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实时 PCR 和血培养法评估长期肾移植受者中的克氏锥虫寄生虫载量。

Evaluation of Trypanosoma cruzi parasitic load by real-time PCR and blood culture in long-term kidney transplant recipients.

机构信息

Department of Medical Clinic, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.

Oswaldo Cruz Foundation Mato Grosso do Sul (FIOCRUZ MS), Campo Grande, Brazil.

出版信息

J Infect Dev Ctries. 2021 Nov 30;15(11):1774-1781. doi: 10.3855/jidc.13973.

Abstract

INTRODUCTION

Acute Chagas disease involving reactivation can occur after organ transplant, and follow-up by direct parasitological or molecular methods is essential for monitoring the parasitic load in such patients. In contrast, there is a little data on the parasitic load in long-term organ recipients. In this study, we examined the parasitic load in long-term kidney transplant patients and assessed the possibility of late Chagas disease reactivation.

METHODOLOGY

Blood cultures and real-time PCR were used to assess the parasitic load in four immunosuppressed patients who underwent kidney transplants (between 1996 and 2014) and were also treated for parasites.

RESULTS

There were no positive blood culture or real-time PCR results in Chagas disease patients who received kidney transplants. The real-time PCR presented detection limit of 0.1 parasite equivalent/mL. The time interval between the transplant and sample collection varied from one to 19 years.

CONCLUSIONS

No parasites were detected in the evaluated patients. The use of benznidazole and immunosuppressive therapy may have contributed to control the T. cruzi infection. In transplanted patients with Chagas disease, the use of methods such real-time PCR and blood culture can monitor the parasitic load and prevent disease reactivation.

摘要

简介

器官移植后可能会发生急性 Chagas 病的再激活,对于此类患者,通过直接寄生虫学或分子方法进行随访对于监测寄生虫负荷至关重要。相比之下,关于长期器官受者寄生虫负荷的数据较少。在这项研究中,我们检查了长期接受肾移植的患者的寄生虫负荷,并评估了晚期 Chagas 病再激活的可能性。

方法

我们使用血液培养和实时 PCR 来评估 4 名接受肾移植(1996 年至 2014 年间)且接受寄生虫治疗的免疫抑制患者的寄生虫负荷。

结果

接受肾移植的 Chagas 病患者的血液培养和实时 PCR 均未检测到阳性结果。实时 PCR 的检测下限为 0.1 寄生虫当量/mL。移植与样本采集之间的时间间隔从 1 年到 19 年不等。

结论

在评估的患者中未检测到寄生虫。贝那唑嗪和免疫抑制治疗的使用可能有助于控制 T. cruzi 感染。在患有 Chagas 病的移植患者中,使用实时 PCR 和血液培养等方法可以监测寄生虫负荷并预防疾病再激活。

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