Carral Liliana, Kaufer Federico, Durlach Ricardo, Freuler Cristina, Olejnik Patricia, Nadal Mónica, Corazza Rosana, Pari Marcela, García Liliana, Córdoba Sofía, Rodriguez Mónica, Ceriotto Mariana, García Gabriela
Centro de toxoplasmosis y otras zoonosis, Hospital Alemán, Buenos Aires.
Medicina (B Aires). 2008;68(6):417-22.
Toxoplasmosis is an infection caused by Toxoplasma gondii, an intracellular parasite of universal distribution, with a variable prevalence depending on the region. This infection causes both morbidity and mortality in the fetus and newborn. The present study is an evaluation of the Argentine Consensus Guidelines regarding prenatal prevention of toxoplasmosis. Screening tests in pregnant women were done in nine different hospitals within the city of Buenos Aires and surroundings, where 19825 births between May 1st 2006 and April 30th 2007 were registered. Screening tests were done in 13632 pregnant women, using IgG and IgM determinations by ELISA. If acute infection was suspected, the patient's serum was sent to the reference laboratory to fulfill the pending tests: Sabin Feldman, ISAGA M, ISAGA A, ISAGA E and avidity. Clinical and serologic evaluation was done to all newborn of these mothers. Three hundred and fifty one specimens were sent and analyzed. Conclusions from the analysis were as follows: 121 (32%) patients probably acquired the infection during pregnancy, in 176 (46%) patients, acute infection was excluded, in 37 women (10%) serologic results were inconclusive, and in 47 (12%) the interpretation of results was impossible due to lack of information on the exact gestational age. Clinical and serologic control was performed in 94 newborns of mothers infected during pregnancy, and 5 congenital toxoplasmosis were detected, with fetal damage, four corioretinitis and one case of microcephaly. This study allowed us to validate the Argentine Consensus of Congenital Toxoplasmosis Guidelines.
弓形虫病是由刚地弓形虫引起的一种感染,刚地弓形虫是一种广泛分布的细胞内寄生虫,其患病率因地区而异。这种感染会导致胎儿和新生儿发病和死亡。本研究是对阿根廷关于产前预防弓形虫病的共识指南的评估。在布宜诺斯艾利斯市及其周边地区的九家不同医院对孕妇进行了筛查测试,在这些医院登记了2006年5月1日至2007年4月30日期间的19825例分娩。对13632名孕妇进行了筛查测试,采用酶联免疫吸附测定法检测IgG和IgM。如果怀疑有急性感染,将患者的血清送至参考实验室以完成未完成的检测:Sabin Feldman检测、ISAGA M检测、ISAGA A检测、ISAGA E检测和亲和力检测。对这些母亲的所有新生儿进行了临床和血清学评估。共送检并分析了351份标本。分析得出的结论如下:121名(32%)患者可能在孕期感染,176名(46%)患者排除急性感染,37名女性(10%)血清学结果不确定,47名(12%)因缺乏确切孕周信息而无法解读结果。对孕期感染母亲的94名新生儿进行了临床和血清学监测,检测出5例先天性弓形虫病,伴有胎儿损伤,4例脉络膜视网膜炎和1例小头畸形。本研究使我们能够验证阿根廷先天性弓形虫病指南的共识。