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Efficiency of two commercial kits in serodiagnosis of leptospiral uveitis
A Kannan1, C G Priya, L Prajna
1Department of Immunology and Stem Cell Biology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Anna Nagar, Madurai, Tamil Nadu, India.
Purpose:
Uveitis is an important complication of systemic leptospirosis that can occur months to years after systemic infection. The gold standard technique Microscopic Agglutination Test (MAT) is less sensitive and more complicated. All the commercial kits currently available are for early detection of acute systemic leptospiral infection. The purpose of this study is to evaluate the efficiency of two commercial kits in serodiagnosis of leptospiral uveitis, which is a late manifestation.
Materials And Methods:
Serum samples from leptospiral uveitis patients 20 MAT positive, 20 MAT negative, 15 non-leptospiral uveitis patients, 20 systemic leptospiral infected patients and 21 controls were selected. These samples were tested for the presence of leptospiral IgM antibodies by (i) MAT using a panel of 20 serovars, (ii) LEPTO IgM MICROLISA (J.Mitra & Co.Pvt. Ltd, India) and (iii) Leptocheck (Zephyr Biomedicals, India). The statistical analysis was carried out using stata 11.0.
Results:
Total of 96 samples were tested with two commercial kits, Lepto IgM MICROLISA and Leptocheck. The sensitivity and specificity of Lepto IgM MICROLISA was 60% and 55% and Leptocheck was 80% and 59% respectively in comparison to MAT. In comparison to clinical diagnosis the sensitivity of IgM Microlisa was 55%, Leptocheck 70% and specificity of IgM MICROLISA was 58.33% and leptocheck was 69.44%.
Conclusion:
Commercial kits though sensitive and specific for systemic leptospirosis, have limited diagnostic capacity for leptospiral uveitis. Therefore it is essential to develop an inhouse serodiagnostic method specific for leptospiral uveitis patients using local leptospiral isolates.
Insights
Commercial kits show limited diagnostic value for leptospiral uveitis, a late complication of leptospirosis. Developing specific in-house serodiagnostic methods is crucial for accurate diagnosis of this ocular manifestation.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Leptospirosis can lead to uveitis, a posterior segment inflammation, months or years after initial infection.
- Current diagnostic tools like the Microscopic Agglutination Test (MAT) are less sensitive and complex for late manifestations.
- Available commercial kits primarily target acute systemic leptospiral infections, not ocular complications.
Purpose of the Study:
- To evaluate the diagnostic efficiency of two commercial kits (Lepto IgM MICROLISA and Leptocheck) for leptospiral uveitis.
- To compare the performance of these kits against the gold standard MAT and clinical diagnosis.
- To assess the utility of commercial kits in identifying leptospiral uveitis as a late sequela of infection.
Main Methods:
- Serum samples from 96 individuals were analyzed, including patients with leptospiral uveitis (MAT positive and negative), non-leptospiral uveitis, systemic leptospirosis, and controls.
- Samples were tested for leptospiral IgM antibodies using MAT, Lepto IgM MICROLISA, and Leptocheck.
- Statistical analysis was performed using Stata 11.0.
Main Results:
- Leptocheck demonstrated higher sensitivity (80%) and specificity (59%) compared to Lepto IgM MICROLISA (60% and 55%) when compared to MAT.
- In comparison to clinical diagnosis, Leptocheck showed 70% sensitivity and 69.44% specificity, while Lepto IgM MICROLISA had 55% sensitivity and 58.33% specificity.
- Both commercial kits exhibited limitations in diagnosing leptospiral uveitis.
Conclusions:
- Commercial kits are not sufficiently sensitive or specific for the serodiagnosis of leptospiral uveitis.
- The diagnostic capacity of current commercial kits is limited for this specific late manifestation of leptospirosis.
- Development of an in-house serodiagnostic method utilizing local leptospiral isolates is recommended for accurate diagnosis of leptospiral uveitis.
