Diagnosis of Strongyloides stercoralis

Detection of parasite-derived DNA in urine

Nilanjan Lodh, Reynaldo Caro, Shterna Sofer, Alan Leroy Scott, Alejandro Krolewiecki, Clive Julian Shiff

Research output: Contribution to journalArticle

Abstract

Detecting infections of Strongyloides stercoralis is arduous and has low sensitivity. Clinically this is a major problem because chronic infections may disseminate in the host and lead to a life threatening condition. Epidemiologically, S. stercoralis is often missed in surveys as it is difficult to identify by standard stool examination procedures. We present, for the first time, evidence that the infection can be detected in filtered urine samples collected and processed in the field and subsequently assayed for the presence of parasite DNA. Urine specimens (∼40 mL) were collected from 125 test and control individuals living in rural and peri-urban regions of Northern Argentina. From the same individuals, fresh stool specimens were processed using three different copropological methods. Urine specimens were filtered in the field through a 12.5 cm Whatman No. 3 filter. The filters were dried and packed individually in sealable plastic bags with desiccant and shipped to a laboratory where DNA was recovered from the filter and PCR-amplified with primers specific to a dispersed repetitive sequence. Prevalence of S. stercoralis infection by stool culture and direct examination was 35/125 (28%), In contrast, PCR-based detection of parasite-specific trans-renal DNA in urine indicated that 56/125 (44.8%) carried the parasite. Of the patients that tested positive for urine-based parasite DNA, approximately half also tested positive in their stool specimens. There were 6.4% of cases where parasite larvae were seen in the stool but no DNA was amplified from the urine. As proof of principle, DNA amplification from urine residue reveals significantly more cases of S. stercoralis infection than the current standard stool examination techniques. Additional work is required to establish the relative utility, sensitivity and specificity of urine-based analysis compared to parasitological and nucleic acid detection from stool for clinical and epidemiological detection for S. stercoralis infection.

Original languageEnglish (US)
Pages (from-to)9-13
Number of pages5
JournalActa Tropica
Volume163
DOIs
StatePublished - Nov 1 2016

Fingerprint

Strongyloides stercoralis
Parasites
urine
Urine
parasites
DNA
Infection
infection
Hygroscopic Agents
Interspersed Repetitive Sequences
desiccants
Polymerase Chain Reaction
plastic bags
Argentina
urban areas
Nucleic Acids
nucleic acids
Plastics
Larva
kidneys

Keywords

  • Diagnostic test
  • DNA detection
  • Gastro-intestinal parasite
  • Strongyloides stercoralis
  • Urine specimen

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

Diagnosis of Strongyloides stercoralis : Detection of parasite-derived DNA in urine. / Lodh, Nilanjan; Caro, Reynaldo; Sofer, Shterna; Scott, Alan Leroy; Krolewiecki, Alejandro; Shiff, Clive Julian.

In: Acta Tropica, Vol. 163, 01.11.2016, p. 9-13.

Research output: Contribution to journalArticle

Lodh, Nilanjan ; Caro, Reynaldo ; Sofer, Shterna ; Scott, Alan Leroy ; Krolewiecki, Alejandro ; Shiff, Clive Julian. / Diagnosis of Strongyloides stercoralis : Detection of parasite-derived DNA in urine. In: Acta Tropica. 2016 ; Vol. 163. pp. 9-13.
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