MyMedR

Fulltext A hospital-based study on seroprevalence of leptospirosis among febrile cases in northeastern Malaysia

Rafizah AA, Aziah BD, Azwany YN, Imran MK, Rusli AM, Nazri SM, et al.

Int J Infect Dis, 2013 Jun;17(6):e394-7.

PMID: 23357246 DOI: 10.1016/j.ijid.2012.12.012

To determine the seroprevalence of leptospirosis among febrile inpatient cases in northeastern Malaysia.

Matched MeSH terms: Leptospirosis/epidemiology*

Risk factors of leptospirosis among febrile hospital admissions in northeastern Malaysia

Rafizah AA, Aziah BD, Azwany YN, Imran MK, Rusli AM, Nazri SM, et al.

Prev Med, 2013;57 Suppl:S11-3.

PMID: 23295174 DOI: 10.1016/j.ypmed.2012.12.017

Leptospirosis is a worldwide zoonotic disease. Risk factors for the disease may vary among countries.

Matched MeSH terms: Leptospirosis/diagnosis; Leptospirosis/etiology*; Leptospirosis/epidemiology

Fulltext A low molecular weight lipopolysaccharide antigen preparation reactive to acute leptospirosis heterologous sera

Riazi M, Abdul Rani B, Fairuz A, Zainul FZ

Trop Biomed, 2010 Aug;27(2):241-53.

PMID: 20962722 MyJurnal

There is a need for identification of new infection markers against common Leptospira isolates in Malaysia. To achieve this goal, seven-day-old cultures of Leptospira interrogans serogroup Icterohemorrhagiae (L44) and Leptospira interrogans serogroup Javanica (L55) were used for antigen preparation by sequential extraction method using 40 mM Tris, 8M Urea and 2M thiourea. Immunoblot analysis of the antigens were performed using serum samples from 46 local patients with confirmed acute leptospirosis, 28 patients with other infections and 14 healthy controls. The patients serum samples used in this study contained heterologous antibody against a number of different leptospira serovars. A strong IgM reactivity to a broad diffuse band of 10-15 kDa was observed. Combining results using L44 and L55 antigens showed sensitivity of 80.4% and specificity of 95.2% for detection of leptospirosis. Proteinase K and periodate treatment indicated that the band is likely to be lipopolysaccharide (LPS) in nature. This study showed that the 10-15 kDa antigen could potentially be useful for serodiagnosis of acute leptospirosis in Malaysia.

Matched MeSH terms: Leptospirosis/blood*; Leptospirosis/epidemiology

Fulltext Work Environment-Related Risk Factors for Leptospirosis among Plantation Workers in Tropical Countries: Evidence from Malaysia

Mohd Ridzuan J, Aziah BD, Zahiruddin WM

Int J Occup Environ Med, 2016 07;7(3):156-63.

PMID: 27393322 DOI: 10.15171/ijoem.2016.699

BACKGROUND: Leptospirosis is a zoonotic disease that is recognized as a re-emerging global public health issue, especially in tropical and subtropical countries. Malaysia, for example, has increasingly registered leptospirosis cases, outbreaks, and fatalities over the past decade. One of the major industries in the country is the palm oil sector, which employs numerous agricultural workers. These laborers are at a particularly high risk of contracting the disease.

OBJECTIVE: To identify the work environment-related risk factors for leptospirosis infection among oil palm plantation workers in Malaysia.

METHODS: A cross-sectional study involving 350 workers was conducted. The participants were interviewed and administered a microscopic agglutination test. Seropositivity was determined using a cut-off titer of ≥1:100.

RESULTS: 100 of 350 workers tested positive for leptospiral antibodies, hence, a seroprevalence of 28.6% (95% CI 23.8% to 33.3%). The workplace environment-related risk factors significantly associated with seropositive leptospirosis were the presence of cows in plantations (adjusted OR 4.78, 95% CI 2.76 to 8.26) and the presence of a landfill in plantations (adjusted OR 2.04, 95% CI 1.22 to 3.40).

CONCLUSION: Preventing leptospirosis incidence among oil palm plantation workers necessitates changes in policy on work environments. Identifying modifiable factors may also contribute to the reduction of the infection.

Matched MeSH terms: Leptospirosis/immunology; Leptospirosis/epidemiology*

Fulltext Antimicrobial prophylaxis for melioidosis and leptospirosis for at risk rescue workers

Yew KL

Med J Malaysia, 2013;68(1):88.

PMID: 23466779

Matched MeSH terms: Leptospirosis

Fulltext Molecular detection of leptospirosis and melioidosis co-infection: A case report

Mohd Ali MR, Mohamad Safiee AW, Thangarajah P, Fauzi MH, Muhd Besari A, Ismail N, et al.

J Infect Public Health, 2017 Nov-Dec;10(6):894-896.

PMID: 28330585 DOI: 10.1016/j.jiph.2017.02.009

Leptospirosis and melioidosis are important tropical infections caused by Leptospira and Burkholdheria pseudomallei, respectively. As both infections share similar clinical manifestations yet require different managements, complementary laboratory tests are crucial for the diagnosis. We describe a case of Leptospira and B. pseudomallei co-infection in a diabetic 40-year-old woman with history of visit to a freshwater camping site in northern Malaysia. To our knowledge, this is the first case of such double-infection, simultaneously demonstrated by molecular approach. This case highlights the possibility of leptospirosis and melioidosis co-infections and their underlying challenges in the rapid and accurate detection of the etiologic microorganism.

Matched MeSH terms: Leptospirosis/diagnosis*; Leptospirosis/pathology

Development and validation of pan-Leptospira Taqman qPCR for the detection of Leptospira spp. in clinical specimens

Mohd Ali MR, Mohd Safee AW, Ismail NH, Abu Sapian R, Mat Hussin H, Ismail N, et al.

Mol Cell Probes, 2018 04;38:1-6.

PMID: 29524642 DOI: 10.1016/j.mcp.2018.03.001

BACKGROUND: Early diagnosis of leptospirosis is important for ensuring better clinical management and achieving better outcomes. Currently, serological assays suffer from inconsistent performance and are less useful for early diagnosis of leptospirosis. As an alternative, qPCR is more sensitive, specific and able to detect the presence of leptospiral DNA during the acute phase of the infection. Meanwhile, most molecular assays do not detect the non-pathogenic group of Leptospira, even though these groups may also infect humans, although less frequently and less severely.

METHODS: A set of primers and probe targeting rrs genes of 22 Leptospira spp. were designed and evaluated on 31 Leptospira isolates, 41 other organisms and 65 clinical samples from suspected patients.

RESULTS: The developed assay was able to detect as low as 20 fg Leptospira DNA per reaction (equivalent to approximately 4 copies) and showed high specificity against the tested leptospiral strains. No cross amplification was observed with the other organisms. During the evaluation of the confirmed clinical specimens, the developed assay was able to correctly identify all positive samples (n = 10/10). One amplification was observed in a negative sample (n = 1/55). The sequencing of the PCR product of the discordant sample revealed that the sequences were similar to those of L. interrogans and L. kirschneri.

CONCLUSION: The findings suggest that the developed Taqman qPCR assay is sensitive, specific and has potential to be applied in a larger subsequent study.

Matched MeSH terms: Leptospirosis

Development of multiplex loop mediated isothermal amplification (m-LAMP) label-based gold nanoparticles lateral flow dipstick biosensor for detection of pathogenic Leptospira

Nurul Najian AB, Engku Nur Syafirah EA, Ismail N, Mohamed M, Yean CY

Anal Chim Acta, 2016 Jan 15;903:142-8.

PMID: 26709307 DOI: 10.1016/j.aca.2015.11.015

In recent years extensive numbers of molecular diagnostic methods have been developed to meet the need of point-of-care devices. Efforts have been made towards producing rapid, simple and inexpensive DNA tests, especially in the diagnostics field. We report on the development of a label-based lateral flow dipstick for the rapid and simple detection of multiplex loop-mediated isothermal amplification (m-LAMP) amplicons. A label-based m-LAMP lateral flow dipstick assay was developed for the simultaneous detection of target DNA template and a LAMP internal control. This biosensor operates through a label based system, in which probe-hybridization and the additional incubation step are eliminated. We demonstrated this m-LAMP assay by detecting pathogenic Leptospira, which causes the re-emerging disease Leptospirosis. The lateral flow dipstick was developed to detect of three targets, the LAMP target amplicon, the LAMP internal control amplicon and a chromatography control. Three lines appeared on the dipstick, indicating positive results for all representative pathogenic Leptospira species, whereas two lines appeared, indicating negative results, for other bacterial species. The specificity of this biosensor assay was 100% when it was tested with 13 representative pathogenic Leptospira species, 2 intermediate Leptospira species, 1 non-pathogenic Leptospira species and 28 other bacteria species. This study found that this DNA biosensor was able to detect DNA at concentrations as low as 3.95 × 10(-1) genomic equivalent ml(-1). An integrated m-LAMP and label-based lateral flow dipstick was successfully developed, promising simple and rapid visual detection in clinical diagnostics and serving as a point-of-care device.

Matched MeSH terms: Leptospirosis

Evaluation of Leptospira biflexa antigens for screening human sera by the microscopic agglutination (MA) test in comparison with the sensitized-erythrocyte-lysis (SEL) test

Tan DS, Welch QB

Southeast Asian J. Trop. Med. Public Health, 1974 Mar;5(1):12-6.

PMID: 4839075

Matched MeSH terms: Leptospirosis/diagnosis*

[A case of leptospirosis infected in Borneo Island, Malaysia]

Sakamoto M, Sagara H, Koizumi N, Watanabe H

Kansenshogaku Zasshi, 2001 Dec;75(12):1057-61.

PMID: 11806141

We report a case of leptospirosis infected in Sabah, Borneo island, Malaysia. The case is 25-year-old male who had participated in the EcoChallenge Sabah 2000 Expedition Race, a multisport event held during August 20 to September 3, 2000 at various sites in Sabah in Malaysian Borneo. He developed a high fever and headache on September 7, and he was admitted to our hospital on September 9. On admission he also had conjunctivitis and myalgias. Laboratory findings on admission revealed leukocytosis with left shift, slightly elevated transaminase levels, high CRP levels and proteinuria. Plasmodium spp. were negative on blood smears, and no bacteria were isolated from blood and feces cultures. We performed the laboratory tests for leptospirosis, based on the information about the probable leptospirosis outbreak among athletes who participated in the EcoChallenge Race, however both Leptospira antigens and antibodies were negative at that time. We diagnosed leptospirosis clinically because he manifested persistent symptoms, and minocycline 100 mg b.i.d. was administered intravenously resulting in excellent efficacy. Serum antibody tests by microscopic agglutination test (MAT) at convalescent stage revealed significant increased antibodies against Leptospira interrogans serovar hebdomadis, and the diagnosis of leptospirosis was confirmed. Infectious diseases have been global and it is important to have information concerning worldwide infectious disease situations as much as possible for accurate diagnosis.

Matched MeSH terms: Leptospirosis/diagnosis; Leptospirosis/etiology*

Fulltext The effect of pH on the survival of leptospires in water

Smith CE, Turner LH

Bull World Health Organ, 1961;24(1):35-43.

PMID: 20604084

One of the factors on which the incidence of leptospirosis is dependent is the survival time of shed leptospires in surface water or soil water, and this time is in turn affected by the acidity or alkalinity of the water. The authors have therefore studied the survival of four leptospiral serotypes in buffered distilled water at pH's ranging from 5.3 to 8.0. All survived longer in alkaline than in acid water, and significant differences between the serotypes were found in response to pH. Survival at pH's under 7.0 ranged from 10 to 117 days and at pH's over 7.0 from 21 to 152 days. Survival was also studied in aqueous extracts of soil samples from different areas in Malaya; no correlation was found between pH and survival time.It was also noted that in a group of Malayan ricefields a low incidence of leptospirosis in man was accompanied by a high infection rate among rodents, and when it was found that this phenomenon could not be explained by pH or salinity, attention was turned to the soil. Bentonite clay, similar to the montmorrillonite clay of the ricefields, was found to adsorb about half the leptospires in suspension. The authors recommend that field study of this laboratory observation be undertaken.

Matched MeSH terms: Leptospirosis

Leptospira brings fresh challenge to adventure sports

Trubo R

Lancet Infect Dis, 2001 Sep;1(2):73.

PMID: 11871475

Matched MeSH terms: Leptospirosis/epidemiology*; Leptospirosis/physiopathology

Fulltext Clinical aspect of leptospirosis in Malaya

Trimble AP

Proc. R. Soc. Med., 1957 Feb;50(2):125-8.

PMID: 13408224

Matched MeSH terms: Leptospirosis/epidemiology*

The bacteriological prevalence of leptospiral infection in cattle and buffaloes in West Malaysia

Bahaman AR, Ibrahim AL, Stallman ND, Tinniswood RD

Epidemiol Infect, 1988 Apr;100(2):239-46.

PMID: 3356222

A cross-sectional bacteriological survey of cattle in West Malaysia revealed 14.4% (32/222) had leptospiral infection. Isolates were obtained from all except one herd with prevalence of infection in herds ranging from 0-44.8%. A small number of buffalo urine samples were examined and all of them were found to be negative. A leptospiral isolate obtained from a bovine kidney proved to be a new serovar of Leptospira interrogans and the name unipertama was assigned to it. Six other leptospiral serovars were isolated, namely canicola, australis, javanica, ballum, pomona and hardjo. All six serovars were isolated for the first time in cattle in Malaysia. Cattle in Malaysia appear to be the maintenance host for serovar hardjo. The presence of the other serovars in cattle was probably due to contact with the maintenance hosts, pigs for serovar pomona and rodents for the other three serovars. It appears that the epidemiology of leptospiral infection in cattle in Malaysia is similar to that reported overseas.

Matched MeSH terms: Leptospirosis/microbiology; Leptospirosis/epidemiology; Leptospirosis/veterinary*

Fulltext Determination of Leptospira borgpetersenii serovar Javanica and Leptospira interrogans serovar Bataviae as the persistent Leptospira serovars circulating in the urban rat populations in Peninsular Malaysia

Benacer D, Mohd Zain SN, Sim SZ, Mohd Khalid MK, Galloway RL, Souris M, et al.

Parasit Vectors, 2016;9:117.

PMID: 26927873 DOI: 10.1186/s13071-016-1400-1

Leptospirosis is an emerging infectious disease of global significance, and is endemic in tropical countries, including Malaysia. Over the last decade, a dramatic increase of human cases was reported; however, information on the primary vector, the rat, and the Leptospira serovars circulating among the rat population is limited. Therefore, the present study was undertaken to isolate Leptospira and characterise the serovars circulating in the urban rat populations from selected main cities in Peninsular Malaysia.

Matched MeSH terms: Leptospirosis

Predominance of the ST143 and ST50 Leptospira clones in the urban rat populations of Peninsular Malaysia

Benacer D, Mohd Zain SN, Ahmed AA, Mohd Khalid MKN, Hartskeerl RA, Thong KL

J Med Microbiol, 2016 Jun;65(6):574-577.

PMID: 27058766 DOI: 10.1099/jmm.0.000262

Matched MeSH terms: Leptospirosis/microbiology; Leptospirosis/epidemiology; Leptospirosis/veterinary*

Fulltext Antimicrobial susceptibility of Leptospira spp. isolated from environmental, human and animal sources in Malaysia

Benacer D, Zain SN, Ooi PT, Thong KL

Indian J Med Microbiol, 2017 Jan-Mar;35(1):124-128.

PMID: 28303833 DOI: 10.4103/ijmm.IJMM_15_458

Leptospirosis is a zoonosis with worldwide distribution caused by pathogenic spirochetes of the genus Leptospira. The aim of this study was to evaluate the susceptibility of isolates obtained from different hosts. A total of 65 Leptospira isolates from humans (n = 1), zoonoses (rat, n = 60; dog, n = 1; swine, n = 1) and environment (n = 2) were tested against six antibiotics. All the isolates were resistant to trimethoprim and sulphamethoxazole and had high MIC toward chloramphenicol (MIC90: 6.25 μg/ml). All except one environment isolate were sensitive to ampicillin, doxycycline and penicillin G.

Matched MeSH terms: Leptospirosis/microbiology*; Leptospirosis/veterinary*

Pathogenic and saprophytic Leptospira species in water and soils from selected urban sites in peninsular Malaysia

Benacer D, Woh PY, Mohd Zain SN, Amran F, Thong KL

Microbes Environ, 2013;28(1):135-40.

PMID: 23363618

Leptospira species were studied in water and soils from selected urban sites in Malaysia. A total of 151 water (n=121) and soil (n=30) samples were collected from 12 recreational lakes and wet markets. All samples were filtered and inoculated into semi-solid Ellinghausen and McCullough modified by Johnson and Harris (EMJH) media supplemented with additional 5-fluorouracil. The cultures were then incubated at 30°C and observed under a dark field microscope with intervals of 10 days. A PCR assay targeting the rrs gene was used to confirm the genus Leptospira among the isolates. Subsequently, the pathogenic status of the isolates was determined using primer sets G1/G2 and Sapro1/Sapro2, which target the secY and rrs genes, respectively. The isolates were identified at serogroup level using the microscopic agglutination test (MAT) while their genetic diversity was assessed by pulsed field gel electrophoresis (PFGE). Based on dark field microscopy, 23.1% (28/121) water and 23.3% (7/30) soil cultures were positive for Leptospira spp. Of the 35 positive cultures, only 8 were pure and confirmed as Leptospira genus by PCR assay. Two out of 8 isolates were confirmed as pathogenic, 5 were saprophytic and one was intermediate. These 8 isolates were negative for the 25 reference hyperimmune rabbit sera tested in the MAT. PFGE showed that all 8 of these environmental Leptospira spp. were genetically diverse. In conclusion, the presence of pathogenic Leptospira spp. in the urban Malaysian environment may indicate and highlight the importance of water screening, especially in recreational lakes, in order to minimize any chance of Leptospira infection.

Matched MeSH terms: Leptospirosis/microbiology

Fulltext Pulmonary haemorrhage associated with severe leptospirosis – the role of low dose intravenous methylprednisolone

Thiam Seong Christopher Lim, Tan Yi Jun, Then Ru Fah

Malaysian Journal of Medicine and Health Sciences, 2018;14(1):69-72.

MyJurnal

Leptospirosis has a wide range of presentation which ranges from mild flu-like symptoms, to severe form including renal failure, liver failure, and hemorrhage. Pulmonary involvement can progress from subtle clinical features to life threatening pulmonary hemorrhage and acute respiratory distress syndrome. Although benefits of corticosteroids in adult respiratory distress syndrome have been proven and accepted, evidence for use of corticosteroids in pulmonary leptospirosis is still limited. Given the vasculitic nature of severe leptospirosis, it has been proposed that addition of intravenous corticosteroid therapy, particularly in cases of pulmonary involvement is beneficial. We report a case of leptospirosis with suspected pulmonary hemorrhage which deteriorates after a few days of admission in our tertiary hospital. We have demonstrated that the prescription of a lower dose of corticosteroid than what was widely reported in the literature can equally led to a satisfactory recovery of the pulmonary hemorrhage.

Matched MeSH terms: Leptospirosis

Fulltext Nonmenstrual toxic shock syndrome--a case report

Ramanathan M, Teng TL

Med J Malaysia, 1991 Sep;46(3):283-6.

PMID: 1839926

We present a young lady who satisfied the criteria for the diagnosis of toxic-shock syndrome (TSS). The differential diagnoses of TSS in the local setting are outlined. The pertinent clinical features of TSS and its increasing association with nonmenstruating females are highlighted.

Matched MeSH terms: Leptospirosis/diagnosis

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