asymptomatic renal colonization of humans in the peruvian amazon by leptospira无症状肾殖民钩端螺旋体的人类秘鲁亚马逊地区.pdfVIP

Asymptomatic Renal Colonization of Humans in the Peruvian Amazon by Leptospira 1,2¤ 2 3,4,5 6 1 Christian A. Ganoza , Michael A. Matthias , Mayuko Saito , Manuel Cespedes , Eduardo Gotuzzo , Joseph M. Vinetz2* 1 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, 2 Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California, United States of America, 3 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America, 4 Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru, 5 Asociacion Benefica PRISMA, Lima, Peru, 6 Instituto Nacional de Salud, Lima, Peru Abstract Background: Renal carriage and shedding of leptospires is characteristic of carrier or maintenance animal hosts. Sporadic reports indicate that after infection, humans may excrete leptospires for extended periods. We hypothesized that, like mammalian reservoir hosts, humans develop asymptomatic leptospiruria in settings of high disease transmission such as the Peruvian Amazon. Methodology/Principal Findings: Using a cross-sectional study design, we used a combination of epidemiological data, serology and molecular detection of the leptospiral 16S rRNA gene to identify asymptomatic urinary shedders of Leptospira. Approximately one-third of the 314 asymptomatic participants had circulating anti-leptospiral antibodies. Among enrolled participants, 189/314 (59%) had evidence of recent infection (microscopic agglutination test (MAT0 $1:800 or ELISA IgM- positive or both). The proportion of MAT-positive