title: Diagnosis of cutaneous leishmaniasis in Guatemala using a real-time polymerase chain reaction assay and the Smartcycler.
abstract: The polymerase chain reaction (PCR) assay has been reported for the diagnosis of cutaneous leishmaniasis (CL). Real-time (RT) PCR offers several advantages over traditional PCR, including faster processing time and decreased risk of contamination. Enhanced portability is another benefit that expands the applicability of the assay. A portable RT-PCR assay was transported from the United States to Guatemala for comparison with traditional diagnostic modalities. With the clinical diagnosis of CL as the gold standard, RT-PCR was positive in 86% (37 of 43) versus 53% (20 of 38) for microscopy and 72% (28 of 39) for culture. Negative RT-PCR samples (6) were also negative by traditional diagnostic methods (although subsequently determined to be positive by a nested kDNA PCR). Sixty-four percent (9 of 14) of cases tested and negative by microscopy and/or culture were positive by RT-PCR. This study demonstrates that a RT-PCR assay can be successfully deployed to offer enhanced sensitivity for the diagnosis of CL.
authors.affiliation: Infectious Diseases Division, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. glenn.Wortmann@na.amedd.army.mil
authors.forename: Glenn
authors.initials: G
authors.lastname: Wortmann
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Hochberg
authors.forename: Byron A
authors.initials: BA
authors.lastname: Arana
authors.forename: Nidia R
authors.initials: NR
authors.lastname: Rizzo
authors.forename: Flora
authors.initials: F
authors.lastname: Arana
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Ryan
mesh_terms: D000328:Adult; D017931:DNA Primers / Q000737:chemistry; D005240:Feasibility Studies; D006166:Guatemala; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis*; D016133:Polymerase Chain Reaction / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology
chemical_list: D017931:DNA Primers