Evaluation of a point-of-care molecular detection device for Leishmania spp. and intercurrent fungal and mycobacterial organisms in Peruvian patients with cutaneous ulcers.
Infection
; 49(6): 1203-1211, 2021 Dec.
Article
en En
| MEDLINE
| ID: mdl-34368941
ABSTRACT
PURPOSE:
Overlapping clinical features of cutaneous leishmaniasis (CL) with ulcers caused by fungi and mycobacteria necessitate confirmatory diagnostic testing. We evaluated a handheld battery-operated device for detection of CL and common fungal and mycobacterial causes of ulcers.METHODS:
We validated Palm PCR™ for detection of common ulcerative skin pathogens using ATCC® reference and clinical strains of Leishmania, mycobacteria, and fungi in the lab and field. Amplified products were Sanger sequenced. Performance characteristics were calculated using conventional PCR as a reference standard.RESULTS:
Palm PCR™ detected 100% of ATCC® strains of Leishmania, fungi, and mycobacteria, with sensitivity and specificity of 90% and 91.7%, respectively. In the field, the sensitivity for detection of Leishmania in patients with suspected CL was 100%. In 61% of CL patients, co-colonization with genera such as Malassezia, Aspergillus, Candida, and Cladosporium was detected. In 50% of CL patients with an inflammatory (secondarily infected) phenotype, detected fungal species had known associations with human cutaneous disease.CONCLUSIONS:
Palm PCR™ performs comparably to conventional PCR for detection of Leishmania, fungi, and mycobacteria. This work has implications for the diagnostic approach to tropical ulcers, and has the potential to improve field detection of ulcerative pathogens in resource constrained areas.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Leishmaniasis Cutánea
/
Leishmania
/
Mycobacterium
Tipo de estudio:
Diagnostic_studies
Límite:
Humans
País/Región como asunto:
America do sul
/
Peru
Idioma:
En
Revista:
Infection
Año:
2021
Tipo del documento:
Article
País de afiliación:
Canadá