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Yamamoto L, Filho AGA, Queiroz JA, de Carvalho MHB, Rodrigues JC, Kanunfre KA, Francisco RPV, Okay TS. Performance of a Multiplex Nested Polymerase Chain Reaction in Detecting 7 Pathogens Containing DNA in Their Genomes Associated With Congenital Infections. Arch Pathol Lab Med 2019; 144:99-106. [PMID: 31219343 DOI: 10.5858/arpa.2018-0544-oa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Infections are the leading cause of perinatal and infant mortality in low-income and low-resource countries, which have a higher prevalence of infections. Definitive diagnosis of congenital and perinatal infections is largely dependent upon the results of laboratory tests. OBJECTIVE.— To develop a multiplex nested polymerase chain reaction (PCR) technique for the simultaneous detection of 7 pathogens containing DNA in their genomes in suspected cases of congenital infection. DESIGN.— Eligible participants were pregnant women with positive immunoglobulin M antibodies raised to one of the pathogens in the prenatal serologic screening, associated or not with fetal ultrasound abnormalities or positive fetal serology. Neonates whose mothers did not attend prenatal care were included when they presented with symptomatology and laboratory parameters suggestive of infection. The detection rate of the multiplex nested PCR was compared with maternal, fetal, and neonatal serology, as well as placental immunohistochemistry and noncommercial amplifications. RESULTS.— Of 161 suspected cases, the multiplex nested PCR detected 60 (37.3%), whereas the tests available in hospital laboratories detected 13 of 60 (21.7%) of the cases detected by the multiplex nested PCR, demonstrating a 4.6 times higher detection rate for the multiplex nested PCR (Fisher exact test, P < .001). Positive amplifications were to Toxoplasma gondii (32 cases), cytomegalovirus (14 cases), parvovirus B19 (5 cases), and adenovirus (5 cases). In 4 cases, 2 pathogens were simultaneously detected. All types of biological matrices were suitable for amplification. Sequencing of multiplex nested PCR products confirmed the molecular findings. CONCLUSIONS.— The multiplex nested PCR significantly increased the number of diagnosed congenital infections. Given the scarcity of DNA recovered from amniotic fluid and some neonatal samples, this multiplex nested PCR allows the simultaneous detection of 7 pathogens associated with congenital infections in a reliable, faster, cost-effective, and more sensitive way.
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Affiliation(s)
- Lidia Yamamoto
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Antonio G Amorim Filho
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Joelma A Queiroz
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Mario H B de Carvalho
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Jonatas C Rodrigues
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Kelly A Kanunfre
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Rossana P V Francisco
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
| | - Thelma Suely Okay
- From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of São Paulo, São Paulo, Brazil
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Caldeira DB, de Souza Luna LK, Watanabe A, Perosa AH, Granato C, Bellei N. The occurrence of polyomaviruses WUPyV and KIPyV among patients with severe respiratory infections. Braz J Microbiol 2018; 50:133-137. [PMID: 30637634 PMCID: PMC6863251 DOI: 10.1007/s42770-018-0038-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/15/2018] [Indexed: 12/30/2022] Open
Abstract
In 2007, the new polyomaviruses WUPyV and KIPyV were identified in patients with acute respiratory infections. The aim of this study was to investigate these viruses in hospitalized patients with severe acute respiratory infection (SARI). A retrospective study was conducted with 251 patients, from April 2009 to November 2010, using nasopharyngeal aspirates, naso- and oropharyngeal swab samples from hospitalized patients (children < 12 years and adults) who had SARI within 7 days of the onset of symptoms, including fever (> 38.8 °C), dyspnea, and cough. Clinical and epidemiological information was obtained through standardized questionnaire. Enrolled patients were initially suspected to have influenza A(H1N1)pdm09 infections. WUPyV and KIPyV were detected by real-time PCR. Samples were also tested for influenza A and B viruses, human respiratory syncytial virus, rhinovirus, metapneumovirus, coronavirus, adenovirus, and parainfluenza viruses. WUPyV and KIPyV were detected in 6.77% (4.78% and 1.99%, respectively) of hospitalized patients with SARI. All samples from children showed coinfections (rhinovirus was the most commonly detected). Six adults had polyomavirus infection and four (1.6%) had monoinfection. Of them, 3 reported comorbidities including immunosuppression and 1 patient had worse outcome, requiring ICU admission. These preliminary data may suggest a possible role of polyomaviruses in SARI among immunocompromised adult patients.
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Affiliation(s)
- Débora Bellini Caldeira
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil.
| | - Luciano Kleber de Souza Luna
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil
| | - Aripuana Watanabe
- Department of parasitology, microbiology and immunology, Biologic Sciences Institute, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - Ana Helena Perosa
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil
| | - Celso Granato
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil
| | - Nancy Bellei
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil
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Paulini I, Siqueira-Silva J, Thomaz L, Rocha L, Harsi C, Bellei N, Granato C. Development of a prototype immunochromatographic test for rapid diagnosis of respiratory adenovirus infection. Braz J Infect Dis 2017. [PMID: 28623675 PMCID: PMC9425546 DOI: 10.1016/j.bjid.2017.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Human adenoviruses comprise an important group of etiologic agents that are responsible for various diseases in adults and children, such as respiratory, ocular, gastroenteric, and urinary infections. In immunocompromised and organ-transplanted individuals, these agents can cause generalized infections. Rapid diagnostic methods for detecting these infectious agents are not widely available. The aim of this work was to produce monoclonal and polyclonal anti-adenovirus antibodies to be used in a rapid diagnostic test for respiratory infections. Adenovirus hexons were satisfactorily purified by ultracentrifugation and chromatography. After virus purification, anti-hexon monoclonal antibodies were produced and characterized, following classical methods. Antibodies were specific for adenoviruses 2, 3, 5, and 41. The proposed immunochromatographic test was standardized using colloidal gold. The standardization of the rapid test was sufficient to detect adenovirus antigens (in nasopharyngeal lavage samples) with sensitivity of 100% and specificity of 85% when compared to direct immunofluorescence. The immunochromatographic assay prototype was sufficiently sensitive to detect B (3), C (2 and 5), and F (41) adenovirus samples. Although based on preliminary data, the test demonstrated the same performance as direct immunofluorescence, but with the advantage of being a point-of-care test. Further studies are still needed to confirm its effectiveness in clinical practice.
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Affiliation(s)
- Inarei Paulini
- Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia, Disciplina de Infectologia, São Paulo, SP, Brazil.
| | - Joselma Siqueira-Silva
- Universidade de São Paulo, Instituto de Biociências, Departamento de Microbiologia, Laboratório de Adenovírus, São Paulo, SP, Brazil
| | - Luciana Thomaz
- Instituto de Biociências, Departamento de Microbiologia, Laboratório de Micologia, São Paulo, SP, Brazil
| | - Leticia Rocha
- Instituto Butantan, Laboratório de Bacteriologia, São Paulo, SP, Brazil
| | - Charlotte Harsi
- Universidade de São Paulo, Instituto de Biociências, Departamento de Microbiologia, Laboratório de Adenovírus, São Paulo, SP, Brazil
| | - Nancy Bellei
- Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia, Disciplina de Infectologia, São Paulo, SP, Brazil
| | - Celso Granato
- Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia, Disciplina de Infectologia, São Paulo, SP, Brazil
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