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An evaluation of dark field microscopy, culture and commercial serological kits in the diagnosis of leptospirosis.
Indian J Med Microbiol. 2015 Jul-Sep; 33(3):416-21.IJ

Abstract

CONTEXT

This study was conducted to analyze the clinical utility of various leptospira diagnostic modalities.

AIMS

To evaluate the role of dark field microscopy (DFM), culture, immunochromatography (IgM Leptocheck), IgM enzyme-linked immunosorbent assay (IgM ELISA), macroscopic slide agglutination test (MSAT) and microscopic agglutination test (MAT) in diagnosing leptospirosis in febrile patients.

SETTINGS AND DESIGN

Descriptive study conducted in a tertiary care hospital from January 2011 to April 2012.

SUBJECTS AND METHODS

Blood, urine and paired sera from 100 patients with clinical suspicion of leptospirosis (study group) were collected and subjected to DFM, culture, IgM Leptocheck, IgM ELISA and MSAT. Fifty randomly selected sera from febrile patients tested positive for infections other than leptospirosis (control sera) were also subjected to the aforementioned serological assays. All the leptospira seropositive samples were subjected to MAT.

STATISTICAL ANALYSIS USED

Positive predictive values (PPV) and coefficient of agreement (kappa).

RESULTS

None of the clinical samples showed positivity by DFM. Leptospira inadai was isolated from a urine sample. The seropositivity of IgM Leptocheck, IgM ELISA and MSAT was 16%, 46% and 47%, respectively. The PPV of these assays was 14.3%, 8.7% and 6.5%, respectively. Poor agreement was obtained among these assays. Only four study group leptospira seropositive samples were confirmed by MAT with Australis being the predominant serovar. None of the leptospira-positive control sera were confirmed by MAT.

CONCLUSIONS

DFM and culture have limited utility in diagnosing leptospirosis with serology being the mainstay. The present study shows discordant results with the commercially available serological kits. Further studies should be done to evaluate the various diagnostic modalities.

Authors+Show Affiliations

Department of Microbiology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, Jawahar Lal Nehru Marg, New Delhi, India.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

26068347

Citation

Bhatia, M, et al. "An Evaluation of Dark Field Microscopy, Culture and Commercial Serological Kits in the Diagnosis of Leptospirosis." Indian Journal of Medical Microbiology, vol. 33, no. 3, 2015, pp. 416-21.
Bhatia M, Umapathy BL, Navaneeth BV. An evaluation of dark field microscopy, culture and commercial serological kits in the diagnosis of leptospirosis. Indian J Med Microbiol. 2015;33(3):416-21.
Bhatia, M., Umapathy, B. L., & Navaneeth, B. V. (2015). An evaluation of dark field microscopy, culture and commercial serological kits in the diagnosis of leptospirosis. Indian Journal of Medical Microbiology, 33(3), 416-21. https://doi.org/10.4103/0255-0857.158570
Bhatia M, Umapathy BL, Navaneeth BV. An Evaluation of Dark Field Microscopy, Culture and Commercial Serological Kits in the Diagnosis of Leptospirosis. Indian J Med Microbiol. 2015 Jul-Sep;33(3):416-21. PubMed PMID: 26068347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An evaluation of dark field microscopy, culture and commercial serological kits in the diagnosis of leptospirosis. AU - Bhatia,M, AU - Umapathy,B L, AU - Navaneeth,B V, PY - 2015/6/13/entrez PY - 2015/6/13/pubmed PY - 2016/3/5/medline SP - 416 EP - 21 JF - Indian journal of medical microbiology JO - Indian J Med Microbiol VL - 33 IS - 3 N2 - CONTEXT: This study was conducted to analyze the clinical utility of various leptospira diagnostic modalities. AIMS: To evaluate the role of dark field microscopy (DFM), culture, immunochromatography (IgM Leptocheck), IgM enzyme-linked immunosorbent assay (IgM ELISA), macroscopic slide agglutination test (MSAT) and microscopic agglutination test (MAT) in diagnosing leptospirosis in febrile patients. SETTINGS AND DESIGN: Descriptive study conducted in a tertiary care hospital from January 2011 to April 2012. SUBJECTS AND METHODS: Blood, urine and paired sera from 100 patients with clinical suspicion of leptospirosis (study group) were collected and subjected to DFM, culture, IgM Leptocheck, IgM ELISA and MSAT. Fifty randomly selected sera from febrile patients tested positive for infections other than leptospirosis (control sera) were also subjected to the aforementioned serological assays. All the leptospira seropositive samples were subjected to MAT. STATISTICAL ANALYSIS USED: Positive predictive values (PPV) and coefficient of agreement (kappa). RESULTS: None of the clinical samples showed positivity by DFM. Leptospira inadai was isolated from a urine sample. The seropositivity of IgM Leptocheck, IgM ELISA and MSAT was 16%, 46% and 47%, respectively. The PPV of these assays was 14.3%, 8.7% and 6.5%, respectively. Poor agreement was obtained among these assays. Only four study group leptospira seropositive samples were confirmed by MAT with Australis being the predominant serovar. None of the leptospira-positive control sera were confirmed by MAT. CONCLUSIONS: DFM and culture have limited utility in diagnosing leptospirosis with serology being the mainstay. The present study shows discordant results with the commercially available serological kits. Further studies should be done to evaluate the various diagnostic modalities. SN - 1998-3646 UR - https://www.unboundmedicine.com/medline/citation/26068347/An_evaluation_of_dark_field_microscopy_culture_and_commercial_serological_kits_in_the_diagnosis_of_leptospirosis_ L2 - http://www.ijmm.org/article.asp?issn=0255-0857;year=2015;volume=33;issue=3;spage=416;epage=421;aulast=Bhatia DB - PRIME DP - Unbound Medicine ER -