Evaluation of Novel Primers for Rapid Single-Step Detection of Pathogenic Leptospira spp. Using Duplex Polymerase Chain Reaction (PCR) Assay

Main Article Content

Noorizan Miswan
Nurlina Rosli
Nur Ain M. Hussin
Eugene Ong Boon Beng
Mohammad Ridhuan Mohd Ali
Siti Aminah Ahmed
Nabilah Ismail
Nurulhasanah Othman
Anizah binti Rahumatullah
G Veera Singham
Nyok-Sean Lau

Abstract

Pathogenic Leptospira spp. infections are the cause of the endemic disease leptospirosis. The flu-like and febrile symptoms can deteriorate severely and become fatal if not treated with antibiotic therapy on time. However, the current gold standard diagnostic method being used, the microscopic agglutination test (MAT), can only detect antibodies approximately one week after the onset of symptoms, besides, it requires skilled personnel and live cultures. In this study, two primer sets targeting rrs and lipL32 genes were designed for simple, multiplex, and rapid molecular detection of Leptospira spp. The duplex PCR assay was evaluated using 15 Leptospira strains, comprising both pathogenic and non-pathogenic species, and demonstrated simultaneous detection and clear differentiation of pathogenic Leptospira spp. within a single PCR run. In a duplex PCR setting, the assay showed 100% sensitivity for both urine-spiked Leptospira interrogans serovar Copenhagenii and its gDNA, with a detection limit of 100 bacteria/mL for urine and 30 fg/uL for gDNA samples. The results were comparable to the adopted primers targeting lfb1 or secYIV genes in a singleplex PCR setting. The duplex PCR assay showed 100% specificity in detecting Leptospira spp. by amplifying the highly conserved rrs gene in Leptospira spp. and pathogenicity differentiation through the highly conserved lipoprotein encoding lipL32 gene in pathogenic strains. In contrast, the specificity of the singleplex PCR assay targeting lfb1 or secYIV genes for pathogenic strain differentiation was 89% and 78%, respectively.

Article Details

How to Cite
Noorizan Miswan, Nurlina Rosli, Nur Ain M. Hussin, Eugene Ong Boon Beng, Mohammad Ridhuan Mohd Ali, Siti Aminah Ahmed, Nabilah Ismail, Nurulhasanah Othman, Anizah binti Rahumatullah, G Veera Singham, & Nyok-Sean Lau. (2026). Evaluation of Novel Primers for Rapid Single-Step Detection of Pathogenic Leptospira spp. Using Duplex Polymerase Chain Reaction (PCR) Assay. Tropical Life Sciences Research, 37(2), 53-74. https://doi.org/10.21315/tlsr2026.37.2.3
Section
Original Article

References

Adler B and de la Moctezuma A P. (2010). Leptospira and leptospirosis. Veterinary Microbiology 140(3–4): 287–296. https://doi.org/10.1016/j.vetmic.2009.03.012

Agampodi S, Gunarathna, S, Lee J S and Excler J L. (2023). Global, regional, and country-level cost of leptospirosis due to loss of productivity in humans. PLOS Neglected Tropical Diseases 17(8): 1–11. https://doi.org/10.1371/journal.pntd.0011291

Ahmed A, Engelberts M F, Boer K R, Ahmed N and Hartskeerl R A. (2009). Development and validation of a real-time PCR for detection of pathogenic Leptospira species in clinical materials. PLOS ONE 4(9): 1–8. https://doi.org/10.1371/journal.pone.0007093

Ali M R M, Safee A W M, Ismail N H, Sapian R A, Hussin H M, Ismail N and Yean C Y. (2018). Development and validation of pan-Leptospira TaqMan qPCR for the detection of Leptospira spp. in clinical specimens. Molecular and Cellular Probes 38: 1–6. https://doi.org/10.1016/j.mcp.2018.03.001

Boonsilp S, Thaipadungpanit J, Amornchai P, Wuthiekanun V, Chierakul W, Limmathurotsakul D, Day N P and Peacock S J. (2011). Molecular detection and speciation of pathogenic Leptospira spp. in blood from patients with culture-negative leptospirosis. BMC Infectious Diseases 11: 1–9. https://doi.org/10.1186/1471-2334-11-338

Bourhy P, Bremont S, Zinini F, Giry C and Picardeau M. (2011). Comparison of real-time PCR assays for detection of pathogenic Leptospira spp. in blood and identification of variations in target sequences. Journal of Clinical Microbiology 49(6): 2154–2160. https://doi.org/10.1128/JCM.02452-10

Clark K, Karsch-Mizrachi I, Lipman D J, Ostell J and Sayers E W. (2016). GenBank. Nucleic Acids Research 44(D1): 67–72. https://doi.org/10.1093/nar/gkv1276

Costa F, Hagan J E, Calcagno J, Kane M, Torgerson P, Martinez-Silveira M S, Stein C, Abela-Ridder B and Ko A I. (2015). Global morbidity and mortality of leptospirosis: A systematic review. PLOS Neglected Tropical Diseases 9(9): 1–19. https://doi.org/10.1371/journal.pntd.0003898

Cullen P A, Cordwell S J, Bulach D M, Haake D A and Adler B. (2002). Global analysis of outer membrane proteins from Leptospira interrogans serovar Lai. Infection and Immunity 70(5): 2311–2318. https://doi.org/10.1128/IAI.70.5.2311-2318.2002

Cullen P A, Haake D A and Adler B. (2004). Outer membrane proteins of pathogenic spirochetes. FEMS Microbiology Reviews 28(3): 291–318. https://doi.org/10.1016/j.femsre.2003.10.004

Cullen P A, Xu X, Matsunaga J, Sanchez Y, Ko A I, Haake D A and Adler B. (2005). Surfaceome of Leptospira spp. Infection and Immunity 73(8): 4853–4863. https://doi.org/10.1128/IAI.73.8.4853-4863.2005de

Fonseca C D A, Teixeira de Freitas V L, Caló Romero E, Spinosa C, Arroyo Sanches M C, da Silva M V and Shikanai-Yasuda M A. (2006). Polymerase chain reaction in comparison with serological tests for early diagnosis of human leptospirosis. Tropical Medicine & International Health 11(11): 1699−1707. https://doi.org/10.1111/j.1365-3156.2006.01727.x

Garcia-Lopez M, Lorioux C, Soares A, Trombert-Paolantoni S, Harran E, Ayral F, Picardeau M, Djelouadji Z, & Bourhy, P. (2023). Genetic diversity of Leptospira strains circulating in humans and dogs in France in 2019–2021. Frontiers in Cellular and Infection Microbiology 13: 1−13. https://doi.org/10.3389/fcimb.2023.1236866

Goris M G A and Hartskeerl R A. (2014). Leptospirosis serodiagnosis by the microscopic agglutination test. Current Protocols in Microbiology 32(1): 1−18. https://doi.org/10.1002/9780471729259.mc12e05s3

Haake D A and Levett P N. (2015). Leptospirosis in humans. In B. Adler (ed.), Leptospira and leptospirosis. Berlin, Heidelberg: Springer, 65–97. https://doi.org/10.1007/978-3-662-45059-8_5

Hagedoorn N N, Maze M J, Carugati M, Cash-Goldwasser S, Allan K J, Chen K, Cossic B, et al. (2024). Global distribution of Leptospira serovar isolations and detections from animal hosts: A systematic review and online database. Tropical Medicine & International Health 29(3): 161–172. https://doi.org/10.1111/tmi.13965

Hoke D E, Egan S, Cullen P A and Adler, B. (2008). LipL32 is an extracellular matrix-interacting protein of Leptospira spp. and Pseudoalteromonas tunicata. Infection and Immunity 76(5): 2063–2079. https://doi.org/10.1128/IAI.01643-07

Jaiswal N K, Chandrasekaran S and Rukadikar A. (2019). Usefulness of dark-field microscopy, IgM ELISA and microscopic agglutination test for early diagnosis of acute leptospirosis. Indian Journal of Microbiology Research 6: 166–169. https://doi.org/10.18231/j.ijmr.2019.036

Kim S H, Lee S Y, Kim U and Oh, S. W. (2023). Diverse methods of reducing and confirming false-positive results of loop-mediated isothermal amplification assays: A review. Analytica Chimica Acta 1280: 1–9. https://doi.org/10.1016/j.aca.2023.341693

Lam J Y, Low G K K and Chee H Y. (2020). Diagnostic accuracy of genetic markers and nucleic acid techniques for detection of Leptospira in clinical samples: A meta-analysis. PLOS Neglected Tropical Diseases 14(2): 1–22. https://doi.org/10.1371/journal.pntd.0008074

Landolt N Y, Chiani Y T, Pujato N, Jacob P, Schmeling M F, Effron G G and Vanasco N B. (2023). Utility evaluation of two molecular methods for Leptospira typing in human serum samples. Heliyon 9(2):1–8. https://doi.org/10.1016/j.heliyon.2022.e12564

Levett P N. (2001). Leptospirosis. Clinical Microbiology Reviews 14(2): 296–326. https://doi.org/10.1128/CMR.14.2.296

Merien F, Portnoi D, Bourhy P, Charavay F, Berlioz-Arthaud A and Baranton, G. (2005). A rapid and quantitative method for detection of Leptospira species in human leptospirosis. FEMS Microbiology Letters 249(1): 139–147. https://doi.org/10.1016/j.femsle.2005.06.011

Mori Y and Notomi T. (2015). Loop-mediated isothermal amplification (LAMP): Principle, features, and future prospects. Journal of Microbiology 53(1): 1–5. https://doi.org/10.1007/s12275-015-4656-9

Nascimento A L T O, Verjovski-Almeida S, Van Sluys M A, Monteiro-Vitorello C B, Camargo L E A, Digiampietri L A, Setubal J C et al (2004). Genome features of Leptospira interrogans serovar Copenhageni. Brazilian Journal of Medical and Biological Research 37: 459–477. https://doi.org/10.1590/S0100-879X2004000400003

Natarajan S, Joseph J, Vinayagamurthy B and Estrela P. (2023). A lateral flow assay for detection of Leptospira lipL32 gene using CRISPR technology. Sensors 23(14): 1–9. https://doi.org/10.3390/s23146544

Othman S, Philip N, Taib N M, Neela V K and Chee H Y. (2019). Detection of leptospiral DNA in urine sample following prolonged hospitalization: A case report. Malaysian Journal of Medicine and Health Sciences 15(SP2): 105–107.

Pérez L J, Lanka S, DeShambo V J, Fredrickson R L and Maddox C W. (2020). A validated multiplex real-time PCR assay for diagnosis of infectious Leptospira spp. Frontiers in Microbiology 11:1–18. https://doi.org/10.3389/fmicb.2020.00457

Picardeau M. (2013). Diagnosis and epidemiology of leptospirosis. Médecine et Maladies Infectieuses 43(1): 1–9. https://doi.org/10.1016/j.medmal.2012.11.005

Picardeau M, Bulach D M, Bouchier C, Zuerner R L, Zidane N, Wilson P J, Creno S, et al. (2008). Genome sequence of the saprophyte Leptospira biflexa provides insights into the evolution of Leptospira and pathogenesis of leptospirosis. PLOS ONE 3(2): 1–9. https://doi.org/10.1371/journal.pone.0001607

Piredda I, Bertoldi L, Benvenuto G, Palmas B, Pedditzi A, Pintore P and Chisu V. (2021). First isolation and molecular typing of pathogenic and intermediate Leptospira species from urine of symptomatic dogs. Veterinary Sciences 8(12): 1–15. https://doi.org/10.3390/vetsci8120304

Podgoršek D, Ružić-Sabljić E, Logar M, Kobal S, Retelj M and Avšič-Županc T. (2020). Evaluation of real-time PCR targeting the lipL32 gene for diagnosis of Leptospira infection. BMC Microbiology 20: 1–9. https://doi.org/10.1186/s12866-020-01744-4

Puche R, Ferrés I, Caraballo L, Rangel Y, Picardeau M, Takiff H and Iraola G. (2018). Leptospira venezuelensis sp. nov., a new member of the intermediate group isolated from rodents, cattle and humans. International Journal of Systematic and Evolutionary Microbiology 68(2): 513–517. https://doi.org/10.1099/ijsem.0.002528

Rajapakse S, Fernando N, Dreyfus A, Smith C and Rodrigo C. (2025). Leptospirosis. Nature Reviews Disease Primers 11: 1–19. https://doi.org/10.1038/s41572-025-00614-5

Shukla S, Mittal V, Singh P and Singh A. (2021). Evaluation of TaqMan-based real-time PCR assay targeting lipL32 gene for leptospirosis in serologically positive human urine samples from north India. Indian Journal of Medical Microbiology 39(1): 11–14. https://doi.org/10.1016/j.ijmmb.2020.10.017

Smythe L D, Smith I L, Smith G A, Dohnt M F, Symonds M L, Barnett L J and McKay D B. (2002). A quantitative PCR (TaqMan) assay for pathogenic Leptospira spp. BMC Infectious Diseases 2: 1–7. https://doi.org/10.1186/1471-2334-2-13

Smythe L D, Wuthiekanun V, Chierakul W, Suputtamongkol Y, Tiengrim S, Dohnt M F, Day N P et al (2009). The microscopic agglutination test is an unreliable predictor of infecting Leptospira serovar in Thailand. The American Journal of Tropical Medicine and Hygiene 81(4): 695–697. https://doi.org/10.4269/ajtmh.2009.09-0252

Soo, Z M P, Khan N A and Siddiqui R. (2020). Leptospirosis: Increasing importance in developing countries. Acta Tropica 201:1–9. https://doi.org/10.1016/j.actatropica.2019.105183

Villumsen S, Pedersen R, Borre M B, Ahrens P, Jensen J S and Krogfelt K A. (2012). Novel TaqMan PCR for detection of Leptospira species in urine and blood: Pitfalls of in silico validation. Journal of Microbiological Methods 91(1): 184–190. https://doi.org/10.1016/j.mimet.2012.06.009

Vincent A T, Schiettekatte O, Goarant C, Neela V K, Bernet E, Thibeaux R., Ismail N, et al. (2019). Revisiting the taxonomy and evolution of pathogenicity of the genus Leptospira through the prism of genomics. PLOS Neglected Tropical Diseases 13(5): 1–25. https://doi.org/10.1371/journal.pntd.0007270

Vinetz J M. (2001). Leptospirosis. Current Opinion in Infectious Diseases 14: 527–538. https://doi.org/10.1097/00001432-200110000-00005

Yeoh T S, Tang T H and Citartan M. (2023). Isolation of a novel DNA aptamer against LipL32 as a potential diagnostic agent for detection of pathogenic Leptospira. Biotechnology Journal 18(3): 1–12. https://doi.org/10.1002/biot.202200418

WHO (2010). Report of the First Meeting of the Leptospirosis Burden Epidemiology Reference Group. https://iris.who.int/handle/10665/44382 (accessed on 12 February 2004).

WHO (2020). Ending the neglect to attain the Sustainable Development Goals: A road map for neglected tropical diseases 2021–2030. (accessed on 12 February 2004).