title: Early diagnosis of scrub typhus in Thailand from clinical specimens by nested polymerase chain reaction.
abstract: The early detection of scrub typhus in Thailand by nested polymerase chain reaction (PCR) is presented. The diagnosis of scrub typhus, from clinical samples obtained from hospitals in the northern part of Thailand, by nested PCR was compared to immunofluorescence (IF) and Weil-Felix (WF) tests. The primer pairs used for the nested PCR were designed on the basis of the nucleotide sequence of the gene that encodes the 56-kDa antigen, and RFLP analysis was used for identification. Clotted blood from 80 patients suspected of scrub typhus infection were tested. With the IF test, antibodies for Orientia tsutsugamushi were observed in 38 patients checking IgM and IgG titers. Only 21 patients showed positive seroconversion while 17 patients were negative. For the WF test, only 13 patients gave a positive seroconversion. In the early stage of infection, 19, 13 and 3 patients were detected with a sensitivity of 90.47% (19/21), 61.90% (13/21) and 14.28% (3/21) by the nested PCR, IF and WF test respectively. Two patients who were negative for seroconvesion by IF and WF were positive by nested PCR. Therefore, this suggests that nested PCR is applicable for specific rapid diagnosis at an early stage of scrub typhus in endemic regions.
authors.affiliation: Pharmaceutical Cosmetic Raw Materials and Natural Products Research and Development Center, Institute for Science and Technology Research and Development/Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand. pmpti006@chiangmai.ac.th
authors.forename: Jiradej
authors.initials: J
authors.lastname: Manosroi
authors.forename: Salakchit
authors.initials: S
authors.lastname: Chutipongvivate
authors.forename: Wattana
authors.initials: W
authors.lastname: Auwanit
authors.forename: Aranya
authors.initials: A
authors.lastname: Manosroi
mesh_terms: D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D002648:Child; D005455:Fluorescent Antibody Technique; D006801:Humans; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012150:Polymorphism, Restriction Fragment Length; D012612:Scrub Typhus / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013785:Thailand