Towards a New Strategy for Diagnosis of Congenital Trypanosoma cruzi Infection
Por:
Abras, A, Munoz, C, Ballart, C, Berenguer, P, Llovet, T, Herrero, M, Tebar, S, Pinazo, MJ, Posada, E, Marti, C, Fumado, V, Bosch, J, Coll, O, Juncosa, T, Ginovart, G, Armengol, J, Gascon, J, Portus, M, Gallego, M
Publicada:
1 may 2017
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:
Univ Barcelona, Fac Farm & Ciencies Alimentacio, Dept Biol Sanitat & Medi Ambient, Seccio Parasitol, Barcelona, Spain
Barcelona Ctr Int Hlth Res CRESIB, ISGlobal, Barcelona, Spain
Univ Girona, Dept Biol, Lab Ictiol Genet, Girona, Spain
Munoz, C:
Hosp Santa Creu & Sant Pau, Serv Microbiol, Barcelona, Spain
Hosp Santa Creu & Sant Pau, IIB St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Cerdanyola Del Valles, Spain
Ballart, C:
Univ Barcelona, Fac Farm & Ciencies Alimentacio, Dept Biol Sanitat & Medi Ambient, Seccio Parasitol, Barcelona, Spain
Barcelona Ctr Int Hlth Res CRESIB, ISGlobal, Barcelona, Spain
Berenguer, P:
Hosp Santa Creu & Sant Pau, Serv Microbiol, Barcelona, Spain
Llovet, T:
Hosp Santa Creu & Sant Pau, Serv Microbiol, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Cerdanyola Del Valles, Spain
Herrero, M:
Hosp Santa Creu & Sant Pau, Serv Microbiol, Barcelona, Spain
Tebar, S:
Univ Barcelona, Fac Farm & Ciencies Alimentacio, Dept Biol Sanitat & Medi Ambient, Seccio Parasitol, Barcelona, Spain
Barcelona Ctr Int Hlth Res CRESIB, ISGlobal, Barcelona, Spain
Pinazo, MJ:
Barcelona Ctr Int Hlth Res CRESIB, ISGlobal, Barcelona, Spain
Posada, E:
Barcelona Ctr Int Hlth Res CRESIB, ISGlobal, Barcelona, Spain
Marti, C:
Hosp Gen Granollers, Unitat Microbiol, Granollers, Spain
Fumado, V:
Hosp Univ Sant Joan de Deu, Serv Pediat, Unitat Med Importada, Esplugas de Llobregat, Spain
Bosch, J:
Barcelona Ctr Int Hlth Res CRESIB, ISGlobal, Barcelona, Spain
Univ Barcelona, Hosp Clin, Serv Microbiol, Barcelona, Spain
Coll, O:
Univ Barcelona, Inst Clin Ginecol Obstet & Neonatol, Hosp Clin, Dept Med Maternofetal, Barcelona, Spain
Juncosa, T:
Hosp Univ St Joan de Deu, Serv Microbiol, Esplugas de Llobregat, Spain
Ginovart, G:
Hosp Santa Creu & Sant Pau, Unitat Neonatol, Barcelona, Spain
Armengol, J:
Hosp Santa Creu & Sant Pau, Serv Ginecol & Obstet, Barcelona, Spain
Gascon, J:
Barcelona Ctr Int Hlth Res CRESIB, ISGlobal, Barcelona, Spain
Portus, M:
Univ Barcelona, Fac Farm & Ciencies Alimentacio, Dept Biol Sanitat & Medi Ambient, Seccio Parasitol, Barcelona, Spain
Gallego, M:
Univ Barcelona, Fac Farm & Ciencies Alimentacio, Dept Biol Sanitat & Medi Ambient, Seccio Parasitol, Barcelona, Spain
Barcelona Ctr Int Hlth Res CRESIB, ISGlobal, Barcelona, Spain
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