Seven Years Leptospirosis Follow-Up in a Critical Care Unit of a French Metropolitan Hospital; Role of Real Time PCR for a Quick and Acute Diagnosis.

Olivier Bahuaud,Adeline Pastuszka,Stephan Ehrmann,Philippe Lanotte,Cécile Le Brun

doi:10.3390/jcm9093011

Abstract

(1) Background: Leptospirosis infection can lead to multiple organ failure, requiring hospitalization in an intensive care unit for supportive care, along with initiation of an adapted antibiotic therapy. Achieving a quick diagnosis is decisive in the management of these patients. (2) Methods: We present here a review of leptospirosis cases diagnosed in the intensive care unit of our hospital over seven years. Clinical and biological data were gathered, and we compared the differences in terms of diagnostic method. (3) Results: Molecular biology method by Polymerase Chain Reaction (PCR) allowed quick and reliable diagnosis when performed in the first days after the symptoms began. Moreover, we identified that sampling blood and urine for PCR was more efficient than performing PCR on only one type of biological sample. (4) Conclusions: Our results confirm the efficiency of PCR for the quick diagnosis of leptospirosis and suggest that testing both blood and urine early in the disease might improve diagnosis.

Highlights

Leptospirosis is a widespread bacterial zoonosis caused by pathogenic Leptospira species
(2) Methods: We present here a review of leptospirosis cases diagnosed in the intensive care unit of our hospital over seven years
Over a seven-year period (January 2011 to January 2018) the PMSI database of Tours University Hospital identified 16 cases of confirmed leptospirosis in adult patients hospitalized in the Intensive Care Unit (ICU)

Summary

Introduction

Leptospirosis is a widespread bacterial zoonosis caused by pathogenic Leptospira species. It is responsible for large epidemics in endemic tropical areas. The global burden of Leptospirosis is estimated at one million cases with approximately 60,000 deaths annually, occurring primarily in rural and peri-urban areas of tropical regions [1]. Humans serve as accidental hosts and small mammals, mainly rodents, constitute the major reservoir. Leptospira colonize their urinary tract, inducing urinary shedding that can last for long periods without symptoms. Infection occurs either through direct contact with infected animals, or indirectly via mucous membranes or skin lesions that have been in contact with soil or water contaminated with urine from infected animals [3,4]

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