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Abstract

. Leptospirosis, caused by spirochetes of the genus , is present in the Koprivnica-Križevci County area, Croatia. Clinical manifestation can range from asymptomatic, short-term mild, non-specific febrile disease, to severe forms with high mortality rates.

The aim of the study was to valuate culture in front of microscopic agglutination test (MAT) for diagnosis of infection, and to evaluate clinical and laboratory features of the disease. Moreover, we want to characterize strains involved in infection in Koprivnica-Križevci County, Croatia.

We included 68 patients with clinical presentation consistent with leptospirosis collected in a 5-year period (2000–2004). Clinical samples (blood, urine and cerebrospinal fluid, CSF) were inoculated in Kolthoff’s medium; species of isolated strains was determined with Tm of real-time PCR, serogroup/serovar with MAT and NotI-RFLP analysis. Demonstration of specific antibodies in patients’ sera was done using microscopic agglutination test.

was isolated from the blood of 14/51(27.5 %) patients and the most often identified serogroup/serovar was Icterohaemorrhagiae (8/10, 80%) followed by Grippotyphosa (10%). Regarding to species level, 8/10 isolated belonged to and one to species. MAT was carried out on 51 patients with suspected leptospirosis, and was positive in 11/51(21.5 %) patients. Most of our patients presented with moderate severe symptoms, were hospitalized from August to October, and were infected mainly during the work or recreation in our county. The frequency of particular clinical features and pathological laboratory findings correlated with the severity of the clinical condition.

Leptospirosis can be confirmed microbiologically, culture and MAT contributed almost equally to the diagnosis of infection. Serovar Icterohaemorrhagiae was found as the dominant one, and as dominant species in our county. Epidemiological data shown that leptospirosis occurs seasonally, affects the rural population, and most commonly is presented with moderate severe clinical course.

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2023-04-26
2025-01-16
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References

  1. Levett PN. Leptospirosis. Clin Microbiol Rev 2001; 14:296–326 [View Article] [PubMed]
    [Google Scholar]
  2. Levett PN. Leptospira. In Jorgensen JP. eds Manual of Clinical Microbiology Washington, DC, USA: ASM Press; 2015 pp 1028–1036 [View Article]
    [Google Scholar]
  3. Centers for Disease Control and Prevention (CDC) Update: outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000. MMWR Morb Mortal Wkly Rep 2001; 50:21–24 [PubMed]
    [Google Scholar]
  4. Lau C, Smythe L, Weinstein P. Leptospirosis: an emerging disease in travellers. Travel Med Infect Dis 2010; 8:33–39 [View Article] [PubMed]
    [Google Scholar]
  5. Radl C, Müller M, Revilla-Fernandez S, Karner-Zuser S, de Martin A et al. Outbreak of leptospirosis among triathlon participants in Langau, Austria, 2010. Wien Klin Wochenschr 2011; 123:751–755 [View Article] [PubMed]
    [Google Scholar]
  6. Gouveia EL, Metcalfe J, de Carvalho ALF, Aires TSF, Villasboas-Bisneto JC et al. Leptospirosis-associated severe pulmonary hemorrhagic syndrome, Salvador, Brazil. Emerg Infect Dis 2008; 14:505–508 [View Article] [PubMed]
    [Google Scholar]
  7. Katz AR, Ansdell VE, Effler PV, Middleton CR, Sasaki DM. Assessment of the clinical presentation and treatment of 353 cases of laboratory-confirmed leptospirosis in Hawaii, 1974-1998. Clin Infect Dis 2001; 33:1834–1841 [View Article] [PubMed]
    [Google Scholar]
  8. Herrmann-Storck C, Saint-Louis M, Foucand T, Lamaury I, Deloumeaux J et al. Severe leptospirosis in hospitalized patients, Guadeloupe. Emerg Infect Dis 2010; 16:331–334 [View Article] [PubMed]
    [Google Scholar]
  9. Papa A, Theoharidou D, Antoniadis A. Pulmonary involvement and leptospirosis, Greece. Emerg Infect Dis 2009; 15:834–835 [View Article] [PubMed]
    [Google Scholar]
  10. Schreier S, Doungchawee G, Chadsuthi S, Triampo D, Triampo W. Leptospirosis: current situation and trends of specific laboratory tests. Expert Rev Clin Immunol 2013; 9:263–280 [View Article] [PubMed]
    [Google Scholar]
  11. Hartskeerl RA, Collares-Pereira M, Ellis WA. Emergence, control and re-emerging leptospirosis: dynamics of infection in the changing world. Clin Microbiol Infect 2011; 17:494–501 [View Article] [PubMed]
    [Google Scholar]
  12. Organization WH Human Leptospirosis: Guidance for Diagnosis, Surveillance and Control 2003
    [Google Scholar]
  13. Brett-Major DM, Coldren R. Antibiotics for leptospirosis. Cochrane Database Syst Rev 2012CD008264 [View Article] [PubMed]
    [Google Scholar]
  14. Mišić Majerus LK V. Području općine koprivnica (1970-1975. Acta Medicorum 1977; 4:19–25
    [Google Scholar]
  15. Kuzman I, Markotić A. Velika epidemija hemoragijske vrućice s bubrežnim sindromom (HVBS) u hrvatskoj (prvo priopćenje). Infektološki Glasnik 2002; 22:77–79 [View Article] [PubMed]
    [Google Scholar]
  16. Mišić-Majerus L, Habuš J, Štritof Z, Bujić N, Mađarić V et al. Epidemiological and clinical features of leptospirosis in a highly endemic area over three time periods. Trop Med Int Health 2017; 22:1405–1413 [View Article] [PubMed]
    [Google Scholar]
  17. Postic DM, Perolat P, Baranton G. Diagnostic Biologique Leptospirose - Borreliose de Lyme, 2nd ed. Paris: Institut Pasteur; 2000
    [Google Scholar]
  18. Herrmann JL, Bellenger E, Perolat P, Baranton G, Saint Girons I. Pulsed-field gel electrophoresis of NotI digests of leptospiral DNA: a new rapid method of serovar identification. J Clin Microbiol 1992; 30:1696–1702 [View Article] [PubMed]
    [Google Scholar]
  19. Merien F, Portnoi D, Bourhy P, Charavay F, Berlioz-Arthaud A et al. A rapid and quantitative method for the detection of Leptospira species in human leptospirosis. FEMS Microbiol Lett 2005; 249:139–147 [View Article] [PubMed]
    [Google Scholar]
  20. Varni V, Ruybal P, Lauthier JJ, Tomasini N, Brihuega B et al. Reassessment of MLST schemes for Leptospira spp. typing worldwide. Infect Genet Evol 2014; 22:216–222 [View Article] [PubMed]
    [Google Scholar]
  21. Ahmed N, Devi SM, Valverde M de los A, Vijayachari P, Machang’u RS et al. Multilocus sequence typing method for identification and genotypic classification of pathogenic Leptospira species. Ann Clin Microbiol Antimicrob 2006; 5:28 [View Article] [PubMed]
    [Google Scholar]
  22. Mišić Majerus L. Od Kužnog Paviljona do pilot Projekta: Opća Bolnica "Dr. Tomislav Bardek" Koprivnica; 2009
    [Google Scholar]
  23. Baranton G, Postic D. Trends in leptospirosis epidemiology in France. Sixty-six years of passive serological surveillance from 1920 to 2003. Int J Infect Dis 2006; 10:162–170 [View Article] [PubMed]
    [Google Scholar]
  24. Topic MB, Habus J, Milas Z, Tosev EC, Stritof Z et al. Human leptospirosis in Croatia: current status of epidemiology and clinical characteristics. Trans R Soc Trop Med Hyg 2010; 104:202–206 [View Article] [PubMed]
    [Google Scholar]
  25. Haake DA, Levett PN. Leptospirosis in humans. Curr Top Microbiol Immunol 2015; 387:65–97 [View Article] [PubMed]
    [Google Scholar]
  26. Dolhnikoff M, Mauad T, Bethlem EP, Carvalho CR. Pathology and pathophysiology of pulmonary manifestations in leptospirosis. The Brazilian journal of infectious diseases: an official publication of the brazilian society of infectious diseases. Braz J Infect Dis 2007; 11:142–148 [View Article] [PubMed]
    [Google Scholar]
  27. Tubiana S, Mikulski M, Becam J, Lacassin F, Lefèvre P et al. Risk factors and predictors of severe leptospirosis in New Caledonia. PLoS Negl Trop Dis 2013; 7:e1991 [View Article] [PubMed]
    [Google Scholar]
  28. Vijayachari P, Sugunan AP, Shriram AN. Leptospirosis: an emerging global public health problem. J Biosci 2008; 33:557–569 [View Article] [PubMed]
    [Google Scholar]
  29. Spichler AS, Vilaça PJ, Athanazio DA, Albuquerque JOM, Buzzar M et al. Predictors of lethality in severe leptospirosis in urban Brazil. Am J Trop Med Hyg 2008; 79:911–914 [PubMed]
    [Google Scholar]
  30. Perić L, Simasek D, Barbić J, Perić N, Prus V et al. Human leptospirosis in eastern Croatia, 1969-2003: epidemiological, clinical, and serological features. Scand J Infect Dis 2005; 37:738–741 [View Article] [PubMed]
    [Google Scholar]
  31. Habuš JC, Željko M, Zoran Š, Zrinka B-T, Mirjana M et al. Seroepidemiološko i seroepizootiološko istraživanje leptospiroze u hrvatskoj tijekom 2007. Infektološki Glasnik 2008; 28:183–188
    [Google Scholar]
  32. Stritof Majetic Z, Galloway R, Ruzic Sabljic E, Milas Z, Mojcec Perko V et al. Epizootiological survey of small mammals as Leptospira spp. reservoirs in Eastern Croatia. Acta Trop 2014; 131:111–116 [View Article] [PubMed]
    [Google Scholar]
  33. Turk N, Milas Z, Mojcec V, Ruzic-Sabljic E, Staresina V et al. Molecular analysis of Leptospira spp. isolated from humans by restriction fragment length polymorphism, real-time PCR and pulsed-field gel electrophoresis. FEMS Microbiol Lett 2009; 300:174–179 [View Article] [PubMed]
    [Google Scholar]
  34. Wuthiekanun V, Chierakul W, Limmathurotsakul D, Smythe LD, Symonds ML et al. Optimization of culture of Leptospira from humans with leptospirosis. J Clin Microbiol 2007; 45:1363–1365 [View Article] [PubMed]
    [Google Scholar]
  35. Podgoršek D, Ružić-Sabljić E, Logar M, Pavlović A, Remec T et al. Evaluation of real-time PCR targeting the lipL32 gene for diagnosis of Leptospira infection. BMC Microbiol 2020; 20:59 [View Article] [PubMed]
    [Google Scholar]
  36. Levett PN, Whittington CU. Evaluation of the indirect hemagglutination assay for diagnosis of acute leptospirosis. J Clin Microbiol 1998; 36:11–14 [View Article] [PubMed]
    [Google Scholar]
  37. Ahmad SN, Shah S, Ahmad FM. Laboratory diagnosis of leptospirosis. J Postgrad Med 2005; 51:195–200 [PubMed]
    [Google Scholar]
  38. Cumberland P, Everard CO, Levett PN. Assessment of the efficacy of an IgM-elisa and microscopic agglutination test (MAT) in the diagnosis of acute leptospirosis. Am J Trop Med Hyg 1999; 61:731–734 [View Article] [PubMed]
    [Google Scholar]
  39. Limmathurotsakul D, Turner EL, Wuthiekanun V, Thaipadungpanit J, Suputtamongkol Y et al. Fool’s gold: Why imperfect reference tests are undermining the evaluation of novel diagnostics: a reevaluation of 5 diagnostic tests for leptospirosis. Clin Infect Dis 2012; 55:322–331 [View Article] [PubMed]
    [Google Scholar]
  40. Bhatia M, Umapathy BL, Navaneeth BV. An evaluation of dark field microscopy, culture and commercial serological kits in the diagnosis of leptospirosis. Indian J Med Microbiol 2015; 33:416–421 [View Article] [PubMed]
    [Google Scholar]
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