Diagnosis of Toxoplasma gondii infection in pregnant women using automated chemiluminescence and quantitative real time PCR
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摘要
Objective: To identify serodiagnosis and quantification of Toxoplasma gondii(T. gondii) infection among pregnant women in Salmas, northwest of Iran. Methods: In this crosssectional study, 276 blood samples were collected from pregnant women referred to the health care centers in Salmas city. The demographic variables were also recorded. Titers of antiToxoplasma IgM and IgG antibodies(Ab) were determined using the chemiluminescence immunoassay. Quantitative real-time PCR targeting the T. gondii repeated element gene was also performed on the blood sample. Results: Out of all, 19.92%(55/276) and 2.17%(6/276) patients were seropositive for anti-Toxoplasma IgG and IgM Ab, respectively. Moreover, the presence of T. gondii DNA was observed in 12.31%(34/276) blood samples. A significant relationship was observed between the IgG Ab seropositivity and contact with the cat as a risk factor(P=0.022). Conclusions: The seroprevalence rate of T. gondii infection in pregnant women is relatively low. Consequently, the seronegative pregnant women are at risk, and a considerable rate of positive blood samples for the presence of parasite's DNA should not be ignored. Besides, quantitative real-time PCR could be considered as an accurate method for diagnosis of acute toxoplasmosis especially when the precise results are of the most importance in pregnancy. Limiting contact with cats is also suggested for pregnant women.
Objective: To identify serodiagnosis and quantification of Toxoplasma gondii(T. gondii) infection among pregnant women in Salmas, northwest of Iran. Methods: In this crosssectional study, 276 blood samples were collected from pregnant women referred to the health care centers in Salmas city. The demographic variables were also recorded. Titers of antiToxoplasma IgM and IgG antibodies(Ab) were determined using the chemiluminescence immunoassay. Quantitative real-time PCR targeting the T. gondii repeated element gene was also performed on the blood sample. Results: Out of all, 19.92%(55/276) and 2.17%(6/276) patients were seropositive for anti-Toxoplasma IgG and IgM Ab, respectively. Moreover, the presence of T. gondii DNA was observed in 12.31%(34/276) blood samples. A significant relationship was observed between the IgG Ab seropositivity and contact with the cat as a risk factor(P=0.022). Conclusions: The seroprevalence rate of T. gondii infection in pregnant women is relatively low. Consequently, the seronegative pregnant women are at risk, and a considerable rate of positive blood samples for the presence of parasite's DNA should not be ignored. Besides, quantitative real-time PCR could be considered as an accurate method for diagnosis of acute toxoplasmosis especially when the precise results are of the most importance in pregnancy. Limiting contact with cats is also suggested for pregnant women.
Objective: To identify serodiagnosis and quantification of Toxoplasma gondii(T. gondii) infection among pregnant women in Salmas, northwest of Iran. Methods: In this crosssectional study, 276 blood samples were collected from pregnant women referred to the health care centers in Salmas city. The demographic variables were also recorded. Titers of antiToxoplasma IgM and IgG antibodies(Ab) were determined using the chemiluminescence immunoassay. Quantitative real-time PCR targeting the T. gondii repeated element gene was also performed on the blood sample. Results: Out of all, 19.92%(55/276) and 2.17%(6/276) patients were seropositive for anti-Toxoplasma IgG and IgM Ab, respectively. Moreover, the presence of T. gondii DNA was observed in 12.31%(34/276) blood samples. A significant relationship was observed between the IgG Ab seropositivity and contact with the cat as a risk factor(P=0.022). Conclusions: The seroprevalence rate of T. gondii infection in pregnant women is relatively low. Consequently, the seronegative pregnant women are at risk, and a considerable rate of positive blood samples for the presence of parasite's DNA should not be ignored. Besides, quantitative real-time PCR could be considered as an accurate method for diagnosis of acute toxoplasmosis especially when the precise results are of the most importance in pregnancy. Limiting contact with cats is also suggested for pregnant women.
引文
[1]Daryani A,Sarvi S,Aarabi M,Mizani A,Ahmadpour E,Shokri A,et al.Seroprevalence of Toxoplasma gondii in the Iranian general population:a systematic review and meta-analysis.Acta Trop 2014;137:185-194.
[2]Hill DE,Chirukandoth S,Dubey J.Biology and epidemiology of Toxoplasma gondii in man and animals.Anim Health Res Rev 2005;6:41-61.
[3]Sarvi S,Daryani A,Rahimi MT,Aarabi M,Shokri A,Ahmadpour E,et al.Cattle toxoplasmosis in Iran:a systematic review and meta-analysis.Asian Pac J Trop Med 2015;8:120-126.
[4]Saadatnia G,Golkar M.A review on human toxoplasmosis.Scand JInfect Dis 2012;44:805-814.
[5]Mizani A,Alipour A,Sharif M,Sarvi S,Amouei A,Shokri A,et al.Toxoplasmosis seroprevalence in Iranian women and risk factors of the disease:a systematic review and meta-analysis.Trop Med Health 2017;45:7.
[6]Torgerson PR,Mastroiacovo P.The global burden of congenital toxoplasmosis:A systematic review.Bull World Health Organ 2013;91:501-508.
[7]Paquet C,Yudin MH,Allen VM,Bouchard C,Boucher M,Caddy S,et al.Toxoplasmosis in pregnancy:Prevention,screening,and treatment.JObstet Gynaecol Can 2013;35:78-79.
[8]Pomares C,Montoya JG.Laboratory diagnosis of congenital toxoplasmosis.J Clin Microbiol 2016;54:2448-2454.
[9]Stegmann B,Carey J.TORCH infections.toxoplasmosis,other(syphilis,varicella-zoster,parvovirus B19),rubella,cytomegalovirus(CMV),and herpes infections.Curr Womens Health Rep 2002;2:253-258.
[10]Deilami KN,Daryani A,Ahmadpour E,Sharif M,Dadimoghaddam Y,Sarvi S,et al.Excretory-secretory antigens:asuitable candidate for immunization against ocular toxoplasmosis in a murine model.Comp Immunol Microbiol Infect Dis 2014;37:369-374.
[11]Montazeri M,Ebrahimzadeh MA,Ahmadpour E,Sharif M,Sarvi S,Daryani A.Evaluation of propranolol effect on experimental acute and chronic toxoplasmosis using quantitative PCR.Antimicrob Agents Chemother 2016;60:7128-7133.
[12]Pappas G,Roussos N,Falagas ME.Toxoplasmosis snapshots:global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis.Int J Parasitol 2009;39:1385-1394.
[13]Sadaghian M,Amani S,Jafari R.Prevalence of toxoplasmosis and related risk factors among humans referred to main laboratories of Urmia city,North West of Iran,2013.J Parasit Dis 2016;40:520-523.
[14]Rasouli S,Sadaghian M,Jafari R.Prevalence of human toxoplasmosis and related risk factors using Electrochemiluminescence(ECLIA)method in West Azarbaijan Province,Iran,2010.Int J Biosci 2014;4:124-130.
[15]Bahhaj R,Ahmadpour E,Mahami-Oskouei M,Fallah E,Shamsasenjan K,Safaiyan A.Toxoplasma gondiiinfection and related risk factors among blood donors in Northwest Iran.Arch Clin Infect Dis 2017;2(2):e62005.
[16]Jafari R,Sadaghian M,Safari M.Seroprevalence of Toxoplasma gondii infection and related risk factors in Tabriz city,Iran,2008.J Res Health Sci 2012;12:119-121.
[17]Doni NY,Simsek Z,Gurses G,Zeyrek FY,Demir C.Prevalence and associated risk factors of Toxoplasma gondii in female farmworkers of southeastern Turkey.J Infect Dev Ctries 2015;9:87-93.
[18]Villard O,Cimon B,L’Ollivier C,Fricker-Hidalgo H,Godineau N,Houze S,et al.Serological diagnosis of Toxoplasma gondii infection:recommendations from the French National Reference Center for Toxoplasmosis.Diagn Microbiol Infect Dis 2016;84:22-33.
[19]Bastien P.Molecular diagnosis of toxoplasmosis.Trans R Soc Trop Med Hyg 2002;96:S205-S215.
[20]Switaj K,Master A,Skrzypczak M,Zaborowski P.Recent trends in molecular diagnostics for Toxoplasma gondii infections.Clin Microbiol Infect 2005;11:170-176.
[21]Cassaing S,Bessieres M,Berry A,Berrebi A,Fabre R,Magnaval J.Comparison between two amplification sets for molecular diagnosis of toxoplasmosis by real-time PCR.J Clin Microbiol 2006;44:720-724.
[22]Calderaro A,Piccolo G,Gorrini C.Comparison between two real-time PCR assays and a nested-PCR for the detection of Toxoplasma gondii.Acta Biomed 2006;77:75-80.
[23]Dadimoghaddam Y,Daryani A,Sharif M,Ahmadpour E,Hossienikhah Z.Tissue tropism and parasite burden of Toxoplasma gondii RH strain in experimentally infected mice.Asian Pac J Trop Med 2014;7:521-524.
[24]Shieh M,Didehdar M,Hajihossein R,Ahmadi F,Eslamirad Z.Toxoplasmosis:Seroprevalence in pregnant women,and serological and molecular screening in neonatal umbilical cord blood.Acta Trop2017;174:38-44.
[25]Rico-Torres CP,Vargas-Villavicencio JA,Correa D.Is Toxoplasma gondii type related to clinical outcome in human congenital infection?Systematic and critical review.Eur J Clin Microbiol Infect Dis 2016;35:1079-1088.
[26]Fuentes I,Rubio JM,Ram??rez C,Alvar J.Genotypic characterization of Toxoplasma gondii strains associated with human toxoplasmosis in Spain:Direct analysis from clinical samples.J Clin Microbiol 2001;39:1566-1570.
[2]Hill DE,Chirukandoth S,Dubey J.Biology and epidemiology of Toxoplasma gondii in man and animals.Anim Health Res Rev 2005;6:41-61.
[3]Sarvi S,Daryani A,Rahimi MT,Aarabi M,Shokri A,Ahmadpour E,et al.Cattle toxoplasmosis in Iran:a systematic review and meta-analysis.Asian Pac J Trop Med 2015;8:120-126.
[4]Saadatnia G,Golkar M.A review on human toxoplasmosis.Scand JInfect Dis 2012;44:805-814.
[5]Mizani A,Alipour A,Sharif M,Sarvi S,Amouei A,Shokri A,et al.Toxoplasmosis seroprevalence in Iranian women and risk factors of the disease:a systematic review and meta-analysis.Trop Med Health 2017;45:7.
[6]Torgerson PR,Mastroiacovo P.The global burden of congenital toxoplasmosis:A systematic review.Bull World Health Organ 2013;91:501-508.
[7]Paquet C,Yudin MH,Allen VM,Bouchard C,Boucher M,Caddy S,et al.Toxoplasmosis in pregnancy:Prevention,screening,and treatment.JObstet Gynaecol Can 2013;35:78-79.
[8]Pomares C,Montoya JG.Laboratory diagnosis of congenital toxoplasmosis.J Clin Microbiol 2016;54:2448-2454.
[9]Stegmann B,Carey J.TORCH infections.toxoplasmosis,other(syphilis,varicella-zoster,parvovirus B19),rubella,cytomegalovirus(CMV),and herpes infections.Curr Womens Health Rep 2002;2:253-258.
[10]Deilami KN,Daryani A,Ahmadpour E,Sharif M,Dadimoghaddam Y,Sarvi S,et al.Excretory-secretory antigens:asuitable candidate for immunization against ocular toxoplasmosis in a murine model.Comp Immunol Microbiol Infect Dis 2014;37:369-374.
[11]Montazeri M,Ebrahimzadeh MA,Ahmadpour E,Sharif M,Sarvi S,Daryani A.Evaluation of propranolol effect on experimental acute and chronic toxoplasmosis using quantitative PCR.Antimicrob Agents Chemother 2016;60:7128-7133.
[12]Pappas G,Roussos N,Falagas ME.Toxoplasmosis snapshots:global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis.Int J Parasitol 2009;39:1385-1394.
[13]Sadaghian M,Amani S,Jafari R.Prevalence of toxoplasmosis and related risk factors among humans referred to main laboratories of Urmia city,North West of Iran,2013.J Parasit Dis 2016;40:520-523.
[14]Rasouli S,Sadaghian M,Jafari R.Prevalence of human toxoplasmosis and related risk factors using Electrochemiluminescence(ECLIA)method in West Azarbaijan Province,Iran,2010.Int J Biosci 2014;4:124-130.
[15]Bahhaj R,Ahmadpour E,Mahami-Oskouei M,Fallah E,Shamsasenjan K,Safaiyan A.Toxoplasma gondiiinfection and related risk factors among blood donors in Northwest Iran.Arch Clin Infect Dis 2017;2(2):e62005.
[16]Jafari R,Sadaghian M,Safari M.Seroprevalence of Toxoplasma gondii infection and related risk factors in Tabriz city,Iran,2008.J Res Health Sci 2012;12:119-121.
[17]Doni NY,Simsek Z,Gurses G,Zeyrek FY,Demir C.Prevalence and associated risk factors of Toxoplasma gondii in female farmworkers of southeastern Turkey.J Infect Dev Ctries 2015;9:87-93.
[18]Villard O,Cimon B,L’Ollivier C,Fricker-Hidalgo H,Godineau N,Houze S,et al.Serological diagnosis of Toxoplasma gondii infection:recommendations from the French National Reference Center for Toxoplasmosis.Diagn Microbiol Infect Dis 2016;84:22-33.
[19]Bastien P.Molecular diagnosis of toxoplasmosis.Trans R Soc Trop Med Hyg 2002;96:S205-S215.
[20]Switaj K,Master A,Skrzypczak M,Zaborowski P.Recent trends in molecular diagnostics for Toxoplasma gondii infections.Clin Microbiol Infect 2005;11:170-176.
[21]Cassaing S,Bessieres M,Berry A,Berrebi A,Fabre R,Magnaval J.Comparison between two amplification sets for molecular diagnosis of toxoplasmosis by real-time PCR.J Clin Microbiol 2006;44:720-724.
[22]Calderaro A,Piccolo G,Gorrini C.Comparison between two real-time PCR assays and a nested-PCR for the detection of Toxoplasma gondii.Acta Biomed 2006;77:75-80.
[23]Dadimoghaddam Y,Daryani A,Sharif M,Ahmadpour E,Hossienikhah Z.Tissue tropism and parasite burden of Toxoplasma gondii RH strain in experimentally infected mice.Asian Pac J Trop Med 2014;7:521-524.
[24]Shieh M,Didehdar M,Hajihossein R,Ahmadi F,Eslamirad Z.Toxoplasmosis:Seroprevalence in pregnant women,and serological and molecular screening in neonatal umbilical cord blood.Acta Trop2017;174:38-44.
[25]Rico-Torres CP,Vargas-Villavicencio JA,Correa D.Is Toxoplasma gondii type related to clinical outcome in human congenital infection?Systematic and critical review.Eur J Clin Microbiol Infect Dis 2016;35:1079-1088.
[26]Fuentes I,Rubio JM,Ram??rez C,Alvar J.Genotypic characterization of Toxoplasma gondii strains associated with human toxoplasmosis in Spain:Direct analysis from clinical samples.J Clin Microbiol 2001;39:1566-1570.