Serological and molecular approaches for leptospirosis at a tertiary care centre in northern India


  • Saurabh Chaurasia Department of Microbiology, Era’s Lucknow Medical University, Lucknow, Uttar Pradesh, India
  • Raj Kumar Kalyan Department of Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Prashant Gupta Department of Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Kamlesh K. Gupta Department of Medicine, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Chandra Kanta Department of Paediatric, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Akanksha Gupta Department of Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh, India



ELISA, Leptospirosis, Microscopic Agglutination Test, PCR, Pyrexia of unknown origin


Background: Aims and objectives of the study was to determine prevalence rate of leptospirosis and recognition of common epidemiological situation and clinical manifestations of leptospirosis in patients with pyrexia of unknown origin at a tertiary care centre.

Methods: This was a hospital based prospective observational study. The duration of study was from August 2015 to July 2016. Patients with clinical symptoms of pyrexia of unknown origin attending Gandhi Memorial and Associated Hospital, King George’s Medical University Lucknow during the study period were enrolled in this study. We performed the IgM ELISA and PCR for the leptospirosis at our centre and for the Micro Agglutination Test (MAT), we sent the serum samples to regional medical research centre Department of Health Research Ministry of Health and Family Welfare, Govt. of India Port Blair.

Results: A Total of 104 symptomatic patients were recruited. Of total, IgM ELISA for leptospirosis were positive in 25 patients, PCR in 20 patients and MAT shows significant titres in 3 samples. The ROC curve analysis revealed significant diagnostic accuracy of IgM ELISA with 100.00% sensitivity and 78.22% specificity however showed less positive predictive value (12.0%) but high negative predictive value (100.0%). Most common presentation were fever, jaundice and rashes (40.4%) followed by fever and jaundice (29.8%).

Conclusions: Leptospirosis IgM ELISA and PCR showed good detection accuracy. Age, sex, occupation is not significantly associated to the leptospirosis.


Adler B, Moctezuma PA. Leptospira and Leptospirosis. Veterinary Microbiology. 2010;140:287-96.

Levett PN. Leptospirosis: A forgotten zoonosis? Clinical Applied Immunology Reviews. 2004;4:435-48.

Ko AI, Goarant C, Picardeau M. Leptospira: the dawn of the molecular genetics era for an emerging zoonotic pathogen. Nature reviews Microbiology. 2009;7:736-47.

Levett PN. Leptospirosis. Clinical microbiology reviews. 2001;14:296-326.

Pappas G, Papadimitriou P, Siozopoulou V, Christou L, Akritidis N. The globalization of leptospirosis: worldwide incidence trends. Int J Infect Dis. 2008;12:351-7.

Bunnel JE, Hice CL, Watts DM, Montrueil V, Tesh RB, Vinetz JM. Detection of pathogenic Leptospira spp. Infections among mammals captured in the Peruvian Amazon basin region. Am J Trop Med Hyg. 2000;63:255-8.

Michel V, Branger C, Andre-Fontaine G. Epidemiology of leptospirosis. RevistaCubana de Medicina Tropical. 2002;54:7-10.

Turk N, Milas Z, Margaletic J, Staresina V, Slavica A, Riquelme-Sertour N, et al. Molecular characterization of Leptospiraspp strains isolated from small rodents in Croatia. Epidemiology Infection. 2003;130:159-66.

Cox TE, Smythe LD and Leung LKP. Flying foxes as carriers of pathogenic Leptospira spp. J Wildlife Diseases. 2005;41:753-7.

Monahan AM, Callanan JJ and Nally JE. Review paper: Host-pathogen interactions in the kidney during chronic leptospirosis. Veterinary Pathology. 2009;46:792-9.

Faine S, Adler B, Bolin C, Perolat P. Clinical leptospirosis in humans. Leptospira and leptospirosis. Medi Sci, Melbourne,;1999.

Sehgal SC, Sugunan AP, Vijayachari P. Outbreak of leptospirosis after the cyclone in Orissa. The National Med J India. 2002;15(1):22-3.

Karande S, Kulkarni H, Kulkarni M, De A, Varaiya A. Leptospirosis in children in Mumbai slums. The Indian J Pediatrics. 2002 Oct 1;69(10):855-8.

Singh SS, Vijayachari P, Sinha A, Sugunan AP. Clinico-epidemiological study of hospitalized cases of severe leptospirosis. Ind J Med Res. 1999 Mar 1;109:94.

Prabhu N, Joseph PID, Chinnaswamy P. In vitro antileptospiral activity of aqueous extract of Eclipta alba Linn. The Antiseptics. 2008;105:300-2.

Natarajaseenivasan K, Prabhu N, Selvanayaki K, Savalaikarankulam S, Raja S, Ratnam S, et al. Human Leptospirosis in Erode, South India: Serology, Isolation and Characterization of the isolates by Rapidly Amplified polymorphic DNA (RAPD) fingerprinting. Jpn J Infect Dis. 2004;57:193-97.

Prabhu N, Joseph PID, Chinnaswamy P. Leptospirosis in Coimbatore, Manchestor of South India: Assessment of clinical presentation of 93 cases. Bom Hosp J. 2008;50(3):434-38.

Winslow WE, Merry DJ, Pirc ML, Devine PL. Evaluation of a commercial enzyme-linked immunosorbent assay for detection of immunoglobulin M antibody in diagnosis of human leptospiral infection. J Clin Microbiol. 1997;35(8):1938-42.

Palaniappan RU, Chang YF, Chang CF, Pan MJ, Yang CW, Harpending P, et al. Evaluation of lig-based conventional and real time PCR for the detection of pathogenic leptospires. Molecular cellular probes. 2005 Apr 1;19(2):111-7.

Chaudhry R, Das A, Premlatha MM, Choudhary A, Chourasia BK, Chandel DS, et al. Serological & molecular approaches for diagnosis of leptospirosis in a tertiary care hospital in north India: a 10-year study. Ind J Med Res. 2013 Apr;137(4):785-90.

Zakeri S, Sepahian N, Afsharpad M, Esfandiari B, Ziapour P, Djadid ND. Molecular epidemiology of leptospirosis in northern Iran by nested polymerase chain reaction/restriction fragment length polymorphism and sequencing methods. Am J Trop Med Hyg. 2010 May 1;82(5):899-903.

Angnani R, Pathak AA, Mishra M. Prevalence of leptospirosis in various risk groups. Indian J Med Microbiol. 2003;21:271-3.

Sumathi G, Narayanan R, Shivakumar S. Leptospirosis laboratory, Madras medical college: Review of our experience (2004-2006). Indian J Med Microbiol. 2008;26:206-7.




How to Cite

Chaurasia, S., Kalyan, R. K., Gupta, P., Gupta, K. K., Kanta, C., & Gupta, A. (2018). Serological and molecular approaches for leptospirosis at a tertiary care centre in northern India. International Journal of Research in Medical Sciences, 6(9), 3084–3088.



Original Research Articles