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Detection of Yersinia pestis using real-time PCR in patients with suspected bubonic plague

Julia M Riehm1, Lila Rahalison, Holger C Scholz

  • 1Bundeswehr Institute of Microbiology, Munich, Germany. juliariehm@bundeswehr.org

Molecular and Cellular Probes
|October 12, 2010
PubMed

Insights

A 5'-nuclease real-time PCR assay targeting the pla gene is a reliable tool for diagnosing bubonic plague. This method offers improved detection of Yersinia pestis DNA in clinical samples compared to other tests.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Yersinia pestis causes plague, a re-emerging infectious disease endemic in various global regions.
  • Rapid and accurate diagnostic tools are crucial for effective plague management.
  • Existing real-time PCR assays for Y. pestis lack clinical validation.

Purpose of the Study:

  • To evaluate the clinical utility of three real-time PCR assays for Yersinia pestis detection.
  • To compare the performance of 5'-nuclease and hybridization probe assay formats.
  • To identify the most effective real-time PCR assay for diagnosing bubonic plague.

Main Methods:

  • Retrospective clinical study involving 149 patients with suspected bubonic plague from Madagascar.
  • Analysis of lymph node aspirates using real-time PCR assays targeting virulence plasmids (pPCP1 and pMT1).
  • Comparison of PCR results with F1-antigen immunochromatographic test (ICT) and bacterial cultivation.

Main Results:

  • Bacterial cultivation confirmed Y. pestis in 47 patients.
  • ICT detected Y. pestis in 88 patients, including all culture-confirmed cases.
  • The 5'-nuclease assay targeting the pla gene demonstrated the highest sensitivity, detecting Y. pestis DNA in 120 cases.

Conclusions:

  • The 5'-nuclease real-time PCR assay targeting the pla gene is a highly sensitive diagnostic tool.
  • This assay can be recommended for presumptive diagnosis of bubonic plague in clinical settings.
  • Real-time PCR offers a rapid and effective alternative for plague diagnosis.

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