Evaluation of Co-Agglutination Test in the early diagnosis of Leptospirosis.

Venkatesh, K G (2008) Evaluation of Co-Agglutination Test in the early diagnosis of Leptospirosis. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION : Leptospirosis is a zoonotic disease caused the spirochaete of the genus Leptospirra. This disease is endemic in many parts India and causes frequent outbreaks. Early diagnosis has got very important therapeutic prognostic significance and helps in controlling the outbreaks. Leptospirosis is an acute generalised infectious disease characterised by extensive vasculitis predominantly affecting the liver and kidneys. Though it is a disease of wild mammals and rodents,humans are infected occasionally through direct or indirect contact. In India it is under reported due to lack of laboratory facilities. The pathogenic leptospira belong to the interrogans complex and are classified into 25 serogroups and more than 280 serovars. In India leptospirosis has been documented since 1930’s. The environmental conditions, host range and reservoir pattern make the country more ideal for the prevalence of leptospirosis. AIMS AND OBJECTIVES : 1. To develop Co-agglutination test for the early diagnosis of leptospirosis. 2. To evaluate Co-aggulatination test as a diagnostic tool in the early diagnosis of leptospirosis as compared to Polymerase Chain Reaction (PCR). MATERIALS AND METHODS : Blood samples from 100 patients with clinical features suggestive of Leptospirosis (Fever, Headache, Muscle pain, Conjunctival suffusion) were included in the study. Blood samples were collected during the early period of illness (3-5 days) and were subjected to DFM, PCR, Co-agglutination test MSAT & MAT. Second samples were collected 4-6 days after the first sample and were subjected to MSAT & MAT tests. Darkfield microscopic examination (DFM) was done using plasma for detecting live leptospires and Polymerase Chain Reaction (PCR), Co-Agglutination Test, Microscopic Agglutination Test (MAT), Macroscopic Slide Agglutination Test (MSAT) were done using serum samples collected from patients. PCR was done using PCR diagnosis kit for Leptospira obtained commercially (Genei, Bangalore) for detecting leptrospira DNA. The primers G1 & G2 were supplied with the same kit. PCR tests were done at Dept. of Microbiology, Bharathidasan University, Trichy. Rabbit antisera raised against leptospira were obtained commercially from Animal House, Dr. M.G.R. - Janaki College of Arts & Science for Women College Chennai - 28. for performing the Co-agglutination test. Leptospiral serovars autumnalis. australis iIcterohaemorrhagiae, louisiana, gripphotyphosa, hebdomadis & non – pathogenic serovars. patoc were used for MSAT & MAT. The above standard research strains were obtained from KIT & Royal Tropical. Inst, Netherlands and subcultured periodically in LRC, Institute of Microbiology, MMC, Chennai - 3. RESULTS : Total no of samples screened : 100 • DFM, PCR, Co-agglutination, MSAT & MAT test were done doing early febrile period (3-5days) • Secondary screening was done during follow up in the late febrile period (9-12 days) by MSAT & MAT. Fever was the major clinical feature (95%) followed by myalgia (55%) headache (45%) and conjunctival suffusion (15%) other symptoms included GIT symptoms and Atypical pneumonia etc. CONCLUSION : Thus the comparative analysis with PCR and the various evaluation criteria shows that Staphylococcal aureus Coagglutination method can be used as a screening test in the routine laboratory testing of leptospirosis. Further this test is simple, rapid, inexpensive and can be used in field settings and small unequipped laboraties located in remote areas of endemic regions. This genus specific test will help in initiating early treatment thus helping in reducing the morbidity & mortality due to leptospirosis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Leptospirosis ; Co-Agglutination Test ; Early Diagnosis ; Evaluation.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 16 Aug 2017 00:33
Last Modified: 16 Aug 2017 00:33
URI: http://repository-tnmgrmu.ac.in/id/eprint/1771

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