Open AccessChanges in the microbiological diagnosis and epidemiology of cutaneous leishmaniasis in real-time PCR era: A six-year experience in a referral center in Barcelona
Author(s) -
Aroa Silgado,
Mayuli Armas,
Adrián Sánchez-Montalvà,
Lidia Goterris,
María Ubals,
Jordi TempranaSalvador,
Gloria Aparicio,
Carmen Chicharro,
Núria Serre-Delcor,
Berta Ferrer,
Israel Molina,
Vicenç García-Patos,
Tomàs Pumarola,
Elena Sulleiro
Publication year - 2021
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0009884
Subject(s) - leishmania infantum , cutaneous leishmaniasis , epidemiology , leishmaniasis , medicine , leishmania , veterinary medicine , dermatology , visceral leishmaniasis , pathology , parasite hosting , world wide web , computer science
Background Leishmaniasis is a neglected disease caused by different species of the protozoa Leishmania spp . Cutaneous lesions are the most common clinical manifestation. This disease is prevalent in tropical and subtropical areas, including the Mediterranean basin. In Spain, Leishmania (L . ) infantum is the only endemic species, but imported cases are often diagnosed. Different classical parasitological methods can be performed for cutaneous leishmaniasis (CL) diagnosis; but currently molecular techniques serve as a relevant tool for the detection and characterization of Leishmania parasites. We aimed to evaluate clinical and epidemiological characteristics of CL diagnosed patients by real-time PCR in a tertiary hospital over a six-year period. Methodology/Principal findings Clinical, epidemiological and microbiological data were retrospectively collected and analyzed. In our study, CL was confirmed in 59 (31.4%) out of 188 patients by real-time PCR, showing an increase over recent years: 11 cases of CL between 2014 and 2016 and 48 between 2017 and 2019. Real-time PCR was performed on skin swabs and/or biopsies samples, with a positivity of 38.5% and 26.5%, respectively. Results were 100% concordant when biopsy and skin swab were performed simultaneously. L . (L . ) infantum was the most frequent species detected (50%), followed by L . (L . ) major (45%) and Viannia subgenus (5%), which were detected only in imported cases. L . (L . ) major was almost entirely detected in travelers/migrants from Morocco. Multiple and atypical skin lesions were more common in imported cases than in autochthonous cases (44.4% vs. 21.8%). Conclusions/Significance An increase in both autochthonous and imported CL cases has been observed in past years in our hospital. Molecular techniques assist in improving CL diagnosis and characterization of the Leishmania species, mainly in imported cases.