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Montoya JG. In defense of children's brain: reshuffling the laboratory toolbox for the diagnosis of congenital toxoplasmosis. J Clin Microbiol 2024; 62:e0169723. [PMID: 38780287 DOI: 10.1128/jcm.01697-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
For decades, an immunosorbent agglutination assay (ISAGA) has been considered the gold standard method for the detection of Toxoplasma gondii-specific IgM in infants for the diagnosis of congenital toxoplasmosis (CT). The Toxoplasma IgM ISAGA was consistently reported as having superior sensitivity. Unfortunately, the commercial kit for the detection of Toxoplasma IgM ISAGA will no longer be available in 2024 and alternatives will only be available at a handful of reference laboratories as in-house or laboratory-developed tests. In a recent study, S. Arkhis, C. Rouges, N. Dahane, H. Guegan, et al. (J Clin Microbiol 62:e01222-23, 2024, https://doi.org/10.1128/jcm.01222-23), reported that the performance of the PLATELIA Toxo IgM was comparable to that of the ISAGA method for the diagnosis of CT. A second study revealing similar results supports the PLATELIA Toxo IgM as the new gold standard for the detection of T. gondii-specific IgM in infants. Although the laboratory toolbox for CT diagnosis has been reshuffled successfully, it is by universally implementing all available serological and molecular tools at the earliest possible time during gestation that we can best defend children's brain from the potential harm caused by trans-placentally transmitted T. gondii.
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Affiliation(s)
- Jose G Montoya
- Dr. Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Laboratory for the Study and Diagnosis of Toxoplasmosis, Palo Alto Medical Foundation, Palo Alto, California, USA
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2
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Márquez-Mauricio A, Caballero-Ortega H, Gómez-Chávez F. Congenital Toxoplasmosis Diagnosis: Current Approaches and New Insights. Acta Parasitol 2023; 68:473-480. [PMID: 37368128 DOI: 10.1007/s11686-023-00693-y] [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: 04/05/2022] [Accepted: 06/07/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE The aim of this study is to describe and discuss current disadvantages in congenital toxoplasmosis (CT) diagnosis, and what can be improved or changed through new perspectives and technological advances. METHODS We used Pubmed, Cochrane, and EBSCO databases to research publications from 10 years to date describing current diagnostic methods for CT. The keywords used for this Mini-Review were Toxoplasma gondii, congenital toxoplasmosis, diagnosis, and prospects using Boolean operators such as AND, OR, identifying scientific publications highlighting the importance of implementing new diagnostic methods. RESULTS Current diagnosis methods have several disadvantages, i.e., time-consuming, low sensitivity or specificity, and non-cost effective, that bring up the necessity of improving or developing new approaches. Recombinant proteins can help improve specificity by generating tests that use circulating strains in a specific geographical region, SAG1 and BAG1, as they are expressed during a particular stage of the disease (acute or chronic, respectively), for its use in serological diagnoses, such as capture ELISA and immunochromatography. Point of Care (POC) tests are methods performed at the patient care site, which leads to rapid patient treatment; despite the advantages, several improvements and perspectives are necessary to be implemented globally. CONCLUSIONS Although already established diagnosis methods for CT may be sufficient in some regions, there is still a persistent demand to develop tests with higher throughput, cost, and time reduction in developing countries, where prevalence is high. New approaches in CT diagnosis, such as recombinant proteins, capture ELISA, immunochromatography, and POC tests methods, can increase performance in terms of specificity and sensitivity simplifying diagnostic tests' requirements.
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Affiliation(s)
| | | | - Fernando Gómez-Chávez
- Laboratorio de Enfermedades Osteoarticulares e Inmunológicas, Sección de Estudios de Posgrado e Investigación, ENMyH-Instituto Politécnico Nacional, Mexico City, Mexico.
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3
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Panazzolo GK, Kmetiuk LB, Domingues OJ, Farinhas JH, Doline FR, França DAD, Rodrigues NJL, Biondo LM, Giuffrida R, Langoni H, Santarém VA, Biondo AW, Fávero GM. One Health Approach in Serosurvey of Toxoplasma gondii in Former Black Slave (Quilombola) Communities in Southern Brazil and Among Their Dogs. Trop Med Infect Dis 2023; 8:377. [PMID: 37505673 PMCID: PMC10386098 DOI: 10.3390/tropicalmed8070377] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/29/2023] Open
Abstract
Brazilian quilombos are rural semi-isolated remnant communities of former black slaves and their descendants who traditionally maintained themselves through archaic subsistence livestock and agriculture practices and historically lacked specific public health policies. Although such individuals and their dogs may be exposed to zoonotic pathogens such as Toxoplasma gondii, no study to date has assessed these human-animal populations together. Populations in four different Brazilian quilombos in southern Brazil were evaluated. Overall, 93/208 people (44.7%) and 63/100 dogs (63.0%) were seropositive for IgG anti-T. gondii antibodies by indirect immunofluorescent antibody test (IFAT), 4/208 (1.9%) human samples seropositive for IgM anti-T. gondii antibodies, with a human-dog seropositivity ratio for IgG of 0.71. Quilombola individuals ingesting game meat were 2.43-fold more likely (95% CI: 1.05-5.9) to be seropositive. No risk factors were associated with seropositivity among dogs, thus suggesting that their exposure to T. gondii was random. Surprisingly, our research group had previously found an inverted human-dog ratio for T. gondii seropositivity of 2.54 in the urban area of a nearby major city. Because consumption of raw/undercooked game meat by quilombola individuals may have contributed to higher exposure, higher overall seroprevalence among dogs may have also indicated interaction with wildlife. Although these dogs may hunt wildlife without their owners' awareness, the higher dog seropositivity may also be related to feeding from discarded food in the community or backyard livestock animals and drinking surface water contaminated with oocysts. Thus, wildlife cannot be singled out as the reason, and future studies should consider sampling water, soil, wildlife, and livestock tissues, to fully establish the source of infection in dogs herein.
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Affiliation(s)
- Giovanni Kalempa Panazzolo
- Graduate College of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa 84030-900, PR, Brazil
| | - Louise Bach Kmetiuk
- Graduate College of Cellular and Molecular Biology, Federal University of Paraná, Curitiba 81530-000, PR, Brazil
| | - Orlei José Domingues
- Graduate College of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa 84030-900, PR, Brazil
| | - João Henrique Farinhas
- Graduate College of Cellular and Molecular Biology, Federal University of Paraná, Curitiba 81530-000, PR, Brazil
| | - Fernando Rodrigo Doline
- Graduate College of Cellular and Molecular Biology, Federal University of Paraná, Curitiba 81530-000, PR, Brazil
| | - Danilo Alves de França
- Department of Veterinary Hygiene and Public Health, São Paulo State University, Botucatu 18618-681, SP, Brazil
| | | | - Leandro Meneguelli Biondo
- National Institute of the Atlantic Forest (INMA), Brazilian Ministry of Science, Technology and Innovation, Santa Teresa 29650-000, ES, Brazil
| | - Rogério Giuffrida
- Laboratory of Veterinary Parasitology, Veterinary Teaching Hospital, University of Western São Paulo, Presidente Prudente 19001-970, SP, Brazil
| | - Helio Langoni
- Department of Veterinary Hygiene and Public Health, São Paulo State University, Botucatu 18618-681, SP, Brazil
| | - Vamilton Alvares Santarém
- Laboratory of Veterinary Parasitology, Veterinary Teaching Hospital, University of Western São Paulo, Presidente Prudente 19001-970, SP, Brazil
| | - Alexander Welker Biondo
- Graduate College of Cellular and Molecular Biology, Federal University of Paraná, Curitiba 81530-000, PR, Brazil
| | - Giovani Marino Fávero
- Graduate College of Pharmaceutical Sciences, State University of Ponta Grossa, Ponta Grossa 84030-900, PR, Brazil
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Khan W, Rahman HU, Fadladdin YAJ, Rafiq N, Naz R, De los Rios-Escalante PR, Ahmad S, Alrobaish SA, Al-Sowayan NS. Toxoplasmosis-Awareness and Knowledge of Pregnant Women in Rural Areas of Malakand Region, Pakistan. J Parasitol Res 2023; 2023:4603066. [PMID: 37213244 PMCID: PMC10199801 DOI: 10.1155/2023/4603066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/01/2023] [Accepted: 03/11/2023] [Indexed: 05/23/2023] Open
Abstract
Background The current study was carried out between October 2017 and October 2018 to explore knowledge, attitudes, practices, and information sources regarding toxoplasmosis among pregnant women in Malakand region, the northwestern part of Pakistan. The current study was carried out between October 2017 and October 2018. Methods A structured questionnaire was used to interview the women after taking verbal informed consent. Graphpad version 5 was used to indicate the differences. Significant was considered as a P-value of less than 0.05. This study revealed poor knowledge regarding toxoplasmosis. Results Overall, 31.2% of the respondents showed good knowledge, and 39.2% showed moderate knowledge. On the other hand, 29.5% of the participants showed poor knowledge about toxoplasmosis. The average knowledge score of pregnant women was 79 ± 12.2, which is considered to be within the scale of good knowledge. Number of children within the pregnant multipara women was significantly associated with knowledge about toxoplasmosis. Pregnant women who measured in number of childbirths within a women showed the highest mean score of 42.3 ± 13.3 with 57 (44.8%) displaying a good knowledge level. Pregnant women with more than one child had significantly higher (<0.0001) knowledge scores compared to women with one child or none child. The majority of pregnant women with one child used the social media, followed by mass media as sources of information about toxoplasmosis. Scientific sources of information were used more commonly by pregnant women with none of the child birth. Conclusion Pregnant women knowledge regarding toxoplasmosis was poor as compared to attitudes and practices. Health workers and newspapers/magazines were the main sources of information.
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Affiliation(s)
- Wali Khan
- Department of Zoology, University of Malakand, Lower Dir, Pakistan
| | - Hafeez ur Rahman
- Department of Zoology, Abdul Wali Khan University, Mardan, Pakistan
| | | | - Naseem Rafiq
- Department of Zoology, Abdul Wali Khan University, Mardan, Pakistan
| | - Robi Naz
- Department of Zoology, University of Malakand, Lower Dir, Pakistan
| | - Patricio R. De los Rios-Escalante
- Universidad Catolica de Temuco, Facultad de Recursos Naturales, Departmento de Ciancias Biologicas Quimicas Casella 15-D, Temuco, Chile
- Núcleo de Estudios Ambientales UC Temuco, Casilla, Temuco, Chile
| | - Shabir Ahmad
- Department of Zoology, Hazara University, Mansehra, Pakistan
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Toxoplasmosis diagnostic techniques: Current developed methods and biosensors. Talanta 2023; 252:123828. [DOI: 10.1016/j.talanta.2022.123828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 11/22/2022]
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Holec-Gąsior L, Sołowińska K. IgG Avidity Test as a Tool for Discrimination between Recent and Distant Toxoplasma gondii Infection—Current Status of Studies. Antibodies (Basel) 2022; 11:antib11030052. [PMID: 35997346 PMCID: PMC9397011 DOI: 10.3390/antib11030052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/31/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Toxoplasma gondii, an obligate intracellular protozoan parasite, is the causative agent of one of the most prevalent zoonoses worldwide. T. gondii infection is extremely important from a medical point of view, especially for pregnant women, newborns with congenital infections, and immunocompromised individuals. Thus, an accurate and proper diagnosis of this infection is essential. Among the available diagnostic tests, serology is commonly used. However, traditional serological techniques have certain limitations in evaluating the duration of T. gondii infection, which is problematic, especially for pregnant women. Avidity of T. gondii-specific IgG antibodies seems to be a significant tool for discrimination between recent and distant infections. This article describes the problem of diagnosis of T. gondii infection, with regard to IgG avidity tests. The IgG avidity test is a useful serological indicator of toxoplasmosis, which in many cases can confirm or exclude the active form of the disease. IgG antibodies produced in the recent primary T. gondii infection are of low avidity while IgG antibodies with high avidity are detected in the chronic phase of infection. Furthermore, this paper presents important topics of current research that concern the usage of parasite recombinant antigens that may improve the performance of IgG avidity tests.
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Diagnosis of Congenital Toxoplasmosis: Performance of Four IgG and IgM Automated Assays at Birth in a Tricentric Evaluation. J Clin Microbiol 2022; 60:e0011522. [DOI: 10.1128/jcm.00115-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
For postnatal diagnosis of congenital toxoplasmosis (CT), the gold standard for the detection of anti-
Toxoplasma
IgM in newborns relies on the immunosorbent agglutination assay (ISAGA), which is manufactured from whole
Toxoplasma
parasites that become difficult to maintain. For IgG, only the Platelia assay provides a validated assay for cord blood according to the manufacturer, allowing its use in this context.
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Jean-Pierre V, Miozzo J, Fricker-Hidalgo H, Garnaud C, Robert MG, Pelloux H, Brenier-Pinchart MP. Serological diagnosis of toxoplasmosis: evaluation of the commercial test recomLine Toxoplasma IgG immunoblot (Mikrogen) based on recombinant antigens. Parasite 2022; 29:52. [PMCID: PMC9645231 DOI: 10.1051/parasite/2022050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022] Open
Abstract
Background: IgG detection to determine immune status to Toxoplasma gondii infection and seroconversion mainly relies on ELISA techniques and, if necessary, on a confirmatory test, Western blot. This study evaluated the performance of the recomLine Toxoplasma IgG immunoblot (IB-recomLine) (Mikrogen) as a confirmatory test on a large number of sera. A total of 171 sera were selected (113 patients) and had previously been analyzed by two ELISA tests, ARCHITECT (Abbott) and VIDAS (bioMérieux) ± LDBIO-Toxo II IgG Western blot (WB-LDBIO) (LDBio). The sera were classified into three groups: group 1 included 50 sera without difficulty in interpreting the IgG results (patients with documented past infection or uninfected); group 2 included 47 sera with difficulty in interpreting the ELISA results; and group 3 included 74 sequential sera from 25 pregnant women with seroconversion. Results: In group 1, overall IgG agreements were 94% and 90% with ARCHITECT and VIDAS, respectively. In group 2, low agreement was observed between IB-recomLine and WB-LDBIO, with eight false-positive and 13 false-negative results. In group 3, 4/13 seroconversions were detected earlier with IB-recomLine compared to other tests. Conclusions: IB-recomLine allowed for earlier diagnosis of toxoplasmic seroconversion compared to both ELISA tests and WB-LDBIO but led to insufficient performance to confirm the immune status when ELISA results were discordant or equivocal.
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Affiliation(s)
- Vincent Jean-Pierre
- Parasitology-Mycology, Grenoble Alpes University Hospital 38000 Grenoble France
- Corresponding author:
| | - Julien Miozzo
- Parasitology-Mycology, Grenoble Alpes University Hospital 38000 Grenoble France
| | | | - Cécile Garnaud
- Parasitology-Mycology, Grenoble Alpes University Hospital 38000 Grenoble France
- TIMC, CNRS, Université Grenoble Alpes 38000 Grenoble France
| | - Marie Gladys Robert
- Parasitology-Mycology, Grenoble Alpes University Hospital 38000 Grenoble France
| | - Hervé Pelloux
- Parasitology-Mycology, Grenoble Alpes University Hospital 38000 Grenoble France
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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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Storchilo HR, Teixeira GM, Moreira ALE, Gomes TC, Borges CL, de Castro AM. Identification of Biomarkers for Diagnosis and Prognosis of Congenital and Acute Toxoplasmosis. J Infect Dis 2021; 223:1965-1972. [PMID: 32995873 DOI: 10.1093/infdis/jiaa613] [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: 08/12/2020] [Accepted: 09/25/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The diagnosis of congenital toxoplasmosis can be inconclusive in many cases. Despite the several serological tests developed, the literature on biomarkers that can assist in the diagnosis of congenital an acute toxoplasmosis is limited. The objective of this study was to analyze the immunoreactive profile of Toxoplasma gondii protein bands with the potential to be biomarkers for diagnosis and prognosis of congenital and acute toxoplasmosis. METHODS Peripheral blood samples from women of childbearing age and/or pregnant women diagnosed with acquired toxoplasmosis as well as from congenitally infected children were selected and submitted to immunoblotting for analysis of the immunoreactive bands profile by immunoglobulin G (IgG) antibodies. RESULTS When comparing the immunoreactive bands profile for antibodies present in samples from different groups and subgroups, the 150, 18.5, and 16.96-kDa bands were more immunoreactive with the antibodies present in serum samples from the acquired infection group. The 343, 189, 150, 75, and 42-kDa bands showed more chance to be detected by the symptomatic congenital infection subgroup samples, while the 61, 50, and 16.96-kDa bands were significantly immunoreactive with the acute infection subgroup samples. CONCLUSIONS The identification of these potential biomarkers can assist in early diagnosis and treatment of congenital toxoplasmosis.
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Affiliation(s)
- Heloisa Ribeiro Storchilo
- Department of Biosciences and Technology - Parasitology sector, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Giulianne Monteiro Teixeira
- Department of Biosciences and Technology - Parasitology sector, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - André Luís Elias Moreira
- Department of Biochemistry and Molecular Biology, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Taynara Cristina Gomes
- Department of Biosciences and Technology - Parasitology sector, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Clayton Luiz Borges
- Department of Biochemistry and Molecular Biology, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana Maria de Castro
- Department of Biosciences and Technology - Parasitology sector, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
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Rezende HHA, Igreja JASLD, Gomes-Júnior AR, Melo JDO, Garcia JL, Martins FDC, Storchilo HR, Gomes TC, Vinaud MC, Castro AMD. Molecular characterization of Toxoplasma gondii isolates from free-range chickens reveals new genotypes in Goiânia, Goiás, Brazil. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA = BRAZILIAN JOURNAL OF VETERINARY PARASITOLOGY : ORGAO OFICIAL DO COLEGIO BRASILEIRO DE PARASITOLOGIA VETERINARIA 2021; 30:e000321. [PMID: 34076043 DOI: 10.1590/s1984-29612021029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/12/2021] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the genotypic characteristics of Toxoplasma gondii isolated from free-range chickens in the metropolitan area of Goiânia, Goiás, in Brazil's central-west region. The seroprevalence rate was found to be 96%, according to an indirect hemagglutination assay. Brain and heart samples were processed by peptic digestion for a mice bioassay. The tissues were homogenized and the resulting samples were subjected to polymerase chain reaction (PCR), which revealed that 64% of them contained the parasite's DNA. The mice bioassay revealed 15 isolates, 8 of them tachyzoites isolates from the peritoneal lavage and 7 from brain cysts. T. gondii genotypes were determined through PCR-RFLP, using the following markers: SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, alt. SAG2, Apico and CS3. Three genotypes were identified, inclued ToxoDB #65, and the other two are not yet described in the literature. Hence, we conclude that the isolates obtained from the metropolitan area of Goiânia showed relatively low genetic diversity.
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Affiliation(s)
- Hanstter Hallison Alves Rezende
- Laboratório de Bioquímica Clínica e Líquidos Corporais, Unidade Acadêmica de Ciências da Saúde, Universidade Federal de Jataí - UFJ, Jataí, GO, Brasil
| | - Jaqueline Ataíde Silva Lima da Igreja
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás - UFG, Goiânia, GO, Brasil
| | - Antônio Roberto Gomes-Júnior
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás - UFG, Goiânia, GO, Brasil
| | - Jade de Oliveira Melo
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás - UFG, Goiânia, GO, Brasil
| | - João Luís Garcia
- Laboratório de Protozoologia Veterinária, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | | | - Heloísa Ribeiro Storchilo
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás - UFG, Goiânia, GO, Brasil
| | - Taynara Cristina Gomes
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás - UFG, Goiânia, GO, Brasil
| | - Marina Clare Vinaud
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás - UFG, Goiânia, GO, Brasil
| | - Ana Maria de Castro
- Laboratório de Estudos da Relação Parasito-Hospedeiro, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás - UFG, Goiânia, GO, Brasil
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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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13
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Maternal Anti- Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate. J Clin Microbiol 2021; 59:JCM.01368-20. [PMID: 33208476 DOI: 10.1128/jcm.01368-20] [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] [Received: 06/04/2020] [Accepted: 11/13/2020] [Indexed: 11/20/2022] Open
Abstract
Neonatal diagnosis of congenital toxoplasmosis is based on a combination of serological and molecular tests. Maternal screening and treatment differ according to national policies and may impact the sensitivity of diagnostic methods in infants at birth. In this multicenter study, 115 neonates born to 61 treated (53%) and 54 (47%) untreated women were retrospectively included in three centers (France, Serbia, and the United States) to assess the impact of maternal anti-Toxoplasma treatment on the performance of neonatal workup at birth (neosynthesized anti-Toxoplasma IgM, IgA, and IgG and quantitative PCR [qPCR]) using univariate and multivariate approaches. Independently of the time of maternal seroconversion, the serological techniques were impacted differently by maternal treatment. The detection of IgM by immunosorbent agglutination assay (ISAGA) and Western blotting (WB) dropped from 90.7% and 88.2% in untreated neonates to 53.3% and 51.9% in treated neonates (P < 0.05), whereas IgM enzyme-linked immunosorbent assay (ELISA) and IgA ISAGA were not significantly affected by maternal treatment. A 2-fold reduction in the sensitivity of neosynthesized IgG by WB was also observed in the case of treatment during pregnancy (37.7% versus 82.3%). Interestingly, the effect of treatment was shown to be duration dependent, especially for IgM detection, when the treatment course exceeded 8 weeks, whatever the therapy. The sensitivity of Toxoplasma PCR in blood was also lowered by maternal treatment from 39.1% to 23.2%. These results highlight that anti-Toxoplasma therapy during pregnancy may set back biological evidence of neonatal infection at birth and underline the need for a careful serological follow-up of infants with normal workup.
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14
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Almeria S, Dubey JP. Foodborne transmission of Toxoplasma gondii infection in the last decade. An overview. Res Vet Sci 2020; 135:371-385. [PMID: 33148402 DOI: 10.1016/j.rvsc.2020.10.019] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 01/07/2023]
Abstract
Toxoplasmosis is a zoonotic disease of global distribution and importance. It is caused by the protozoan parasite Toxoplasma gondii, the only species in the Toxoplasma genus. This parasite can infect most warm-blooded animals, including humans and livestock. Main routes of transmission are by ingestion of tissue cysts in raw or undercooked meat of infected animals, ingestion of raw vegetables or water contaminated with T. gondii oocysts from cat feces, and transplacental. Around one-third of human beings are chronically infected with T. gondii. Most infections appear to be asymptomatic in immunocompetent persons, but toxoplasmosis can be fatal to the fetus and immunocompromised adults. Water and foodborne outbreaks have been caused by this parasite worldwide, but few are well documented. Importantly, T. gondii is a parasite of high importance in animal health, causing reproductive failure, particularly in small ruminants, and clinical toxoplasmosis in many species. This overview discusses the knowledge of T. gondii infections in the last decade focusing on the foodborne transmission of this parasite.
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Affiliation(s)
- S Almeria
- Department of Health and Human Services, Food and Drug Administration, Center for Food Safety and Nutrition, Office of Applied Research and Safety Assessment, Division of Virulence Assessment, Laurel, MD 20708, USA.
| | - J P Dubey
- USA Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Service, Animal Parasitic Disease Laboratory, Building 1001, BARC-East, Beltsville, MD 20705-2350, USA
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15
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Saso A, Bamford A, Grewal K, Noori M, Hatcher J, D'Arco F, Guy E, Lyall H. Fifteen-minute consultation: Management of the infant born to a mother with toxoplasmosis in pregnancy. Arch Dis Child Educ Pract Ed 2020; 105:262-269. [PMID: 32071105 DOI: 10.1136/archdischild-2018-316603] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 09/12/2019] [Accepted: 12/06/2019] [Indexed: 11/03/2022]
Abstract
Congenital toxoplasmosis occurs following transplacental transfer of Toxoplasma gondii Irrespective of symptom status at birth, infants with congenital infection may develop serious long-term sequelae, including learning disability, seizures, hydrocephalus, motor and hearing deficits, chorioretinitis and retinal scarring with impaired vision. Timely diagnosis facilitates early initiation of therapy, aimed at prevention or amelioration of adverse clinical consequences. Diagnosis can be difficult, however, since acutely infected mothers are often asymptomatic and laboratory testing can be complex. Moreover, any decision to start treatment in the newborn must include careful consideration of the benefits and risks. This paper outlines a structured approach for managing an infant born to a woman with possible or confirmed T. gondii infection during pregnancy, including key aspects of the antenatal history, interpretation and timing of investigations, treatment and appropriate follow-up. Our recommendations are based on current evidence in the literature, consensus from two UK paediatric infectious disease centres and the UK specialist Toxoplasma Reference Unit.
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Affiliation(s)
- Anja Saso
- Department of Academic Paediatrics, Imperial College London, London, UK .,Vaccines & Immunity Theme, MRC The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Alasdair Bamford
- Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Section of Infection, Inflammation and Rheumatology, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Karen Grewal
- Tommy's National Centre for Miscarriage Research, Imperial College London, London, UK
| | - Muna Noori
- Department of Women and Children, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - James Hatcher
- Department of Microbiology, Laboratory Medicine, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Felice D'Arco
- Department of Paediatric Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Edward Guy
- Toxoplasma Reference Unit, Public Health Wales, Swansea, UK
| | - Hermione Lyall
- Department of Paediatric Infectious Diseases, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
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16
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Roy M, Siddique N, Bathina B, Ahmad S. Rare Presentation of Toxoplasma Pneumonitis in the Absence of Neurological Symptoms in an AIDS Patient and Use of Next-Generation Sequencing for Diagnosis. Eur J Case Rep Intern Med 2020; 7:001862. [PMID: 33194865 DOI: 10.12890/2020_001862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/07/2020] [Indexed: 11/05/2022] Open
Abstract
Toxoplasma gondii is a known cause of encephalitis in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. Toxoplasma pneumonitis is a manifestation of extracerebral toxoplasmosis and can be clinically indistinguishable from other opportunistic infections including Pneumocystis jirovecii pneumonia (PJP) and miliary tuberculosis. In this case report, Toxoplasma pneumonitis and disseminated toxoplasmosis was diagnosed using next-generation sequencing (NGS) and polymerase chain reaction (PCR) assessment. NGS can detect microbial cell-free DNA (cfDNA) circulating in the plasma of over 1,000 pathogens. This case is a rare presentation of Toxoplasma pneumonitis in the absence of neurological symptoms and we discuss the use of NGS of microbial cfDNA and PCR tests that may be utilized for the timely diagnosis of such challenging cases. LEARNING POINTS Next-generation sequencing can help make a correct diagnosis and detect culture-negative opportunistic infections.Recognition of Toxoplasma pneumonitis as a rare presentation of disseminated toxoplasmosis.In cases of Toxoplasma pneumonitis, brain imaging should be conducted to rule out CNS involvement even in the absence of neurological symptoms.
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Affiliation(s)
- Moni Roy
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois AND OSF Saint Francis Medical Center, Peoria, Illinois
| | - Nikhut Siddique
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Bindu Bathina
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois AND OSF Saint Francis Medical Center, Peoria, Illinois
| | - Sharjeel Ahmad
- Department of Internal Medicine, Section of Infectious Diseases, University of Illinois College of Medicine, Peoria, Illinois, USA
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17
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Murata FHA, Previato M, Frederico FB, Barbosa AP, Nakashima F, de Faria GM, Silveira Carvalho AP, Meira Strejevitch CDS, Pereira-Chioccola VL, Castiglioni L, de Mattos LC, Siqueira RC, Brandão de Mattos CC. Evaluation of Serological and Molecular Tests Used for the Identification of Toxoplasma gondii Infection in Patients Treated in an Ophthalmology Clinic of a Public Health Service in São Paulo State, Brazil. Front Cell Infect Microbiol 2020; 9:472. [PMID: 32117820 PMCID: PMC7019025 DOI: 10.3389/fcimb.2019.00472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/23/2019] [Indexed: 11/13/2022] Open
Abstract
Ocular toxoplasmosis is one of the most common complications caused by the infection with the parasite Toxoplasma gondii. The risk of developing eye lesions and impaired vision is considered higher in Brazil than other countries. The clinical diagnosis is difficult and the use of sensitive and specific laboratorial methods can aid to the correct diagnosis of this infection. We compared serological methods ELISA and ELFA, and molecular cPCR, Nested PCR and qPCR for the diagnosis of T. gondii infection in groups of patients clinically evaluated with ocular diseases non-toxoplasma related (G1 = 185) and with lesions caused by toxoplasmosis (G2 = 164) in an Ophthalmology clinic in Brazil. Results were compared by the Kappa index, and sensitivity (S), specificity (E), positive predictive value (PPV), and negative (NPV) were calculated. Serologic methods were in agreement with ELISA more sensitive and ELFA more specific to characterize the acute and chronic infections while molecular methods were discrepant where qPCR presented higher sensitivity, however, lower specificity when compared to cPCR and Nested PCR.
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Affiliation(s)
- Fernando Henrique Antunes Murata
- Faculdade de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil.,FAMERP Toxoplasma Research Group, São José Do Rio Preto, Brazil
| | - Mariana Previato
- Faculdade de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil.,FAMERP Toxoplasma Research Group, São José Do Rio Preto, Brazil
| | - Fábio Batista Frederico
- FAMERP Toxoplasma Research Group, São José Do Rio Preto, Brazil.,Ambulatório de Oftalmologia Do Hospital de Base, Fundação Faculdade Regional de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil
| | - Amanda Pires Barbosa
- Ambulatório de Oftalmologia Do Hospital de Base, Fundação Faculdade Regional de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil
| | - Fabiana Nakashima
- Faculdade de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil
| | - Geraldo Magela de Faria
- Faculdade de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil.,FAMERP Toxoplasma Research Group, São José Do Rio Preto, Brazil
| | | | | | - Vera Lucia Pereira-Chioccola
- Laboratório de Biologia Molecular de Parasitas e Fungos Do Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, São Paulo, Brazil
| | - Lilian Castiglioni
- Faculdade de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil
| | - Luiz Carlos de Mattos
- Faculdade de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil.,FAMERP Toxoplasma Research Group, São José Do Rio Preto, Brazil
| | - Rubens Camargo Siqueira
- Faculdade de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil.,FAMERP Toxoplasma Research Group, São José Do Rio Preto, Brazil
| | - Cinara Cássia Brandão de Mattos
- Faculdade de Medicina de São José Do Rio Preto, São José Do Rio Preto, Brazil.,FAMERP Toxoplasma Research Group, São José Do Rio Preto, Brazil
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18
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How to estimate time of infection with Toxoplasma gondii in pregnant women. Use of specific IgG and IgM kinetics by 7 techniques on 691 sera. Diagn Microbiol Infect Dis 2020; 96:114987. [PMID: 32005405 DOI: 10.1016/j.diagmicrobio.2020.114987] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 11/20/2022]
Abstract
A difficulty when detecting both anti-Toxoplasma gondii-specific IgG and IgM in pregnant women is estimating the date of infection. The aim of this study was to compare the anti-Toxoplasma-specific immunoglobulin kinetics of 7 serological techniques to date the infection and to draw kinetic curves that are easy to use on a daily basis. IgG and IgM antibodies were measured on 691 sera samples. IgM appeared a few days, less than 1 week, after the beginning of the infection. Then, the levels of IgM reached a peak at approximately 3, 4, and 5 weeks with Toxo-ISAGA® IgM, IgM homemade indirect immunofluorescence assays, and Vidas Toxo® IgM, respectively. Furthermore, the Architect Toxo® IgG titers were higher than those of the Vidas Toxo® IgG results in recent infection (less than 6 months). This study provides new average IgM and IgG curves that can help to determine the approximate date of infection.
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19
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Liu Y, Wu Y, Wang F, Wang S, Zhao W, Chen L, Tu S, Qian Y, Liao Y, Huang Y, Zhang R, Xu G, Zhang D. The Association Between Previous TORCH Infections and Pregnancy and Neonatal Outcomes in IVF/ICSI-ET: A Retrospective Cohort Study. Front Endocrinol (Lausanne) 2020; 11:466. [PMID: 32849269 PMCID: PMC7419419 DOI: 10.3389/fendo.2020.00466] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 06/15/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to investigate the associations between previous TORCH infection (cytomegalovirus, toxoplasmosis, herpes simplex virus, and rubella) with pregnancy and neonatal outcomes in couples undergoing IVF/ICSI-ET. Materials and Methods: A total of 18,074 couples underwent fresh IVF/ICSI-ET (in vitro fertilization/intracytoplasmic sperm injection-embryo transfer) cycles were included in our analyses. TORCH infection status was determined by serological confirmation of cytomegalovirus, toxoplasmosis, herpes simplex virus, and rubella IgG in the absence of IgM antibodies. Clinical pregnancy, ectopic pregnancy, miscarriage, live birth, preterm birth, congenital malformation, and perinatal death were evaluated in both infection and non-infection group. Multivariate logistic regression was applied to calculate odds ratio. Results: Previous toxoplasmosis infection is associated with a significantly decreased preterm birth rate [P = 0.045, OR = 0.755 (95% CI, 0.571-0.997), Adjusted OR = 0.749 (95%CI, 0.566-0.991)]. No differences in clinical pregnancy, ectopic pregnancy, miscarriage, and perinatal death were observed between the corresponding TORCH infection group [IgM (-) IgG(+)] and the non-infection group [IgM (-) IgG (-)]. Conclusions: Previous TORCH infections were not associated with adverse pregnancy and neonatal outcomes in IVF/ICSI-ET overall, and toxoplasmosis infection might be associated with a lower preterm birth rate in patients underwent IVF/ICSI-ET. The necessity of TORCH IgG screening in IVF procedure might need re-evaluation, and further cost-effective analysis might be helpful for the clinical management strategy.
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Affiliation(s)
- Yifeng Liu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Yiqing Wu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Feixia Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Siwen Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Wei Zhao
- Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Hangzhou, China
| | - Lifen Chen
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Shijiong Tu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Yuli Qian
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Yun Liao
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Yun Huang
- Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Hangzhou, China
| | - Runjv Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
| | - Gufeng Xu
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Gufeng Xu
| | - Dan Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
- Women's Reproductive Health Research Key Laboratory of Zhejiang Province, Hangzhou, China
- *Correspondence: Dan Zhang
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20
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Diezma-Díaz C, Ferre I, Saldias B, Blanco-Murcia J, Ortega-Mora LM, Álvarez-García G. Added value of IgM detection and low avidity index as markers of acute bovine besnoitiosis. Vet Parasitol 2019; 277:109012. [PMID: 31884316 DOI: 10.1016/j.vetpar.2019.109012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/17/2022]
Abstract
Early in vivo diagnosis of bovine besnoitiosis is crucial for the success of control programmes. However, diagnosis in acutely infected animals is hindered by the low sensitivity of the available serological tools. In this study, a novel ELISA to detect specific anti-Besnoitia besnoiti IgM antibodies was developed. The usefulness of this tool together with an avidity ELISA were studied with a well-coded sera panel from experimentally and naturally infected cattle. First, the kinetics of specific IgM levels were determined in experimentally infected calves during the acute and chronic infection. Next, IgM levels were determined in naturally infected cattle with either acute or chronic infection. Finally, the IgG avidity index was monitored in both experimentally and naturally infected cattle. Specific IgM antibodies were detected prior to specific IgG antibodies (7-19 days vs. 17-26 days post-infection). A prompt IgM response was associated with the end of the febrile stage in experimentally infected calves. Naturally and experimentally infected animals with acute clinical signs tested IgM-positive but IgG-negative, followed by IgG seroconversion 2-3 weeks later. Chronically infected cattle developed both IgM and IgG specific antibodies. Moreover, a progressive increase in the avidity index (AI) was observed in all experimentally infected calves during the course of the experimental trials. However, a low AI coincided with visible tissue cysts. Low avidity values were also detected when naturally infected cattle with acute clinical signs seroconverted, in contrast to a high AI detected in chronically infected cattle. In summary, IgM and avidity ELISAs improved the early in vivo diagnosis of bovine besnoitiosis. IgM-positive but IgG-negative results were indicative of an acute infection, whereas IgG positive results accompanied by low avidity values confirmed a recent infection.
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Affiliation(s)
- Carlos Diezma-Díaz
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain
| | - Ignacio Ferre
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain
| | - Begonia Saldias
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain
| | - Javier Blanco-Murcia
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain; Animal Medicine and Surgery Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain
| | - Luis Miguel Ortega-Mora
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain
| | - Gema Álvarez-García
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria s/n, 28040 Madrid, Spain.
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21
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Performance of Zika Assays in the Context of Toxoplasma gondii, Parvovirus B19, Rubella Virus, and Cytomegalovirus (TORCH) Diagnostic Assays. Clin Microbiol Rev 2019; 33:33/1/e00130-18. [PMID: 31826871 DOI: 10.1128/cmr.00130-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Infections during pregnancy that may cause congenital abnormalities have been recognized for decades, but their diagnosis is challenging. This was again illustrated with the emergence of Zika virus (ZIKV), highlighting the inherent difficulties in estimating the extent of pre- and postnatal ZIKV complications because of the difficulties in establishing definitive diagnoses. We reviewed the epidemiology, infection kinetics, and diagnostic methods used for Toxoplasma gondii, parvovirus B19, rubella virus, and cytomegalovirus (TORCH) infections and compared the results with current knowledge of ZIKV diagnostic assays to provide a basis for the inclusion of ZIKV in the TORCH complex evaluations. Similarities between TORCH pathogens and ZIKV support inclusion of ZIKV as an emerging TORCH infection. Our review evaluates the diagnostic performance of various TORCH diagnostic assays for maternal screening, fetal screening, and neonatal screening. We show that the sensitivity, specificity, and positive and negative predictive value of TORCH complex pathogens are widely variable, stressing the importance of confirmatory testing and the need for novel techniques for earlier and accurate diagnosis of maternal and congenital infections. In this context it is also important to acknowledge different needs and access to care for different geographic and resource settings.
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22
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Hannachi E, Bouratbine A, Mousli M. Enhancing the detection of Toxoplasma gondii via an anti-SAG1 scFv-alkaline phosphatase immunoconjugate. BIOTECHNOLOGY REPORTS (AMSTERDAM, NETHERLANDS) 2019; 23:e00360. [PMID: 31341791 PMCID: PMC6630058 DOI: 10.1016/j.btre.2019.e00360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/29/2019] [Accepted: 06/30/2019] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to implement a fluorometric method for enhancing the detection sensitivity of Toxoplasma gondii in biological fluids. To address this challenge, we designed and produced a recombinant immunoconjugate tool based on a single-chain antibody fragment anti-T. gondii SAG1 antigen (scFvSG15) genetically fused to the bacterial alkaline phosphatase (AP) using 4-methyl-umbelliferyl-phosphate as fluorogenic substrate. The anti-SAG1 scFv-AP conjugate was fully bifunctional and was used successfully in different assays including immunoblot, fluorometric ELISA and direct immunofluorescence. The fluorometric immunoassay afforded an extremely low detection limit (1 tachyzoite/well), which was in agreement with the real-time PCR control test. The immunofluorescence imaging has provided captivating visual evidence of T. gondii detection. These results strongly suggest that the recombinant anti-SAG1-AP conjugate generated here might serve as useful and highly sensitive immunoassay probe to direct detect T. gondii in a one-step procedure, opening up new perspectives for diagnosis of toxoplasmosis.
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Affiliation(s)
| | | | - Mohamed Mousli
- Laboratoire de Parasitologie Médicale, Biotechnologies et Biomolécules, LR11-IPT06, Institut Pasteur de Tunis, Université Tunis El-Manar, 13 Place Pasteur -BP74, 1002 Tunis-Belvédère, Tunisia
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23
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Shariat Bahadory E, Dalir Ghaffari A, Namrood S, Mosavipour SS, Sadraie J. Electrochemiluminescence Epidemiologic Detection of Toxoplasma gondii Infection in Pregnant Women With Direct and Indirect Diagnostic Techniques (ELISA Avidity Plus Biochemical Assay), Tehran, Iran. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2019. [DOI: 10.15171/ijer.2019.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims: Toxoplasmosis is a very common disease in the world and has two types, including chronic and acute toxoplasmosis. In the chronic toxoplasmosis, the abnormality of tissue function is negligible, but in acute toxoplasmosis, the function of the reticuloendothelial system is interrupted and the assessment of Toxoplasma antibody with tissue enzymes is very essential in this stage. In addition, in some conditions, serum ferritin increases in the acute phase of the infectious disease. In congenital toxoplasmosis, the evaluation of biochemical factors and IgG avidity test is important for detecting the acute congenital toxoplasmosis in pregnant women. Based on the above-mentioned explanations, the present study aimed to evaluate the biochemical factors in patients with acute toxoplasmosis (congenital toxoplasmosis) among the Iranian population using electrochemiluminescence and IgG ELISA avidity. Methods: The study was based on a comparative abundance study and was conducted from March to June 2017. Material included 980 serum and amniotic fluid samples collected from human blood with a high level of IgG antibody against Toxoplasma gondii in Rajaie Center, Tehran, Iran. The standard and the main tests included the ELISA assay and the measurement of the liver transaminases (i.e., SGOT and SGPT), along with/namely bilirubin and ferritin used to detect IgG antibodies and to evaluate the acute toxoplasmosis, respectively. Finally, the results were analyzed by SPSS software. Results: The results showed that the level of liver transaminases, namely, serum bilirubin and ferritin increase in some patients with a high level of IgG avidity antibody against Toxoplasma gondii. For example, the mean serum levels of SGOT was 108 IU/L in 120 patients with acute toxoplasmosis and the mean serum bilirubin was about 5 mg/dL in 80 patients. Conclusion: Overall, in acute congenital toxoplasmosis, the evaluation of IgG AVIDITY is regarded as the first step and then the measurement of biochemical factors such as serum transaminases, serum bilirubin, and serum ferritin is important.
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Affiliation(s)
- Ehsan Shariat Bahadory
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modaress University, Tehran, Iran
| | - Ali Dalir Ghaffari
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modaress University, Tehran, Iran
| | - Somayyeh Namrood
- Assistant Professor, Department of Environmental Sciences, Faculty of Fisheries and Environmental Sciences, University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | | | - Javid Sadraie
- Department of Medical Parasitology, Faculty of Medical Sciences, Tarbiat Modaress University, Tehran, Iran
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Shehata AI, Hassanein F, Abdul-Ghani R. Opportunistic parasitoses among Egyptian hemodialysis patients in relation to CD4+ T-cell counts: a comparative study. BMC Infect Dis 2019; 19:480. [PMID: 31142275 PMCID: PMC6542030 DOI: 10.1186/s12879-019-4110-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/20/2019] [Indexed: 12/30/2022] Open
Abstract
Background Some reports are available on the prevalence of opportunistic parasitoses among hemodialysis (HD) patients, yet there is a paucity of data on the association of CD4+ T-cell counts with such infections. Therefore, this study aimed to determine the prevalence of intestinal parasites and Toxoplasma gondii in relation to CD4+ counts among HD patients in Alexandria, Egypt. Methods A comparative cross-sectional study was conducted on 120 HD patients and 100 apparently healthy individuals between December 2014 and January 2016. Data and samples (stool and blood) were collected from the participants after obtaining their informed consent. Stool samples were examined for parasites after concentration and staining, EDTA-blood samples were used for CD4+ counting by flow cytometry, and sera were analyzed for anti-Toxoplasma IgM and IgG antibodies. Results A significantly higher prevalence rate of intestinal parasitoses was found among HD patients compared to apparently healthy individuals (52.5% vs. 12.0%, respectively), with absence of helminths. Cryptosporidium species (32.5%), B. hominis(24.2%) and microsporidia (11.7%) were the most frequent parasites among HD patients, while B. hominis (13.0%), Cryptosporidium species (11.0%) and G. lamblia (4.0%) were the most frequent parasites among their counterparts. Statistically significant differences in parasite infection rates between patients and their counterparts were found for Cryptosporidium species, B. hominis and microsporidia. However, parasite species were not significantly associated with diarrhea. On the other hand, the overall T. gondii seroprevalence rate among HD patients was significantly higher than that among their counterparts (33.3% vs. 8%, respectively). HD patients with CD4+ counts < 200 cells/μl were twice more exposed to intestinal parasitoses compared to those with counts ≥200 cells/μl, but the difference was not statistically significant. However, low CD4+ counts were significantly associated with higher rates of Cryptosporidium species, microsporidia and T. gondii. Conclusions Intestinal parasitoses and T. gondii infection rates are significantly higher among Egyptian HD patients compared to apparently healthy individuals, with Cryptosporidium species, B. hominis, microsporidia and T. gondii being the most frequent parasites. CD4+ counts < 200 cells/μl are significantly associated with Cryptosporidium species, microsporidia and T. gondii among HD patients. Therefore, regular screening of HD patients for opportunistic parasites is recommended.
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Affiliation(s)
- Amany I Shehata
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Faika Hassanein
- Department of Microbiology and Immunology, Faculty of Pharmacy and Drug Manufacturing, Pharos University, Alexandria, Egypt
| | - Rashad Abdul-Ghani
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen. .,Tropical Disease Research Center, Faculty of Medicine and Health Sciences, University of Science and Technology, Sana'a, Yemen.
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25
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Vidal JE. HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease. J Int Assoc Provid AIDS Care 2019; 18:2325958219867315. [PMID: 31429353 PMCID: PMC6900575 DOI: 10.1177/2325958219867315] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/14/2019] [Accepted: 06/28/2019] [Indexed: 01/06/2023] Open
Abstract
Cerebral toxoplasmosis is the most common cause of expansive brain lesions in people living with HIV/AIDS (PLWHA) and continues to cause high morbidity and mortality. The most frequent characteristics are focal subacute neurological deficits and ring-enhancing brain lesions in the basal ganglia, but the spectrum of clinical and neuroradiological manifestations is broad. Early initiation of antitoxoplasma therapy is an important feature of the diagnostic approach of expansive brain lesions in PLWHA. Pyrimethamine-based regimens and trimethoprim-sulfamethoxazole (TMP-SMX) seem to present similar efficacy, but TMP-SMX shows potential practical advantages. The immune reconstitution inflammatory syndrome is uncommon in cerebral toxoplasmosis, and we now have more effective, safe, and friendly combined antiretroviral therapy (cART) options. As a consequence of these 2 variables, the initiation of cART can be performed within 2 weeks after initiation of antitoxoplasma therapy. Herein, we will review historical and current concepts of epidemiology, diagnosis, and treatment of HIV-related cerebral toxoplasmosis.
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Affiliation(s)
- José Ernesto Vidal
- Departamento de Neurologia, Instituto de Infectologia Emílio Ribas, São
Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas
HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Investigação Médica em Protozoologia, Bacteriologia e
Resistência Antimicrobiana (LIM 49), Instituto de Medicina Tropical, Universidade de São
Paulo, São Paulo, Brazil
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26
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Simanjuntak TP, Hatta M, Tahir AM, Sirait RH, Karo MB, Tambaib T, Dwiyanti R, Noviyanthi RA, Junita AR. Analysis of Anti-toxoplasma Immunoglobulin G and Immunoglobulin M Antibody Levels after Intervention with Curcuma Longa Extract on Early Pregnant Mice with Acute Toxoplasmosis. J Glob Infect Dis 2019; 11:25-29. [PMID: 30814832 PMCID: PMC6380095 DOI: 10.4103/jgid.jgid_28_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Curcuma longa has strong anti-inflammatory effect. This study aims to evaluated the level of anti-Toxoplasma immunoglobulin G and immunoglobulin M (IgG-IgM) antibody after intervention with C. longa extract in early pregnant mice with acute toxoplasmosis. Materials and Methods: We evaluated 20 early pregnant mice that were divided into five groups, four mice in each. Group 1-4 received injections of Toxoplasma gondii tachyzoites. Three days later, G1 and G2 were given orally 125 mg/kg/day and 500 mg/kg/day of C. longa extract, respectively. G3 was given 60 mg/kg/day of spiramycin (positive control), and G4 was given 0.2 ml of distilled water (negative control). G5 underwent no intervention at all. Blood samples were obtained serially (before and 3 days after injection of tachyzoites, 3 days and 7 days after intervention) to assess anti-Toxoplasma IgG-IgM antibody levels by enzyme-linked immunosorbent assay methods. Results: Anti-Toxoplasma IgG-IgM antibody levels increased significantly 3 days after injection of tachyzoites (P < 0.05), but decreased significantly (P < 0.05) 3 days, and 7 days after administration of C. longa extract dose 125 mg, 500 mg, and spiramycin 60 mg, and there was no significant difference between these three groups. Anti-Toxoplasma IgG-IgM antibody levels increased significantly (P < 0.05) 3 days, 6 days, and 10 days after injections of tachyzoites on G4. The IgG-IgM antibody levels fluctuated on G5 and considered as insignificant (P > 0.05). Conclusion: The administration of C. longa extract at a dose of 125 mg/kg/day for 7 days effectively decreased anti-Toxoplasma IgG-IgM antibody level in early pregnant mice with acute toxoplasmosis.
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Affiliation(s)
- Tigor Peniel Simanjuntak
- Department of Obstetrics and Gynecology, Faculty of Medicine, Christian University of Indonesia, Jakarta, Indonesia
| | - Mochammad Hatta
- Department of Microbiology, Molecular Biology and Immunology Laboratory and Faculty of Medicine, Hasanuddin University, Makassar,, Indonesia
| | - Andi M Tahir
- Department of Obstetric and Gynecology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Robert H Sirait
- Department of Anaestesiology, Faculty of Medicine, Christian University of Indonesia, Jakarta, Indonesia
| | - Marni B Karo
- Midwife Program of Medistra Health Higher School, Jakarta, Indonesia
| | - Titus Tambaib
- Midwife Program of Yaleka-Maro School, Merauke, Papua, Indonesia
| | - Ressy Dwiyanti
- Department of Microbiology, Molecular Biology and Immunology Laboratory and Faculty of Medicine, Hasanuddin University, Makassar,, Indonesia.,Department of Medical Microbiology, Faculty of Medicine, Tadulako University, Palu, Indonesia
| | - Rizki Amelia Noviyanthi
- Department of Microbiology, Molecular Biology and Immunology Laboratory and Faculty of Medicine, Hasanuddin University, Makassar,, Indonesia
| | - Ade Rifka Junita
- Department of Microbiology, Molecular Biology and Immunology Laboratory and Faculty of Medicine, Hasanuddin University, Makassar,, Indonesia
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Hu Z, Weng X, Xu C, Lin Y, Cheng C, Wei H, Chen W. Metagenomic next-generation sequencing as a diagnostic tool for toxoplasmic encephalitis. Ann Clin Microbiol Antimicrob 2018; 17:45. [PMID: 30587202 PMCID: PMC6305995 DOI: 10.1186/s12941-018-0298-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More than 100 different pathogens can cause encephalitis. Testing of all the neurological pathogens by conventional methods can be difficult. Metagenomic next-generation sequencing (NGS) could identify the infectious agents in a target-independent manner. The role of this novel method in clinical diagnostic microbiology still needs to be evaluated. In present study, we used metagenomic NGS to search for an infectious etiology in a human immunodeficiency virus (HIV)-infected patient with lethally diffuse brain lesions. Sequences mapping to Toxoplasma gondii were unexpectedly detected. CASE PRESENTATION A 31-year-old HIV-infected patient presented to hospital in a critical ill condition with a Glasgow coma scale score of 3. Brain magnetic resonance imaging showed diffuse brain abnormalities with contrast enhancement. Metagenomic NGS was performed on DNA extract from 300 μL patient's cerebrospinal fluid (CSF) with the BGISEQ-50 platform. The sequencing detection identified 65,357 sequence reads uniquely aligned to the Toxoplasma gondii genome. Presence of Toxoplasma gondii genome in CSF was further verified by Toxoplasma gondii-specific polymerase chain reaction and Sanger sequencing. Altogether, those results confirmed the diagnosis of toxoplasmic encephalitis. CONCLUSIONS This study suggests that metagenomic NGS may be a useful diagnostic tool for toxoplasmic encephalitis. As metagenomic NGS is able to identify all pathogens in a single run, it may be a promising strategy to explore the clinical causative pathogens in central nervous system infections with atypical features.
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Affiliation(s)
- Zhiliang Hu
- Department of Infectious Disease, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, 1-1 Zhongfu Road, Nanjing, 210003, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Xing Weng
- Department of Pathogen Detection Products, BGI-Shenzhen, Shenzhen, 518083, China
| | - Chunhua Xu
- Department of Infectious Disease, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, 1-1 Zhongfu Road, Nanjing, 210003, China
| | - Yang Lin
- Department of Research and Development of Infectious Diseases, BGI-Wuhan, Wuhan, 430075, China
| | - Cong Cheng
- Department of Infectious Disease, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, 1-1 Zhongfu Road, Nanjing, 210003, China
| | - Hongxia Wei
- Department of Infectious Disease, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, 1-1 Zhongfu Road, Nanjing, 210003, China.
| | - Wei Chen
- Department of Clinical Research Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, 1-1 Zhongfu Road, Nanjing, 210003, China.
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28
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Toxoplasma Encephalitis following Tandem Autologous Hematopoietic Stem Cell Transplantation: A Case Report and Review of the Literature. Case Rep Infect Dis 2018; 2018:9409121. [PMID: 30534451 PMCID: PMC6252224 DOI: 10.1155/2018/9409121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/24/2018] [Indexed: 11/17/2022] Open
Abstract
Infection with Toxoplasma gondii is a rare but often fatal complication in hematopoietic stem cell transplantation (HSCT) recipients. Most cases have been reported in allogeneic (allo-) HSCT recipients, with only narrative reports following autologous HSCT (ASCT). We report the case of a 58-year-old Caucasian male presenting with toxoplasma encephalitis following tandem ASCT for myeloma and successfully treated with diagnosis by polymerase chain reaction analysis of cerebrospinal fluid. He was treated with sulfadiazine and pyrimethamine (with leucovorin) followed by pyrimethamine and atovaquone as secondary prophylaxis while receiving subsequent therapy for progressive multiple myeloma. Toxoplasmosis is a potential complication in allo-HSCT as well as ASCT recipients and should be considered in any post-HSCT patient with neurological dysfunction. Rapid diagnosis and immediate antimicrobial treatment are essential to avoid morbidity and mortality.
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Abstract
Several infections have unique consequences or considerations in pregnancy. Some common infections such as urinary tract infections, influenza, sexually transmitted diseases, and vaginitis affect pregnant women differently than the general population, can cause pregnancy complications, and require treatments that are safe in pregnancy. Infections such as hepatitis B and C and human immunodeficiency virus can be transmitted vertically and therefore management focuses on decreasing perinatal transmission. Certain infections can be transmitted in utero and cause congenital infections. Classically, these were grouped together as the TORCH infections, although now several others, including varicella virus, parvovirus, and Zika virus, have also been recognized.
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Affiliation(s)
- Connie Leeper
- Department of Family, Internal, and Rural Medicine, University of Alabama, 850 Peter Bryce Boulevard, Tuscaloosa, AL 35401, USA.
| | - Andrew Lutzkanin
- Department of Family and Community Medicine, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
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30
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Detection of toxoplasma-specific immunoglobulin G in human sera: performance comparison of in house Dot-ELISA with ECLIA and ELISA. Eur J Clin Microbiol Infect Dis 2018; 37:1421-1429. [DOI: 10.1007/s10096-018-3266-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/23/2018] [Indexed: 10/17/2022]
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31
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Evaluation of serological and molecular tests used to identify Toxoplasma gondii infection in pregnant women attended in a public health service in São Paulo state, Brazil. Diagn Microbiol Infect Dis 2017; 89:13-19. [PMID: 28689893 DOI: 10.1016/j.diagmicrobio.2017.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 06/07/2017] [Accepted: 06/09/2017] [Indexed: 11/23/2022]
Abstract
Toxoplasmosis during pregnancy can have severe consequences. The use of sensitive and specific serological and molecular methods is extremely important for the correct diagnosis of the disease. We compared the ELISA and ELFA serological methods, conventional PCR (cPCR), Nested PCR and quantitative PCR (qPCR) in the diagnosis of Toxoplasma gondii infection in pregnant women without clinical suspicion of toxoplasmosis (G1=94) and with clinical suspicion of toxoplasmosis (G2=53). The results were compared using the Kappa index, and the sensitivity, specificity, positive predictive value and negative predictive value were calculated. The results of the serological methods showed concordance between the ELISA and ELFA methods even though ELFA identified more positive cases than ELISA. Molecular methods were discrepant with cPCR using B22/23 primers having greater sensitivity and lower specificity compared to the other molecular methods.
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32
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Long-term sera storage does not significantly modify the interpretation of toxoplasmosis serologies. J Microbiol Methods 2017; 134:38-45. [DOI: 10.1016/j.mimet.2017.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 11/21/2022]
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33
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Mahdy MAK, Alareqi LMQ, Abdul-Ghani R, Al-Eryani SMA, Al-Mikhlafy AA, Al-Mekhlafi AM, Alkarshy F, Mahmud R. A community-based survey of Toxoplasma gondii infection among pregnant women in rural areas of Taiz governorate, Yemen: the risk of waterborne transmission. Infect Dis Poverty 2017; 6:26. [PMID: 28190399 PMCID: PMC5304399 DOI: 10.1186/s40249-017-0243-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 01/13/2017] [Indexed: 11/10/2022] Open
Abstract
Background Toxoplasma gondii is a zoonotic coccidian parasite causing morbidity and mortality. In Yemen, T. gondii infection has been reported among pregnant women seeking healthcare in the main cities. However, no data are available on the prevalence of T. gondii infection and its associated risk factors among pregnant women in the rural communities of the country. Thus, the present study aimed to determine the seroprevalence of T. gondii and identify its risk factors among pregnant women in the rural communities of Taiz governorate, Yemen. Methods A total of 359 pregnant women living in the rural communities of Taiz governorate were enrolled in this study by house-to-house visits. Data were collected using a pre-designed questionnaire, and blood samples were collected and tested for the detection of anti- T. gondii IgM and IgG antibodies by enzyme-linked immunosorbent assay. Results The prevalence of T. gondii infection among pregnant women in this study was 46.2% (166/359). Bivariate analysis identified the age of ≥ 30 years (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.09–2.65, P = 0.019) and unimproved water sources (OR = 2.2; 95% CI = 1.10–4.55, P = 0.023) as factors associated with T. gondii infection among pregnant women. The multivariable analysis, however, identified unimproved water sources as an independent risk factor (adjusted OR = 2.4; 95% CI = 1.16–5.0, P = 0.018) associated with T. gondii infection among pregnant women. Conclusions Pregnant women in the rural communities of Taiz, Yemen are at high risk of contracting T. gondii infection. Unimproved water sources (wells, water streams and water tanks) are significantly associated with T. gondii infection and should be considered in prevention and control strategies, especially among pregnant women. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0243-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mohammed A K Mahdy
- Tropical Disease Research Center, University of Science and Technology, Sana'a, Yemen. .,Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
| | - Lina M Q Alareqi
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Rashad Abdul-Ghani
- Tropical Disease Research Center, University of Science and Technology, Sana'a, Yemen.,Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Samira M A Al-Eryani
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Abdullah A Al-Mikhlafy
- Department of Community Medicine, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Abdulsalam M Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Fawzya Alkarshy
- Yemeni-Swedish Hospital, Ministry of Public Health and Population, Taiz, Yemen
| | - Rohela Mahmud
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Interpretation of the Elecsys Toxo IgG avidity results for very low and very high index: study on 741 sera with a determined date of toxoplasmosis. Eur J Clin Microbiol Infect Dis 2016; 36:847-852. [DOI: 10.1007/s10096-016-2870-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 12/06/2016] [Indexed: 11/25/2022]
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35
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Dard C, Fricker-Hidalgo H, Brenier-Pinchart MP, Pelloux H. Relevance of and New Developments in Serology for Toxoplasmosis. Trends Parasitol 2016; 32:492-506. [PMID: 27167666 DOI: 10.1016/j.pt.2016.04.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 12/26/2022]
Abstract
Toxoplasmosis is a widespread parasitic disease caused by the intracellular parasite Toxoplasma gondii with a wide spectrum of clinical outcomes. The biological diagnosis of toxoplasmosis is often difficult and of paramount importance because clinical features are not sufficient to discriminate between toxoplasmosis and other illnesses. Serological tests are the most widely used biological tools for the diagnosis of toxoplasmosis worldwide. This review focuses on the crucial role of serology in providing answers to the most important questions related to the epidemiology and diagnosis of toxoplasmosis in human pathology. Notwithstanding their undeniable importance, serological tools need to be continuously improved and the interpretation of the ensuing results remains complex in many circumstances.
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Affiliation(s)
- Céline Dard
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier et Universitaire de Grenoble Alpes, Grenoble, France; Institut Albert Bonniot, INSERM U1209 - CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France.
| | - Hélène Fricker-Hidalgo
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier et Universitaire de Grenoble Alpes, Grenoble, France
| | - Marie-Pierre Brenier-Pinchart
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier et Universitaire de Grenoble Alpes, Grenoble, France; Institut Albert Bonniot, INSERM U1209 - CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
| | - Hervé Pelloux
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier et Universitaire de Grenoble Alpes, Grenoble, France; Institut Albert Bonniot, INSERM U1209 - CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France
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Abstract
Recent studies have demonstrated that screening and treatment for toxoplasmosis during gestation result in a decrease of vertical transmission and clinical sequelae. Early treatment was associated with improved outcomes. Thus, laboratory methods should aim for early identification of infants with congenital toxoplasmosis (CT). Diagnostic approaches should include, at least, detection of Toxoplasma IgG, IgM, and IgA and a comprehensive review of maternal history, including the gestational age at which the mother was infected and treatment. Here, we review laboratory methods for the diagnosis of CT, with emphasis on serological tools. A diagnostic algorithm that takes into account maternal history is presented.
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37
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Gashout A, Amro A, Erhuma M, Al-Dwibe H, Elmaihub E, Babba H, Nattah N, Abudher A. Molecular diagnosis of Toxoplasma gondii infection in Libya. BMC Infect Dis 2016; 16:157. [PMID: 27083153 PMCID: PMC4833959 DOI: 10.1186/s12879-016-1491-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 03/31/2016] [Indexed: 11/19/2022] Open
Abstract
Background Toxoplasma gondii infections are prevalent in humans and animals throughout Libya. Current diagnosis is based on detection of Toxoplasma-specific IgM and IgG. In this study, we established and optimized a diagnostic PCR assay for molecular diagnosis of T. gondii in Libya. Methods From January to December, 2010, 177 blood and serum samples were collected from suspected patients. This includes: 140 women who have had spontaneous abortions, 26 HIV-positive patients, nine patients with leukemia and lymphoma, and two infants with ocular infection. Samples were screened for anti-Toxoplasma IgG and IgM antibodies before DNA extraction. The surface antigen gene 2 (SAG2) was targeted in a semi-nested PCR to amplify a 999 bp and a 614 bp fragment in the first and the second run respectively. Results A total of 54/140 (38.5 %) women who have had spontaneous abortions, 23/26 (88 %) HIV patients, 6/9 (66.6 %) of the leukaemia and lymphoma patients, and one child with ocular infection were seropositive for anti-Toxoplasma IgG and/or IgM. Genomic DNA was extracted from 38 selected seropositive samples. The PCR was sensitive enough to detect DNA concentration of 12 ng/μL. PCR analysis was performed for 38 selected seropositive patients (16 women who have had spontaneous abortions, 15 positive HIV patients, six leukaemia patients and one child with ocular infection). Our designed primers were successfully amplified in 22/38 (57.9 %) samples; 5/12 (35.7 %) from serum and 17/26 (65.8 %) from whole blood samples. All PCR positive samples were IgG-positive except two samples which were IgM and IgG & IgM-positive serum samples respectively. The semi-nested PCR confirmed five more samples. These included two leukaemia and two HIV-positive whole blood samples and one serum sample from an aborted woman. Conclusion The ability of PCR to diagnose active toxoplasmosis is needed in immunocompromised patients and congenital toxoplasmosis cases, especially when serological techniques fail. For the first time in Libya, we established and optimized semi-nested PCR of SAG2 gene. The developed PCR method was able to detect as little as 12 ng/μL of T. gondii DNA and was useful to diagnose the diseases in women who have had spontaneous abortions, HIV-positive patients, patients with leukemia and lymphoma, and infants with ocular infection.
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Affiliation(s)
- Aisha Gashout
- Faculty of Medical Technology Pathology Department, University of Tripoli, Tripoli, Libya
| | - Ahmad Amro
- Faculty of Pharmacy, Al-Quds University, Main Campus, Abu Dis, P.O. Box 5100, Jerusalem, Palestine.
| | - Mabruk Erhuma
- Medical Laboratory Department, Immunology Unit, Tripoli Central Hospital, Tripoli, Libya
| | - Hamida Al-Dwibe
- Faculty of Medicine, Dermatology Department, University of Tripoli, Tripoli, Libya
| | - Eanas Elmaihub
- Scientific College - Sabrata, Zoology Department, University of Zawia, Zawia, Libya
| | - Hamouda Babba
- Laboratoire de Parasitologie-Mycologie à la Faculté de Pharmacie, Monastir, Tunisia
| | - Nabil Nattah
- Genetic Laboratory at Bio- technologies Researches Centre, Tripoli, Libya
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38
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Multiplexed Anti-Toxoplasma IgG, IgM, and IgA Assay on Plasmonic Gold Chips: towards Making Mass Screening Possible with Dye Test Precision. J Clin Microbiol 2016; 54:1726-1733. [PMID: 27008879 DOI: 10.1128/jcm.03371-15] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/16/2016] [Indexed: 11/20/2022] Open
Abstract
Toxoplasmosis is an infection caused by the protozoan parasite Toxoplasma gondii that can lead to severe sequelae in the fetus during pregnancy. Definitive serologic diagnosis of the infection during gestation is made mostly by detecting T. gondii-specific antibodies, including IgG and IgM, individually in a single serum sample by using commercially available kits. The IgA test is used by some laboratories as an additional marker of acute infection. Most of the commercial tests have failed to reach 100% correlation with the reference method, the Sabin-Feldman dye test for the detection of Toxoplasma IgG antibodies. For Toxoplasma IgM and IgA antibodies, there is no reference method and their evaluation is done by comparing the results of one assay to those of another. There is a need for multiplexed assay platforms, as the serological diagnosis of T. gondii infection does not rely on the detection of a single Ig subtype. Here we describe the development of a plasmonic gold chip with vast fluorescence enhancement in the near-infrared region for simultaneous detection of IgG, IgM, and IgA antibodies against T. gondii in an ∼1-μl serum or whole-blood sample. When 168 samples were tested on this platform, IgG antibody detection sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were all 100%. IgM antibody detection achieved 97.6% sensitivity and 96.9% specificity with a 90.9% PPV and a 99.2% NPV. Thus, the nanoscience-based plasmonic gold platform enables a high-performance, low-cost, multiplexed assay requiring ultrasmall blood volumes, paving the way for the implementation of universal screening for toxoplasmosis infection during gestation.
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Desoubeaux G, Cabanne É, Franck-Martel C, Gombert M, Gyan E, Lissandre S, Renaud M, Monjanel H, Dartigeas C, Bailly É, Van Langendonck N, Chandenier J. Pulmonary toxoplasmosis in immunocompromised patients with interstitial pneumonia: a single-centre prospective study assessing PCR-based diagnosis. J Clin Pathol 2016; 69:726-30. [PMID: 26729012 DOI: 10.1136/jclinpath-2015-203385] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 12/01/2015] [Indexed: 01/09/2023]
Abstract
AIMS Pulmonary toxoplasmosis has become a very rare parasitic infection since the advent of highly active antiretroviral therapies. It is generally diagnosed by the direct microscopic observation of Toxoplasma gondii tachyzoites in bronchoalveolar lavage fluid (BALF). The aim of this study was to assess possible improvements in diagnostic performance associated with the use of real-time PCR. METHODS This prospective study was carried out on BALFs obtained from immunocompromised patients over a 2-year period. We systematically compared the results of conventional staining with those of molecular detection. RESULTS Two cases of pulmonary toxoplasmosis were diagnosed for a total of 336 samples. PCR did not detect any additional cases and was more time-consuming than conventional staining. CONCLUSIONS Conventional staining is a reliable technique and is probably the most appropriate method for experienced microbiology laboratories, whereas T. gondii-specific PCR may be useful for laboratories with less experience in parasitology. TRIAL REGISTRATION NUMBER 2015_030, May 27th 2015.
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Affiliation(s)
- Guillaume Desoubeaux
- Service de Parasitologie-Mycologie-Médecine tropicale, CHU de Tours, Tours, France Faculté de Médecine, Université François-Rabelais, CEPR-INSERM U1100/Équipe 3, Université François-Rabelais Tours, France
| | - Églantine Cabanne
- Service de Parasitologie-Mycologie-Médecine tropicale, CHU de Tours, Tours, France
| | - Claire Franck-Martel
- Service de Parasitologie-Mycologie-Médecine tropicale, CHU de Tours, Tours, France
| | - Martin Gombert
- Service de Parasitologie-Mycologie-Médecine tropicale, CHU de Tours, Tours, France
| | - Emmanuel Gyan
- Service d'Hématologie et Thérapie Cellulaire, CHU de Tours, Tours, France Faculté de Médecine, Université François-Rabelais, N2C-INSERM U1069, Université François-Rabelais Tours, France
| | - Séverine Lissandre
- Service d'Hématologie et Thérapie Cellulaire, CHU de Tours, Tours, France
| | - Marc Renaud
- Service d'Hématologie et Thérapie Cellulaire, CHU de Tours, Tours, France
| | - Hélène Monjanel
- Service d'Hématologie et Thérapie Cellulaire, CHU de Tours, Tours, France
| | - Caroline Dartigeas
- Service d'Hématologie et Thérapie Cellulaire, CHU de Tours, Tours, France
| | - Éric Bailly
- Service de Parasitologie-Mycologie-Médecine tropicale, CHU de Tours, Tours, France
| | | | - Jacques Chandenier
- Service de Parasitologie-Mycologie-Médecine tropicale, CHU de Tours, Tours, France Faculté de Médecine, Université François-Rabelais, CEPR-INSERM U1100/Équipe 3, Université François-Rabelais Tours, France
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40
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Grzybowski MM, Gatkowska JM, Dziadek B, Dzitko K, Długońska H. Human toxoplasmosis: a comparative evaluation of the diagnostic potential of recombinant Toxoplasma gondii ROP5 and ROP18 antigens. J Med Microbiol 2015; 64:1201-1207. [PMID: 26242602 DOI: 10.1099/jmm.0.000148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Toxoplasmosis is one of the most common parasitic diseases worldwide and it poses a serious challenge regarding prevention, diagnosis and therapy. The commonly used diagnostic methods are mostly based on the detection of specific antibodies in sera. Since they are not always accurate enough and do not allow precise definition of the phase of the Toxoplasma gondii infection, there is an urgent need to find specific molecular markers of acute or chronic infection stages. This study provides a comparative assessment of recombinant ROP5 and ROP18 T. gondii proteins in the serodiagnosis of human toxoplasmosis. We found that both ROP5 and ROP18 proteins allowed the detection of specific IgM and IgG antibodies with a relatively low sensitivity; however, ROP18 IgM ELISA proved to be more sensitive than the SAG1 assay. This study also points to a relatively weak potential of the corresponding native ROP5 and ROP18 kinases in the generation of a strong antibody response in humans.
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Affiliation(s)
- Marcin M Grzybowski
- Department of Immunoparasitology, Faculty of Biology and Environmental Protection, University of Łódź, Łódź, Poland
| | - Justyna M Gatkowska
- Department of Immunoparasitology, Faculty of Biology and Environmental Protection, University of Łódź, Łódź, Poland
| | - Bożena Dziadek
- Department of Immunoparasitology, Faculty of Biology and Environmental Protection, University of Łódź, Łódź, Poland
| | - Katarzyna Dzitko
- Department of Immunoparasitology, Faculty of Biology and Environmental Protection, University of Łódź, Łódź, Poland
| | - Henryka Długońska
- Department of Immunoparasitology, Faculty of Biology and Environmental Protection, University of Łódź, Łódź, Poland
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41
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Abstract
TORCH infections classically comprise toxoplasmosis, Treponema pallidum, rubella, cytomegalovirus, herpesvirus, hepatitis viruses, human immunodeficiency virus, and other infections, such as varicella, parvovirus B19, and enteroviruses. The epidemiology of these infections varies; in low-income and middle-income countries, TORCH infections are major contributors to prenatal, perinatal, and postnatal morbidity and mortality. Evidence of infection may be seen at birth, in infancy, or years later. For many of these pathogens, treatment or prevention strategies are available. Early recognition, including prenatal screening, is key. This article covers toxoplasmosis, parvovirus B19, syphilis, rubella, hepatitis B virus, hepatitis C virus, and human immunodeficiency virus.
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Affiliation(s)
- Natalie Neu
- Division of Pediatric Infectious Disease, Columbia University Medical Center, 622 West 168th Street, PH-468, New York, NY 10032, USA.
| | - Jennifer Duchon
- Division of Pediatric Infectious Disease, New York-Presbyterian Morgan Stanley Children's Hospital, 622 West 168th Street, PH-471, New York, NY 10032, USA
| | - Philip Zachariah
- Division of Pediatric Infectious Disease, New York-Presbyterian Morgan Stanley Children's Hospital, 622 West 168th Street, PH-471, New York, NY 10032, USA
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42
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Contribution of neonatal amniotic fluid testing to diagnosis of congenital toxoplasmosis. J Clin Microbiol 2015; 53:1719-21. [PMID: 25694528 DOI: 10.1128/jcm.02358-14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 02/10/2015] [Indexed: 11/20/2022] Open
Abstract
We evaluated the molecular diagnosis of congenital toxoplasmosis (CT) on neonatal amniotic fluid samples from 488 mother-child pairs. Maternal infection during pregnancy was diagnosed and dated or could not be ruled out. Forty-six cases of CT were defined according to the European Research Network on CT classification system and case definitions. Neonatal amniotic fluid testing had an overall sensitivity of 54% (95% confidence interval [95% CI], 39 to 69%) and a specificity of 100% (95% CI, 99 to 100%). Its sensitivity was 33% (95% CI, 13 to 59%) when antenatal diagnosis was positive and 68% (95% CI, 48 to 84%) when antenatal diagnosis was negative or lacking. This difference in sensitivity may have been due to treatment of antenatally diagnosed cases. Relative to postnatal serology, neonatal amniotic fluid testing allowed an earlier diagnosis to be made in 26% of the cases (95% CI, 9 to 51%).
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