Towards a New Strategy for Diagnosis of Congenital Trypanosoma cruzi Infection
Por:
Abras A, Muñoz C, Ballart C, Berenguer P, Llovet T, Herrero M, Tebar S, Pinazo MJ, Posada E, Martí C, Fumadó V, Bosch J, Coll O, Juncosa-Morros T, Ginovart G, Armengol J, Gascón J, Portús M and Gállego M
Publicada:
1 may 2017
Ahead of Print:
15 feb 2017
Categoría:
Microbiology (medical)
Resumen:
The immigration of Latin American women of childbearing age has spread the congenital transmission of Chagas disease to areas of nonendemicity, and the disease is now a worldwide problem. Some European health authorities have implemented screening programs to prevent vertical transmission, but the lack of a uniform protocol calls for the urgent establishment of a new strategy common to all laboratories. Our aims were to (i) analyze the trend of passive IgG antibodies in the newborn by means of five serological tests for the diagnosis and follow-up of congenital Trypanosoma cruzi infection, (ii) assess the utility of these techniques for diagnosing a congenital transmission, and (iii) propose a strategy for a prompt, efficient, and cost-effective diagnosis of T. cruzi infection. In noninfected newborns, a continuous decreasing trend of passive IgG antibodies was observed, but none of the serological assays seroreverted in any the infants before 12 months. From 12 months onwards, serological tests achieved negative results in all the samples analyzed, with the exception of the highly sensitive chemiluminescent microparticle immunoassay (CMIA). In contrast, in congenitally infected infants, the antibody decline was detected only after treatment initiation. In order to improve the diagnosis of congenital T. cruzi infection, we propose a new strategy involving fewer tests that allows significant cost savings. The protocol could start 1 month after birth with a parasitological test and/or a PCR. If negative, a serological test would be carried out at 9 months, which if positive, would be followed by another at around 12 months for confirmation.
Filiaciones:
Abras A:
Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
ISGlobal, Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
Laboratori d'Ictiologia Genètica, Departament de Biologia, Universitat de Girona, Girona, Spain
Muñoz C:
Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
Ballart C:
Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
ISGlobal, Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
Llovet T:
Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
Tebar S:
Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
ISGlobal, Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
Pinazo MJ:
ISGlobal, Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
Posada E:
ISGlobal, Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
Martí C:
Unitat de Microbiologia, Hospital General de Granollers, Granollers, Spain
Fumadó V:
Servei de Pediatria, Unitat de Medicina Importada, Hospital Universitari Sant Joan de Déu, Esplugues de Llobregat, Spain
Bosch J:
ISGlobal, Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
Servei de Microbiologia, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
Coll O:
Departament de Medicina Materno-Fetal, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
Juncosa-Morros T:
Servei de Microbiologia, Hospital Universitari Sant Joan de Déu, Esplugues de Llobregat, Spain
Ginovart G:
Unitat de Neonatologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Armengol J:
Servei de Ginecologia i Obstetrícia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Gascón J:
ISGlobal, Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
Portús M:
Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
Gállego M:
Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l'Alimentació, Universitat de Barcelona, Barcelona, Spain
ISGlobal, Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
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