1921
Volume 71, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Primary maternal infection with toxoplasmosis during pregnancy is frequently associated with transplacental transmission to the fetus. This study was conducted to test the utility of a polymerase chain reaction (PCR) assay to detect recent infections with in pregnant women. One hundred forty-eight women with high-risk pregnancies who had abnormal pregnancy outcomes (cases) and 100 with normal pregnancies (controls) were tested for the presence of DNA in their blood by a nested PCR and specific antibodies to by an enzyme-linked immunosorbent assay. The IgG results of the cases differed significantly from those of the controls (54% and 12%, respectively; < 0.02). Four (2.7%) of the cases were IgM positive, but none of the controls were positive. Detection of DNA in 20 (8.1%) of the IgG-positive cases suggests a recent infection. The risk factors associated with the infection were eating raw meat and contact with soil. The diagnostic serology of recent infection in early pregnancy could be confirmed by a positive -specific PCR result in blood samples collected in the first half of pregnancy, even in the presence of serologic results difficult to interpret due to the lack of sequential follow-up during pregnancy.

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2004-12-01
2017-11-25
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References

  1. Zuber P, Jacquier P, 1995. Epidemiology of toxoplasmosis: worldwide status. Schweiz Med Wochenschr 65 (Suppl): 19S–22S.
  2. Franzen C, Altfeld M, Hegener P, Hartmann P, Arendt G, Jablonowski H, Rockstroh J, Diehl V, Salzberger B, Fatkenheuer G, 1997. Limited Value of PCR for detection of Toxoplasma gondii in blood from human immunodeficiency virus-infected patients. J Clin Microbiol 35 : 2639–2641.
  3. Roberts CW, Walker W, Alexander J, 2001. Sex-associated hormones and immunity to protozoan parasites. Clin Microbiol Rev 14 : 476–488.
  4. Phillips AN, Antunes F, Stergious G, Ranki A, Jensen GF, Bentwich Z, Sacks T, Pedersen C, Lundgren JD, Johnson AM, 1994. A sex comparison of rates of new AIDS-defining disease and death in 2,554 AIDS cases. AIDS 8 : 831–835.
  5. Wong SY, Remington JS, 1994. Toxoplasmosis in pregnancy. Clin Infect Dis 18 : 853–861.
  6. Kopecky D, Hayde M, Prusa AR, Adlassnig KP, 2001. Knowledge-based interpretation of toxoplasmosis serology test results including fuzzy temporal concepts-the ToxoNet system. Medinfo 10 : 484–488.
  7. Gagne SS, 2001. Toxoplasmosis. Prim Care Update Obstet Gynecol 8 : 122–126.
  8. Dubey JP, Beattie CP, 1988. Toxoplasmosis of Animals and Man. Fourth edition. Boca Raton, FL: CRC Press.
  9. Remington JS, Mcleod R, Desmonts G, 1995. Toxoplasmosis. Remington JS, Klein JO, eds. Infectious Diseases of the Fetus and Newborn Infant. Philadelphia: W. B. Saunders Co., 140–267.
  10. Sahwi SY, Zaki MS, Haiba NY, Elsaid OK, Anwar MY, AbdRabbo SA, 1995. Toxoplasmosis as a cause of repeated abortion. J Obstet Gynaecol 21 : 145–148.
  11. Zargar AH, Wani AI, Masoodi SR, Laway BA, Kakro DK, Thokar MA, Sofi BA, Bashir MI, 1999. Seroprevalence of toxoplasmosis in women with recurrent abortions/neonatal deaths and its treatment outcome. Indian J Pathol Microbiol 42 : 483–486.
  12. James GS, Sintchenko VG, Dickeson DJ, Gilbert GL, 1996. Comparison of cell culture, mouse inoculation, and PCR for detection of Toxoplasma gondii: effects of storage conditions on sensitivity. J Clin Microbiol 34 : 1572–1575.
  13. Pinon JM, Dumon H, Chemla C, Franck J, Petersen E, Lebech M, Zufferey J, Bessieres M-H, Marty P, Holliman R, Johnson J, Luyasu V, Lecolier B, Guy E, Joynson DHM, Decoster A, Enders G, Pelloux H, Candolfi E, 2001. Strategy for diagnosis of congenital toxoplasmosis: evaluation of methods comparing mothers and newborns and standard methods for postnatal detection of Immunoglobulin G, M, and A antibodies. J Clin Microbiol 39 : 2267–2271.
  14. Romand S, Wallon M, Franck J, Thulliez P, Peyron F, Dumon H, 2001. Prenatal diagnosis using polymerase chain reaction on amniotic fluid for congenital toxoplasmosis. Obstet Gynecol 97 : 296–300.
  15. Guy EC, Joynson DHM, 1995. Potential of the polymerase chain reaction in the diagnosis of active Toxoplasma infection by detection of parasite in blood. J Infect Dis 172 : 319–322.
  16. Burg JL, Grover CM, Poulety P, Boothroyd JC, 1989. Direct and sensitive detection of a pathogenic protozoan, Toxoplasma gondii by polymerase chain reaction. J Clin Microbiol 27 : 1787–1792.
  17. Vimercati A, Greco P, D’apolito A, Angelici MC, Possenti A, Carbonara S, Selvaggil L, 2000. Risk assessment of vertical transmission of Toxoplasma infections. Acta Biomed Ateneo Parmense 71 (Suppl 1): 537–540.
  18. Jenum P, Stray-Pedersen B, Gundersen A-G, 1997. Improved diagnosis of primary Toxoplasma gondii infection in early pregnancy by determination of antitoxoplasma immunoglobulin G Avidity. J Clin Microbiol 35 : 1972–1977.
  19. Li S, Maine G, Suzuki Y, Araujo FG, Galvan G, Remington JS, Parmley S, 2000. Serodiagnosis of recently acquired Toxoplasma gondii infection with a recombinant antigen. J Clin Microbiol 38 : 179–184.
  20. Lebech M, Petersen E, 1992. Neonatal screening for congenital toxoplasmosis in Denmark: presentation of the design of a prospective study. Scand J Infect Dis (Suppl 84): 70–74.
  21. Hofgärtner WT, Swanzy SR, Bacina RM, Condon J, Gupta M, Matlock PE, Bergeron DL, Plorde JJ, Fritsche TR, 1997. Detection of immunoglobulin G (IgG) and IgM antibodies to Toxoplasma gondii: evaluation of four commercial immunoassay systems. J Clin Microbiol 35 : 3313–3315.
  22. Wilson M, Remington JS, Clavet C, Varney G, Press C, Ware D, 1997. Evaluation of six commercial kits for the detection of immunoglobulin M antibodies to Toxoplasma gondii, The FDA Toxoplasmosis Ad Hoc Working Group. J Clin Microbiol 35 : 3112–3115.
  23. Liesenfeld O, Press C, Montoya JG, Gill R, Isaac-Renton JL, Hedman K, Remington JS, 1997. False-positive results in immunoglobulin IgM) Toxoplasma antibody tests and importance of confirmatory testing: the Platelia Toxo IgM test. J Clin Microbiol 35 : 174–179.
  24. Bobic B, Sibalic D, Djurkovic-Djakovic O, 1991. High levels of IgM antibodies specific to Toxoplasma gondii in pregnancy 12 years after primary Toxoplasma infection. Gynecol Obstet Invest 31 : 182–184.
  25. Francis JM, Joynson DHM, 1993. Duration of specific immunoglobulin A antibody following acute toxoplasmosis as determined by enzyme immunoassay and immunosorbent agglutination assay. Eur J Clin Microbiol Infect Dis 12 : 556–559.
  26. Pelloux H, Brun E, Vernet G, Marcillat S, Jolivet M, Guergour D, Fricker-Hidalgo H, Goullier-Fleuret A, Ambroise-Thomas P, 1998. Determination of anti-Toxoplasma gondii immunoglobulin G avidity: adaptation to the Vidas system BioMerieux). Diagn Microbiol Infect Dis 32 : 69–73.
  27. El-Awady MK, el-Hosseiny LA, Ismail SM, Abdel-Aziz MT, el-Demellawy MA, 2000. Comparison between Toxoplasma gondii DNA and specific immunoglobulins during pregnancy. East Mediterr Health J 6 : 888–897.
  28. Hussein AH, Nagaty IM, Fouad MA, 2002. Evaluation of IgMELISA versus PCR in diagnosis of recent Toxoplasma gondii infection. J Egypt Soc Parasitol 32 : 639–646.
  29. Abdel-Hafez SK, Shbeeb I, Ismail NS, Abdel-Rahman F, 1986. Serodiagnosis of Toxoplasma gondii in habitually aborting women and other adults from North Jordan. Folia Parasitol 33 : 7–13.
  30. Galvan Ramirez M de la L, Soto Mancilla JL, Velasco Castrejon O, Perez Medina R, 1995. Incidence of anti-Toxoplasma antibodies in women with high-risk pregnancy and habitual abortions. Rev Soc Bras Med Trop 28 : 333–337.
  31. Robert-Gangneux F, Gavinet M-F, Anelle T, Raymond J, Tourte-Schaferer CT, Dupouy-Camet J, 1999. Value of prenatal diagnosis and early postnatal diagnosis of congenital toxoplasmosis: retrospective study of 110 cases. J Clin Microbiol 37 : 2893–2898.
  32. Liesenfeld O, Montoya JG, Tathinen NJ, Davis M, Brown BW, Cobb KL, Parsonet J, Remington JS, 2001. Confirmatory serologic testing for acute toxoplasmsis and rate of induced abortions among women reported to have positive Toxoplasma immunoglobulin M antibody titers. Am J Obstet Gynecol 184 : 140–145.
  33. Stray-Pedersen B, Lorentzen-Styr AM, 1977. Uterine Toxoplasma infections and repeated abortions. Am J Obstet Gynecol 128 : 716–721.
  34. Cook DC, Gilbert RE, Buffolano W, Zufferey J, Petersen E, Jenum PA, Foulon W, Semprini AE, Dunn DT, 2000. Sources of Toxoplasma infection in pregnant women: European multicentre case-control study. BMJ 21 : 142–147.
  35. Cao Y, Qiu L, Zhang Q, 1999. Study on the relationship between the history of abnormal pregnancy and TORCH infection in pregnant woman. Zhonghua Fu Chan Ke Za Zhi 34 : 517–520.
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  • Received : 31 May 2004
  • Accepted : 28 Jun 2004

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