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伊朗眼部弓形虫病临床诊断中的血清学和分子方法

Serological and molecular approaches in clinical diagnosis of ocular toxoplasmosis in Iran.

作者信息

Saber Vafa, Seyyed Tabaei Seyyed Javad, Tabatabaei Seyyed Ali, Soleimani Mohammad, Haghighi Ali

机构信息

Department of Parasitology and Mycology, School of Medicine, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Med J Islam Repub Iran. 2019 Aug 12;33:82. doi: 10.34171/mjiri.33.82. eCollection 2019.

Abstract

) is the most common parasite that can lead to a disease called toxoplasmosis. In this study, serological and molecular complementary tests have been conducted to detect or diagnose this parasite. A total of 71 patients with clinical symptoms of ocular toxoplasmosis and 20 patients with other ocular infections were evaluated. Serum and buffy coat samples were collected and tested using enzyme-linked immunosorbent assay (ELISA) and nested polymerase chain reaction (nPCR) assessments. Superficial B1 gene was evaluated in PCR. The ocular toxoplasmosis patients were followed-up 2 weeks after the first sampling and 4 weeks following the first laboratory testing. The main outcome measures were the efficiency of the diagnostic procedure and positive and negative predictive values (PPV and NPV). Overall, of the samples, 69% were PCR+, IgG+, and IgM-, and 4.2% showed PCR+, IgG+, and IgM+. In the first follow-up, after 2 weeks, from the 41 referred patients, 29 (70%) showed PCR+, IgG+, and IgM-, which confirmed the results of the first sampling. In the second follow-up, 9 (47%) patients were PCR+, IgG+, and IgM-. A correlation was observed between the first referral and the follow-ups. Also, from 71 patients, diagnosed clinically as ocular toxoplasmosis, the disease was confirmed in 73.2% and 26.8% of those suffering from other ocular infections. Of the 20 control group samples, 55% showed PCR-, IgG+, and IgM-. The sensitivity, specificity, negative and positive predictive values, and negative and positive likelihoods were analyzed for IgG and IgM antibodies and for PCR using ELISA method. As the ophthalmologic signs of may be mimicked by other infections, clinical methods may be complemented by laboratory approaches for a definite diagnosis. This would assist clinicians to achieve timely diagnosis and successful therapy and to control the infection.

摘要

弓形虫是最常见的可导致一种名为弓形虫病的寄生虫。在本研究中,已进行血清学和分子补充检测以检测或诊断这种寄生虫。共评估了71例有眼部弓形虫病临床症状的患者和20例有其他眼部感染的患者。收集血清和血沉棕黄层样本,并使用酶联免疫吸附测定(ELISA)和巢式聚合酶链反应(nPCR)评估进行检测。在PCR中评估表面B1基因。对眼部弓形虫病患者在首次采样后2周以及首次实验室检测后4周进行随访。主要结局指标为诊断程序的效率以及阳性和阴性预测值(PPV和NPV)。总体而言,在样本中,69%为PCR阳性、IgG阳性且IgM阴性,4.2%显示为PCR阳性、IgG阳性且IgM阳性。在首次随访中,2周后,在41例转诊患者中,29例(70%)为PCR阳性、IgG阳性且IgM阴性,这证实了首次采样的结果。在第二次随访中,9例(47%)患者为PCR阳性、IgG阳性且IgM阴性。在首次转诊和随访之间观察到相关性。此外,在71例临床诊断为眼部弓形虫病的患者中,73.2%的患者确诊为此病,26.8%的患者患有其他眼部感染。在20份对照组样本中,55%显示为PCR阴性、IgG阳性且IgM阴性。使用ELISA方法分析了IgG和IgM抗体以及PCR的敏感性、特异性、阴性和阳性预测值以及阴性和阳性似然比。由于弓形虫的眼科体征可能被其他感染所模仿,临床方法可能需要实验室方法的补充以进行明确诊断。这将有助于临床医生实现及时诊断和成功治疗,并控制感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ebe/6825372/929cf5f9cdaa/mjiri-33-82-g001.jpg

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