Evaluation of different serological assays for early diagnosis of leptospirosis in Martinique (French West Indies)

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Courdurie, Christophe | Le Govic, Yohann | Bourhy, Pascale | Alexer, Dorothee | Pailla, Karine | Theodose, Rafaelle | Césaire, Raymond | Rosine, Jacques | Hochedez, Patrick | Olive, Claude

Edité par CCSD ; Public Library of Science -

International audience. Leptospirosis is a ubiquitous zoonosis caused by spirochetes. This infection is responsible for a wide range of symptoms mimicking many other diseases. Laboratory tests are thus essential to confirm the diagnosis. Furthermore, earlier diagnosis helps to prevent severe outcomes by a prompt initiation of antibiotic therapy. In early phase, quantitative Polymerase Chain Reaction (qPCR) was proved to be more efficient than the traditional microagglutination test (MAT), which remains the ‘gold standard’ for diagnosis of leptospirosis. However, both tests are seldom available in resource-limited settings, where leptospirosis burden is highest. To find a suitable alternative to qPCR and MAT in the early phase (i.e., within the first 2 weeks) of the disease, we compared 3 serological assays (2 ELISAs plus one immunodot) using sera collected from patients with a qPCR-confirmed diagnosis of leptospirosis. This work reveals high performances for all serological assays after (but not before) 6 days’ post onset of symptoms, regardless of the species studied. Excellent specificity, as found after threshold optimization, suggests that these tests could useful in high prevalence areas.

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