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先天性弓形虫病的诊断:意大利西西里岛流行区的产前和产后评估。初步数据。

Diagnosis of congenital toxoplasmosis: pre- and post-natal evaluation in Sicilian (Italy) epidemiological area. Preliminary data.

作者信息

Di Carlo P, Casuccio A, La Chiusa S, Mazzola A, Pampinella D, Romano A, Schimmenti M G, Titone L, Mancuso G

机构信息

Institute of Infectious Diseases, University of Palermo, Italy.

出版信息

Parassitologia. 2007 Jun;49(1-2):39-41.

Abstract

To evaluate the usefulness of conventional serological methods with western blot assay (WB) in congenital toxoplasmosis diagnosis, we prospectively enrolled in a clinical and serological follow-up all pregnant women with Toxoplasma gondii infection and their offspring, referred to us from October 2004. Western blot and standard serological test were performed on sera collected from mother during pregnancy and from mother and child at birth, at postpartum month 1-3-6-9 and 12. At this point in time, 22 pregnant women and 14 infants have completed the follow-up. 4 newborns were infected and 2 had specific toxoplasmosis anomalies at the birth. In mothers without seroconversion, the WB performed during pregnancy demonstrates the highest accordance with postnatal follow-up whereas in 1 case the negative result of PCR analysis was not confirmed by postnatal observation. The detection of anti-T gondii IgG against 8 kDa accessory antigenic band and against the accessory band included between 35 and 40 kDa band in immunoblot assay was useful for diagnosis of acute phase but did not improve the evaluation of comparative postnatal profile. Althougth few infants have concluded the postnatal follow-up, the preliminary results showed a greater value of using a IgM and IgA WB test than other standard method for the early diagnosis of toxoplasmosis at birth also in child born to treated mothers. The comparative anti-T gondii IgG immunoblot profile of mother and child permitted us to reduce the time of ruling out infection in newborns born to mothers with probable or possible infection and/or when prenatal diagnosis is negative or not performed.

摘要

为评估传统血清学方法联合蛋白质印迹法(WB)在先天性弓形虫病诊断中的效用,我们对2004年10月转诊至我院的所有感染弓形虫的孕妇及其后代进行了临床和血清学的前瞻性随访。在孕期采集母亲的血清,在出生时、产后1、3、6、9和12个月采集母亲和孩子的血清,进行蛋白质印迹法和标准血清学检测。此时,22名孕妇和14名婴儿已完成随访。4名新生儿被感染,2名在出生时有特异性弓形虫病异常表现。在血清未发生转换的母亲中,孕期进行的蛋白质印迹法检测结果与产后随访结果一致性最高,而有1例PCR分析的阴性结果未得到产后观察的证实。免疫印迹法检测抗弓形虫IgG抗体针对8 kDa辅助抗原条带以及35至40 kDa条带之间的辅助条带,对急性期诊断有用,但并未改善产后对比情况的评估。尽管只有少数婴儿完成了产后随访,但初步结果显示,对于感染弓形虫的母亲所生的婴儿,在出生时早期诊断弓形虫病,使用IgM和IgA蛋白质印迹法检测比其他标准方法更有价值。母婴抗弓形虫IgG免疫印迹图谱的对比,使我们能够缩短对可能或疑似感染弓形虫的母亲所生新生儿排除感染的时间,以及在产前诊断为阴性或未进行产前诊断时排除感染的时间。

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