title: Leishmaniasis in Turkey: Determination of Leishmania Species by Matrix-Assisted Laser Desorption Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS).
abstract: BACKGROUND
  Cutaneous leishmaniasis (CL) is endemic in Southeastern Anatolia, mainly in Sanliurfa and Hatay provinces, and the causative agents are mostly Leishmania tropica and less frequently L. infantum. Here, we report the first MALDI-TOF analyses of Leishmania promastigotes obtained from the cultures of two CL cases from Osmaniye and Hatay provinces who were initially diagnosed by microscopy, culture and identified as L. infantum with Real-Time PCR (RT-PCR).
  
  
  METHODS
  Samples obtained from the skin lesions of patients were initially stained with Giemsa and cultivated in NNN medium. Examination of the smears and cultures revealed Leishmania amastigotes and promastigotes, respectively. The promastigotes (MHOM/TR/2012/CBU15 and MHOM/TR/2012/MK05) obtained from the cultures of both patients were used for RT-PCR targeting the ITS-1 region in the SSU of rRNA. The reference strains of four Leishmania species (L. infantum, L. donovani, L. tropica and L. major) were initially assessed with MALDI-TOF and their data were added to MALDI-TOF Biotyper Library.
  
  
  RESULTS
  Both RT-PCR and MALDI-TOF analyses indicated that the causative agent in both patient samples was L. infantum.
  
  
  CONCLUSIONS
  Despite disadvantages such as requirement of culture fluid with nothing but promastigotes and high cost, MALDI-TOF analysis may be a fast, sensitive and specific diagnostic tool in especially large-scale research studies, where the cost declines, relatively.
authors.affiliation: Department of Microbiology and Clinical Microbiology, School of Medicine, Mustafa Kemal University, Hatay, Turkey.
authors.forename: Gülnaz
authors.initials: G
authors.lastname: Culha
authors.affiliation: Department of Medical Microbiology, School of Medicine, Acibadem University, Istanbul, Turkey.
authors.forename: Isin
authors.initials: I
authors.lastname: Akyar
authors.affiliation: Department of Microbiology and Clinical Microbiology, School of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Fadile
authors.initials: F
authors.lastname: Yildiz Zeyrek
authors.affiliation: Department of Medical Microbiology, School of Medicine, Acibadem University, Istanbul, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Kurt
authors.affiliation: Department of Medical Biology, School of Medicine, Ege University, Izmir, Turkey.
authors.forename: Cumhur
authors.initials: C
authors.lastname: Gündüz
authors.affiliation: Department of Medical Parasitology, School of Medicine, Ege University, Izmir, Turkey.
authors.forename: Seray
authors.initials: S
authors.lastname: Özensoy Töz
authors.affiliation: Vocational School of Health Sciences, Celal Bayar University, Manisa, Turkey.
authors.forename: Ipek
authors.initials: I
authors.lastname: Östan
authors.affiliation: Department of Medical Parasitology, School of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Cavus
authors.affiliation: Department of Microbiology and Clinical Microbiology, School of Medicine, Mustafa Kemal University, Hatay, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Gülkan
authors.affiliation: Department of Medical Microbiology, School of Medicine, Acibadem University, Istanbul, Turkey.
authors.forename: Tanil
authors.initials: T
authors.lastname: Kocagöz
authors.affiliation: Department of Medical Parasitology, School of Medicine, Ege University, Izmir, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Özbel
authors.affiliation: Department of Medical Parasitology, School of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Özbilgin
keywords: Cutaneous leishmaniasis; Leishmania infantum; MALDI -TOF; Real-Time PCR; Turkey
references.citation: J Proteome Res. 2009 Sep;8(9):4372-82
references.pmid: 19603824
references.citation: J Clin Microbiol. 2010 Mar;48(3):900-7
references.pmid: 20053859
references.citation: Curr Opin Infect Dis. 2003 Apr;16(2):97-101
references.pmid: 12734442
references.citation: Proteomics. 2006 Jul;6(14):4187-94
references.pmid: 16791830
references.citation: Mass Spectrom Rev. 2001 Jul-Aug;20(4):172-94
references.pmid: 11835305
references.citation: Mass Spectrom Rev. 2001 Jul-Aug;20(4):157-71
references.pmid: 11835304
references.citation: Rapid Commun Mass Spectrom. 1996;10(15):1992-6
references.pmid: 9004531
references.citation: Clin Infect Dis. 2009 Aug 15;49(4):543-51
references.pmid: 19583519
references.citation: Antimicrob Agents Chemother. 2004 Feb;48(2):466-72
references.pmid: 14742196
references.citation: Anal Chem. 2002 Dec 15;74(24):6191-9
references.pmid: 12510738
references.citation: Proteomics. 2007 Mar;7(5):816-23
references.pmid: 17295358
references.citation: Pathog Dis. 2014 Feb;70(1):84-7
references.pmid: 24115687
references.citation: Int J Dermatol. 2006 May;45(5):569-72
references.pmid: 16700794
references.citation: Med Microbiol Immunol. 2001 Nov;190(1-2):61-3
references.pmid: 11770112
references.citation: J Eukaryot Microbiol. 2000 Nov-Dec;47(6):545-54
references.pmid: 11128706
references.citation: Science. 2005 Jul 15;309(5733):473-6
references.pmid: 16020736
references.citation: Proteomics. 2012 May;12(9):1337-48
references.pmid: 22589184
references.citation: PLoS Negl Trop Dis. 2013 May 09;7(5):e2205
references.pmid: 23675543
references.citation: Turkiye Parazitol Derg. 2012;36(2):121-9
references.pmid: 22801920
references.citation: Br J Dermatol. 1999 Feb;140(2):347-50
references.pmid: 10233236
references.citation: J Clin Microbiol. 2006 Aug;44(8):2677-80
references.pmid: 16891477
references.citation: Clin Microbiol Infect. 2014 Jun;20(6):551-7
references.pmid: 24165542
references.citation: Trans R Soc Trop Med Hyg. 2001 Mar-Apr;95(2):217-24
references.pmid: 11355565
references.citation: J Clin Microbiol. 2008 Sep;46(9):2848-55
references.pmid: 18614659
references.citation: Trans R Soc Trop Med Hyg. 2000 Sep-Oct;94(5):575-9
references.pmid: 11132393
references.citation: Diagn Microbiol Infect Dis. 2007 Mar;57(3):295-9
references.pmid: 17141456
references.citation: Proteomics. 2002 Aug;2(8):1007-17
references.pmid: 12203896
references.citation: Eur J Clin Microbiol Infect Dis. 2014 Apr;33(4):529-36
references.pmid: 24078024
references.citation: Trop Med Int Health. 2009 Sep;14(9):1071-85
references.pmid: 19624480
references.citation: Acta Trop. 2002 Oct;84(1):43-8
references.pmid: 12387909
references.citation: Diagn Microbiol Infect Dis. 2003 Sep;47(1):349-58
references.pmid: 12967749
references.citation: Nat Biotechnol. 1996 Nov;14(11):1584-6
references.pmid: 9634826
references.citation: Am J Trop Med Hyg. 2010 May;82(5):814-8
references.pmid: 20439960
references.citation: Proteomics. 2003 Sep;3(9):1811-29
references.pmid: 12973740