Photographic and luminometric detection of luciferase reporter phages for drug susceptibility testing of clinical Mycobacterium tuberculosis isolates.

Luciferase reporter phages (LRPs) have proven to be efficient tools for drug susceptibility testing of Mycobacterium tuberculosis. Luminometric detection of LRP activity offers higher sensitivity and quantitative results, while a Polaroid film detection method offers a "low-tech" inexpensive alternative that is called the Bronx box. In this work we evaluated, improved, and compared the performance of the luminometer and the Bronx box formats for drug susceptibility testing with LRPs by using 51 clinical isolates of M. tuberculosis, with the agar proportion method (PM) serving as reference. The sensitivity in detecting resistance to isoniazid and rifampin, antibiotics that define multidrug resistance (MDR), was 100% for both methods. The turnaround time for results was reduced from 3 weeks for PM to 54 or 94 h for luminometry or the Bronx box, respectively. These results support the utility of LRPs as a screening test for the surveillance of MDR tuberculosis.

PCR-based diagnosis of acute and chronic cutaneous leishmaniasis caused by Leishmania (Viannia).

We evaluated PCR methods for diagnosis of acute and chronic cutaneous leishmaniasis (CL) in an area of Colombia where Leishmania (Viannia) is endemic. The PCR method specifically amplified whole linearized minicircle kinetoplast DNA (kDNA) of the Leishmania subgenus Viannia from biopsy lysates. PCR products were detected in agarose gels. For 255 acute cases, this PCR method had greater sensitivity (75.7%) than each conventional method, i.e., microscopic examination of Giemsa-stained lesion scraping (46.7%), biopsy culture (55.3%), aspirate culture (46.3%), and the conventional methods combined (70.2%). Among 44 cases of chronic CL, amplification of biopsy DNA was more sensitive (45.5%) than the individual (4.5 to 27.7%) and combined (27.3%) conventional methods. The detection of kDNA in biopsies from chronic lesions was enhanced by a chemiluminescent dot blot hybridization, which produced a sensitivity of 65.8% when alone and 90.9% when in combination with DNA extraction of biopsy lysates (P < 0.001). Three biopsies from 84 skin lesions of other etiologies were falsely positive by PCR (specificity, 96.4%). PCR detected kDNA more frequently in biopsies (detection level, 83.9%) than in aspirates (74.7%) from 103 cases of acute CL. Among aspirates from 53 chronic cases of CL, the alternative methods, DNA extraction and hybridization, increased sensitivity from 41.5 to 56.6% (P > 0.05). This enhanced PCR method in chronic biopsies was so much more sensitive than conventional methods that it should be considered the preferred diagnostic method for chronic CL. These findings support the appropriate incorporation of PCR into diagnostic strategies for cutaneous leishmaniasis.

Resumen del taller sobre el uso de la reacción en cadena de la polimerasa (PCR) para distinguir entre Trypanosoma cruzi y Trypanosoma rangeli / Summary of the workshop: use of the polymerase chain reaction (PCR) to differentiate Trypanosoma cruzi from Trypanosoma rangeli

Este taller se realizó con el propósito de transferir la tecnología de la reacción en cadena de la polimerasa (PCR) para la detección de T. cruzi y T. rangeli a laboratorios en Colombia involucrados en el diagnóstico y estudios epidemiológicos de la enfermedad de Chagas. Para demostración de la técnica se utilizaron muestras clínicas y epidemiológicas de áreas endémicas colombianas. En los ensayos se emplearon muestras de tripanosomas provenientes de diferentes medios de cultivo para evaluar el posible efecto de los componentes de estos medios sobre la sensibilidad de PCR. Se hizo extracción de ADN utilizando los métodos de ebullición, lisis hipotónica y geneclean. El ADN se amplificó utilizando oligonucleótidos sintéticos, correspondientes a una secuencia conservada de 22 nucleótidos dentro de un gen mini-exón. Los dos organismos fueron distinguidos por las movilidades electroforéticas de sus respectivos productos de amplificación, confirmando su identidad con sondas intergénicas específicas de especie, marcadas con digoxigenina dUTP. La hibridación se visualizó con la reacción de color del NBT. De un total de 28 muestras analizadas, se lograron 17 identificaciones que coincidieron con la clasificación original. De cinco muestras desconocidas, tres fueron identificadas como T. rangeli y dos como infecciones mixtas. Se presentaron resultados ambiguos en dos muestras, ocasionados por contaminación en PCR. Solamente dos muestras no se pudieron identificar mediante PCR por problemas en la extracción del ADN de la muestra. Teniendo en cuenta estos resultados preliminares se abre la posibilidad de utilizar esta técnica como una herramienta útil o método adicional a las técnicas de rutina para detectar y diagnósticar la enfermedad de Chagas en Colombia