A polymerase chain reaction (PCR)-based assay which amplifies repetitive DNA elements present within bacterial genomes was used to characterize and differentiate Leptospira sp. Thirty-five strains from a reference culture collection and 18 clinical isolates which had been previously analyzed by cross agglutinin absorption test (CAAT) were evaluated by this technique. PCR results from analysis of the reference culture collection showed no bands corresponding to serogroups Australis, Autumnalis, Bataviae, Celledoni, Cynopteri, Djasiman, Panama, Pomona, Pyrogenes, and Tarassovi. However, the PCR method was able to clearly discriminate the serogroups Andamana, Ballum, Canicola, Grippotyphosa, Hebdomadis, Icterohaemorrhagiae, Javanica, Sejroe, Semaranga, and Shermani. Clinical isolates previously characterized by CAAT as serovar Copenhageni, serovar Castellonis, and as serovar Canicola were in agreement with PCR results. The clinical isolate previously characterized as serovar Pomona was not differentiated by PCR. Forty additional clinical isolates from patients with leptospirosis obtained in São Paulo, Brazil were also evaluated by this PCR method. Thirty-nine of these were determined to belong to serogroup Icterohaemorrhagiae (97.5%) and one to serogroup Sejroe (2.5%). These results demonstrate that the PCR method described in this study has utility for rapid typing of Leptospira sp. at the serogroup level and can be used in epidemiological survey.

Estudo retrospectivo com 9.335 casos de leptospirose humana no Estado de São Paulo, Brasil, diagnosticados entre 1969 e 1997 mostrou que a doença é endêmica no estado. Adultos com idade entre 20-39 anos foram os mais infectados (32,40%) sendo 87,0% dos casos do sexo masculino. A incidência anual média foi de 0,53 por uma população de 100.000. Casos ocorreram principalmente em janeiro a abril de cada ano. O maior número de casos foi observado em 1991 e 1996 com média pluviométrica de 159,9 e 160,3, respectivamente. Estes dados enfatizam a importância da leptospirose na saúde pública no Estado de São Paulo, Brasil.

A retrospective study of 9,335 cases of human leptospirosis in the state of São Paulo, Brazil, diagnosed between 1969 and 1997 showed that the disease is endemic throughout the state. Middle-aged adults, with a range of 20-39 years, were most frequently infected (32.40%). The mean annual incidence was 0.53 per 100,000 population and the disease was more frequent in males (87.0%). Cases occurred mainly in January to April each year. A peak was observed in 1991 and 1996 which rainfall average was 159.9 and 160.3, respectively. These data emphasize the potential public health importance of leptospirosis in the state of São Paulo, Brazil.

Persistência de títulos de aglutininas anti-leptospiras em soros humanos diagnosticados pelo teste de aglutinação microscópica A persistência de aglutininas detectadas por MAT tem criado problemas na interpretação dos resultados. O objetivo deste trabalho foi examinar os resultados da sorologia de 70 pacientes com confirmação sorológica de leptospirose durante 3-13 meses após terem sido infectados para se poder elucidar a interpretação da persistência de aglutininas detectadas por MAT. Sessenta e um soros de pacientes (87,14%) apresentaram títulos iguais, ou maiores, que 800. Destes, 2 indivíduos mantiveram títulos de 800 treze meses após terem sido infectados. Este estudo mostra que apenas uma amostra de soro, mesmo com alto título de aglutininas, não pode ser considerada para determinar a fase da doença.

The persistence of agglutinins detected by MAT has created some problems to the interpretation of the results. The aim of this study was to examine the data of serology from 70 patients with serologically confirmed diagnosis of leptospirosis by during 3-13 months after being affected with leptospires in order to elucidate the interpretation of the persistence of agglutinins detected by MAT. Sixty-one patients sera (87.14%) had titers equal or greater than 800. Of these, two individuals maintained titers of 800 thirteen months after the onset. This study showed that only one sample of sera with high titers is not reliable to determine the time at which infection occurred.

Avaliou-se o desempenho da contraimunoeletroforese (CIE) no diagnóstico sorológico da leptospirose humana utilizando três tipos de antígenos derivados da L. interrogans sorovar icterohaemorrhagiae e do sorovar patoc da L. biflexa. Comparou-se os resultados obtidos na CIE com a prova de referência a soroaglutinação microscópica (SAM). Soros pareados de 135 pacientes com leptospirose foram subdivididos em 4 grupos de acordo com os resultados da SAM. Como controle coletou-se sangue de 69 indivíduos sadios. A concordância entre as duas técnicas variou de 92,64 a 94,11%. Os resultados obtidos pela CIE com os antígenos do sorovar icterohaemorrhagiae foram mais favoráveis do que aqueles derivados do patoc. Ressaltam-se as características de elevada sensibilidade detectando anticorpos antileptospiras mais precocemente do que a microaglutinação. As características encontradas no presente estudo credenciam o emprego da CIE como um método útil e prático para o diagnóstico da leptospirose humana na fase aguda da doença.

Counterimmunoelectrophoresis (CIE) was applied on paired sera from 135 pacients with leptospirosis and on 69 sera from a control group. The sera from pacients were subdivided in 4 groups according to the results obtained by the Microscopic Agglutination Test (MAT). The first samples sera from 58 pacientes were non reagent by MAT. Six monthly samples of sera were taken from 7 patients to follow-up and to determine the level of agglutinin and precipitin antibodies present using MAT and CIE. Serovars icterohaemorrhagie and patoc were used as antigens. Three types of antigens were compared, 1) Triton-X-100 extracted; 2) heat extacted and 3) a pool of them. The CIE using icterohaemorrhagiae derivated antigens types agreed with MAT in 92.64, 92.64 and 94.11% of the leptospirosis sera. The patoc antigens types reacted with the control group in 7.24, 86.95 and 84.05% of the samples, and consequently were eliminated from the present study. The icterohaemorrhagiae CIE reaction become positive earlier than MAT negative sera, and reverted to negative earlier in the follow-up samples from the pacients. The CIE was sensitive and specific, gave rapid results and was easy to perform.

Os autores apresentam uma técnica de imunoperoxidase para a identificação de leptospiras em cortes de rim fixados em formol e emblocados em parafina. A variante metodológica inclui a utilização do complexo peroxidase-antiperoxidase, conferindo alta sensibilidade à reação. São, ainda, discutidas algumas possíveis aplicações do método ao estudo do acometimento renal na leptospirose.

An Immunoperoxidase technique for identification of leptospires in formalin fixed, paraffin embedded kidney sections is presented, using peroxidase-antiperoxidase complex. The anti-leptospiral antibody was raised in rabbit. Possible applications of this technique are discussed.