title: Combined antibody and DNA detection for early diagnosis of leptospirosis after a disaster.
abstract: Early diagnosis based on laboratory confirmation is essential for managing leptospirosis. This study investigated the effectiveness of a novel method of detecting leptospirosis that combines measurement of anti-Leptospira antibodies by the microscopic agglutination test (MAT), enzyme-linked immunosorbent assay (ELISA), and immunochromatographic test (ICT) and leptospiral DNA by loop-mediated isothermal amplification (LAMP) and real-time PCR in plasma and 2 types of urine pellets. Of 113 suspected cases, 68.1%, 76.1%, and 60.2% were positive by MAT, ELISA, and ICT, respectively. Real-time PCR using DNA purified from urine pellets collected by low-speed centrifugation yielded positive signals for patients in late acute as well as early phase who were positive by LAMP using plasma DNA or urine pellets. Among antibody-negative patients, 9.5% were positive by DNA detection. These findings indicate that the leptospirosis detection rate is increased by combining antibody and DNA detection, providing a new tool for timely diagnosis of infection.
authors: Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.
authors: Hiroko
authors: H
authors: Iwasaki
authors: Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan; Division of Emerging Infectious Diseases, Department of Internal Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors: Haorile
authors: H
authors: Chagan-Yasutan
authors: National Reference Laboratory for HIV/AIDS, Hepatitis, and Other STDs, STD/AIDS Cooperative Central Laboratory, Manila, Philippines.
authors: Prisca Susan A
authors: PS
authors: Leano
authors: Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
authors: Nobuo
authors: N
authors: Koizumi
authors: Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan.
authors: Chie
authors: C
authors: Nakajima
authors: Division of Emerging Infectious Diseases, Department of Internal Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors: Delsi
authors: D
authors: Taurustiati
authors: Division of Emerging Infectious Diseases, Department of Internal Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors: Firmanto
authors: F
authors: Hanan
authors: Department of Blood Borne Diseases, San Lazaro Hospital, Manila, Philippines.
authors: Talitha Lea
authors: TL
authors: Lacuesta
authors: Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan; Division of Emerging Infectious Diseases, Department of Internal Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.
authors: Yugo
authors: Y
authors: Ashino
authors: Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan.
authors: Yasuhiko
authors: Y
authors: Suzuki
authors: Department of Medical Microbiology, College of Public Health, University of the Philippines-Manila, Manila, Philippines.
authors: Nina G
authors: NG
authors: Gloriani
authors: National Reference Laboratory for HIV/AIDS, Hepatitis, and Other STDs, STD/AIDS Cooperative Central Laboratory, Manila, Philippines.
authors: Elizabeth Freda O
authors: EF
authors: Telan
authors: Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan; Division of Emerging Infectious Diseases, Department of Internal Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan. Electronic address: toshatto@med.tohoku.ac.jp.
authors: Toshio
authors: T
authors: Hattori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D004269:DNA, Bacterial / Q000097:blood* / Q000652:urine*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004190:Disasters; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007919:Leptospira / Q000302:isolation & purification*; D007922:Leptospirosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial
keywords: Antibody detection; DNA detection; Disaster; Leptospirosis; Urine