Evaluation of the Diagnostic Sensitivity of the VIASURE Leishmania Real-Time PCR Detection Kit Prototype for the Diagnosis of Cutaneous and Visceral Leishmaniasis

Abstract

Leishmaniasis is a parasitic disease with clinical presentations that vary from asymptomatic infection to cutaneous, mucocutaneous, or visceral disease. Global change, with migratory movements and travels, among others, has had an impact on the presentation of the clinical forms of leishmaniasis in a given area, hindering its diagnosis. The traditional parasitological techniques have limited sensitivity, and currently, there is no reference or gold-standard molecular diagnostic method. The aim of this study was to evaluate the effectivity of the VIASURE Leishmania Real-Time PCR Detection Kit prototype (CerTest Biotec, Zaragoza, Spain) for the diagnosis of autochthonous and imported leishmaniasis in comparison with two other commercialized molecular kits: STAT-NAT® Leishmania spp. (Sentinel, Milano, Italy) and Leishmania spp. Real-TM PCR Kit (Sacace Biotechnologies, Como, Italy). Four species of Leishmania, L. infantum, L. major, L. braziliensis, and L. panamensis, were targeted to assess analytical sensitivity, whereas diagnostic sensitivity was evaluated by studying a panel of 49 DNA samples from patients with suspected or confirmed Leishmania infection. The prototype could detect all the New and Old World species studied and achieved a limit of detection of 5 × 10−5 ng DNA/μL in all species. Also, it allowed the diagnosis of autochthonous and imported cases of cutaneous and visceral leishmaniasis (VL). Diagnostic sensitivity was 81.8% for the prototype and 100% for the Sacace kit (27 and 33 positive samples detected, respectively). The STAT-NAT® kit failed to detect Vianna species. The VIASURE Leishmania Real-Time PCR Detection Kit prototype was found to have good analytical and diagnostic sensitivity. Using a simple protocol and ready-to-use reagents, results are obtained quickly and are easy to interpret. The evaluation results indicate that the test is a promising candidate for routine diagnosis of cutaneous leishmaniasis and VL in endemic countries, but more studies are necessary to address its sensitivity and specificity.