Human Hardjo leptospirosis detected in the Slovak Republic by using serum antibody absorption test.

OBJECTIVE: The study was aimed at the discovery of the possible presence of the human Hardjo leptospirosis in Slovakia. BACKGROUND: Throughout the world, there is a considerable number of publications confirming the presence of this zoonotic infection in domestic animals. On the contrary, scarcely more than a dozen of reports dealing with this occupational disease in humans was published till now. Moreover, the results of them are not convincing in all cases. MATERIAL AND METHODS: Patients´ and dairy cattle serum samples with detected antibodies against the Leptospira strains belonging to four different serovars of the serogroup Sejroe known to be present in Slovakia (i. e. Sejroe, Istrica, Saxkoebing, Polonica) and also reacting with serovar Hardjo strains were examined by using the serum-agglutinin absorption tests in order to determine the etiological agent of the illness on serovar level.  RESULTS: The Hardjo infection was unequivocally confirmed approximately in 1/5 of patients´sera and in 3/5 of dairy cattle sera. CONCLUSION: The AATs are useful tools for detection of Hardjo leptospirosis what is a necessary condition for determination of appropriate epidemiological measures related to this occupational disease. As our knowledge, this methodological approach was not used by other authors till now (Tab. 4, Fig. 1, Ref. 19).

Human Mozdok leptospirosis first diagnosed by serum agglutinin-absorption tests in the Slovak Republic.

INTRODUCTION: The serovar Mozdok related leptospirosis in humans were not yet feasibly diagnosed using merely the standard micro-agglutination test (MAT) what was perhaps due to the impossibility to distinguish them from illnesses that are caused by Leptospira strains belonging to other serovars of the serogroup Pomona. On the contrary, leptospires of the Mozdok serovar were cultured from rodents and domestic animals world-wide including Central Europe where only Leptospira strains of the serovars Pomona and Mozdok are known to be present till now. STUDY OBJECTIVE: The aim of the study was to discover if leptospires of Mozdok serovar may cause human leptospirosis that remained hidden till now among infections diagnosed merely by MAT as Pomona illnesses. MATERIAL AND METHODS: The reference Leptospira strains of Pomona and Mozdok serovars (Pomona and 5621), as well as three endemic, and in some tests only two strains of human and pig origin (Simon, S-23, Pöstényi), and two strains of rodent provenance - Apodemus agrarius (M-210/98 and M-71/01) were used for this purpose. First, the endemic strains were assigned to one of the afore-mentioned two serovars by agglutinin cross-absorption tests performed using rabbit immune sera, monoclonal antibodies and random amplified polymorphic DNA methods. Afterwards, twenty-one sera of patients with a Pomona leptospirosis confirmed by MAT were examined by agglutinin absorption test (AAT). RESULTS: Based on the results of the mentioned laboratory method used, the endemic Leptospira strains of human and pig origin could be affiliated to the serovar Pomona, while those of rodent origin were classified as serovar Mozdok strains. Out of the 21 patients sera, an illness caused by the serovar Mozdok strains was found out in 13 cases and a disease caused by serovar Pomona strains in 8 cases. Their differentiation was made on the strength of the following results of AATs: All strains from the serovar Mozdok have completely absorbed antibodies (anti-Pomona and anti-Mozdok) from the tested sera, however following the absorption of these sera with the Pomona strains, high levels of residual antibodies reacting in MAT with the Mozdok strains have still persisted. In this way, it was possible to prove the Mozdok infection in thirteen patients. On the contrary, following the absorption of the sera with the strains of the serovar Pomona, a complete absorption of all antibodies (anti-Pomona and anti-Mozdok) was achieved in seven cases using the strain Simon, and in one case with the strain S-23, whereas after absorption using the Pomona strain, the residual antibodies were still present in all sera, and also in the majority of them when they were absorbed using the strains S-23 and Pöstényi. In this context, the Pomona infection was determined in the case of eight patients. Hence it follows that not all strains of the Pomona serovar were suitable for the AATs. CONCLUSION: The presence of the human Mozdok leptospirosis was confirmed for the first time by the use of the agglutinin absorption test. A clear correlation between the habitat areas of the A. agrarius and the patients who were infected with the strains of the Mozdok serovar was determined.

[Legionellosis and its diagnosis]. / Legionelózy a ich diagnostika.

The diagnosis of legionellosis, especially of its severe, life-threatening form, Legionnaires' disease, is complicated, primarily because of non-typical symptoms of the infection, not always dominating atypical pneumonia, and often a very dramatic septic course of the disease with multiorgan failures. The diagnosis of the acute phase of the disease can be established by the detection of Legionella antigen in urine and by PCR/real-time PCR detection of Legionella DNA in serum and lower respiratory tract and urine samples. Cultivation on specific media remains the gold standard, but this very demanding method is rarely used. Serological testing requires paired samples and thus is relevant to the diagnosis at a later stage of infection, although it is to be noted that about 20% of patients do not produce the antibodies. Great progress has been made in typing methods (RFLP, PFGE, or PCR based and sequence based methods) and rapid identification methods (MALDI-TOF).

[Possibilities for laboratory diagnosis of leptospiroses]. / Moznosti laboratórnej diagnostiky leptospiróz.

Leptospiroses are worldwide spread zoonoses caused by hydrophilic bacteria of the genus Leptospira. Humans can be infected by contact with an infected animal or indirectly via staying in a contaminated environment (water, wet soil), in natural foci, while working outdoors, or while doing outdoor sport and leisure activities. Leptospirosis may manifest as a mild flu-like illness or in a severe febrile form (meningitis, pulmonary haemorrhage, hepato-renal syndrome, or myocarditis). Presented are the laboratory diagnostic methods for leptospiroses with their advantages and disadvantages. In practice, serological diagnosis by the microscopic agglutination test, which is also a confirmatory test, and, less often, the enzyme-linked immunosorbent assay are used. Methods of molecular biology are being introduced for direct rapid diagnosis of leptospiroses, in particular the polymerase chain reaction and its modifications, which allow the detection of Leptospira infection in acute phase.