<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Background</h3><p>Leptospirosis, caused by pathogenic <italic>Leptospira</italic> spp., is a widespread zoonotic disease worldwide. Early diagnosis is required for proper patient management and reducing leptospirosis morbidity and mortality.</p></sec><sec><h3>Objective</h3><p>To summarize current literature regarding commonly used and new promising molecular approaches to <italic>Leptospira</italic> detection and diagnostic tests of human leptospirosis.</p></sec><sec><h3>Method</h3><p>The relevant articles in <italic>Leptospira</italic> and leptospirosis were retrieved from MEDLINE (PubMed) and Scopus.</p></sec><sec><h3>Results</h3><p>Several molecular techniques have been developed for diagnosis of human leptospirosis. Polymerase chain reaction-based techniques targeting on either <italic>lipL32</italic> or 16S rRNA (<italic>rrs</italic>) gene are most commonly used to detect leptospiral DNA in various clinical specimens. Whole blood and urine are recommended specimens for suspected cases in the first (acute) and the second (immune) phases, respectively. Isothermal amplification with less expensive instrument is an alternative DNA detection technique that may be suitable for resource-limited laboratories.</p></sec><sec><h3>Conclusion</h3><p>Detection of leptospiral DNA in clinical specimens using molecular techniques enhances sensitivity for diagnosis of leptospirosis. The efficient and robust molecular detection especially in the early leptospiremic phase may prompt early and appropriate treatment leading to reduced morbidity and mortality of patients with leptospirosis.</p></sec></abstract>

BackgroundLeptospirosis, caused by pathogenic Leptospira spp., is a widespread zoonotic disease worldwide. Early diagnosis is required for proper patient management and reducing leptospirosis morbidity and mortality.ObjectiveTo summarize current literature regarding commonly used and new promising molecular approaches to Leptospira detection and diagnostic tests of human leptospirosis.MethodThe relevant articles in Leptospira and leptospirosis were retrieved from MEDLINE (PubMed) and Scopus.ResultsSeveral molecular techniques have been developed for diagnosis of human leptospirosis. Polymerase chain reaction-based techniques targeting on either lipL32 or 16S rRNA (rrs) gene are most commonly used to detect leptospiral DNA in various clinical specimens. Whole blood and urine are recommended specimens for suspected cases in the first (acute) and the second (immune) phases, respectively. Isothermal amplification with less expensive instrument is an alternative DNA detection technique that may be suitable for resource-limited laboratories.ConclusionDetection of leptospiral DNA in clinical specimens using molecular techniques enhances sensitivity for diagnosis of leptospirosis. The efficient and robust molecular detection especially in the early leptospiremic phase may prompt early and appropriate treatment leading to reduced morbidity and mortality of patients with leptospirosis.

Update on molecular diagnosis of human leptospirosis

Department of Microbiology, Faculty of Medicine

Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

{"article-title":"Update on molecular diagnosis of human leptospirosis"}

BackgroundLeptospirosis, caused by pathogenic Leptospira spp., is a widespread zoonotic disease worldwide. Early diagnosis is required for proper patient...

Detection method	Molecular target	Limit of detection^a	Clinical Evaluation			References

			Sample	% Sensitivity	% Specificity
SYBR green	secY	60 GE/PCR	Whole blood	67.7	90.0	[63, 71, 72, 73]

	lfb1	10³ cells/mL	ND	ND	ND

	lipL32	10² cells/mL, 3 GE/PCR	Serum	30	100

TaqMan	lipL32	40 cells/mL, 1 GE/PCR	Whole blood	43.0–60.6	93.0–99.0	[21, 60, 74, 75]
			Serum	29.1	99.0
			Blood culture	86	100.0
			Urine	ND	100.0

	rrs	40 cells/mL, 1 GE/PCR	Whole blood	18.4–96.4	90.0–99.5	[20, 74, 75, 76, 77]
			Serum	50.0–51.0	99.2
			Buffy coat	35.7	99.7
			Blood culture	69.5–100.0	95.2–97.0
			Urine	39.1	91.5–92.5

	rrs/lipL32	ND	Serum	53.9	99.6	[22]
			Buffy coat	58.8	99.9
			Urine	45.0	99.6

RT-PCR	rrs	1 cell/mL	Whole blood	64.0	100.0	[66]

ddPCR	lipL32	10 cells/mL, 1 GE/PCR	Spiked whole blood	ND	ND	Our study

RPA	lipL32	≤2 GE/Rx	Serum	94.7	97.7	[78]

LAMP	lipL32	10 GE/Rx	Serum, urine	91.67	100	[79]

	rrs	10 GE/Rx	Serum	43.6	83.5

Update on molecular diagnosis of human leptospirosis

Article Category: Review article

Published Online: Jun 25, 2020

Page range: 207 - 216

DOI: https://doi.org/10.1515/abm-2019-0063

Keywords
genomic detection, leptospirosis, molecular diagnosis, real-time PCR

© 2019 Teerasit Techawiwattanaboon et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Molecular diagnosis of human leptospirosis

Update on molecular diagnosis of human leptospirosis

Article Category: Review article

Published Online: Jun 25, 2020

Page range: 207 - 216

DOI: https://doi.org/10.1515/abm-2019-0063

Keywordsgenomic detection, leptospirosis, molecular diagnosis, real-time PCR

© 2019 Teerasit Techawiwattanaboon et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Molecular diagnosis of human leptospirosis

Keywords
genomic detection, leptospirosis, molecular diagnosis, real-time PCR