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Journal of Clinical Microbiology, February 2001, p. 613-617, Vol. 39, No. 2
Laboratoire de Parasitologie-Mycologie et
Centre National de Référence sur les Leishmanioses (Prof.
J. P. Dedet)1 and Service des
Maladies Infectieuses et Tropicales,3 Centre
Hospitalier Universitaire, and CNRS UMR5093 "Génome des
Protozoaires Parasites," Faculté de
Médecine,2 Montpellier, and
Clinique Vétérinaire de Carros,
Carros,4 France
Received 17 May 2000/Returned for modification 7 August
2000/Accepted 16 November 2000
We have compared various sample preparation methods for the PCR
diagnosis of visceral leishmaniasis (VL) using peripheral blood samples
and tested the influence of these protocols upon sensitivity. Four
methods of lysis-DNA extraction were used with two types of blood
samples: whole blood (WB) and buffy coat (BC). Comparisons were first
carried out with seeded samples at various parasite concentrations. At
high concentrations (
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.2.613-617.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Comparison of Various Sample Preparation Methods
for PCR Diagnosis of Visceral Leishmaniasis Using Peripheral
Blood
1,000 parasites/ml), there were no significant
differences in PCR sensitivity among the methods tested. At
concentrations of
100 parasites/ml, proteinase K (PK)-based methods
proved clearly superior to guanidine-EDTA-based methods. Moreover, a
10-fold increase in sensitivity was observed for BC over that for WB.
Thus, the best sensitivity was obtained with the BC prepared with
PK-based methods. With this combination, the PCR reliably detected 10 parasites/ml but was inconsistent when the sample contained 1 parasite/ml of blood. The methods that yielded the highest
sensitivities were evaluated with seven dogs and four human VL
patients. Again, the utilization of the BC prepared with PK-based
methods gave the best results. The optimization of each step of
the assay (sample preparation, DNA extraction, and PCR conditions)
yielded a highly sensitive tool for the diagnosis of VL using patient
blood, thus avoiding more invasive diagnostic procedures and allowing
the detection of low parasitemia during posttherapeutic follow-up.
*
Corresponding author. Mailing address: Laboratoire de
Parasitologie-Mycologie, Centre Hospitalier Universitaire, 163 Rue A. Brousssonet, F-34090 Montpellier, France. Phone: 33-4-67-63-27-51. Fax:
33-4-67-63-00-49. E-mail: genpara{at}sc.univ-montp1.fr.
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