BACKGROUND Leptospirosis, commonly known as rat-urine disease, is a global but endemic zoonotic disease in the tropics. Despite the historical report of leptospirosis in Malaysia, the information on human-infecting species is limited. Determining the circulating species is important to understand its epidemiology, thereby to strategize appropriate control measures through public health interventions, diagnostics, therapeutics and vaccine development. METHODOLOGY/PRINCIPLE FINDINGS We investigated the human-infecting Leptospira species in blood and serum samples collected from clinically suspected leptospirosis patients admitted to three tertiary care hospitals in Malaysia. From a total of 165 patients, 92 (56%) were confirmed cases of leptospirosis through Microscopic Agglutination Test (MAT) (n = 43; 47%), Polymerase Chain Reaction (PCR) (n = 63; 68%) or both MAT and PCR (n = 14; 15%). The infecting Leptospira spp., determined by partial 16S rDNA (rrs) gene sequencing revealed two pathogenic species namely Leptospira interrogans (n = 44, 70%) and Leptospira kirschneri (n = 17, 27%) and one intermediate species Leptospira wolffii (n = 2, 3%). Multilocus sequence typing (MLST) identified an isolate of L. interrogans as a novel sequence type (ST 265), suggesting that this human-infecting strain has a unique genetic profile different from similar species isolated from rodents so far. CONCLUSIONS/SIGNIFICANCE Leptospira interrogans and Leptospira kirschneri were identified as the dominant Leptospira species causing human leptospirosis in Central Malaysia. The existence of novel clinically important ST 265 (infecting human), that is different from rodent L. interrogans strains cautions reservoir(s) of these Leptospira lineages are yet to be identified.

中文翻译：

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问号钩端螺旋体和克氏钩端螺旋体是导致马来西亚中部人类钩端螺旋体病的主要钩端螺旋体物种。

背景技术钩端螺旋体病，通常称为鼠尿病，是热带地区的一种普遍但普遍的人畜共患病。尽管有马来西亚钩端螺旋体病的历史报道，但有关人类感染物种的信息仍然有限。确定流行物种对于了解其流行病学很重要，从而通过公共卫生干预措施，诊断方法，治疗方法和疫苗开发来制定适当的控制措施。方法/主要发现我们调查了从马来西亚三所三级医院收治的临床怀疑钩端螺旋体病患者的血液和血清样本中感染人类的​​钩端螺旋体物种。通过显微镜凝集试验（MAT）（n = 43； 47％），聚合酶链反应（PCR）（n = 63； n = 60；通过显微镜凝集试验（MAT）），在总共165名患者中，确认了92例（56％）钩端螺旋体病病例。68％）或同时使用MAT和PCR（n = 14; 15％）。通过部分16S rDNA（rrs）基因测序确定的感染钩端螺旋体属有两个致病物种，即问号钩端螺旋体（n = 44，70％）和克氏钩端螺旋体（n = 17，27％）和一个中间钩端螺旋体Wolffii（n = 2、3％）。多基因座序列分型（MLST）将问号乳酸杆菌的分离物鉴定为一种新型序列类型（ST 265），这表明该人类感染菌株具有独特的遗传特征，与迄今为止从啮齿类动物分离的相似物种不同。结论/重要性被确认为钩端螺旋体和克氏钩端螺旋体是导致马来西亚中部钩端螺旋体病的主要钩端螺旋体物种。存在新的具有临床意义的重要ST 265（感染人类），与啮齿动物L不同。