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Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis

The bacilloscopy of the slit-skin smear (SSS) is the exclusive laboratory test associated with dermato-neurological evaluation for Hansen’s disease (HD) diagnosis; however, it is negative in the majority of PB or primary neural forms. Thus, a PCR technique involving different sequences and target ge...

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Autores principales: Lima, Filipe Rocha, de Paula, Natália Aparecida, Simões, Mateus Mendonça Ramos, Manso, Gabriel Martins da Costa, Albertino, Gustavo Sartori, Felisbino, Giovani Cesar, Antunes, Vanderson Mayron Granemann, Perecin, Fernanda André Martins Cruz, Westin, Andrezza Telles, Lugão, Helena Barbosa, Frade, Marco Andrey Cipriani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399463/
https://www.ncbi.nlm.nih.gov/pubmed/36035405
http://dx.doi.org/10.3389/fmed.2022.972244
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author Lima, Filipe Rocha
de Paula, Natália Aparecida
Simões, Mateus Mendonça Ramos
Manso, Gabriel Martins da Costa
Albertino, Gustavo Sartori
Felisbino, Giovani Cesar
Antunes, Vanderson Mayron Granemann
Perecin, Fernanda André Martins Cruz
Westin, Andrezza Telles
Lugão, Helena Barbosa
Frade, Marco Andrey Cipriani
author_facet Lima, Filipe Rocha
de Paula, Natália Aparecida
Simões, Mateus Mendonça Ramos
Manso, Gabriel Martins da Costa
Albertino, Gustavo Sartori
Felisbino, Giovani Cesar
Antunes, Vanderson Mayron Granemann
Perecin, Fernanda André Martins Cruz
Westin, Andrezza Telles
Lugão, Helena Barbosa
Frade, Marco Andrey Cipriani
author_sort Lima, Filipe Rocha
collection PubMed
description The bacilloscopy of the slit-skin smear (SSS) is the exclusive laboratory test associated with dermato-neurological evaluation for Hansen’s disease (HD) diagnosis; however, it is negative in the majority of PB or primary neural forms. Thus, a PCR technique involving different sequences and target genes has been performed with an aim to increase the sensitivity and specificity of M. leprae identification, especially in patients with low bacillary loads. Additionally, serological assays based on antibody response reflect infection levels and indicate that this could be a simpler, less invasive technique for estimating M. leprae exposure. Serological tests and PCR have been shown to be more sensitive and accurate than the SSS. Our study aimed to measure accuracy and performance among the SSS and PCR of dermal scrapings stored on filter paper and APGL-I serology for diagnosis in HD. A cross-sectional study analyzing the medical records (n = 345) of an HD outpatient-dermatology clinic from 2014 to 2021 was conducted. Accuracy performance parameters, correlation, and concordance were used to assess the value among the SSS, PCR, and APGL-I exams in HD. The SSS presented 24.5% sensitivity, 100% specificity, 37.4% accuracy, and the lowest negative predictive value (21.5%). The PCR assay had 41, 100, and 51% sensitivity, specificity, and accuracy, respectively. PCR and APGL-I serology increased the detection of HD cases by 16 and 20.6%, respectively. PCR was positive in 51.3% of patients when the SSS was negative. The SSS obtained moderate concordance with PCR [k-value: 0.43 (CI: 0.33–0.55)] and APGL-I [k-value: 0.41 (CI: 0.31–0.53)]. A moderate positive correlation was found between the APGL-I index and the bacillary index (r = 0.53; P < 0.0001). Thus, the use of the SSS is a low sensitivity and accuracy method due to its low performance in HD detection. The use of PCR and serological tests allows for a more sensitive and accurate diagnosis of patients.
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spelling pubmed-93994632022-08-25 Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis Lima, Filipe Rocha de Paula, Natália Aparecida Simões, Mateus Mendonça Ramos Manso, Gabriel Martins da Costa Albertino, Gustavo Sartori Felisbino, Giovani Cesar Antunes, Vanderson Mayron Granemann Perecin, Fernanda André Martins Cruz Westin, Andrezza Telles Lugão, Helena Barbosa Frade, Marco Andrey Cipriani Front Med (Lausanne) Medicine The bacilloscopy of the slit-skin smear (SSS) is the exclusive laboratory test associated with dermato-neurological evaluation for Hansen’s disease (HD) diagnosis; however, it is negative in the majority of PB or primary neural forms. Thus, a PCR technique involving different sequences and target genes has been performed with an aim to increase the sensitivity and specificity of M. leprae identification, especially in patients with low bacillary loads. Additionally, serological assays based on antibody response reflect infection levels and indicate that this could be a simpler, less invasive technique for estimating M. leprae exposure. Serological tests and PCR have been shown to be more sensitive and accurate than the SSS. Our study aimed to measure accuracy and performance among the SSS and PCR of dermal scrapings stored on filter paper and APGL-I serology for diagnosis in HD. A cross-sectional study analyzing the medical records (n = 345) of an HD outpatient-dermatology clinic from 2014 to 2021 was conducted. Accuracy performance parameters, correlation, and concordance were used to assess the value among the SSS, PCR, and APGL-I exams in HD. The SSS presented 24.5% sensitivity, 100% specificity, 37.4% accuracy, and the lowest negative predictive value (21.5%). The PCR assay had 41, 100, and 51% sensitivity, specificity, and accuracy, respectively. PCR and APGL-I serology increased the detection of HD cases by 16 and 20.6%, respectively. PCR was positive in 51.3% of patients when the SSS was negative. The SSS obtained moderate concordance with PCR [k-value: 0.43 (CI: 0.33–0.55)] and APGL-I [k-value: 0.41 (CI: 0.31–0.53)]. A moderate positive correlation was found between the APGL-I index and the bacillary index (r = 0.53; P < 0.0001). Thus, the use of the SSS is a low sensitivity and accuracy method due to its low performance in HD detection. The use of PCR and serological tests allows for a more sensitive and accurate diagnosis of patients. Frontiers Media S.A. 2022-08-10 /pmc/articles/PMC9399463/ /pubmed/36035405 http://dx.doi.org/10.3389/fmed.2022.972244 Text en Copyright © 2022 Lima, de Paula, Simões, Manso, Albertino, Felisbino, Antunes, Perecin, Westin, Lugão and Frade. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Lima, Filipe Rocha
de Paula, Natália Aparecida
Simões, Mateus Mendonça Ramos
Manso, Gabriel Martins da Costa
Albertino, Gustavo Sartori
Felisbino, Giovani Cesar
Antunes, Vanderson Mayron Granemann
Perecin, Fernanda André Martins Cruz
Westin, Andrezza Telles
Lugão, Helena Barbosa
Frade, Marco Andrey Cipriani
Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis
title Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis
title_full Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis
title_fullStr Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis
title_full_unstemmed Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis
title_short Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis
title_sort bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-i serology for hansen’s disease diagnosis
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399463/
https://www.ncbi.nlm.nih.gov/pubmed/36035405
http://dx.doi.org/10.3389/fmed.2022.972244
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