Smears from lesion scrapings and leishmanin skin test were also performed. Outcome measures were sensitivity and specificity. Composite reference standard was any 2 of 5 tests positive. Species identification was performed by PCR assays of positive specimens. Results: Ninety patients with 129 lesions were enrolled, 117 of which fulfilled reference criteria for a diagnosis of CL. Of these 117 lesions, 113 were positive by PCR of lancets used for lesion scrapings versus 116 by PCR of FPLIs (p = 0.930) or 116 by PCR of cytology brushes (p = 0.930). Sensitivity and specificity of PCR on lancets were 96.6% [95% CI 93.3-99.9%] and 100%, respectively. Sensitivity and specificity of FPLI PCR were 99.1% [95% CI 97.4-100%] and 100%, respectively. Sensitivity and specificity of cytology brush PCR were 99.1% [95% CI 97.4-100%] and 100%, respectively. Giemsa-stained lesion smear and leishmanin skin test had inferior sensitivities at 47.9% [95% CI 38.9-57.0%] and 82.3% [95% CI 73.9-90.7%], respectively, compared to PCR of invasive or non-invasive specimens (p<0.001). Conclusions: Cytology brush PCR constitutes a sensitive and specific alternative to traditional diagnostic assays performed on invasive specimens such as lesion scrapings. It performs comparatively to non-invasive FPLI PCR. This novel, rapid, and well-tolerated method has the potential for widespread use in the field and in pediatric populations where traditional specimen collection is difficult. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Peru en_US
dc.subject controlled study en_US
dc.subject major clinical study en_US
dc.subject polymerase chain reaction en_US
dc.subject Leishmaniasis, Cutaneous en_US
dc.subject Polymerase Chain Reaction en_US
dc.subject Skin en_US
dc.subject skin leishmaniasis en_US
dc.subject Sensitivity and Specificity en_US
dc.subject cytology en_US
dc.subject diagnostic test accuracy study en_US
dc.subject Polymorphism, Restriction Fragment Length en_US
dc.subject DNA, Kinetoplast en_US
dc.subject diagnostic accuracy en_US
dc.subject DNA en_US
dc.subject Skin Tests en_US
dc.subject non invasive procedure en_US
dc.subject Species Specificity en_US
dc.subject Specimen Handling en_US
dc.subject species identification en_US
dc.subject assay en_US
dc.subject denaturation en_US
dc.subject kinetoplast en_US
dc.subject Paper en_US
dc.title Non-Invasive Cytology Brush PCR for the Diagnosis and Causative Species Identification of American Cutaneous Leishmaniasis in Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0049738
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.00
dc.relation.issn 1932-6203


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