Evaluation of Real Time PCR Detection of the 47 kDa Gene for Reliable Diagnosis of Pediatric Scrub Typhus

Diagnosis of scrub typhus is difficult, because of its non-specific clinical features and a lack of reliable serological assays. This study assessed real time PCR detection of the 47 kDa gene along with routine IgM ELISA for confirmatory diagnosis of scrub typhus. This observational study was conduc...

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Main Authors: Sara Chandy, Sudheer Kumar Peddi, M. Gurumoorthy, Hemalatha Ramachandran, M. S. Ramya, S. Balasubramanian, Anand Manoharan
Format: Article
Language:English
Published: Compuscript Ltd 2024-01-01
Series:Zoonoses
Online Access:https://www.scienceopen.com/hosted-document?doi=10.15212/ZOONOSES-2023-0052
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author Sara Chandy
Sudheer Kumar Peddi
M. Gurumoorthy
Hemalatha Ramachandran
M. S. Ramya
S. Balasubramanian
Anand Manoharan
author_facet Sara Chandy
Sudheer Kumar Peddi
M. Gurumoorthy
Hemalatha Ramachandran
M. S. Ramya
S. Balasubramanian
Anand Manoharan
author_sort Sara Chandy
collection DOAJ
description Diagnosis of scrub typhus is difficult, because of its non-specific clinical features and a lack of reliable serological assays. This study assessed real time PCR detection of the 47 kDa gene along with routine IgM ELISA for confirmatory diagnosis of scrub typhus. This observational study was conducted between March 2021 and February 2023. Real time PCR detection of the 47 kDa gene was used as a diagnostic assay. Confirmed scrub typhus cases were defined by IgM ELISA and/or real time PCR positivity. A total of 105 children (0–18 years of age) were enrolled, 30 (28.57%) of whom were confirmed to have scrub typhus, according to IgM ELISA and/or real time PCR positivity. The clinical symptoms of scrub typhus positive children included fever, diarrhea, abdominal pain, breathing difficulties, lymphadenopathy, rash, headache, edema, seizure, and poor intake. Good statistical correlations were observed among real time scrub positivity, high grade fever of 8.2 days’ duration, the presence of eschar and thrombocytopenia. Non-specific respiratory symptoms; cough, and cold were more severe in patients with scrub typhus. The real time PCR test showed good specificity in discriminating scrub typhus from enteric fever, a common pediatric disease. Detection of the 47 kDa gene with real time PCR has good sensitivity and specificity. The number of days between fever onset and sampling, as well as the administration of antibiotics before sampling, influence the performance of real-time PCR.
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spelling doaj-art-4f6d5a6df8564ead9e55005ede88b84e2025-08-20T03:17:32ZengCompuscript LtdZoonoses2737-74662737-74742024-01-014198810.15212/ZOONOSES-2023-0052Evaluation of Real Time PCR Detection of the 47 kDa Gene for Reliable Diagnosis of Pediatric Scrub TyphusSara ChandySudheer Kumar PeddiM. GurumoorthyHemalatha RamachandranM. S. RamyaS. BalasubramanianAnand ManoharanDiagnosis of scrub typhus is difficult, because of its non-specific clinical features and a lack of reliable serological assays. This study assessed real time PCR detection of the 47 kDa gene along with routine IgM ELISA for confirmatory diagnosis of scrub typhus. This observational study was conducted between March 2021 and February 2023. Real time PCR detection of the 47 kDa gene was used as a diagnostic assay. Confirmed scrub typhus cases were defined by IgM ELISA and/or real time PCR positivity. A total of 105 children (0–18 years of age) were enrolled, 30 (28.57%) of whom were confirmed to have scrub typhus, according to IgM ELISA and/or real time PCR positivity. The clinical symptoms of scrub typhus positive children included fever, diarrhea, abdominal pain, breathing difficulties, lymphadenopathy, rash, headache, edema, seizure, and poor intake. Good statistical correlations were observed among real time scrub positivity, high grade fever of 8.2 days’ duration, the presence of eschar and thrombocytopenia. Non-specific respiratory symptoms; cough, and cold were more severe in patients with scrub typhus. The real time PCR test showed good specificity in discriminating scrub typhus from enteric fever, a common pediatric disease. Detection of the 47 kDa gene with real time PCR has good sensitivity and specificity. The number of days between fever onset and sampling, as well as the administration of antibiotics before sampling, influence the performance of real-time PCR.https://www.scienceopen.com/hosted-document?doi=10.15212/ZOONOSES-2023-0052
spellingShingle Sara Chandy
Sudheer Kumar Peddi
M. Gurumoorthy
Hemalatha Ramachandran
M. S. Ramya
S. Balasubramanian
Anand Manoharan
Evaluation of Real Time PCR Detection of the 47 kDa Gene for Reliable Diagnosis of Pediatric Scrub Typhus
Zoonoses
title Evaluation of Real Time PCR Detection of the 47 kDa Gene for Reliable Diagnosis of Pediatric Scrub Typhus
title_full Evaluation of Real Time PCR Detection of the 47 kDa Gene for Reliable Diagnosis of Pediatric Scrub Typhus
title_fullStr Evaluation of Real Time PCR Detection of the 47 kDa Gene for Reliable Diagnosis of Pediatric Scrub Typhus
title_full_unstemmed Evaluation of Real Time PCR Detection of the 47 kDa Gene for Reliable Diagnosis of Pediatric Scrub Typhus
title_short Evaluation of Real Time PCR Detection of the 47 kDa Gene for Reliable Diagnosis of Pediatric Scrub Typhus
title_sort evaluation of real time pcr detection of the 47 kda gene for reliable diagnosis of pediatric scrub typhus
url https://www.scienceopen.com/hosted-document?doi=10.15212/ZOONOSES-2023-0052
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