Integration of IgM ELISA and 56 kDa gene PCR in management of pediatric acute encephalitis syndrome associated with scrub typhus

• Published in: Infectious diseases now (Online) 2024-03, Vol.54 (2), p.104865-104865, Article 104865
• Main Authors: Bhardwaj, Pooja, Yadav, Vishal, Sharma, Alok, Gulafshan, Shahzadi, Pragnya Behera, Sthita, Raj Dwivedi, Gaurav, Deval, Hirawati, Paluru, Vijayachari, Murhekar, Manoj, Singh, Rajeev
• Format: Article
• Language: English
• Subjects: 56 kDa; Acute encephalitis syndrome; Eastern-Uttar Pradesh; Orientia tsutsugamushi; Scrub typhus
• ISSN: 2666-9919; 2666-9919
• DOI: 10.1016/j.idnow.2024.104865

•This study examines a novel gene 27 kDa for scrub typhus (ST) detection in AES cases.•56 kDa gene has higher sensitivity for ST detection than other reported genes.•64.4 % of AES cases negative for IgM Antibody of ST were positive by 56 kDa gene PCR.•Integration of IgM ELISA and 56 kDa:PCR may contribute to management of AES cases with ST.•Gilliam and Karp were the predominant strains of Orientia among AES patients. To identify the potential target genes for detection of Orientia tsutsugamushi (OT) in pediatric acute encephalitis syndrome (pAES). DNA was extracted from whole blood of 100 pAES cases having tested positive (n = 41) and negative (n = 59) for scrub typhus (ST) by IgM ELISA. These samples were subjected to standard PCR for 56 kDa, 47 kDa, 16 s rRNA, groEL, traD genes and the newly identified 27 kDa gene. Among the selected gene targets, 56 kDa demonstrated its superiority for OT detection over the other tested genes. The presence of OT was confirmed via PCR targeting 56 kDa gene in 17 out of the 41 (41.4 %) IgM-positive ST AES cases and 38 out of the 59 (64.4 %) ST IgM negative cases. None of the other gene targets were amplified. Integration of serological diagnosis with molecular diagnostics targeting the 56 kDa gene for routine testing of AES patients would facilitate detection of OT in AES endemic regions.