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Leishmaniasis in Turkey: first clinical isolation of Leishmania major from 18 autochthonous cases of cutaneous leishmaniasis in four geographical regions
Author(s) -
Özbilgin Ahmet,
Çulha Gülnaz,
Uzun Soner,
Harman Mehmet,
Topal Suhan Günaştı,
Okudan Fulya,
Zeyrek Fadile,
Gündüz Cumhur,
Östan İpek,
Karakuş Mehmet,
Töz Seray,
Kurt Özgür,
Akyar Işın,
Erat Ayşegül,
Güngör Dilek,
Kayabaşı Çağla,
Çavuş İbrahim,
Bastien Patrick,
Pratlong Francine,
Kocagöz Tanıl,
Özbel Yusuf
Publication year - 2016
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12698
Subject(s) - cutaneous leishmaniasis , leishmaniasis , leishmania , leishmania major , isolation (microbiology) , biology , visceral leishmaniasis , veterinary medicine , medicine , microbiology and biotechnology , immunology , parasite hosting , world wide web , computer science
Objective To report isolation of Leishmania major strains obtained from 18 Turkish autochthonous cutaneous leishmaniasis ( CL ) patients infected with L. major between 2011 and 2014. Methods Initial diagnosis relied on microscopy and culture in enriched medium, prepared by adding specific amounts of liver extract, protein and lipid sources to NNN medium. Promastigotes were then transferred to RPMI medium including 10% of foetal calf serum for mass culture. Species‐specific real‐time PCR targeting ITS 1 region of Leishmania spp. was performed using both lesion aspiration samples and cultured promastigotes. Two of 18 isolates were identified by isoenzyme analysis in the Leishmaniasis Reference Center in Montpellier, France. Each isolate was inoculated into the footpads of six mice to observe the pathogenicity of L. major . Developing lesions were observed, and the thickening of footpads was measured weekly. Results Melting curve analyses of 18 isolates showed a peak concordant with L. major , and two of them were confirmed by isoenzyme analyses as L. major zymodeme MON 103. In the mouse model, acute lesions seen on day 21 were accepted as an indication of heavy infection. Severe impairments were observed on all mouse footpads over 3 weeks, which even progressed to extremity amputation. Conclusion Cutaneous leishmaniasis‐causing L. major was recently identified in Adana province in southern Turkey, with PCR . Our study shows that such CL cases are not limited to Adana but currently present from western to Southeastern Anatolia, and along the Mediterranean coast. The role of small mammals, the main reservoirs of L. major in Anatolia, needs to be elucidated, as do the underlying factors that cause severe clinical manifestations in L. major infections in Turkey, contrary to the infections in neighbouring countries.