Department of Ophthalmology, Charité Campus Virchow, University Faculty of Medicine, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Medical Microbiology and German Reference Laboratory for Toxoplasma Infection, Faculty of Medicine University of Göttingen; Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH); Unit 35: Gastrointestinal Infections, Zoonoses and Tropical Infections, Robert Koch Institute, Berlin; Unit 16: Mycotic and parasitic agents and mycobacteria, Robert Koch Institute, Berlin.
Dtsch Arztebl Int. 2019 Jun 21;116(25):435-444. doi: 10.3238/arztebl.2019.0435.
With approximately 30% of the world population infected, Toxoplasma gondii is one of the most widespread pathogenic parasites in both humans and animals and a major problem for health economics in many countries.
This review is based on the findings of individual studies, meta-analyses, and Cochrane Reviews retrieved by a selective literature survey of the Medline and Google Scholar databases.
Current data indicate a high rate of Toxoplasma gondii infection in Germany, ranging from 20% to 77% depending on age (95% confidence interval for 18- to 29-year-olds [17.0; 23.1]; for 70- to 79-year-olds [72.7; 80.5]). Male sex, caring for a cat, and a body mass index of 30 or more are independent risk factors for seroconversion. Postnatally acquired (food-related) infec- tion is predominant, but maternal-to-fetal transmission still plays an important role. While most infections are asymptomatic, congenital toxoplasmosis and reactivated Toxoplasma encephalitis in immunosuppressed persons (transplant recipients and others) are sources of considerable morbidity. Toxoplasma gondii infection of the retina is the most common cause of infectious uveitis in Germany. The diagnosis and treatment of this type of parasitic infection are particular to the specific organs involved in the individual patient.
Desirable steps for the near future include development of an effective treatment for the cystic stage and identifica- tion of biomarkers to assess the risk of reactivation and predict the disease course.
全世界约有 30%的人口受到感染，刚地弓形虫是人类和动物中分布最广泛的致病性寄生虫之一，也是许多国家卫生经济学的主要问题。
本综述基于通过对 Medline 和 Google Scholar 数据库的选择性文献调查，对个体研究、荟萃分析和 Cochrane 综述的发现进行总结。
目前的数据表明，德国的弓形虫感染率很高，范围在 20%至 77%之间，具体取决于年龄（18 至 29 岁者的 95%置信区间[17.0；23.1]；70 至 79 岁者[72.7；80.5]）。男性、照顾猫、体重指数达到或超过 30 是血清转换的独立危险因素。后天获得（食物相关）的感染占主导地位，但母婴传播仍起着重要作用。虽然大多数感染是无症状的，但免疫抑制人群（移植受者和其他人群）的先天性弓形虫病和复发性弓形虫脑炎是导致相当大发病率的原因。视网膜弓形虫感染是德国感染性葡萄膜炎最常见的原因。这种寄生虫感染的诊断和治疗因个体患者受累的具体器官而异。
在不久的将来，理想的步骤包括开发针对包囊期的有效治疗方法以及确定生物标志物以评估再激活的风险并预测疾病进程。
