Q Fever in Greenland

We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection

Expanding the Diagnostic Use of PCR in Leptospirosis: Improved Method for DNA Extraction from Blood Cultures

Background: Leptospirosis is a neglected zoonosis of ubiquitous distribution. Symptoms are often non-specific and may range from flu-like symptoms to multi-organ failure. Diagnosis can only be made by specific diagnostic tests like serology and PCR. In non-endemic countries, leptospirosis is often not suspected before antibiotic treatment has been initiated and consequently, relevant samples for diagnostic PCR are difficult to obtain. Blood cultures are obtained from most hospitalized patients before antibiotic therapy and incubated for at least five days, thus providing an important source of blood for PCR diagnosis. However, blood cultures contain inhibitors of PCR that are not readily removed by most DNAextraction methods, primarily sodium polyanetholesulfonate (SPS). Methodology/Principal Findings: In this study, two improved DNA extraction methods for use with blood cultures are presented and found to be superior in recovering DNA of Leptospira interrogans when compared with three previously described methods. The improved methods were easy and robust in use with all tested brands of blood culture media. Applied to 96 blood cultures obtained from 36 patients suspected of leptospirosis, all seven patients with positive convalescence serology were found positive by PCR if at least one anaerobic and one aerobic blood culture, sampled before antibiotic therapy were tested. Conclusions/Significance: This study suggests that a specific and early diagnosis can be obtained in most cases of sever

<i>Leptospira</i> sp. DNA recovery and inhibition of PCR.

<p>Estimated total copy-number of <i>Leptospira interrogans</i> DNA recovered from a spiked sample of BACTEC™ anaerobic Plus containing approximately 50.000 <i>Leptospira</i>/5 µl by five DNA extraction methods. The mean copy-numbers are given above each column. Error bars indicate the 95% confidence interval. M1: Qiagen, DNeasy® Blood & Tissue Kit; M2: Molzym, MolYsis Plus Kit; M3: Protocol described by Fredricks and Relman; M4: Improved protocol for anaerobic and paediatric blood culture media; M5: Improved protocol adapted for all blood culture media.</p

Comparison of the mean Ct value of the internal amplification control in no-template controls and blood cultures tested negative for <i>Leptospira</i> sp. DNA.

<p>Comparison of the mean Ct value of the internal amplification control in no-template controls and blood cultures tested negative for <i>Leptospira</i> sp. DNA.</p