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Fadel EF, EL-Hady HA, Ahmed AM, Tolba MEM. Molecular diagnosis of human toxoplasmosis: the state of the art. J Parasit Dis 2024; 48:201-216. [PMID: 38840888 PMCID: PMC11147977 DOI: 10.1007/s12639-024-01667-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 03/23/2024] [Indexed: 06/07/2024] Open
Abstract
Toxoplasma gondii (T. gondii) is an obligate intracellular apicomplexan protozoan that causes toxoplasmosis. Approximately one-third of the world's population is currently T. gondii-seropositive. Although most infections are symptomless, a few can produce retinal lesions and, in immunocompromised persons or when congenitally contracted, can progress to life-threatening central nervous system disseminated infections. Therefore, quick, and precise diagnosis is a must. Molecular techniques nowadays play a crucial role in toxoplasmosis diagnosis, particularly in immunocompromised patients or congenital toxoplasmosis. This review aimed to detail recent advancements in molecular diagnostics of T. gondii infections. The terms "Toxoplasmosis," "Molecular diagnostics," "PCR," "qPCR," "B1," and "rep529" were used to search the English-language literature. In developed nations, conventional PCR (PCR) and nested PCR have been supplanted by quantitative PCR (qPCR), although they are still widely employed in poor nations. The diagnosis of toxoplasmosis has been revolutionized by the emergence of molecular diagnostics. Unfortunately, there is still substantial interlaboratory variability. There is an immediate need for standardization to increase the comparability of results between laboratories and clinical trials. Graphical abstract A graphical abstract highlighting the summary of Toxoplasma molecular diagnostics, created using Biorender.com.
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Affiliation(s)
- Eman Fathi Fadel
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanaa Ahmed EL-Hady
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amal Mostafa Ahmed
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohammed Essa Marghany Tolba
- Department of Microbiology and Clinical Parasitology, Faculty of Medicine, King Khaled University, Abha, Saudi Arabia
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Rico-Torres CP, Valenzuela-Moreno LF, Robles-González E, Cruz-Tamayo AA, Huchin-Cab M, Pérez-Flores J, Xicoténcatl-García L, Luna-Pastén H, Ortiz-Alegría LB, Cañedo-Solares I, Cedillo-Peláez C, García-Lacy F, Caballero-Ortega H. Genotyping of Toxoplasma gondii in domestic animals from Campeche, México, reveals virulent genotypes and a recombinant ROP5 allele. Parasitology 2024; 151:363-369. [PMID: 38379406 PMCID: PMC11044059 DOI: 10.1017/s0031182024000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/27/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024]
Abstract
Toxoplasma gondii has at least 318 genotypes distributed worldwide, and tropical regions usually have greater genetic diversity. Campeche is a state located in the southeastern region of México and has favourable climate conditions for the replication and dissemination of this protozoan, similar to those in South American countries where broad genetic diversity has been described. Thus, in this study, 4 T. gondii isolates were obtained from tissues of stray dogs and free-range chickens in Campeche, México, and were genotyped by Mn-PCR-RFLP with 10 typing markers (SAG1, altSAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico) and 5 virulence markers (CS3, ROP16, ROP17, ROP18 and ROP5) to provide new information about the distribution and virulence prediction of T. gondii genotypes. Two isolates of T. gondii genotype #116 and 2 of genotype #38 were obtained from stray dogs and chickens, respectively. The parasite load found in these species was between <50 and more than 35 000 tachyzoites per mg of tissue. Virulence marker genotyping revealed a recombinant 1&3 ROP5 RFLP pattern in 2 ToxoDB #116 isolates with no prediction of virulence in a murine model, while in the 2 ToxoDB #38 isolates, the ROP18/ROP5 combination predicted high virulence. Considering all the typed markers, there is a predominance of type I and III alleles, as constantly reported for the isolates characterized in various regions of México. It is crucial to determine their phenotype to corroborate the genetic virulence profile of the T. gondii isolates obtained in this study.
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Affiliation(s)
| | | | | | | | - Miguel Huchin-Cab
- Facultad de Ciencias Agropecuarias, Universidad Autónoma de Campeche, México
| | - Jonathan Pérez-Flores
- Departamento de Observación y Estudio de la Tierra, la Atmósfera y el Océano, El Colegio de la Frontera Sur, México
| | | | - Héctor Luna-Pastén
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, México
| | | | - Irma Cañedo-Solares
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, México
| | | | - Fernando García-Lacy
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, México
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Kadkhodaei S, Jahromi ZK, Taghipour A, Rezanezhad H, Solhjoo K. A Case-Control Seroprevalence Survey of Toxoplasmosis in Hemodialysis Patients and Healthy Subjects in Kazeroon and Jahrom Districts in Fars Province, Southern Iran. J Parasitol Res 2023; 2023:8251462. [PMID: 37808168 PMCID: PMC10560106 DOI: 10.1155/2023/8251462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/05/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
Opportunistic parasites such as Toxoplasma gondii (T. gondii) are capable of causing neurological and ocular manifestations in patients undergoing hemodialysis. By designing a matched case-control study, we conducted a seromolecular survey of T. gondii in hemodialysis patients compared to a healthy group from Jahrom and Kazeroon cities in Fars Province, Iran. For this purpose, 75 hemodialysis patients from Kazeroon city, 75 hemodialysis patients from Jahrom city, and 75 healthy individuals were recruited for the study. The serum levels of specific immunoglobulins (IgG/IgM) in the case and control groups were evaluated using the enzyme-linked immunosorbent assay (ELISA) method. Also, buffy coat samples were used to extract genomic DNA. Then, Polymerase Chain Reaction (PCR) was accomplished using the RE and GRA6 genes of T. gondii. A standard questionnaire containing demographic factors was administered. Although the seroprevalence of the anti-T. gondii IgG antibody in hemodialysis patients from Kazeroon (18.66% (14/75)) and Jahrom (25.33% (19/75)) was higher than that in the control group (13.33% (10/75)), no statistically significant difference was observed between the case and control groups (P value = 0.373 from Kazeroon and P value = 0.354 from Jahrom). Among the studied variables, only residence (urban) was significantly associated with the anti-T. gondii IgG antibody in the case group from Kazeroon. Also, no IgM antibody titers and DNA of T. gondii were detected in the case and control groups from both cities. Although high seroprevalence of anti-T. gondii IgG antibody was seen in hemodialysis patients, further epidemiological studies with larger samples need to be done in Jahrom and Kazeroon cities and in other parts of Iran. It is also necessary for health officials to establish programs for the prevention and control of T. gondii infection in hemodialysis patients.
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Affiliation(s)
- Shahin Kadkhodaei
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hassan Rezanezhad
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Kavous Solhjoo
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
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De La Fuente Villar BB, Gomes LHF, Portari EA, Ramos CNP, Rocha DN, Pereira JP, Neves EDS, Guida LDC. Real-time PCR in the diagnosis of congenital toxoplasmosis. Braz J Infect Dis 2023; 27:102804. [PMID: 37743041 PMCID: PMC10539865 DOI: 10.1016/j.bjid.2023.102804] [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: 04/06/2023] [Revised: 08/09/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023] Open
Abstract
The diagnosis of congenital toxoplasmosis presents limitations and therefore new options are necessary. The analysis of amniotic fluid by real-time PCR has already proved effective for confirmation of fetal infection. However, its performance in other biological samples is not clear yet. The aim of this study is to better understand the role of real-time PCR in the blood of the mother and newborn as well as in the amniotic fluid and placenta in the diagnosis of congenital toxoplasmosis. This is a descriptive cohort study of pregnant women with toxoplasmosis followed up in Rio de Janeiro, Brazil. Real-time PCR was performed in samples of maternal blood, amniotic fluid, placenta, and blood of newborns. In addition, histopathological examination of placentas was performed, and data collected from babies were collected. 116 pregnant women were followed up and 298 samples were analyzed. One (0.9%) pregnant woman presented positive PCR in the blood, 3 (3.5%) in the amniotic fluid, 1 (2.3%) in the placenta and no newborn had positive PCR in the blood. Histopathological study was suggestive of toxoplasmosis infection in 24 (49%) placentas. Six (5.2%) newborns were diagnosed with congenital toxoplasmosis, and only cases with positive PCR in the amniotic fluid had correlation of the PCR result with the diagnosis of congenital infection. Both maternal and blood samples of newborns and placenta did not prove to be promising in the diagnosis of congenital toxoplasmosis. Further studies are needed to evaluate the real role of molecular diagnosis in other biological materials rather than the amniotic fluid.
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Affiliation(s)
| | | | - Elyzabeth Avvad Portari
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Carla Nasser Patrocinio Ramos
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Danielle Nascimento Rocha
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fiocruz, Rio de Janeiro, RJ, Brazil
| | - José Paulo Pereira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Elizabeth de Souza Neves
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Letícia da Cunha Guida
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fiocruz, Rio de Janeiro, RJ, Brazil.
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Sharifzadeh M, Rezanezhad H, Solhjoo K, Kargar Jahromi Z, Shadmand E, Shahabi S, Taghipour A. Sero-molecular survey on Toxoplasma gondii infection among drug addicted and non-addicted individuals: a case-control study. BMC Infect Dis 2022; 22:19. [PMID: 34983410 PMCID: PMC8725485 DOI: 10.1186/s12879-021-06979-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Up to now, epidemiological studies on the prevalence of Toxoplasma gondii infection among drug addicted individuals have been rarely performed. By designing an age and sex matched case–control study, we sought to determine the prevalence and associated factors with T. gondii infection in these population using serological and molecular techniques. Methods One hundred and thirty-seven drug addicted individuals and 141 healthy subjects were enrolled in this study. Informed consent as well as a standard questionnaire were obtained from all subjects participating. Blood samples were collected from each participant and the serum was screened for anti-Toxoplasma antibodies (IgG and IgM). PCR assay was performed using the primer pair targeting the RE and GRA6 genes of T. gondii. Then, PCR products were sequenced to determine genotype. Results The seroprevalence of T. gondii infection based on IgG titer was 34.3% in case and 9.9% in the control groups, revealing a statistically significant difference (OR = 4.37; 95% CI = 2.46–9.12; P = 0.001). After analyzing the variables studied through the questionnaire, age was the only significantly factor associated with the anti-T. gondii IgG antibody in case group. Considering PCR assays with RE genomic target, the prevalence of T. gondii infection was 5.1% in the case and 3.5% in control groups which the difference was no statistically significant (OR = 1.46; 95% CI = 0.45–4.73; P = 0.521). Subsequently, all sequenced samples were genotype #1 using the GRA6 genomic target. Conclusions T. gondii exposure is relatively high among drug addicted individuals in Iran, and there is a need for health policymakers and researchers to establish enlightenment and prevention programs for these population at risk of infection. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06979-8.
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Affiliation(s)
- Majid Sharifzadeh
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hassan Rezanezhad
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. .,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Kavous Solhjoo
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Enayatollah Shadmand
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Saeed Shahabi
- Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
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Robert MG, Brenier-Pinchart MP, Garnaud C, Fricker-Hidalgo H, Pelloux H. Molecular diagnosis of toxoplasmosis: recent advances and a look to the future. Expert Rev Anti Infect Ther 2021; 19:1529-1542. [PMID: 34112045 DOI: 10.1080/14787210.2021.1941867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Toxoplasmosis is a globally distributed parasitic infection that can be particularly severe when opportunistic or congenital. Its diagnosis requires accurate and rapid techniques that rely mainly on serology and molecular methods. AREAS COVERED The aim of this review was to discuss the positioning of the molecular diagnosis of toxoplasmosis according to the different clinical situations possibly resulting from infection with T. gondii, and to detail recent developments in this technique. The English and French literature were searched with the following keywords: 'Toxoplasmosis', "Molecular diagnosis" and 'PCR'. EXPERT OPINION Molecular techniques have revolutionized the diagnosis of toxoplasmosis, and practices have considerably evolved over the past decades. However, there is still a high degree of inter-laboratory heterogeneity which impairs comparisons between results and studies. Efforts to standardize practices are underway.
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Affiliation(s)
- Marie Gladys Robert
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France
| | - Marie-Pierre Brenier-Pinchart
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France.,Centre National de Référence Toxoplasmose - Pôle Biologie Moléculaire, France
| | - Cécile Garnaud
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG, Grenoble, France
| | | | - Hervé Pelloux
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France.,Centre National de Référence Toxoplasmose - Pôle Biologie Moléculaire, France
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Multicenter Comparative Assessment of the TIB MolBiol Toxoplasma gondii Detection Kit and Four Laboratory-Developed PCR Assays for Molecular Diagnosis of Toxoplasmosis. J Mol Diagn 2021; 23:1000-1006. [PMID: 34082073 DOI: 10.1016/j.jmoldx.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022] Open
Abstract
Toxoplasmosis can be a life-threatening infection, particularly during pregnancy and in immunocompromised patients. The biological diagnosis of toxoplasmosis is challenging and has been revolutionized by molecular detection methods. This article summarizes the data of a multicenter study involving four centers to assess the performances of a commercial PCR assay as compared with four in-house PCR assays using Toxoplasma gondii standards, 20 external quality control specimens, and 133 clinical samples. This clinical cohort includes well-characterized clinical samples corresponding to different clinical situations: confirmed congenital toxoplasmosis (44 samples), toxoplasmosis in immunocompromised patients (25 samples), and chorioretinitis (5 samples). Furthermore, 59 samples from patients without toxoplasmosis were included as negative controls. The analytical sensitivities of the five methods tested were very similar; and the limit of Toxoplasma DNA detection was around 0.01 T. gondii genome per reaction for all the methods. The overall concordance between the commercial PCR and the four in-house PCR assays was 97.7% (130/133). The clinical sensitivity and specificity were >98% and could be increased for the commercial kit when PCR was performed in multiplicate to detect low parasitic loads. In conclusion, the commercial PCR assay shows suitable performances to diagnose the different clinical forms of toxoplasmosis.
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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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Neves ES, Espíndola OM, Curi A, Amendoeira MR, Rocha DN, Gomes LHF, Guida LC. PCR-based diagnosis is not always useful in the acute acquired toxoplasmosis in immunocompetent individuals. Parasitol Res 2021; 120:763-767. [PMID: 33415403 DOI: 10.1007/s00436-020-07022-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
Toxoplasmosis is the most prevalent zoonosis in the world and is associated with a large spectrum of diseases. Acute acquired toxoplasmosis (AAT) is considered a benign and self-limiting disease but severe postnatal infections have been reported, particularly in South America. Laboratory diagnosis is based on the detection of anti-Toxoplasma gondii IgM, IgG, and presence of low IgG avidity. However, these assays present limitations, and therefore, PCR has been suggested as an alternative diagnostic tool. In this study, we performed real-time and nested PCR in DNA blood samples from 59 individuals with AAT lasting less than 80 days. None of the patients had parasitic DNA detected by PCR, even in the more severe cases or when blood was collected early after disease onset. These negative results indicate that the parasitemia kinetics needs investigation to determine the best time for blood sampling, especially in immunocompetent individuals. Thus, we emphasize that a negative PCR result does not exclude recent T. gondii infection, and serological criteria are still decisive for the laboratory diagnosis of AAT.
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Affiliation(s)
- Elizabeth Souza Neves
- Laboratório de Parasitologia, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil.
| | - Otavio Melo Espíndola
- Laboratório de Pesquisa Clínica em Neuroinfecções, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil.
| | - André Curi
- Laboratório de Oftalmologia, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | - Letícia Cunha Guida
- Laboratório de Alta Complexidade, Instituto Fernandes Figueira, Fiocruz, Rio de Janeiro, Brazil
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Nakashima F, Pardo VS, Miola MP, Murata FHA, Paduan N, Longo SM, Brandão de Mattos CC, Pereira-Chioccola VL, Ricci O, de Mattos LC. Serum IgG Anti- Toxoplasma gondii Antibody Concentrations Do Not Correlate Nested PCR Results in Blood Donors. Front Cell Infect Microbiol 2020; 9:461. [PMID: 31993377 PMCID: PMC6970978 DOI: 10.3389/fcimb.2019.00461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/16/2019] [Indexed: 12/31/2022] Open
Abstract
Background:Toxoplasma gondii infects millions of individuals worldwide. This protozoan is food and water-borne transmitted but blood transfusion and organ transplantation constitute alternative forms for transmission. However, the influence of IgG anti-T. gondii antibodies in molecular analysis carried out in peripheral blood still remain unclear. This study aimed to investigate the serum IgG anti-T. gondii antibody concentrations correlate Nested PCR results in blood donors. Methods: 750 blood donors were enrolled. IgM and IgG anti-T. gondii antibodies were assessed by ELISA (DiaSorin, Italy). Nested PCR was performed with primers JW62/JW63 (288 bp) and B22/B23 (115 bp) of the T. gondii B1 gene. The mean values of IgG concentration were compared for PCR positive and PCR Negative blood donors using the t-test or Mann-Whitney according to the normal distribution (p-value ≤ 0.05). Results: 361 (48.1%) blood donors presented positive serology as follow: IgM+/IgG−: 5 (0.6%); IgM+/IgG+: 21 (2.8%); IgM−/IgG+: 335 (44.7%) and 389 (51.9%), negative serology. From 353 blood donors with positive serology tested, the Nested PCR was positive in 38 (10.8%) and negative in 315 (89.2%). There were no differences statistically significant between the mean values of serum IgG anti-T. gondii antibody concentrations and the Nested PCR results. Conclusions: In conclusion, our data show that variations in the serum IgG anti-T. gondii antibody concentrations do not correlate T. gondii parasitemia detected by Nested PCR in chronically infected healthy blood donors.
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Affiliation(s)
- Fabiana Nakashima
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil
| | - Valquíria Sousa Pardo
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil
| | - Marcos Paulo Miola
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil.,Blood Bank São José do Rio Preto, Fundação Faculdade Regional de Medicina, São Paulo, Brazil
| | | | - Natalia Paduan
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil
| | - Stefani Miqueline Longo
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil
| | - Cinara Cássia Brandão de Mattos
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil.,FAMERP Toxoplasma Research Group, São Paulo, Brazil
| | | | - Octávio Ricci
- Blood Bank São José do Rio Preto, Fundação Faculdade Regional de Medicina, São Paulo, Brazil
| | - Luiz Carlos de Mattos
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil.,FAMERP Toxoplasma Research Group, São Paulo, Brazil
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11
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Valenzuela-Moreno LF, Rico-Torres CP, Cedillo-Peláez C, Luna-Pastén H, Méndez-Cruz ST, Reyes-García ME, Correa D, Alves BF, Pena HFJ, Caballero-Ortega H. Stray dogs in the tropical state of Chiapas, Mexico, harbour atypical and novel genotypes of Toxoplasma gondii. Int J Parasitol 2019; 50:85-90. [PMID: 31863764 DOI: 10.1016/j.ijpara.2019.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
Genotyping of Toxoplasma gondii remains a relevant topic of study, since genotypes can be related to the presentation and severity of toxoplasmosis. To date, 292 restriction fragment length polymorphism genotypes have been described around the world. Serosurveys in southeastern Mexico have documented exposure in over 70% of people and certain animals. Recently, we have described new genotypes and mixed infections in feral cats from Quintana Roo. Thus, the aim of this study was to genotype T. gondii and to describe its genetic variability, from naturally infected stray dogs of Chiapas, which has different geographical and climatic conditions from those found at the Yucatan Peninsula and the other parts of the country. Eleven stray dogs were captured and bled to obtain DNA, and then they were euthanized to perform necropsies and to collect target tissues. Diagnosis of T. gondii was done by quantitative real-time PCR (qPCR) and endpoint PCR. Genotyping was carried out, amplifying 12 polymorphic markers and 15 microsatellites. Atypical SAG3 gene products were cloned and sequenced. All blood samples of dogs were positive to T. gondii DNA by PCR. Two isolates were obtained from pooled heart and diaphragm tissue of two dogs. Two complete PCR-RFLP genotypes were identified (type BrIII and #28). Four animals had mixed infections. A new RFLP atypical allele for the SAG3 marker was observed; cloning and sequencing analysis of this locus revealed mixed infection by a strain identical to GT1, and one type I × II intragenic recombinant. The microsatellite analysis revealed that both isolates are atypical. Thus, atypical new genotypes of T. gondii and mixed infections were found in dogs of Chiapas. The results found here and in genotyping studies in México suggest that the southeastern region favours wide genetic diversity of T. gondii and the possible presence of virulent genotypes such as those found in central and South America.
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Affiliation(s)
- Luis Fernando Valenzuela-Moreno
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico; Programa de Doctorado en Ciencias de la Producción y de la Salud Animal, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Av. Universidad 3000, Circuito Exterior S/N Delegación Coyoacán, C.P. 04510 Ciudad Universitaria, Ciudad de México, Mexico
| | - Claudia Patricia Rico-Torres
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Carlos Cedillo-Peláez
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Héctor Luna-Pastén
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Sara Teresa Méndez-Cruz
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - María Eréndira Reyes-García
- Laboratorio de Biotecnología de Pequeños Rumiantes y Patología, FMVZ-UNACH, Tuxtla Gutiérrez, Chiapas, Mexico
| | - Dolores Correa
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Bruna Farias Alves
- Laboratório de Doenças Parasitárias, Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo - USP, São Paulo, SP, Brazil
| | - Hilda Fátima Jesus Pena
- Laboratório de Doenças Parasitárias, Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo - USP, São Paulo, SP, Brazil.
| | - Heriberto Caballero-Ortega
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico.
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12
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Döşkaya M, Pullukçu H, Karakavuk M, Şahar EA, Taşbakan MS, Taşbakan MI, Yılmaz M, Can H, Döşkaya AD, Gürüz AY. Comparison of an in house and a commercial real-time polymerase chain reaction targeting Toxoplasma gondii RE gene using various samples collected from patients in Turkey. BMC Infect Dis 2019; 19:1042. [PMID: 31823777 PMCID: PMC6902542 DOI: 10.1186/s12879-019-4666-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023] Open
Abstract
Background Toxoplasma gondii is an opportunistic protozoan parasite that can infect all warm-blooded animals including humans and cause serious clinical manifestations. Toxoplasmosis can be diagnosed using histological, serological, and molecular methods. In this study, we aimed to detect T. gondii RE gene in various human samples by in house and commercial real time polymerase chain reactions. Methods A total of 38 suspected cases of toxoplasmosis [peripheral blood (n:12), amnion fluid (n:11), tissue (n:9), cerebrospinal fluid (n:5), and intraocular fluid (n:1)] were included to the study. An in house and a commercial RT-PCR were applied to investigate the T. gondii RE gene in these samples. Results The compatibility rate of the two tests was 94.7% (37/38). When the commercial RT-PCR kit was taken as reference, the sensitivity and specificity of in house RT-PCR test was 87.5 and 100%. When the in house RT-PCR test was taken as reference, the commercial RT-PCR kit has 100% sensitivity and 96.8% specificity. Incompatibility was detected in only in a buffy coat sample with high protein content. Conclusions Both the commercial and in house RT-PCR tests can be used to investigate T. gondii RE gene in various clinical specimens with their high sensitivity and specificity. In house RT-PCR assay can be favorable due to cost savings compared to using the commercial test.
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Affiliation(s)
- Mert Döşkaya
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases, Ege University Faculty of Medicine, İzmir, Bornova, Turkey
| | - Muhammet Karakavuk
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey.,Ege University, Ödemiș Vocational High School, İzmir, Ödemiș, Turkey
| | - Esra Atalay Şahar
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey.,Department of Biotechnology, Ege University Faculty of Engineering, İzmir, Bornova, Turkey
| | - Mehmet Sezai Taşbakan
- Department of Chest Diseases, Ege University Faculty of Medicine, İzmir, Bornova, Turkey
| | - Meltem Işıkgöz Taşbakan
- Department of Infectious Diseases, Ege University Faculty of Medicine, İzmir, Bornova, Turkey
| | - Mümtaz Yılmaz
- Department of Internal Medicine, Ege University Faculty of Medicine, İzmir, Bornova, Turkey
| | - Hüseyin Can
- Department of Biology, Molecular Biology Section, Ege University Faculty of Sciences, İzmir, Bornova, Turkey
| | - Aysu Değirmenci Döşkaya
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey.
| | - Adnan Yüksel Gürüz
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey
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13
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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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14
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Valenzuela-Moreno LF, Rico-Torres CP, Cedillo-Peláez C, Luna-Pastén H, Méndez-Cruz ST, Lara-Martínez G, Correa D, Caballero-Ortega H. Mixed Toxoplasma gondii infection and new genotypes in feral cats of Quintana Roo, México. Acta Trop 2019; 193:199-205. [PMID: 30851257 DOI: 10.1016/j.actatropica.2019.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/07/2019] [Accepted: 03/04/2019] [Indexed: 01/22/2023]
Abstract
Toxoplasmosis is a zoonosis caused by Toxoplasma gondii that infects homeothermic animals, including humans. To date, as many as 287 genotypes have been described worldwide. Genetic characterization of the parasite is crucial because the parasite type can determine the presentation and severity of toxoplasmosis. Previously, we reported that the Yucatán Peninsula has a frequency of infection of over 70% in humans and other animals; moreover, there are seven species of felids, including domestic cats; thus, we hypothesized that this might be a region with a high diversity of the parasite. Nevertheless, no genotyping of this protozoan has been performed in this region. Thus, the aim of this study was to genotype T. gondii from naturally infected feral cats of Quintana Roo, within the Yucatán Peninsula, and to describe its genetic variability. Eleven feral cats were captured and bled to obtain the buffy coat; then, they were euthanized to collect target organs or tissues to extract DNA. Samples were processed by PCR for diagnosis, and ten polymorphic markers were genotyped by PCR-RFLP. Atypical GRA6 gene products were cloned and sequenced. Ten of the eleven cats were PCR positive for toxoplasmosis in blood; of these, seven had mixed infections. Also, two isolates were obtained from the heart and diaphragm of two animals. At least 23 different genotypes were detected, from which 18 are new worldwide. From the atypical GRA6 gene cloning and sequencing analysis, a mixed infection was discovered, due to one strain identical to GT1 and another to VAND. In conclusion, T. gondii genetic diversity in the region is high and different from that in other regions, with new genotypes exclusive to México and some others shared with USA and South America.
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15
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Cubas-Atienzar AI, Hide G, Jiménez-Coello M, Ortega-Pacheco A, Smith JE. Genotyping of Toxoplasma gondii from pigs in Yucatan, Mexico. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2018; 14:191-199. [PMID: 31014729 DOI: 10.1016/j.vprsr.2018.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/13/2018] [Accepted: 10/26/2018] [Indexed: 01/19/2023]
Abstract
Toxoplasmosis is a zoonotic disease of worldwide distribution. The parasite exhibits strong geographical patterns of strain variation with contrasting high levels of diversity across South America and restricted variation across North America. Little is known about the diversity of strains in the transitional area between the two continents. Here we present data on the prevalance and diversity of Toxoplasma gondii in the Yucatan peninsula of Mexico, through a study in commercially reared pigs. A survey of 12 farms found evidence of circulating T. gondii DNA in 125 of 632 blood samples (19.8%, CI: 16.7%-23%). In addition, 46 tongue samples were collected from culled animals and 16 of these were positive for T. gondii DNA and 3 were positive in mouse bioassay. PCR-sequencing was used to generate genotyping data from blood and tissue samples. Four loci (SAG1, 2, 3 and GRA6) were reliably amplified and revealed a high diversity among Yucatan strains with evidence of recombination and novel alleles. Sequencing data from the four loci was achieved in eight samples each of which had a different genotype. The predominant allelic type was atypical, in relation to the dominant strain types (I, II, III), the number of allelic variants being 27 (I, II-III, u-1-25), 20 (I, III, u1-18), 6 (I, III, u1-4) and 11 (I, II, u1-9) for the SAG1, SAG2, SAG3 and GRA6 loci respectively. Phylogenetic analysis showed that T. gondii strains from Yucatan shared alleles with strains originating from both North and South America. Our findings are consistent with data from other regions of Central America and suggest the genetic population structure of the parasite, with significant levels of allelic variation and recombination, constitutes a reservoir from which new strains may emerge. Positive bioassay results (7.5%) indicate that consumption of undercooked pork could be a potential T. gondii infection risk to humans.
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Affiliation(s)
- Ana I Cubas-Atienzar
- Ecosystems and Environment Research Centre, School of Environment and Life Sciences, University of Salford, Salford, M5 4WT Manchester, UK.
| | - Geoff Hide
- Ecosystems and Environment Research Centre, School of Environment and Life Sciences, University of Salford, Salford, M5 4WT Manchester, UK
| | - Matilde Jiménez-Coello
- Campus de Ciencias Biológicas y Agropecuarias, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Yucatán, Km 15.5 Carretera Mérida-Xmatkuil, Mérida, Yucatán, Mexico
| | - Antonio Ortega-Pacheco
- Campus de Ciencias Biológicas y Agropecuarias, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Yucatán, Km 15.5 Carretera Mérida-Xmatkuil, Mérida, Yucatán, Mexico
| | - Judith E Smith
- Ecosystems and Environment Research Centre, School of Environment and Life Sciences, University of Salford, Salford, M5 4WT Manchester, UK
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16
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Dard C, Marty P, Brenier-Pinchart MP, Garnaud C, Fricker-Hidalgo H, Pelloux H, Pomares C. Management of toxoplasmosis in transplant recipients: an update. Expert Rev Anti Infect Ther 2018; 16:447-460. [DOI: 10.1080/14787210.2018.1483721] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Céline Dard
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Cedex France
- Institute for Advanced Biosciences (IAB), Team Host-Pathogen Interactions and Immunity to Infection, INSERM U1209 - CNRS UMR5309, Université Grenoble Alpes, Grenoble France
| | - Pierre Marty
- Faculté de Médecine, Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice, 06202 Nice, France Université de la Côte d’Azur, Nice, France
- 38043, INSERM U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Nice, France
| | - Marie-Pierre Brenier-Pinchart
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Cedex France
- Institute for Advanced Biosciences (IAB), Team Host-Pathogen Interactions and Immunity to Infection, INSERM U1209 - CNRS UMR5309, Université Grenoble Alpes, Grenoble France
| | - Cécile Garnaud
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Cedex France
| | - Hélène Fricker-Hidalgo
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Cedex France
| | - Hervé Pelloux
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Cedex France
- Institute for Advanced Biosciences (IAB), Team Host-Pathogen Interactions and Immunity to Infection, INSERM U1209 - CNRS UMR5309, Université Grenoble Alpes, Grenoble France
| | - Christelle Pomares
- Faculté de Médecine, Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice, 06202 Nice, France Université de la Côte d’Azur, Nice, France
- 38043, INSERM U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Nice, France
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Abstract
PURPOSE OF REVIEW Toxoplasmosis in immunocompromised patients is associated with a high mortality rate. Molecular techniques are important tools to diagnose acute disease in immunocompromised patients, but there are various methods with variable efficiency. Some of them have been validated for the diagnosis of congenital toxoplasmosis, but the impact of their use has not been evaluated in immunocompromised patients. RECENT FINDINGS Toxoplasmosis is of increasing importance in non-HIV immunocompromised patients. In addition, the picture of disease shows greater severity in South America, both in immunocompetent study participants and in congenitally infected infants. These epidemiological differences could influence the sensitivity of diagnostic methods. This review analyzes recent data on molecular diagnosis and compares them with older ones, in light of progress gained in molecular techniques and of recent epidemiological findings. Most recent studies were conducted in South America and used PCR targeting the B1 gene. PCR on blood could allow diagnosing a significant proportion of patients with ocular toxoplasmosis in Brazil. SUMMARY Quantitative PCR methods with specific probes should be used to improve sensitivity and warrant specificity. Performance of quantitative PCR targeting the repeated 529 bp sequence for the diagnosis of toxoplasmosis in immunocompromised patients needs evaluation in field studies in South America and in western countries.
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18
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Performance Testing of PCR Assay in Blood Samples for the Diagnosis of Toxoplasmic Encephalitis in AIDS Patients from the French Departments of America and Genetic Diversity of Toxoplasma gondii: A Prospective and Multicentric Study. PLoS Negl Trop Dis 2016; 10:e0004790. [PMID: 27355620 PMCID: PMC4927177 DOI: 10.1371/journal.pntd.0004790] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/30/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Toxoplasmic encephalitis in patients with AIDS is a life-threatening disease mostly due to reactivation of Toxoplasma gondii cysts in the brain. The main objective of this study was to evaluate the performance of real-time PCR assay in peripheral blood samples for the diagnosis of toxoplasmic encephalitis in AIDS patients in the French West Indies and Guiana. METHODOLOGY/PRINCIPAL FINDINGS Adult patients with HIV and suspicion of toxoplasmic encephalitis with start of specific antitoxoplasmic therapy were included in this study during 40 months. The real-time PCR assay targeting the 529 bp repeat region of T. gondii was performed in two different centers for all blood samples. A Neighbor-Joining tree was reconstructed from microsatellite data to examine the relationships between strains from human cases of toxoplasmosis in South America and the Caribbean. A total of 44 cases were validated by a committee of experts, including 36 cases with toxoplasmic encephalitis. The specificity of the PCR assay in blood samples was 100% but the sensitivity was only 25% with moderate agreement between the two centers. Altered level of consciousness and being born in the French West Indies and Guiana were the only two variables that were associated with significantly decreased risk of false negative results with the PCR assay. CONCLUSION/SIGNIFICANCE Our results showed that PCR sensitivity in blood samples increased with severity of toxoplasmic encephalitis in AIDS patients. Geographic origin of patients was likely to influence PCR sensitivity but there was little evidence that it was caused by differences in T. gondii strains. TRIAL REGISTRATION ClinicalTrials.gov NCT00803621.
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