| Real-time polymerase chain reaction assay for the rapid detection and characterization of chloroquine-resistant Plasmodium falciparum malaria in returned travelers. | |
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MedLine Citation:
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PMID: 16447106 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Imported drug-resistant malaria is a growing problem in industrialized countries. Rapid and accurate diagnosis is essential to prevent malaria-associated mortality in returned travelers. However, outside of a limited number of specialized centers, the microscopic diagnosis of malaria is slow, unreliable, and provides little information about drug resistance. Molecular diagnostics have the potential to overcome these limitations. OBJECTIVE: We developed and evaluated a rapid, real-time polymerase chain reaction (PCR) assay to detect Plasmodium falciparum malaria and chloroquine (CQ)-resistance determinants in returned travelers who are febrile. METHODS: A real-time PCR assay based on detection of the K76T mutation in PfCRT (K76T) of P. falciparum was developed on a LightCycler platform (Roche). The performance characteristics of the real-time assay were compared with those of the nested PCR-restriction fragment-length polymorphism (RFLP) and the sequence analyses of samples obtained from 200 febrile returned travelers, who included 125 infected with P. falciparum (48 of whom were infected CQ-susceptible [K76] and 77 of whom were CQ-resistant [T76] P. falciparum), 22 infected with Plasmodium vivax, 10 infected with Plasmodium ovale, 3 infected with Plasmodium malariae malaria, and 40 infected with other febrile syndromes. All patient samples were coded, and all analyses were performed blindly. RESULTS: The real-time PCR assay detected multiple pfcrt haplotypes associated with CQ resistance in geographically diverse malaria isolates acquired by travelers. Compared with nested-PCR RFLP (the reference standard), the real-time assay was 100% sensitive and 96.2% specific for detection of the P. falciparum K76T mutation. CONCLUSION: This assay is rapid, sensitive, and specific for the detection and characterization of CQ-resistant P. falciparum malaria in returned travelers. This assay is automated, standardized, and suitable for routine use in clinical diagnostic laboratories. |
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Authors:
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Gabriella A Farcas; Rainer Soeller; Kathleen Zhong; Alireza Zahirieh; Kevin C Kain |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-01-25 |
Journal Detail:
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Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Volume: 42 ISSN: 1537-6591 ISO Abbreviation: Clin. Infect. Dis. Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-01-31 Completed Date: 2006-10-16 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9203213 Medline TA: Clin Infect Dis Country: United States |
Other Details:
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Languages: eng Pagination: 622-7 Citation Subset: IM |
Affiliation:
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Tropical Disease Unit, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Antimalarials / pharmacology* Chloroquine / pharmacology* Drug Resistance* Humans India Malaria, Falciparum / diagnosis*, drug therapy, parasitology* Membrane Proteins / genetics Membrane Transport Proteins Mutation Plasmodium falciparum / genetics Polymerase Chain Reaction / methods* Protozoan Proteins Sensitivity and Specificity Travel |
| Chemical | |
Reg. No./Substance:
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0/Antimalarials; 0/Membrane Proteins; 0/Membrane Transport Proteins; 0/PfCRT protein, Plasmodium falciparum; 0/Protozoan Proteins; 54-05-7/Chloroquine |
| Comments/Corrections | |
Comment In:
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Clin Infect Dis. 2006 Jun 15;42(12):1806-7
[PMID:
16705592
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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