Serological and molecular tools to diagnose visceral leishmaniasis: 2-years' experience of a single center in Northern Italy.

Stefania Varani, M Ortalli, L Attard, E. Vanino, P. Gaibani, Caterina Vocale, G. Rossini, Cagarelli Roberto, A Pierro, P. Billi, A Mastroianni, S Di Cesare, M. Codeluppi, E. Franceschini, Fraia Melchionda, M. Gramiccia, A. Scalone, Giovanna Angela Gentilomi, M. P. Landini

Research output: Contribution to journalArticle

Abstract

The diagnosis of visceral leishmaniasis (VL) remains challenging, due to the limited sensitivity of microscopy, the poor performance of serological methods in immunocompromised patients and the lack of standardization of molecular tests. The aim of this study was to implement a combined diagnostic workflow by integrating serological and molecular tests with standardized clinical criteria. Between July 2013 and June 2015, the proposed workflow was applied to specimens obtained from 94 in-patients with clinical suspicion of VL in the Emilia-Romagna region, Northern Italy. Serological tests and molecular techniques were employed. Twenty-one adult patients (22%) had a confirmed diagnosis of VL by clinical criteria, serology and/or real-time polymerase chain reaction; 4 of these patients were HIV-positive. Molecular tests exhibited higher sensitivity than serological tests for the diagnosis of VL. In our experience, the rK39 immunochromatographic test was insufficiently sensitive for use as a screening test for the diagnosis of VL caused by L. infantum in Italy. However, as molecular tests are yet not standardized, further studies are required to identify an optimal screening test for Mediterranean VL.
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalPLoS One
Volume23
Issue number12
Publication statusPublished - 2017
Externally publishedYes

Fingerprint

visceral leishmaniasis
Visceral Leishmaniasis
Italy
Serologic Tests
Screening
Workflow
immunologic techniques
testing
Polymerase chain reaction
Standardization
screening
Microscopic examination
Immunocompromised Host
Serology
standardization
Real-Time Polymerase Chain Reaction
Microscopy
microscopy
quantitative polymerase chain reaction
HIV

Cite this

Varani, S., Ortalli, M., Attard, L., Vanino, E., Gaibani, P., Vocale, C., ... Landini, M. P. (2017). Serological and molecular tools to diagnose visceral leishmaniasis: 2-years' experience of a single center in Northern Italy. PLoS One, 23(12), 1-10.

Serological and molecular tools to diagnose visceral leishmaniasis: 2-years' experience of a single center in Northern Italy. / Varani, Stefania; Ortalli, M; Attard, L; Vanino, E.; Gaibani, P.; Vocale, Caterina; Rossini, G.; Roberto, Cagarelli; Pierro, A; Billi, P.; Mastroianni, A; Di Cesare, S; Codeluppi, M.; Franceschini, E.; Melchionda, Fraia; Gramiccia, M.; Scalone, A.; Gentilomi, Giovanna Angela; Landini, M. P.

In: PLoS One, Vol. 23, No. 12, 2017, p. 1-10.

Research output: Contribution to journalArticle

Varani, S, Ortalli, M, Attard, L, Vanino, E, Gaibani, P, Vocale, C, Rossini, G, Roberto, C, Pierro, A, Billi, P, Mastroianni, A, Di Cesare, S, Codeluppi, M, Franceschini, E, Melchionda, F, Gramiccia, M, Scalone, A, Gentilomi, GA & Landini, MP 2017, 'Serological and molecular tools to diagnose visceral leishmaniasis: 2-years' experience of a single center in Northern Italy.', PLoS One, vol. 23, no. 12, pp. 1-10.
Varani, Stefania ; Ortalli, M ; Attard, L ; Vanino, E. ; Gaibani, P. ; Vocale, Caterina ; Rossini, G. ; Roberto, Cagarelli ; Pierro, A ; Billi, P. ; Mastroianni, A ; Di Cesare, S ; Codeluppi, M. ; Franceschini, E. ; Melchionda, Fraia ; Gramiccia, M. ; Scalone, A. ; Gentilomi, Giovanna Angela ; Landini, M. P. / Serological and molecular tools to diagnose visceral leishmaniasis: 2-years' experience of a single center in Northern Italy. In: PLoS One. 2017 ; Vol. 23, No. 12. pp. 1-10.
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abstract = "The diagnosis of visceral leishmaniasis (VL) remains challenging, due to the limited sensitivity of microscopy, the poor performance of serological methods in immunocompromised patients and the lack of standardization of molecular tests. The aim of this study was to implement a combined diagnostic workflow by integrating serological and molecular tests with standardized clinical criteria. Between July 2013 and June 2015, the proposed workflow was applied to specimens obtained from 94 in-patients with clinical suspicion of VL in the Emilia-Romagna region, Northern Italy. Serological tests and molecular techniques were employed. Twenty-one adult patients (22{\%}) had a confirmed diagnosis of VL by clinical criteria, serology and/or real-time polymerase chain reaction; 4 of these patients were HIV-positive. Molecular tests exhibited higher sensitivity than serological tests for the diagnosis of VL. In our experience, the rK39 immunochromatographic test was insufficiently sensitive for use as a screening test for the diagnosis of VL caused by L. infantum in Italy. However, as molecular tests are yet not standardized, further studies are required to identify an optimal screening test for Mediterranean VL.",
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AU - Attard, L

AU - Vanino, E.

AU - Gaibani, P.

AU - Vocale, Caterina

AU - Rossini, G.

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AU - Gentilomi, Giovanna Angela

AU - Landini, M. P.

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