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  1. Fulltext Increased detection of Plasmodium knowlesi in Sandakan division, Sabah as revealed by PlasmoNex™
    Goh XT, Lim YA, Vythilingam I, Chew CH, Lee PC, Ngui R, et al.
    Malar J, 2013 Jul 31;12:264.
    PMID: 23902626 DOI: 10.1186/1475-2875-12-264
    BACKGROUND: Plasmodium knowlesi is a simian malaria parasite that is widespread in humans in Malaysian Borneo. However, little is known about the incidence and distribution of this parasite in the Sandakan division, Malaysian Borneo. Therefore, the aim of the present epidemiological study was to investigate the incidence and distribution of P. knowlesi as well as other Plasmodium species in this division based on a most recent developed hexaplex PCR system (PlasmoNex™).

    METHODS: A total of 189 whole blood samples were collected from Telupid Health Clinic, Sabah, Malaysia, from 2008 to 2011. All patients who participated in the study were microscopically malaria positive before recruitment. Complete demographic details and haematological profiles were obtained from 85 patients (13 females and 72 males). Identification of Plasmodium species was conducted using PlasmoNex™ targeting the 18S ssu rRNA gene.

    RESULTS: A total of 178 samples were positive for Plasmodium species by using PlasmoNex™. Plasmodium falciparum was identified in 68 samples (38.2%) followed by 64 cases (36.0%) of Plasmodium vivax, 42 (23.6%) cases of P. knowlesi, two (1.1%) cases of Plasmodium malariae and two (1.1%) mixed-species infections (i e, P. vivax/P. falciparum). Thirty-five PlasmoNex™ positive P. knowlesi samples were misdiagnosed as P. malariae by microscopy. Plasmodium knowlesi was detected in all four districts of Sandakan division with the highest incidence in the Kinabatangan district. Thrombocytopaenia and anaemia showed to be the most frequent malaria-associated haematological complications in this study.

    CONCLUSIONS: The discovery of P. knowlesi in Sandakan division showed that prospective studies on the epidemiological risk factors and transmission dynamics of P. knowlesi in these areas are crucial in order to develop strategies for effective malaria control. The availability of advanced diagnostic tool PlasmoNex™ enhanced the accuracy and accelerated the speed in the diagnosis of malaria.

    Matched MeSH terms: Plasmodium knowlesi/isolation & purification*
  2. Fulltext Human infections and detection of Plasmodium knowlesi
    Singh B, Daneshvar C
    Clin Microbiol Rev, 2013 Apr;26(2):165-84.
    PMID: 23554413 DOI: 10.1128/CMR.00079-12
    Plasmodium knowlesi is a malaria parasite that is found in nature in long-tailed and pig-tailed macaques. Naturally acquired human infections were thought to be extremely rare until a large focus of human infections was reported in 2004 in Sarawak, Malaysian Borneo. Human infections have since been described throughout Southeast Asia, and P. knowlesi is now recognized as the fifth species of Plasmodium causing malaria in humans. The molecular, entomological, and epidemiological data indicate that human infections with P. knowlesi are not newly emergent and that knowlesi malaria is primarily a zoonosis. Human infections were undiagnosed until molecular detection methods that could distinguish P. knowlesi from the morphologically similar human malaria parasite P. malariae became available. P. knowlesi infections cause a spectrum of disease and are potentially fatal, but if detected early enough, infections in humans are readily treatable. In this review on knowlesi malaria, we describe the early studies on P. knowlesi and focus on the epidemiology, diagnosis, clinical aspects, and treatment of knowlesi malaria. We also discuss the gaps in our knowledge and the challenges that lie ahead in studying the epidemiology and pathogenesis of knowlesi malaria and in the prevention and control of this zoonotic infection.
    Matched MeSH terms: Plasmodium knowlesi/isolation & purification*
  3. Prevalence and genetic characterization of Vibrio vulnificus in raw seafood and seawater in Malaysia
    Paydar M, Thong KL
    J Food Prot, 2013 Oct;76(10):1797-800.
    PMID: 24112583 DOI: 10.4315/0362-028X.JFP-13-141
    Vibrio vulnificus is a highly invasive human pathogen that exists naturally in estuarine environment and coastal waters. In this study, we used different PCR assays to detect V. vulnificus in 260 seafood and 80 seawater samples. V. vulnificus was present in about 34 (13%) of the 260 seafood samples and 18 (23%) of the 80 seawater samples. Repetitive extragenic palindromic PCR (REP-PCR) and enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) were applied to subtype the V. vulnificus isolates. Twenty-five REP profiles and 45 ERIC profiles were observed, and the isolates were categorized into 9 and 10 distinct clusters at the similarity of 80%, by REP-PCR and ERIC-PCR, respectively. ERIC-PCR is more discriminative than REP-PCR in subtyping V. vulnificus, demonstrating high genetic diversity among the isolates.
    Matched MeSH terms: Vibrio vulnificus/isolation & purification*
  4. 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: Leptospira/isolation & purification*
  5. Simulation of improper food hygiene practices: A quantitative assessment of Vibrio parahaemolyticus distribution
    Malcolm TTH, Chang WS, Loo YY, Cheah YK, Radzi CWJWM, Kantilal HK, et al.
    Int J Food Microbiol, 2018 Nov 02;284:112-119.
    PMID: 30142576 DOI: 10.1016/j.ijfoodmicro.2018.08.012
    Kitchen mishandling practices contribute to a large number of foodborne illnesses. In this study, the transfer and cross-contamination potential of Vibrio parahaemolyticus from bloody clams to ready-to-eat food (lettuce) was assessed. Three scenarios were investigated: 1) direct cross-contamination, the transfer of V. parahaemolyticus from bloody clams to non-food contact surfaces (hands and kitchen utensils) to lettuce (via slicing), was evaluated; 2) perfunctory decontamination, the efficacy of two superficial cleaning treatments: a) rinsing in a pail of water, and b) wiping with a kitchen towel, were determined; and 3) secondary cross-contamination, the microbial transfer from cleaning residuals (wash water or stained kitchen towel) to lettuce was assessed. The mean of percent transfer rates through direct contact was 3.6%, and an average of 3.5% of total V. parahaemolyticus was recovered from sliced lettuce. The attempted treatments reduced the transferred population by 99.0% (rinsing) and 94.5% (wiping), and the relative amount of V. parahaemolyticus on sliced lettuce was reduced to 0.008%. V. parahaemolyticus exposure via secondary cross-contamination was marginal. The relative amount of V. parahaemolyticus recovered from washed lettuce was 0.07%, and the transfers from stained kitchen towel to lettuce were insubstantial. Our study highlights that V. parahaemolyticus was readily spread in the kitchen, potentially through sharing of non-food contact surfaces. Results from this study can be used to better understand and potentially raising the awareness of proper handling practices to avert the spread of foodborne pathogens.
    Matched MeSH terms: Vibrio parahaemolyticus/isolation & purification*
  6. Multiple rare opportunistic and pathogenic fungi in persistent foot skin infection
    Chan GF, Sinniah S, Idris TI, Puad MS, Abd Rahman AZ
    Pak J Biol Sci, 2013 Mar 01;16(5):208-18.
    PMID: 24175430
    Persistent superficial skin infection caused by multiple fungi is rarely reported. Recently, a number of fungi, both opportunistic and persistent in nature were isolated from the foot skin of a 24-year old male in Malaysia. The fungi were identified as Candida parapsilosis, Rhodotorula mucilaginosa, Phoma spp., Debaryomyces hansenii, Acremonium spp., Aureobasidium pullulans and Aspergillus spp., This is the first report on these opportunistic strains were co-isolated from a healthy individual who suffered from persistent foot skin infection which was diagnosed as athlete's foot for more than 12 years. Among the isolated fungi, C. parapsilosis has been an increasingly common cause of skin infections. R. mucilaginosa and D. hansenii were rarely reported in cases of skin infection. A. pullulans, an emerging fungal pathogen was also being isolated in this case. Interestingly, it was noted that C. parapsilosis, R. mucilaginosa, D. hansenii and A. pullulans are among the common halophiles and this suggests the association of halotolerant fungi in causing persistent superficial skin infection. This discovery will shed light on future research to explore on effective treatment for inhibition of pathogenic halophiles as well as to understand the interaction of multiple fungi in the progress of skin infection.
    Matched MeSH terms: Fungi/isolation & purification*
  7. ENTEROAGGREGATIVE ESCHERICHIA COLI O104 FROM THAI AND IMPORTED MALAYSIAN RAW BEEF
    Wameadesa N, Sae-lim A, Hayeebilan F, Rattanachuay P, Sukhumungoon P
    Southeast Asian J Trop Med Public Health, 2017 Mar;48(2):338-50.
    PMID: 29642296
    Local Thai and imported Malaysian beef in southern Thailand area carry
    several Shiga toxin-producing Escherichia coli (STEC) serotypes. STEC O104 is an
    important pathogen capable of causing outbreaks with considerable morbidity
    and mortality. This study investigated the presence of E. coli O104 from local Thai
    and imported Malaysian beef obtained from markets in Hat Yai City, Songkhla
    Province during August 2015 - February 2016. Thirty-one E. coli O104 strains
    were isolated from 12 beef samples (16% and 23% Thai and imported Malaysian,
    respectively). Thirty strains possessed aggA (coding for a major component of
    AAF/I fimbriae), a gene associated with enteroaggregative E. coli (EAEC) pathotype,
    and all strains carried fimH (encoding Type 1 fimbriae). Thirty strains
    belonged to phylogenetic group B1 and one strain (from Malaysian beef) to group
    A. Agglutination of yeast cells was observed among 29 E. coli O104 strains. Investigation
    of stx2 phage occupancy loci demonstrated that sbcB was occupied in 12
    strains. Antimicrobial susceptibility assay revealed that 7 strains were resistant
    to at least one antimicrobial agent and two were multi-drug resistant. One strain
    carried extended spectrum β-lactamase gene blaCTX-M and three carried blaTEM. PFGE-generated DNA profiling showed identical DNA pattern between that of
    one EAEC O104 strain from Thai beef and another from Malaysian beef, indicating
    that these two strains originated from the same clone. This is the first report
    in Thailand describing the presence of EAEC O104 from both Thai and imported
    Malaysian beef and their transfer between both countries. Thorough surveillance
    of this pathogen in fresh meats and vegetables should help to prevent any possible
    outbreak of E. coli O104.
    Matched MeSH terms: Escherichia coli O104/isolation & purification*
  8. Pulmonary tuberculosis in a rural area of Sarawak, Malaysia
    Yano K, Goto S, Sado M, Takeuchi M, Iguchi M
    Southeast Asian J Trop Med Public Health, 1974 Sep;5(3):417-23.
    PMID: 4215145
    Matched MeSH terms: Mycobacterium tuberculosis/isolation & purification
  9. Ecological studies on Coccidia of Malaysian forest mammals
    Mullin SW, Colley FC, Welch QB
    Southeast Asian J Trop Med Public Health, 1975 Mar;6(1):93-8.
    PMID: 806971
    Matched MeSH terms: Coccidia/isolation & purification
  10. Studies on Plasmodium gallinaceum and Plasmodium juxtanucleare from the Malayan jungle fowl Gallue gallus spadiceus
    Fernando MA, Dissanaike AS
    Southeast Asian J Trop Med Public Health, 1975 Mar;6(1):25-32.
    PMID: 806969
    Matched MeSH terms: Plasmodium/isolation & purification*
  11. Genetic red cell abnormalities in Trengganu and Perlis (West Malaysia)
    Eng LI, McKay DA, Govindasamy S
    Southeast Asian J Trop Med Public Health, 1971 Jun;2(2):133-9.
    PMID: 5002823
    Matched MeSH terms: Hemoglobins, Abnormal/isolation & purification*
  12. Fulltext Comparison of genotypic and virtual phenotypic drug resistance interpretations with laboratory-based phenotypes among CRF01_AE and subtype B HIV-infected individuals
    Jiamsakul A, Chaiwarith R, Durier N, Sirivichayakul S, Kiertiburanakul S, Van Den Eede P, et al.
    J Med Virol, 2016 Feb;88(2):234-43.
    PMID: 26147742 DOI: 10.1002/jmv.24320
    HIV drug resistance assessments and interpretations can be obtained from genotyping (GT), virtual phenotyping (VP) and laboratory-based phenotyping (PT). We compared resistance calls obtained from GT and VP with those from PT (GT-PT and VP-PT) among CRF01_AE and subtype B HIV-1 infected patients. GT predictions were obtained from the Stanford HIV database. VP and PT were obtained from Janssen Diagnostics BVBA's vircoType(TM) HIV-1 and Antivirogram®, respectively. With PT assumed as the "gold standard," the area under the curve (AUC) and the Bland-Altman plot were used to assess the level of agreement in resistance interpretations. A total of 80 CRF01_AE samples from Asia and 100 subtype B from Janssen Diagnostics BVBA's database were analysed. CRF01_AE showed discordances ranging from 3 to 27 samples for GT-PT and 1 to 20 samples for VP-PT. The GT-PT and VP-PT AUCs were 0.76-0.97 and 0.81-0.99, respectively. Subtype B showed 3-61 discordances for GT-PT and 2-75 discordances for VP-PT. The AUCs ranged from 0.55 to 0.95 for GT-PT and 0.55 to 0.97 for VP-PT. Didanosine had the highest proportion of discordances and/or AUC in all comparisons. The patient with the largest didanosine FC difference in each subtype harboured Q151M mutation. Overall, GT and VP predictions for CRF01_AE performed significantly better than subtype B for three NRTIs. Although discrepancies exist, GT and VP resistance interpretations in HIV-1 CRF01_AE strains were highly robust in comparison with the gold-standard PT.
    Matched MeSH terms: HIV-1/isolation & purification
  13. Molecular surveillance of rubella viruses in Taiwan from 2005 to 2011
    Cheng WY, Wang HC, Liu MT, Wu HS
    J Med Virol, 2013 Apr;85(4):745-53.
    PMID: 23417619 DOI: 10.1002/jmv.23451
    Rubella has been listed as a mandatory notifiable disease in Taiwan since 1988. Because of high coverage rates with an effective vaccine, rubella cases have decreased dramatically in Taiwan since 1994. However, rubella outbreaks still occur due to imported transmission. Five large clusters were detected in Taiwan from 2007 to 2011. In 2007, one cluster was caused by rubella genotype 1E viruses that were imported from Vietnam, whereas another cluster was caused by genotype 2B viruses and was untraceable. In 2008, two clusters were caused by different lineages of genotype 1E viruses that were imported from Malaysia. In 2009, a cluster that was caused by genotype 2B viruses was associated with imported cases from Vietnam. The rubella viruses from 124 confirmed cases from 2005 to 2011 were characterized, and the data revealed that these viruses were distributed in the following four genotypes: 1E (n = 56), 1h (n = 1), 1j (n = 4), and 2B (n = 63). Of these viruses, 93 (75%) were associated with imported cases, and 43 of 56 genotype 1E viruses were associated with imported cases from China, Vietnam, Malaysia, and Indonesia. One genotype 1h virus was imported from Belarus, and three of four genotype 1j viruses were imported from the Philippines. Of 63 rubella genotype 2B viruses, 46 were imported from Vietnam, Thailand, Malaysia, China, Germany, and South Africa. Molecular surveillance allows for the differentiation of circulating rubella viruses and can be used to investigate transmission pathways, which are important to identify the interruption of endemic virus transmission.
    Matched MeSH terms: Rubella virus/isolation & purification*
  14. The distribution of hepatitis B virus genotypes in Thailand
    Louisirirotchanakul S, Olinger CM, Arunkaewchaemsri P, Poovorawan Y, Kanoksinsombat C, Thongme C, et al.
    J Med Virol, 2012 Oct;84(10):1541-7.
    PMID: 22930500 DOI: 10.1002/jmv.23363
    Phylogenetic analysis was performed on hepatitis B virus (HBV) strains obtained from 86 hepatitis B surface antigen (HBsAg) positive donors from Thailand originating throughout the country. Based on the S gene, 87.5% of strains were of genotype C while 10.5% were of genotype B, with all genotype B strains obtained from patients originating from the central or the south Thailand. No genotype B strains were found in the north of Thailand. Surprisingly, one patient was infected with a genotype H strain while another patient was infected with a genotype G strain. Complete genome sequencing and recombination analysis identified the latter as being a genotype G and C2 recombinant with the breakpoint around nucleotide position 700. The origin of the genotype G fragment was not identifiable while the genotype C2 fragment most likely came from strains circulating in Laos or Malaysia. The performance of different HBsAg diagnostic kits and HBV nucleic acid amplification technology (NAT) was evaluated. The genotype H and G/C2 recombination did not interfere with HBV detection.
    Matched MeSH terms: Hepatitis B virus/isolation & purification
  15. Fulltext Emergence of Undetectable Malaria Parasites: A Threat under the Radar amid the COVID-19 Pandemic?
    Beshir KB, Grignard L, Hajissa K, Mohammed A, Nurhussein AM, Ishengoma DS, et al.
    Am J Trop Med Hyg, 2020 08;103(2):558-560.
    PMID: 32553046 DOI: 10.4269/ajtmh.20-0467
    Rapid diagnostic tests (RDTs) play a critical role in malaria diagnosis and control. The emergence of Plasmodium falciparum parasites that can evade detection by RDTs threatens control and elimination efforts. These parasites lack or have altered genes encoding histidine-rich proteins (HRPs) 2 and 3, the antigens recognized by HRP2-based RDTs. Surveillance of such parasites is dependent on identifying false-negative RDT results among suspected malaria cases, a task made more challenging during the current pandemic because of the overlap of symptoms between malaria and COVID-19, particularly in areas of low malaria transmission. Here, we share our perspective on the emergence of P. falciparum parasites lacking HRP2 and HRP3, and the surveillance needed to identify them amid the COVID-19 pandemic.
    Matched MeSH terms: Plasmodium falciparum/isolation & purification*
  16. Fulltext Laboratory Evaluation of a Rapid IgG4 Antibody Test (BLF Rapid™) for Bancroftian Filariasis
    Noordin R, Yunus MH, Robinson K, Won KY, Babu S, Fischer PU, et al.
    Am J Trop Med Hyg, 2018 12;99(6):1587-1590.
    PMID: 30350768 DOI: 10.4269/ajtmh.18-0566
    At the end phase of the Global Programme to Eliminate Lymphatic Filariasis, antibody testing may have a role in decision-making for bancroftian filariasis-endemic areas. This study evaluated the diagnostic performance of BLF Rapid™, a prototype immunochromatographic IgG4-based test using BmSXP recombinant protein, for detection of bancroftian filariasis. The test was evaluated using 258 serum samples, comprising 96 samples tested at Universiti Sains Malaysia (in-house) and 162 samples tested independently at three international laboratories in the USA and India, and two laboratories in Malaysia. The independent testing involved 99 samples from Wuchereria bancrofti microfilaria or antigen positive individuals and 63 samples from people who were healthy or had other infections. The in-house evaluation showed 100% diagnostic sensitivity and specificity. The independent evaluations showed a diagnostic sensitivity of 84-100% and 100% specificity (excluding non-lymphatic filarial infections). BLF Rapid has potential as a surveillance diagnostic tool to make "Transmission Assessment Survey"-stopping decisions and conduct post-elimination surveillance.
    Matched MeSH terms: Wuchereria bancrofti/isolation & purification
  17. Anisakiasis causing acute dysentery in Malaysia
    Amir A, Ngui R, Ismail WH, Wong KT, Ong JS, Lim YA, et al.
    Am J Trop Med Hyg, 2016 Aug 03;95(2):410-2.
    PMID: 27325803 DOI: 10.4269/ajtmh.16-0007
    Human anisakiasis is a zoonosis acquired by eating raw or undercooked infected seafood. Herein, we report a case of acute dysentery caused by anisakiasis in a 64-year-old man in Malaysia. A colonoscopy was performed and a nematode larva was found penetrating the mucosa of the ascending colon. Bleeding was observed at the site of penetration. Y-shaped lateral epidermal cords were seen from the cross section of the worm, which is a prominent feature of Anisakis larva. Molecular analysis using polymerase chain reaction of cytochrome oxidase 2 (cox2) gene confirmed the specimen to be larva of Anisakis simplex.
    Matched MeSH terms: Anisakis/isolation & purification
  18. Fulltext A Sensitive, Colorimetric, High-Throughput Loop-Mediated Isothermal Amplification Assay for the Detection of Plasmodium knowlesi
    Britton S, Cheng Q, Grigg MJ, William T, Anstey NM, McCarthy JS
    Am J Trop Med Hyg, 2016 07 06;95(1):120-2.
    PMID: 27162264 DOI: 10.4269/ajtmh.15-0670
    The simian parasite Plasmodium knowlesi is now the commonest cause of malaria in Malaysia and can rapidly cause severe and fatal malaria. However, microscopic misdiagnosis of Plasmodium species is common, rapid antigen detection tests remain insufficiently sensitive and confirmation of P. knowlesi requires polymerase chain reaction (PCR). Thus available point-of-care diagnostic tests are inadequate. This study reports the development of a simple, sensitive, colorimetric, high-throughput loop-mediated isothermal amplification assay (HtLAMP) diagnostic test using novel primers for the detection of P. knowlesi. This assay is able to detect 0.2 parasites/μL, and compared with PCR has a sensitivity of 96% for the detection of P. knowlesi, making it a potentially field-applicable point-of-care diagnostic tool.
    Matched MeSH terms: Plasmodium knowlesi/isolation & purification*
  19. Diagnostic criteria for scrub typhus: probability values for immunofluorescent antibody and Proteus OXK agglutinin titers
    Brown GW, Shirai A, Rogers C, Groves MG
    Am J Trop Med Hyg, 1983 Sep;32(5):1101-7.
    PMID: 6414321
    The sensitivities and specificities of the indirect microimmunofluorescent antibody (IFA) and Weil-Felix (OXK) tests for scrub typhus were established for a range of titers using groups of diseased and control (other febrile illnesses) patients diagnosed by other methods. At a cut-off point of greater than or equal to 1:400, the IFA test was 0.96 specific, and at greater than or equal to 1:320, the OXK was 0.97 specific. Using either these highly specific levels of antibody or other rigorous diagnostic criteria (isolation or 4-fold rising titers), the prevalence of scrub typhus infection was determined to be 0.22 in an unselected population of febrile patients in a rural Malaysian hospital. Probability values (Pr) for the correct diagnosis of scrub typhus were then calculated from the specificity, sensitivity and prevalence determination for a range of titers. The Pr for an OXK titer of greater than or equal to 1:320 was 0.79, and the Pr for an IFA titer of greater than or equal to 1:400 was 0.78. When both these titers were present in a single specimen, the Pr increased to 0.96.
    Matched MeSH terms: Orientia tsutsugamushi/isolation & purification
  20. Diagnosis of scrub typhus in Malaysian aborigines using nested polymerase chain reaction
    Tay ST, Nazma S, Rohani MY
    Southeast Asian J Trop Med Public Health, 1996 Sep;27(3):580-3.
    PMID: 9185274
    A rapid diagnostic system for scrub typhus using nested polymerase chain reaction (PCR) was applied to clinical samples from Malaysian Aborigines. Whole blood from twenty-four patients suspected of scrub typhus infection were tested using nested polymerase chain reaction and sera were evaluated by the indirect immunoperoxidase test. Antibody responses towards Rickettsia tsutsugamushi were observed in seventeen patients with the majority having high titers of IgG antibodies. Seven patients were seronegative. The nested PCR amplified R. tsutsugamushi DNA from six patients, of which two were negative serologically and four had high titers of IgG antibodies. Second samples collected seven days after treatment were negative by PCR testing. Nested PCR is highly sensitive and specific and may be used to provide rapid confirmation of scrub typhus cases in endemic region.
    Matched MeSH terms: Orientia tsutsugamushi/isolation & purification*
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