Comparison of liver extract medium with novy-macneal-nicolle medium and the molecular method for the diagnosis of leishmaniasis [Layşmanyaz tanısı için karaciğer ekstreli besiyerinin novy-macneal-nicolle besiyeri ve moleküler yöntemle karşılaştırılması]

Abstract

Objective: Diagnosis of Leishmaniasis is based on culture, mi-croscopic examination, serological tests, molecular methods. Novy-MacNeal-Nicolle (NNN) medium is mostly used for culture all over the world. The use of molecular methods for diagnostic purposes led to the questioning of the sensitivity of NNN medium. In this study, it is aimed to compare the performance of a new culture medium with those of NNN medium and the molecular method. Methods: Samples of 22 patients with suspected cutaneous leishmaniasis (CL) and 4 patients with suspected visceral leishmaniasis (VL) were sent to Manisa Celal Bayar University Faculty of Medicine Department of Medical Parasitology for diagnosis or confirmation from Kilis, Osmaniye, Bitlis, Gazian-tep and Manisa provinces. Pre-prepared media were sent to the health centers in these provinces and inoculation of these media with clinical samples was requested. Needle aspiration fluid for CL and bone marrow samples for VL were cultured simultaneously on NNN medium and newly developed liver extracted medium (LEM), and were sent to our institution with their smears. Smears were examined by staining with Giemsa method. In addition, parasite DNA was identified with real-time polymerase chain reaction method in these materials. Results: Leishmania amastigotes were detected in 14 of 26 samples. Promastigote proliferation was observed in 8 and 24 of the samples cultured in NNN and LEM respectively. No proliferation was detected by either method in samples of 2 patients with suspected CL. L. tropica, L. major and L. infantum/donovani were detected among isolates showing dermotropic location, and L. tropica and L. infantum/don-ovani were detected among isolates with viscerotropic location by genotyping. Conclusions: NNN medium, which is widely used in leishmaniasis di-agnosis, is not sensitive enough for the diagnosis of some Leishmania strains in Turkey. Therefore, an enrichment medium such as liver extract medium which we have presented in this study should be used for di-agnosis. However our results should be confirmed with more studies. Klimik Dergisi 2020; 33(2): 137-41. © 2020, AVES. All rights reserved.