Diagnosis and Identification of Leptospira sp. from Direct Clinical Specimens in Pyrexia of Unknown Origin Patients
Diagnosis and Identification of Leptospira sp. in PUO Patients
Keywords:
Leptospirosis diagnosis, Leptospira identification, Pyrexia of Unknown Origin, PhylogeneticsAbstract
Leptospirosis is a zoonotic disease caused by the bacterium Leptospira. Currently, laboratory diagnoses of Leptospira infection are performed using serological techniques, particularly the Indirect Immunofluorescence Assay (IFA), and nucleic acid amplification techniques, such as Real-time PCR. This study aimed to diagnose Leptospira infections through both IFA and Real-time PCR and identify the Leptospira species using direct typing of the 16S rRNA (rrs2) gene from clinical specimens. A total of 2,110 samples from patients with pyrexia of unknown origin were included in this study. Leptospira infection was detected in 33 samples (1.56%). Among these, only 14 samples provided interpretable data from rrs2 gene sequencing. Phylogenetic analysis revealed that 8 samples clustered with L. weilii, 5 with L. interrogans, and 1 with L. alexanderi. Notably, the identification of L. weilii and L. alexanderi from direct clinical specimens has not been previously reported in Thailand. This study suggests that L. weilii and L. alexanderi may be endemic Leptospira species in Thailand, in addition to L. interrogans.
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