title: Identification and differentiation of Leishmania species in clinical samples by PCR amplification of the miniexon sequence and subsequent restriction fragment length polymorphism analysis.
abstract: We recently developed a new PCR-restriction fragment length polymorphism (RFLP)-based assay using the miniexon sequence from the genus Leishmania. Here we report the application of this new genotyping method to naturally infected clinical samples for the differentiation of New and Old World Leishmania species. Of the newly developed assay and four currently applied diagnostic tests (i.e., in vitro cultivation, serology, and two other molecular assays using either the small subunit-internal transcribed spacer sequence or a repetitive genomic sequence), the miniexon assay showed the highest sensitivity, 89.7%, compared to 70.6, 57.1, 51.7, and 79.3%, respectively. Species differentiation was robust and reliable compared with that by two other Leishmania genotyping techniques. The assay provides a valuable tool for the identification of Leishmania directly from clinical samples and enables determination of the infecting species by a facile technique with high discrimination power. Since Leishmania causes a broad spectrum of diseases distinguished by different parasite and host factors, detection and characterization of the infecting species is crucial for the confirmation of a diagnosis as well as the establishment of the clinical prognosis and the initiation of an adequate therapeutic approach. The miniexon PCR-RFLP assay will facilitate such determination and might improve diagnosis and treatment of leishmaniasis.
authors.affiliation: Department of Medical Parasitology and Infection Biology, Swiss Tropical Institute, Basel, Switzerland.
authors.forename: Jutta
authors.initials: J
authors.lastname: Marfurt
authors.forename: Abed
authors.initials: A
authors.lastname: Nasereddin
authors.forename: Igor
authors.initials: I
authors.lastname: Niederwieser
authors.forename: Charles L
authors.initials: CL
authors.lastname: Jaffe
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Beck
authors.forename: Ingrid
authors.initials: I
authors.lastname: Felger
mesh_terms: D000818:Animals; D021903:DNA, Ribosomal Spacer / Q000235:genetics; D005091:Exons / Q000235:genetics; D020459:Genes, rRNA; D005838:Genotype; D006801:Humans; D007891:Leishmania / Q000145:classification* / Q000235:genetics* / Q000254:growth & development; D007896:Leishmaniasis / Q000469:parasitology*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012150:Polymorphism, Restriction Fragment Length; D017422:Sequence Analysis, DNA
chemical_list: D021903:DNA, Ribosomal Spacer