title: Cutaneous leishmaniasis caused by Leishmania tropica in Bikaner, India: parasite identification and characterization using molecular and immunologic tools.
abstract: Identification of new foci of cutaneous leishmaniasis (CL), along with reports of Leishmania donovani causing the disease, is an issue of concern. Clinico-epidemiologic analysis of 98 cases in the endemic regions of Rajasthan state, India, suggested the preponderance of infection in men (62.24%) compared with women (37.75%). Species characterization by internal transcribed spacer 1 (ITS1) polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP), kDNA-PCR, and immunofluorescence assay established L. tropica as the causative organism. When applied directly to 32 clinical samples, kDNA PCR had a sensitivity of 96.6%, whereas ITS1 PCR had a sensitivity of 82.75%, thus facilitating diagnosis and species identification. Either parasite culture or direct microscopy alone detected 48.2% and 65.5% of the positive samples, respectively, whereas culture and microscopy together improved overall sensitivity to 89.3% (25/28). Except for the kDNA PCR, all other assays were 100% specific. This study provides the first comprehensive molecular and immunologic studies of CL in India.
authors.affiliation: Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Ram Avtar
authors.initials: RA
authors.lastname: Bumb
authors.forename: Nasim A
authors.initials: NA
authors.lastname: Ansari
authors.forename: Rajesh D
authors.initials: RD
authors.lastname: Mehta
authors.forename: Poonam
authors.initials: P
authors.lastname: Salotra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000913:Antibodies, Protozoan / Q000032:analysis / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D021901:DNA, Intergenic / Q000032:analysis / Q000737:chemistry; D018105:DNA, Kinetoplast / Q000032:analysis / Q000737:chemistry; D016054:DNA, Protozoan / Q000032:analysis / Q000737:chemistry; D005260:Female; D019085:Fluorescent Antibody Technique, Direct / Q000379:methods; D006801:Humans; D007194:India / Q000453:epidemiology; D007895:Leishmania tropica / Q000235:genetics* / Q000276:immunology* / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D012150:Polymorphism, Restriction Fragment Length
chemical_list: D000913:Antibodies, Protozoan; D021901:DNA, Intergenic; D018105:DNA, Kinetoplast; D016054:DNA, Protozoan