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Franco PS, Scussel ACMO, Silva RJ, Araújo TE, Gonzaga HT, Marcon CF, Brito-de-Sousa JP, Diniz ALD, Paschoini MC, Barbosa BF, Martins-Filho OA, Mineo JR, Ferro EAV, Gomes AO. Systematic Review and Meta-Analysis of Congenital Toxoplasmosis Diagnosis: Advances and Challenges. J Trop Med 2024; 2024:1514178. [PMID: 38419946 PMCID: PMC10901580 DOI: 10.1155/2024/1514178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 10/21/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
Objective To understand how congenital toxoplasmosis (CT) diagnosis has evolved over the years, we performed a systematic review and meta-analysis to summarize the kind of analysis that has been employed for CT diagnosis. Methods PubMed and Lilacs databases were used in order to access the kind of analysis that has been employed for CT diagnosis in several samples. Our search combined the following combining terms: "congenital toxoplasmosis" or "gestational toxoplasmosis" and "diagnosis" and "blood," "serum," "amniotic fluid," "placenta," or "colostrum." We extracted data on true positive, true negative, false positive, and false negative to generate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Random-effects models using MetaDTA were used for analysis. Results Sixty-five articles were included in the study aiming for comparisons (75.4%), diagnosis performance (52.3%), diagnosis improvement (32.3%), or to distinguish acute/chronic infection phases (36.9%). Amniotic fluid (AF) and placenta were used in 36.9% and 10.8% of articles, respectively, targeting parasites and/or T. gondii DNA. Blood was used in 86% of articles for enzymatic assays. Colostrum was used in one article to search for antibodies. In meta-analysis, PCR in AF showed the best performance for CT diagnosis based on the highest summary sensitivity (85.1%) and specificity (99.7%) added to lower magnitude heterogeneity. Conclusion Most of the assays being researched to diagnose CT are basically the same traditional approaches available for clinical purposes. The range in diagnostic performance and the challenges imposed by CT diagnosis indicate the need to better explore pregnancy samples in search of new possibilities for diagnostic tools. Exploring immunological markers and using bioinformatics tools and T. gondii recombinant antigens should address the research needed for a new generation of diagnostic tools to face these challenges.
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Affiliation(s)
- Priscila Silva Franco
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | | | - Rafaela José Silva
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Thadia Evelyn Araújo
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
- Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil
| | - Henrique Tomaz Gonzaga
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Camila Ferreira Marcon
- Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil
| | - Joaquim Pedro Brito-de-Sousa
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
- Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil
| | - Angélica Lemos Debs Diniz
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Marina Carvalho Paschoini
- Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil
| | - Bellisa Freitas Barbosa
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Olindo Assis Martins-Filho
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
- Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil
| | - José Roberto Mineo
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Eloisa Amália Vieira Ferro
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Angelica Oliveira Gomes
- Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil
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Rząd M, Kanecki K, Lewtak K, Goryński P, Tyszko P, Lewandowska-Andruszuk I, Nitsch-Osuch A. Congenital toxoplasmosis among hospitalized infants in Poland in the years 2007-2021: study based on the national hospital registry. Sci Rep 2023; 13:11060. [PMID: 37422492 PMCID: PMC10329637 DOI: 10.1038/s41598-023-38270-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/06/2023] [Indexed: 07/10/2023] Open
Abstract
Congenital toxoplasmosis (CT) is a rare entity and it may pose a life-threatening risk for the newborns. The aim of the study was to evaluate the incidence and other selected factors of CT in Poland. Our study is a population-based study on CT patients in 2007-2021. The study was based on 1504 hospitalization records of first-time diagnosis of CT in newborns. In the study group, we observed 763 males (50.7%) and 741 females (49.3%). The mean and median age was 31 days and 10 days, respectively. Based on the hospital registry, the mean annual CT incidence was estimated to be 2.6 per 10,000 live births (95% CI 2.0-3.2 per 10,000 live births). The incidence of CT cases fluctuated over the years 2007-2021, with the highest incidence in 2010 and the lowest one in 2014. There were no statistically significant differences between the incidence of CT in relation to sex or place of residence. The periodic fluctuations in the number of cases of congenital toxoplasmosis indicates the need to develop effective prevention programs to effectively counteract the disease and its consequences.
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Affiliation(s)
- Michał Rząd
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland
- Doctoral School, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland
| | - Katarzyna Lewtak
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland.
| | - Paweł Goryński
- National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland
- Institute of Rural Health in Lublin, Lublin, Poland
| | - Izabela Lewandowska-Andruszuk
- Department of Obstetrics, Gynaecology and Gynaecologic Oncology, Mazovian Specialist Hospital, Radom, Poland
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland
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Nabet C, Brossas JY, Poignon C, Bouzidi A, Paris L, Touafek F, Varlet-Marie E, Sterkers Y, Passebosc-Faure K, Dardé ML, Piarroux R, Denis JA. Assessment of Droplet Digital PCR for the Detection and Absolute Quantification of Toxoplasma gondii: A Comparative Retrospective Study. J Mol Diagn 2023; 25:467-476. [PMID: 37068735 DOI: 10.1016/j.jmoldx.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/16/2023] [Accepted: 03/30/2023] [Indexed: 04/19/2023] Open
Abstract
Accurate tools for Toxoplasma gondii detection and quantification can be valuable for the early and effective management of toxoplasmosis. Droplet digital PCR (ddPCR) is a next-generation end-point PCR technique with high performance. The objective of the study was to evaluate the performance of ddPCR for the detection and absolute quantification of T. gondii. From January 2019 to October 2020, DNA samples collected at the Laboratory of Parasitology and Mycology of Pitié-Salpêtrière Hospital in Paris were retrospectively analyzed by ddPCR and real-time quantitative PCR (qPCR). To detect T. gondii with the best sensitivity possible, the REP-529 multicopy target was used. For absolute quantification of T. gondii, a specific single-copy target of α-tubulin was designed. T. gondii detection by ddPCR and qPCR was strongly correlated (R2 = 0.93), with a total concordance of 96.7% (n = 145/150). Quantification of T. gondii using ddPCR was successful for 15 of 35 samples showing a parasite load ≥170 copies/mL of DNA eluate using the α-tubulin target. The qPCR REP-529 quantification based on a standard curve was approximate and dependent on the strain genotype, which led to an estimate of parasite copy number 14- to 160-fold superior to the ddPCR result. In total, ddPCR is an effective molecular method for T. gondii detection that shows equivalent performance to qPCR. For robust T. gondii quantification, ddPCR is clearly more accurate than semiquantitative qPCR methods.
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Affiliation(s)
- Cécile Nabet
- Sorbonne University, INSERM, Pierre-Louis Institute of Epidemiology and Public Health (IPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Parasitology and Mycology Department, Paris, France.
| | - Jean-Yves Brossas
- Sorbonne University, Parasitology and Mycology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Corentin Poignon
- Sorbonne University, Parasitology and Mycology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Amira Bouzidi
- Sorbonne University, INSERM, Research Unit on Cardiovascular and Metabolic Disease, Institut of Cardiometabolism and Nutrition (ICAN), Department of Endocrine Biochemistry and Oncology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Luc Paris
- Sorbonne University, Parasitology and Mycology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Feriel Touafek
- Sorbonne University, Parasitology and Mycology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Emmanuelle Varlet-Marie
- University of Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut de Rechercher pour le Développement (IRD), MiVEGEC, University Hospital of Montpellier, Molecular Biology Pole of the National Reference Centre (CNR) for Toxoplasmosis, Montpellier, France
| | - Yvon Sterkers
- University of Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut de Rechercher pour le Développement (IRD), MiVEGEC, University Hospital of Montpellier, Molecular Biology Pole of the National Reference Centre (CNR) for Toxoplasmosis, Montpellier, France
| | - Karine Passebosc-Faure
- National Reference Centre (CNR) for Toxoplasmosis/Toxoplasma Biological Research Centre (BRC), Dupuytren University Hospital Centre, Limoges, France
| | - Marie-Laure Dardé
- National Reference Centre (CNR) for Toxoplasmosis/Toxoplasma Biological Research Centre (BRC), Dupuytren University Hospital Centre, Limoges, France; Limoges University, INSERM, University Hospital Centre Limoges, Institut de Recherche pour le Développement (IRD), Tropical Neuroepidemiology Unit, Institute of Epidemiology and Tropical Neurology, Limoges, France
| | - Renaud Piarroux
- Sorbonne University, INSERM, Pierre-Louis Institute of Epidemiology and Public Health (IPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Parasitology and Mycology Department, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne University, INSERM, Saint-Antoine Research Centre, Cancer Biology and Therapeutics, Department of Endocrine Biochemistry and Oncology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
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Brenier-Pinchart MP, Filisetti D, Cassaing S, Varlet-Marie E, Robert-Gangneux F, Delhaes L, Guitard J, Yéra H, Bastien P, Pelloux H, Sterkers Y. Molecular Diagnosis of Toxoplasmosis: Multicenter Evaluation of the Toxoplasma RealCycler Universal PCR Assay on 168 Characterized Human Samples. J Mol Diagn 2022; 24:687-696. [PMID: 35452843 DOI: 10.1016/j.jmoldx.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/20/2022] [Accepted: 03/04/2022] [Indexed: 10/18/2022] Open
Abstract
Real-time PCR plays a crucial role in the diagnosis of toxoplasmosis. In this multicenter study, the Toxoplasma RealCycler Universal assay was assessed for the diagnosis of toxoplasmosis by eight reference laboratories. DNAs from diverse clinical samples were included: 141 characterized samples from patients with different clinical forms of proven toxoplasmosis and 27 from patients without toxoplasmosis were tested in duplicate with the commercial assay. Final diagnosis was affirmed by each center by analysis of clinical settings and biological follow-up. Calibrated Toxoplasma gondii standards and 11 external quality control samples were also included. Discrepant results observed after the first run of commercial PCR were controlled by both reference and commercial PCR assays. Using the commercial assay, the detection threshold varied from 0.01 to 1 tachyzoites/mL, depending on the center. The relationship between crossing point and DNA concentration was linear over 4 log units (r2 > 0.99), and PCR efficiencies were satisfactory (89% to 104%). The results of the 11 external quality control samples were concordant after one retesting, but those for 3 clinical samples remained discrepant. Sensitivity and specificity were calculated at 97.8% (95% CI, 97.8%-100%) and 100% (95% CI, 87.2%-100%), respectively. Provided that PCRs are performed at least in duplicate to detect low parasitic loads, Toxoplasma RealCycler Universal PCR showed suitable performances to diagnose the different forms of toxoplasmosis.
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Affiliation(s)
- Marie-Pierre Brenier-Pinchart
- Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire Grenoble Alpes and University of Grenoble Alpes, Grenoble, France; "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France.
| | - Denis Filisetti
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Medical Mycology Laboratory, Parasitology and Tropical Diseases Institute, University Hospitals and University of Strasbourg, Strasbourg, France
| | - Sophie Cassaing
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire de Toulouse and University of Toulouse, Toulouse, France
| | - Emmanuelle Varlet-Marie
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Florence Robert-Gangneux
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Centre Hospitalier Universitaire de Rennes and Ecole des Hautes Etudes en Santé Publique, University of Rennes, Rennes, France
| | - Laurence Delhaes
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire de Bordeaux and Cardio-Thoracic Research Center, University of Bordeaux, Bordeaux, France
| | - Juliette Guitard
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology Mycology Department, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris and Saint-Antoine Research Center, Sorbonne University, Paris, France
| | - Hélène Yéra
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Laboratory, Cochin Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Paris, France
| | - Patrick Bastien
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Department, Centre Hospitalier Universitaire de Montpellier and MiVEGEC, Institut de Recherche pour Le Développement, University of Montpellier, Montpellier, France
| | - Hervé Pelloux
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire Grenoble Alpes and University of Grenoble Alpes, Grenoble, France
| | - Yvon Sterkers
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Department, Centre Hospitalier Universitaire de Montpellier and MiVEGEC, Institut de Recherche pour Le Développement, University of Montpellier, Montpellier, France
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Chen XX, Chen W, Liu YL, Lin CX, Li M, Chen WJ, Xie SH, Lin DF, Cao SM. Development and validation of a flexible DNA extraction (PAN) method for liquid biopsy of multiple sample types. J Clin Lab Anal 2021; 35:e23962. [PMID: 34399000 PMCID: PMC8418477 DOI: 10.1002/jcla.23962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/07/2021] [Accepted: 08/03/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Liquid biopsy is gaining increasing popularity in cancer screening and diagnosis. However, there is no relatively mature DNA isolation method or commercial kit available that is compatible with different LB sample types. This study developed a PAN-sample DNA isolation method (PAN method) for liquid biopsy samples. METHODS The PAN method has two key steps, including biosample-specific pretreatments for various LB sample types and high concentration guanidine thiocyanate buffer for lysis and denaturation procedure. Subsequently, the performance of PAN method was validated by a series of molecular analyses. RESULTS The PAN method was used to isolate DNA from multiple sample types related to LB, including plasma, serum, saliva, nasopharyngeal swab, and stool. All purified DNA products showed good quality and high quantity. Comparison of KRAS mutation analysis using DNA purified using PAN method versus QIAamp methods showed similar efficiency. Epstein-Barr virus DNA was detected via Q-PCR using DNA purified from serum, plasma, nasopharyngeal swab, and saliva samples collected from nasopharyngeal carcinoma patients. Similarly, methylation sequencing of swab and saliva samples revealed good coverage of target region and high methylation of HLA-DPB1 gene. Finally, 16S rDNA gene sequencing of saliva, swab, and stool samples successfully defines the relative abundance of microbial communities. CONCLUSIONS This study developed and validated a PAN-sample DNA isolation method that can be used for different LB samples, which can be applied to molecular epidemiological research and other areas.
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Affiliation(s)
- Xiao-Xia Chen
- Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wei Chen
- Department of Pathology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yi-Long Liu
- Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Can-Xiang Lin
- Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Mengmeng Li
- Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wen-Jie Chen
- Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Shang-Hang Xie
- Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Dong-Feng Lin
- Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Su-Mei Cao
- Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, and Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, China
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Nourrisson C, Moniot M, Poirier P, Sterkers Y. Evaluation of Two Commercial Kits on the Automated ELITe InGenius PCR Platform for Molecular Diagnosis of Toxoplasmosis. J Mol Diagn 2021; 23:865-871. [PMID: 33962054 DOI: 10.1016/j.jmoldx.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/17/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022] Open
Abstract
Molecular diagnosis of toxoplasmosis is essential for establishing the diagnosis of congenital contaminations and for primary infection or reactivation of immunocompromised patients. An integrated extraction and real-time PCR-based system is of particular interest in this context. Commercial kits for automated extraction and amplification steps are now available. Herein, we assessed two commercial PCR assays for this diagnosis, those of Bio-Evolution and Elitech, on the ELITe InGenius platform. The Bio-Evolution assay showed a specificity and a sensitivity of 100% on clinical samples, but a lower analytical detection threshold than the Elitech assay. The latter showed a specificity of 100% and a sensitivity of 96%. The SP1000 cartridges, which allow DNA extraction from 1 mL of template, showed interesting performances on amniotic fluid samples. Overall, the two kits had good performances on the InGenius platform, which offers a turn-key solution suitable for the molecular diagnosis of toxoplasmosis.
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Affiliation(s)
- Céline Nourrisson
- Department of Parasitology and Mycology, University Hospital Center of Clermont-Ferrand, 3IHP, Clermont-Ferrand, France; University Clermont Auvergne, CNRS, Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France.
| | - Maxime Moniot
- Department of Parasitology and Mycology, University Hospital Center of Clermont-Ferrand, 3IHP, Clermont-Ferrand, France
| | - Philippe Poirier
- Department of Parasitology and Mycology, University Hospital Center of Clermont-Ferrand, 3IHP, Clermont-Ferrand, France; University Clermont Auvergne, CNRS, Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Yvon Sterkers
- University Montpellier, CNRS, IRD, University Hospital Center of Montpellier, "MiVEGEC", Department of Parasitology-Mycology and Molecular Biology Pole of the National Reference Center for Toxoplasmosis, Montpellier, France
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Brenier-Pinchart MP, Varlet-Marie E, Robert-Gangneux F, Filisetti D, Guitard J, Sterkers Y, Yera H, Pelloux H, Bastien P. Impact of pre-analytic step duration on molecular diagnosis of toxoplasmosis for five types of biological samples. PLoS One 2021; 16:e0246802. [PMID: 33596222 PMCID: PMC7888589 DOI: 10.1371/journal.pone.0246802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/26/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Toxoplasma-PCR is essential to diagnose ocular, cerebral, disseminated and congenital toxoplasmosis. This multicenter study evaluated the impact of sample storage duration at +4°C on PCR assay performances in order to propose guidelines for the storage of samples during shipment or/and before PCR. Materials and methods Five matrices, amniotic (AF), cerebrospinal (CSF), and bronchoalveolar lavage fluids (BALF), whole blood (WB) and buffy coat (BC), were artificially spiked with different amounts of Toxoplasma gondii (20, 100, 500 tachyzoites per mL of sample) or with previously infected THP1 cells. DNA extractions were performed at day 0 and after 2, 4 and 7 days of storage at +4°C. Each extract was amplified at least twice by real-time PCR. Results A total of 252 spiked samples was studied. No increase of crossing point was observed and all samples were positive for AF, BALF, BC and infected THP1-spiked WB after up to 7 days at 4°C. For CSF spiked with 20 parasites/mL, only 50% of PCR reactions were positive at D7 (p<0.05). For WB spiked with type II parasites, all reactions remained positive at D7 but amplifications were significantly delayed from D2; and for WB spiked with RH strain, the proportion of positive reactions decreased at D7. Conclusion The storage of clinical samples at +4°C is compatible with the molecular detection of T. gondii parasites. Provided that PCR assays are performed in duplicate, storage of samples is possible up to 7 days. However, from the fifth day onwards, and for samples susceptible to contain low parasitic loads, we recommend to perform the PCR in multiplicate.
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Affiliation(s)
- Marie-Pierre Brenier-Pinchart
- Laboratoire de Parasitologie-Mycologie, CHU Grenoble Alpes et Institut pour l’Avancée des Biosciences (IAB), INSERM U1209-CNRS UMR 5309, Université Grenoble Alpes Grenoble, Grenoble, France
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
- * E-mail:
| | - Emmanuelle Varlet-Marie
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
- Université de Montpellier et Laboratoire de Parasitologie-Mycologie CHU Montpellier, Montpellier, France
| | - Florence Robert-Gangneux
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
- CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085, Université de Rennes, Rennes, France
| | - Denis Filisetti
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
- Institut de Parasitologie et de Pathologie Tropicale, Université de Strasbourg et Laboratoire de Parasitologie et Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Juliette Guitard
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
- Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Sorbonne Université, Paris, France
| | - Yvon Sterkers
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
- CNRS, IRD, CHU de Montpellier, "MiVEGEC" et Laboratoire de Parasitologie-Mycologie, Université de Montpellier, Montpellier, France
| | - Hélène Yera
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
- Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, Université de Paris, AP-HP, Paris, France
| | - Hervé Pelloux
- Laboratoire de Parasitologie-Mycologie, CHU Grenoble Alpes et Institut pour l’Avancée des Biosciences (IAB), INSERM U1209-CNRS UMR 5309, Université Grenoble Alpes Grenoble, Grenoble, France
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
| | - Patrick Bastien
- Centre National de Référence Toxoplasmose-Pôle Biologie Moléculaire, France
- CNRS, IRD, CHU de Montpellier, "MiVEGEC" et Laboratoire de Parasitologie-Mycologie, Université de Montpellier, Montpellier, France
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Valeix N, Costa D, Basmaciyan L, Valot S, Vincent A, Razakandrainibe R, Robert-Gangneux F, Nourrisson C, Pereira B, Fréalle E, Poirier P, Favennec L, Dalle F. Multicenter Comparative Study of Six Cryptosporidium parvum DNA Extraction Protocols Including Mechanical Pretreatment from Stool Samples. Microorganisms 2020; 8:E1450. [PMID: 32971858 PMCID: PMC7564494 DOI: 10.3390/microorganisms8091450] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/13/2020] [Accepted: 09/20/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Nowadays, many commercial kits allow the detection of Cryptosporidium sp. in stool samples after deoxyribonucleic acid (DNA) extraction. Protocols of stool pretreatment have been proposed to optimize oocysts' DNA extraction. Among them, mechanical grinding was reported to improve the performance of Cryptosporidium oocysts' DNA extraction. METHODS A multicenter comparative study was conducted within the framework of the French National Reference Center-Expert Laboratory for Cryptosporidiosis. Six extraction systems (i.e., manual or automated) associated with various mechanical pretreatment protocols, were compared for the Cryptosporidium parvum oocyst' DNA extraction, before amplification using the same real-time PCR method targeting. RESULTS The sensitivity of real-time PCR assay was unequally impacted by the pretreatment/extraction protocol. We observed significant differences for the lowest concentrations of C. parvum oocysts (i.e., 0-94.4% and 33.3-100% respectively for 10 and 50 oocysts/mL). All in all, the protocol using Quick DNA Fecal/Soil Microbe-Miniprep® manual kit showed the best performances. In addition, optimal performances of mechanical pretreatment were obtained by combining a grinding duration of 60 s with a speed of 4 m/s using Fastprep24® with Lysing Matrix E®. CONCLUSIONS Sample pretreatment, as well as the extraction method, needs to be properly adapted to improve the diagnostic performances of the C. parvum DNA amplification methods.
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Affiliation(s)
- Nicolas Valeix
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire, 2 rue A. Ducoudray, BP 37013, CEDEX, 21070 Dijon, France; (N.V.); (L.B.); (S.V.); (A.V.)
| | - Damien Costa
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalo-Universitaire C. Nicolle de Rouen, 76000 Rouen, France; (D.C.); (R.R.); (L.F.)
- Centre National de Référence–Laboratoire Expert des Cryptosporidioses, Institut de Biologie Clinique, Centre Hospitalo-Universitaire C. Nicolle de Rouen, 76000 Rouen, France
| | - Louise Basmaciyan
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire, 2 rue A. Ducoudray, BP 37013, CEDEX, 21070 Dijon, France; (N.V.); (L.B.); (S.V.); (A.V.)
- UMR PAM, University Bourgogne Franche-Comté-AgroSup Dijon-Equipe Vin, Aliment, Microbiologie, Stress, CEDEX, 21078 Dijon, France
| | - Stéphane Valot
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire, 2 rue A. Ducoudray, BP 37013, CEDEX, 21070 Dijon, France; (N.V.); (L.B.); (S.V.); (A.V.)
| | - Anne Vincent
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire, 2 rue A. Ducoudray, BP 37013, CEDEX, 21070 Dijon, France; (N.V.); (L.B.); (S.V.); (A.V.)
| | - Romy Razakandrainibe
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalo-Universitaire C. Nicolle de Rouen, 76000 Rouen, France; (D.C.); (R.R.); (L.F.)
- Centre National de Référence–Laboratoire Expert des Cryptosporidioses, Institut de Biologie Clinique, Centre Hospitalo-Universitaire C. Nicolle de Rouen, 76000 Rouen, France
| | - Florence Robert-Gangneux
- Univ. Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085, 35000 Rennes, France;
| | - Céline Nourrisson
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalo-Universitaire de Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.N.); (B.P.); (P.P.)
| | - Bruno Pereira
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalo-Universitaire de Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.N.); (B.P.); (P.P.)
| | - Emilie Fréalle
- CHU Lille, Laboratoire de Parasitologie-Mycologie, F-59000 Lille, France;
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019–UMR8204-CIIL-Center for Infection and Immunity of Lille, F-59000 Lille, France
| | - Philippe Poirier
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalo-Universitaire de Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.N.); (B.P.); (P.P.)
| | - Loic Favennec
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalo-Universitaire C. Nicolle de Rouen, 76000 Rouen, France; (D.C.); (R.R.); (L.F.)
- Centre National de Référence–Laboratoire Expert des Cryptosporidioses, Institut de Biologie Clinique, Centre Hospitalo-Universitaire C. Nicolle de Rouen, 76000 Rouen, France
| | - Frederic Dalle
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire, 2 rue A. Ducoudray, BP 37013, CEDEX, 21070 Dijon, France; (N.V.); (L.B.); (S.V.); (A.V.)
- UMR PAM, University Bourgogne Franche-Comté-AgroSup Dijon-Equipe Vin, Aliment, Microbiologie, Stress, CEDEX, 21078 Dijon, France
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Is Real-Time PCR Targeting Rep 529 Suitable for Diagnosis of Toxoplasmosis in Patients Infected with Non-Type II Strains in North America? J Clin Microbiol 2020; 58:JCM.01223-19. [PMID: 31694976 DOI: 10.1128/jcm.01223-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/23/2019] [Indexed: 11/20/2022] Open
Abstract
Toxoplasma gondii DNA detection is essential to antenatally diagnose a congenital infection and reactivation of a past infection in an immunocompromised patient. Initially, PCR methods targeted the 35-fold repetitive B1 gene, and more recently, coding sequence Rep 529 has been preferred, as it was reported to be repeated 200- to 300-fold and yielded far better sensitivity than amplification of the B1 sequence. To date, few data are available in regard to the efficacy of Rep 529 for non-type II genotypes. In this study, we compared the results of B1 quantitative PCR (qPCR) with those of two different Rep 529 qPCRs performed on 111 samples in two different laboratories (Rep 529-1 and Rep 529-2). The performances of the 3 qPCRs were also compared according to the genotypes of the isolates for 13 type II and 21 non-type II samples. The performance of the Rep 529 target was superior to that of the B1 target regardless of the genotype (threshold cycle [CT ] values for the Rep 529-1 and Rep 529-2 qPCRs were lower than those for the B1 qPCR [P < 0.001 and P < 0.01, respectively]). The same results were observed when a comparison was made according to the genotype of the strain (type II and non-type II genotypes). To our knowledge, these results provide the first relative quantitative data revealing that the efficiency of Rep 529 qPCR does not depend on the genotype of T. gondii isolates and that, in fact, it is superior to B1 qPCR.
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Zhao F, Bulin L, Fricker-Hidalgo H, Renaut Q, Robert MG, Garnaud C, Pelloux H, Brenier-Pinchart MP. Molecular diagnosis of toxoplasmosis: evaluation of automated DNA extraction using eMAG® (bioMérieux) on buffy coat, cerebrospinal and bronchoalveolar lavage fluids. ACTA ACUST UNITED AC 2019; 58:e91-e93. [DOI: 10.1515/cclm-2019-0753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/15/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Fanny Zhao
- Parasitology-Mycology Laboratory, Institute of Biology and Pathology , Grenoble-Alpes University Hospital , Grenoble , France
| | - Lionnel Bulin
- Parasitology-Mycology Laboratory, Institute of Biology and Pathology , Grenoble-Alpes University Hospital , Grenoble , France
| | - Hélène Fricker-Hidalgo
- Parasitology-Mycology Laboratory, Institute of Biology and Pathology , Grenoble-Alpes University Hospital , Grenoble , France
| | - Quentin Renaut
- Parasitology-Mycology Laboratory, Institute of Biology and Pathology , Grenoble-Alpes University Hospital , Grenoble , France
| | - Marie Gladys Robert
- Parasitology-Mycology Laboratory, Institute of Biology and Pathology , Grenoble-Alpes University Hospital , Grenoble , France
- Host-Pathogen Interactions and Immunity to Infections, Institute for Advanced Biosciences , Grenoble Alpes University , Grenoble , France
| | - Cécile Garnaud
- Parasitology-Mycology Laboratory, Institute of Biology and Pathology , Grenoble-Alpes University Hospital , Grenoble , France
- TIMC-TheREx , Grenoble Alpes University , Grenoble , France
| | - Hervé Pelloux
- Parasitology-Mycology Laboratory, Institute of Biology and Pathology , Grenoble-Alpes University Hospital , Grenoble , France
- Host-Pathogen Interactions and Immunity to Infections, Institute for Advanced Biosciences , Grenoble Alpes University , Grenoble , France
| | - Marie-Pierre Brenier-Pinchart
- Parasitology-Mycology Laboratory, Institute of Biology and Pathology , Grenoble-Alpes University Hospital , Grenoble , France
- Host-Pathogen Interactions and Immunity to Infections, Institute for Advanced Biosciences, Grenoble Alpes University, INSERMU1209 , CNRS UMR 5309, Grenoble , France
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Risk of congenital toxoplasmosis in women with low or indeterminate anti-Toxoplasma IgG avidity index in the first trimester of pregnancy: an observational retrospective study. Clin Microbiol Infect 2018; 25:761.e9-761.e13. [PMID: 30315959 DOI: 10.1016/j.cmi.2018.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/28/2018] [Accepted: 09/30/2018] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Congenital toxoplasmosis (CT) affects one to ten fetuses per 10 000 live newborns in western countries. Without knowing pre-conception serostatus, it is hard to date the infection when anti-Toxoplasma IgG and IgM antibodies are positive at first screening. Although a high IgG avidity index (AI) in the first trimester excludes CT, the same cannot be said of intermediate and low AI. The aim of this study was to estimate the risk of CT when intermediate or low AI is detected in the first trimester of pregnancy. METHODS Our observational retrospective study enrolled women with positive anti-Toxoplasma IgG and IgM, and low/intermediate AI in the first trimester of gestation seen at two reference centres in northern Italy between 2006 and 2015. All women received spiramycin. When requested by women, a sample of fluid obtained through amniocentesis was tested with a commercial real-time PCR. CT was defined by positive PCR result confirmed on aborted materials or by newborn follow up. RESULTS Overall, 778 first-trimester pregnant women were included; AI was low in 532/778 (68%) and intermediate in 246/778 (32%). Amniocenteses were performed in 528/778 (67.9%), with no fetal loss. In all, 19/778 (2.4%) miscarriages and 15/778 (1.9%) pregnancy terminations were recorded; 9/778 (1.6%) were lost to follow up. In two women, PCR on amniotic fluid was positive, but CT was confirmed in only 1/747 cases (0.13%, 95% CI 0.02%-0.75%). CONCLUSION In our study, the risk of CT was much lower than anticipated. These data must be considered when counselling these women.
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