Distribution, treatment outcome and genetic diversity of Leishmania species in military personnel from Colombia with cutaneous leishmaniasis

Abstract

Background Leishmaniasis is one of the most important infectious diseases affecting the Colombian National Army due to the high number of reported cases and exposure throughout military operations in endemic areas. The main aim of this study was to estimate the geographical distribution along with the genetic diversity and treatment outcome of Leishmania species in Colombian military personnel. Methods Skin lesion samples by smear and aspirate were collected in 136 patients having parasitological cutaneous leishmaniasis (CL) diagnosis. DNA was extracted, the nuclear marker heat shock protein 70 (HSP70) was amplified by PCR and sequenced. Leishmania species were identified by BLASTn. The geo-spatial distribution of the identified parasites was determined according to the possible site of infection. Gene tree was constructed by maximum likelihood (ML), diversity indices (π, h) were estimated and haplotype network was constructed under the Templeton-Crandall-Sing algorithm in order to determine the geographic relationships of the genetic variants of Leishmania species circulating in Colombian military population. Results The species were identified in 77.94% of the samples, with a predominance of L. braziliensis (65.09%), followed by L. panamensis (31.13%), L. naiffi by the first time reported in Colombia in two patients (1.89%) as well as L. lindenbergi in a single patient (0.945%) with possible infection in the municipality of Miraflores, Guaviare and L. infantum in a single patient (0.945%) notified with CL in the municipality of Tumaco, Nariño. The phylogenetic analysis was consistent according to bootstrap, showing four strongly differentiated clades. Conclusions The geo-spatial distribution suggested that L. braziliensis has a greater abundance, while L. panamensis has a greater dispersion. The phylogenetic relationships of Leishmania species in Colombian military personnel was estimated with the confirmation of two new species circulating without prior report in the country and a species with no background for CL in the Colombian army. A substantial genetic diversity of Leishmania braziliensis was defined. This study contributes through the understanding of the molecular epidemiology to the CL transmission in Colombia.

Development of an Amplicon-Based Next-Generation Sequencing Protocol to Identify Leishmania Species and Other Trypanosomatids in Leishmaniasis Endemic Areas

“…Therefore, this is the first report of Leishmania polyparasitism in naturally infected dogs from Colombia, showing triple-infection events. Interestingly, two of the canines showed coinfection with L. naiffi , a recently identified species in Colombia ( 53 ) that is known to cause human cutaneous disease in Panama, French Guiana, and the Brazilian Amazon ( 53 , 54 ). Furthermore, the facts that L. naiffi had not been previously identified in Sincelejo, where the sample was obtained, and that one of its vectors ( Lutzomyia gomezi ) is endemic across neighboring departments (Cordoba, Atlantico, and La Guajira) ( 30 , 55 , 56 ) where cutaneous leishmaniasis is endemic strongly suggest a possible expansion of the ecological range of the sand fly vector, thus highlighting the introduction of new species and/or genotypes to certain geographical areas where they had not been previously reported, increasing the possibility that a vector/reservoir could be infected with more than one species.…”

Imported leishmaniasis in travelers: a 7-year retrospective from a Parisian hospital in France

“…The main goal then is species identification, and we indeed identified different species, in accordance with the wealth of Leishmania spp. in this region [ 31 , 32 ]. Importantly, none of the cases presented with mucosal lesions, confirming that patients seek medical advice soon enough after the appearance of such lesions.…”

Imported Cases of Cutaneous Leishmaniasis in Cuba, 2017: Role of Human Movement.

“…Nevertheless, longer and complex treatment was administered to L. braziliensis (case 17-01). It is known that L. braziliensis is the main causal agent of CL and MCL in the Americas [28] with the greatest relative abundance in Colombia and frequently results in therapeutic failure [29]. Recently, a study to determine drug susceptibility pro les of amphotericin B and uconazole in cultured isolates of Old World and New World Leishmania spp, showed reduced susceptibility to drugs against New World species compared with Old World strains.…”