Identification by PS-PCR of Leishmania Species and its Correlation with Clinical, Epidemiologic, and Therapeutic Characteristics in Salta, Argentina

Abstract

Leishmaniasis is endemic in the province of Salta, Argentina, with hundreds of cases annually. Identifying the species of Leishmania is necessary due to differences in clinical presentation and treatment response between species. PS-PCR technique has been validated by the method of isozymes to identify Leishmania species in Argentina. OBJECTIVES: To optimize the PS-PCR technique to identify the species of parasites isolated by culture and in clinical specimens from patients of Salta and its correlation with clinical characteristics and response to treatment. RESULTS: The PS-PCR allowed us to identify the species of Leishmania in 24 samples analyzed: 9 isolated from clinical specimens and 15 culture swabs taken from lesions (100% specificity). The species found were: L(V) braziliensis (19/24, P <0.0001), L(L) amazonensis (4/24) and L(V) guyanensis (1/24). The first one was related to all severe cases (8 with mucocutaneous lesions and 1 with disseminated disease), and to all failures to treatment with Glucantime (4) observed. In the cases of L(L) amazonensis, there were no serious disease or resistance to treatment. The case of L(V) guyanensis was not indigenous to the area. CONCLUTIONS: This study demonstrates that PS-PCR technique is suitable for specific diagnosis of leishmaniasis. The diagnosis of L(V) braziliensis undertakes to consider alternative treatments for severe cases of the disease.