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Euro Surveill. 2016 Dec 8;21(49). pii: 30418. doi: 10.2807/1560-7917.ES.2016.21.49.30418.

Comparison of Leishmania typing results obtained from 16 European clinical laboratories in 2014.

Author information

1
Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
2
Academic Medical Center, Amsterdam, The Netherlands.
3
Instituto de Salud Carlos III, Madrid, Spain.
4
Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, UNL, Lisbon, Portugal.
5
The Public Health Agency of Sweden, Stockholm, Sweden.
6
Istituto Superiore di Sanità, Rome, Italy.
7
Biomedical Sciences, Antwerp University, Antwerp, Belgium.
8
Swiss Tropical and Public Health Institute, Basel, Switzerland.
9
University of Basel, Basel, Switzerland.
10
National Institute for Infectious Diseases (INMI) Lazzaro Spallanzani, Rome, Italy.
11
Institute of Parasitology, University of Zürich, Zürich, Switzerland.
12
Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany.
13
Hebrew University, Hadassah Medical Centre, Jerusalem, Israel.
14
United Kingdom National External Quality Assessment Service, London, United Kingdom.
15
University of Montpellier, Montpellier, France.
16
Centre Hospitalier Universitaire de Rennes, Rennes, France.
17
National Institute for Public Health and the Environment, RIVM, Bilthoven, The Netherlands.
18
Ege University, Faculty of Medicine, Department of Parasitology, Izmir, Turkey.
19
St. Elisabeth Hospital, Tilburg, The Netherlands.
20
Hospital for Tropical Diseases, London, United Kingdom.
21
London School of Hygiene and Tropical Medicine, London, United Kingdom.

Abstract

Leishmaniasis is endemic in southern Europe, and in other European countries cases are diagnosed in travellers who have visited affected areas both within the continent and beyond. Prompt and accurate diagnosis poses a challenge in clinical practice in Europe. Different methods exist for identification of the infecting Leishmania species. Sixteen clinical laboratories in 10 European countries, plus Israel and Turkey, conducted a study to assess their genotyping performance. DNA from 21 promastigote cultures of 13 species was analysed blindly by the routinely used typing method. Five different molecular targets were used, which were analysed with PCR-based methods. Different levels of identification were achieved, and either the Leishmania subgenus, species complex, or actual species were reported. The overall error rate of strains placed in the wrong complex or species was 8.5%. Various reasons for incorrect typing were identified. The study shows there is considerable room for improvement and standardisation of Leishmania typing. The use of well validated standard operating procedures is recommended, covering testing, interpretation, and reporting guidelines. Application of the internal transcribed spacer 1 of the rDNA array should be restricted to Old World samples, while the heat-shock protein 70 gene and the mini-exon can be applied globally.

KEYWORDS:

Typing; hsp70; kinetoplast DNA; leishmaniasis; mini-exon; rDNA ITS1

[Indexed for MEDLINE]
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