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Application of PCR-Based Tools to Explore Strongyloides Infection in People in Parts of Northern Australia

Public and Environmental Health, Forensic and Scientific Services, Health Support Queensland, Brisbane, QLD 4108, Australia
Department of Veterinary Biosciences, The University of Melbourne, Melbourne, VIC 3053, Australia
Centre for Infectious Diseases and Microbiology, Institute for Clinical Pathology and Medical Research NSW Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia
Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW 2145, Australia
Pathology Queensland, The Townsville Hospital, Townsville, QLD 4814, Australia
School of Health, Medical and Applied Sciences, Central Queensland University, North Rockhampton, QLD 4700, Australia
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2017, 2(4), 62;
Received: 12 October 2017 / Revised: 1 December 2017 / Accepted: 1 December 2017 / Published: 8 December 2017
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Strongyloidiasis, which is caused by infection with the nematode Strongyloides stercoralis, is endemic to areas of northern Australia. Diagnosis in this region remains difficult due to the distances between endemic communities and diagnostic laboratories, leading to lengthy delays in stool processing for microscopy and culture. PCR represents a viable solution to this difficulty, having potential for high sensitivity detection of S. stercoralis, even in older, unpreserved faecal samples. We prospectively collected 695 faecal specimens that were submitted to The Townsville Hospital Microbiology Laboratory from the North Queensland region for routine parasitological examination, and subjected them to a Strongyloides sp. real-time (q)PCR. Results were confirmed with a novel nested conventional PCR assay targeting the 18S rRNA gene, followed by single-strand conformation polymorphism analysis (SSCP). Of the 695 specimens tested, S. stercoralis was detected in three specimens (0.4%) by classical parasitological methods (direct microscopy and formyl-ether acetate concentration), whereas 42 positives were detected by qPCR (6.0%). Conventional PCR confirmed the real-time PCR results in 24 of the samples (3.5%). Several apparent false-positive results occurred at higher cycle times (Ct) in the qPCR. Use of real-time PCR in these populations is promising for the enhanced detection of disease and to support eradication efforts. View Full-Text
Keywords: strongyloidiasis; Strongyloides stercoralis; Australia; PCR; SSCP strongyloidiasis; Strongyloides stercoralis; Australia; PCR; SSCP

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Robertson, G.J.; Koehler, A.V.; Gasser, R.B.; Watts, M.; Norton, R.; Bradbury, R.S. Application of PCR-Based Tools to Explore Strongyloides Infection in People in Parts of Northern Australia. Trop. Med. Infect. Dis. 2017, 2, 62.

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