Early diagnosis of dengue infection using blood and non-blood specimens: a pilot study
Abstract number: P2184
Suwanpimolkul G., Pinyochotiwong C., Kittitrakul C., Krajiw S., Arunyingmongkol K., Pancharoen C., Thisyakorn U., Kulwichit W.
Objectives: Dengue infection is the most wide-spread mosquito-borne disease worldwide. Serologic diagnosis is often made retrospectively upon clinical recovery. Our group has demonstrated the value of late febrile and early postfebrile urine and oral specimens in dengue virologic and serologic diagnoses. In this study, we sought to determine clinical utility of reverse transcription-polymerase chain reaction (RT-PCR) using early febrile blood and non-blood specimens for virologic diagnosis of dengue infection.
Methods: Adults with acute fever of no more than 3 days and without obvious organ-specific symptoms during June 2006 to October 2007 entered the study. Saliva, buccal brush, urine, plasma, and peripheral blood mononuclear cells (PBMC) were collected and tested by dengue-specific RT-nested PCR with primers targeting conserved regions of the 3' untranslated region of the virus. Where available, 3 consecutive specimens from febrile days 3, 4, and 5 were tested. Diagnosis of dengue infection was based on positive standard ELISA assay on paired serum/plasma specimens. Those with negative dengue ELISA tests served as a control group.
Results: Of over 30 enrolled patients, 24 were eligible for analysis. Secondary dengue infection was diagnosed in 12 patients, leaving the other 12 as negative controls. The virus was detected in urine in half of the patients. The results were the same using both saliva and the buccal brush. With all non-blood specimens combined, three-fourths of the patients were detected. Plasma and PBMC both provided perfect yields (Table).
Conclusion: This is the first study demonstrating utility of both blood and non-blood specimens for early dengue virologic diagnosis. Even though this is only a pilot study, the results are promising. We are further performing the study in more patients. A similar study in paediatric patients is also under way.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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