Pavia Paula Ximena, Montilla Marleny, Flórez Carolina, Herrera Giomar, Ospina Juan Manuel, Manrique Fred, Nicholls Rubén Santiago, Puerta Concepción
Laboratorio de Parasitología Molecular, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, D.C, Colombia.
Biomedica. 2009 Dec;29(4):513-22.
The main route of Chagas disease transmission is through vectors of the insect family Reduviidae. However, the parasite can also be transmitted from infected mothers to their fetus in utero. Until now, no cases of congenital Chagas disease have been reported in Colombia.
A congenital Chagas disease case occurred in Moniquirá County, Boyacá, Colombia. It was confirmed by comparing strains isolated from the mother and her baby using polymerase chain reaction (PCR) with arbitrary primers.
The parasite DNA was extracted from positive blood cultures of the afflicted mother and her son. The species confirmation and group detection were performed by PCR. The strain genotypes were determined by AP-PCR with two oligonucleotides based on the genes for the b-globin (5'-CCTCACCTTCTTTCATGGAG-3') and 16S RrNA (5'-ACGGGCAGTGTGTACAAGACC-3'), in different reactions.
The T. cruzi strains isolated from the blood cultures of the mother and her son showed the same amplification profile by the two AP-PCR tests; this corresponded with profiles of the T. cruzi I strains used as controls. However, T. cruzi II was also found in the blood culture from the newborn.
This is the first case of Chagas disease transmission reported in Moniquirá, demonstrating that this form of transmission occurs in Colombia. The presence of both groups of T. cruzi in the newborn sample suggests mixed infection in the mother as well, with a higher prevalence of T. cruzi I, at least in the mother's blood culture.
恰加斯病的主要传播途径是通过锥蝽科昆虫媒介。然而，该寄生虫也可在子宫内由受感染的母亲传播给胎儿。到目前为止，哥伦比亚尚未报告先天性恰加斯病病例。
在哥伦比亚博亚卡省莫尼基拉县发生了一例先天性恰加斯病病例。通过使用任意引物的聚合酶链反应（PCR）比较从母亲及其婴儿分离的菌株进行确诊。
从患病母亲及其儿子的阳性血培养物中提取寄生虫DNA。通过PCR进行物种确认和群体检测。在不同反应中，基于β-珠蛋白（5'-CCTCACCTTCTTTCATGGAG-3'）和16S rRNA（5'-ACGGGCAGTGTGTACAAGACC-3'）基因的两种寡核苷酸通过AP-PCR确定菌株基因型。
从母亲及其儿子的血培养物中分离出的克氏锥虫菌株在两次AP-PCR试验中显示出相同的扩增图谱；这与用作对照的克氏锥虫I型菌株的图谱一致。然而，在新生儿的血培养物中也发现了克氏锥虫II型。
这是莫尼基拉首次报告的恰加斯病传播病例，表明这种传播形式在哥伦比亚存在。新生儿样本中同时存在两组克氏锥虫表明母亲也存在混合感染，至少在母亲的血培养物中克氏锥虫I型的患病率更高。
