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Journal of Clinical Microbiology, January 2000, p. 268-273, Vol. 38, No. 1
0095-1137/0/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Etiology of Genital Ulcer Disease in Dakar, Senegal, and Comparison of PCR and Serologic Assays for Detection of Haemophilus ducreyi

Patricia A. Totten,1,* Jane M. Kuypers,2 Cheng-Yen Chen,3 Michelle J. Alfa,4 Linda M. Parsons,5 Susan M. Dutro,1 Stephen A. Morse,3 and Nancy B. Kiviat2

Departments of Medicine1 and Pathology,2 University of Washington, Seattle, Washington; Division of AIDS, STD, and TB Laboratory Research, Centers for Disease Control and Prevention, Atlanta, Georgia3; Department of Microbiology, St. Boniface General Hospital, Winnipeg, Manitoba, Canada4; and Wadsworth Center, Division of Infectious Diseases, New York State Department of Health, Albany, New York5

Received 9 April 1999/Returned for modification 22 June 1999/Accepted 20 September 1999

We used PCR assays to determine the etiology of genital ulcers in patients presenting to a sexually transmitted disease clinic in Dakar, Senegal, and evaluated the ability of two PCR tests (groEL and recD) and two serological tests (adsorption enzyme immunoassay [EIA] and lipooligosaccharide [LOS] EIA) to detect current Haemophilus ducreyi infection. We found that in this population, H. ducreyi, T. pallidum, and herpes simplex virus HSV DNA were detected in 56, 15, and 13% of 39 genital ulcer specimens, respectively, and H. ducreyi DNA was detected in 60% (3 of 5) of samples from ulcerated bubos. Among 40 consecutive patients with genital ulcer disease and with sufficient sample for both PCR assays, the recD and groEL H. ducreyi PCR assays were 83% concordant, with the recD PCR assay detecting six (15%) additional positive specimens and the groEL assay detecting one (3%) additional positive specimen. Compared to PCR, the adsorption EIA and LOS EIA tests had sensitivities of 71 and 59% and specificities of 57 and 90%, respectively, for the diagnosis of current H. ducreyi infection. While these differences in specificity could be due either to previous infection with H. ducreyi or to the detection of cross-reacting antibodies, only 6% of patients from a nearby family planning clinic gave a positive reaction in both the adsorption EIA and LOS EIA assays, indicating that cross-reacting antibodies are not prevalent among clinic attendees in this city. Our studies indicate that the adsorption EIA detects both current and past infection, while the LOS EIA assay is more specific for current infection with H. ducreyi in this population.

* Corresponding author. Mailing address: Department of Medicine, Division of Infectious Diseases, University of Washington, Harborview Medical Center 325 9th Ave., Seattle, WA 98104-2499. Phone: (206) 341-5350. Fax: (206) 341-5363. E-mail: patotten{at}u.washington.edu.

Journal of Clinical Microbiology, January 2000, p. 268-273, Vol. 38, No. 1
0095-1137/0/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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