LEPTOSPIRIOSIS
(Diagnosis, Diagnostics, Immunodiagnosis,
Immunodiagnostics, Pathogenesis, Vaccines
& Drugs)
ABSTRACTS
1753.
Guidugli F.
Castro AA. Atallah AN. Systematic reviews on leptospirosis. Revista do Instituto de Medicina Tropical de
Sao Paulo. 42(1):47-9, 2000 Jan-Feb.
Abstract
OBJECTIVES: To find the existing clinical
evidence on interventions for leptospirosis. The objective is to evaluate
the effectiveness and safety of any intervention on leptospirosis through
systematic reviews of randomized controlled trials (RCTs). DATA SOURCE: The sources of studies
used (where there were no limitations
concerning language, date, or other restrictions) were: EMBASE, LILACS, MEDLINE,
the Cochrane Controlled Clinical Trials Database, and the Cochrane
Hepato-Biliary Group Randomized Trials register. SELECTION OF STUDIES: Type
of Study: All systematic reviews of randomized controlled trials.
Participants: patients with clinical and/or laboratorial diagnosis of
leptospirosis, and subjects potencially exposed to leptospirosis as
defined by the authors Interventions: any intervention for leptospirosis (as antibiotics or
vaccines for prevention or treatment). DATA COLLECTION: The assessment
will be independently made by the reviewers
and cross-checked. The external validity was assessed by analysis
of: studies, interventions, and outcomes. DATA SYNTHESIS: Located 163
studies using the search strategy described above, at the electronic databases
above. Only 2 hits were selected, which are protocols of systematic
reviews of Cochrane Collaboration, and not full reviews. One of
the protocols evaluates antibiotics for treatment, and the other evaluates antibiotics for
prevention of leptospirosis. CONCLUSIONS:
There were not complete systematic reviews on interventions for
leptospirosis. Any interventions for leptospirosis, such as prevention and
treatment remains unclear for guidelines and practice.
1754. Smythe L.
Dohnt M. Symonds M. Barnett L.
Moore M. Brookes D. Vallanjon M. Review of leptospirosis notifications in
Queensland and Australia: January 1998-June 1999.
Source
Communicable Diseases Intelligence. 24(6):153-7, 2000 Jun.
Abstract
The World Health Organization/Food and
Agricultural Organization Collaborating Centre for Reference and
Research on Leptospirosis, Western Pacific Region, accredited since 1958, is
part of Queensland Health Scientific Services, which provide tertiary level support in
epidemiology, surveillance, training and diagnosis for
hospitals and pathology laboratories across the State. Databases for
leptospirosis on a global, Australian and State-wide basis are
maintained on site and support public health authorities in Australia, WHO and the
International Leptospirosis Society. Queensland data collated and
analysed from leptospirosis questionnaires, and a brief overview of Australian data based on
questionnaire responses for notified cases
from 1998 to June 1999, are summarised. The increase in leptospirosis
notifications (77%) during 1998 possibly signalled greater awareness of the
disease by clinicians. There was a significant increase in leptospirosis
notifications for children and students and a high rate of hospitalisation
of cases. An outbreak in North Queensland during the first half of 1999
resulted in 184 notifications with over 50% of cases hospitalised. Polymorphic presentation of the
disease with severe pulmonary haemorrhage is
associated in particular with the serovar australis. Serovar zanoni
continues to be a major cause of severe clinical leptospirosis. Several cases
were diagnosed in tourists. One of these cases presented with severe
respiratory distress and required
14 days in hospital.
1755.
Authors
Sonrier C.
Branger C. Michel V. Ruvoen-Clouet N. Ganiere JP.
Andre-Fontaine G.
Title
Evidence of cross-protection within
Leptospira interrogans in an
experimental model.
Source
Vaccine.
19(1):86-94, 2000 Aug 15.
Abstract
Killed whole-cell preparations were used as
bacterins against leptospirosis. As this type of protection is
considered to be serogroup-specific, several serogroups were
added to the usual vaccines, and the most pathogenic serovar was chosen
for each group. Different leptospire extracts were evaluated for their
protective capacity against acute lethal leptospirosis in gerbils
(Meriones unguiculatus). Total extracts induced complete protection against
homologous challenges and partial protection against heterologous
challenges. LPS fractions protected against homologous but not
heterologous challenges, whereas protein extract induced significant
protection against both types of challenge. Thus, cross-protection within L.
interrogans was related to the protein extract.
2235. Anonymous. From the Centers for Disease Control and
Prevention. Update: outbreak of acute febrile illness among athletes
participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000. JAMA. 285(6):728-30, 2001 Feb 14.
2236. No abstract
2237. No abstract
2238. No abstract
2239. No abstract
2240. Sorabjee JS. The liver in enteric fever and leptospirosis. [Review] [13 refs] Indian Journal of Gastroenterology. 20 Suppl 1:C44-6, 2001 Mar.
2241. Zochowski WJ. Palmer MF. Coleman TJ. An evaluation of three commercial kits for use as screening methods for the detection of leptospiral antibodies in the UK. Journal of Clinical Pathology. 54(1):25-30, 2001 Jan.
Abstract
AIMS: To compare three commercial screening tests--the PanBio leptospiral IgM enzyme linked immunosorbent assay (ELISA), the Biolisa leptospiral IgM ELISA, and the indirect haemagglutination assay (IHA)--with the microscopic agglutination test (MAT) and two "in house" ELISAs--urease and horseradish peroxidase (HRP)--for the detection of leptospiral antibodies in a local UK and Eire population. METHOD: Two hundred sera submitted for a differential diagnosis of leptospirosis were tested by all methods. A further 142 sera from patients with antibodies to toxoplasma, Epstein-Barr virus (EBV), hepatitis A virus, rheumatoid factor, Borrelia burgdorferi, Mycoplasma pneumoniae, syphilis, cytomegalovirus, and Q fever were tested for crossreactivity. RESULTS: Compared with the MAT, sensitivity and specificity were found to be: PanBio, 90%/94%; Biolisa with sorbent, 100%/85%; and IHA, 54%/95%. Seven of 200 trial sera gave false negative results with PanBio; 14 of 200 trial sera gave false positive results with Biolisa with sorbent, as did a further 25 of the 142 sera tested for potential crossreactivity. Two of 142 sera gave crossreactions with PanBio and IHA (one each). CONCLUSIONS: The degree of false positivity seen with the Biolisa suggests that the recommended positive value of > or = 26 Eu/ml should be reassessed using pools of sera from local populations. When the cut off value was reassessed, using a value of > or = 40 Eu/ml, a sensitivity and specificity of 96% and 94%, respectively, was achieved. Even the modified Biolisa appears to be over sensitive and to show a high degree of non-specificity. The IHA, although specific (95%), lacked sensitivity in this study. The PanBio appeared to be the most suitable as a screening test for leptospiral IgM in the UK, although it would be advisable for all positive test results to be confirmed by a different enzyme immunoassay and the MAT.
2830.
Levett
PN. Branch SL. Whittington CU. Edwards CN. Paxton H. Two
methods for rapid serological diagnosis of acute leptospirosis. Clinical & Diagnostic Laboratory
Immunology. 8(2):349-51, 2001 Mar.
Abstract
Leptospirosis is a common and underdiagnosed
zoonosis. Two rapid assays for serological diagnosis of acute leptospirosis in
diagnostic laboratories, the immunoglobulin M (IgM)-dipstick assay and the
indirect hemagglutination assay (IHA), were evaluated and compared with
standard assays. Sera were examined from 104 patients admitted to a hospital
for investigation in a leptospirosis diagnostic protocol. Specimens for
serology were taken on days 1 and 4 of the patients' hospital stay. Antibodies
were detected using an IgM-enzyme-linked immunosorbent assay (ELISA),
microscopic agglutination test (MAT), an IgM-dipstick assay, and an IHA.
Fifty-one patients were found to have leptospirosis. The sensitivity of the
IgM-dipstick assay was 98%, its specificity was 90.6%, its positive predictive
value was 90.9%, and its negative predictive value was 98%. The sensitivity of
the IHA was 92.2%, its specificity was 94.4%, its positive predictive value was
95.9%, and its negative predictive value was 92.7%. The standard IgM-ELISA and
MAT, were positive in the first samples tested from 67 and 55% of the cases,
respectively, and the rapid IgM-dipstick assay and IHA were positive in 71 and
49%, respectively, in the first sample tested. Both rapid assays are highly
sensitive and specific. Neither requires specialized equipment, and both are
suitable for use in diagnostic laboratories.
2831.
Werts
C. Tapping RI. Mathison JC. Chuang TH. Kravchenko
V. Saint Girons I. Haake DA.
Godowski PJ. Hayashi F. Ozinsky A.
Underhill DM. Kirschning
CJ. Wagner H. Aderem A. Tobias PS. Ulevitch RJ. Leptospiral lipopolysaccharide
activates cells through a TLR2-dependent mechanism. [see comments]. Nature
Immunology. 2(4):346-52, 2001 Apr.
Abstract
Leptospira interrogans are zoonotic
pathogens that have been linked to a recent increased incidence of morbidity
and mortality in highly populated tropical urban centers. They are unique among
invasive spirochetes in that they contain outer membrane lipopolysaccharide
(LPS) as well as lipoproteins. Here we show that both these leptospiral outer
membrane constituents activate macrophages through CD14 and the Toll-like
receptor 2 (TLR2). Conversely, it seems that TLR4, a central component for
recognition of Gram-negative LPS, is not involved in cellular responses to L.
interrogans. We also show that for intact L. interrogans, it is LPS, not
lipoprotein, that constitutes the predominant signaling component for
macrophages through a TLR2 pathway. These data provide a basis for
understanding the innate immune response caused by leptospirosis and
demonstrate a new ligand specificity for TLR2.