Service de Parasitologie-Mycologie, Université Toulouse 3, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Département de Parasitologie-Mycologie, Université de Montpellier, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
J Clin Microbiol. 2022 May 18;60(5):e0011522. doi: 10.1128/jcm.00115-22. Epub 2022 May 2.
For postnatal diagnosis of congenital toxoplasmosis (CT), the gold standard for the detection of anti- IgM in newborns relies on the immunosorbent agglutination assay (ISAGA), which is manufactured from whole parasites that become difficult to maintain. For IgG, only the Platelia assay provides a validated assay for cord blood according to the manufacturer, allowing its use in this context. We compared the analytical performance of four commercialized automated assays, Platelia, Abbott, Vidas, and Liaison, for the detection of IgG and IgM in the cord blood or peripheral blood of newborns from women infected during pregnancy. The assays were performed on samples from 509 newborns, collected from the university hospitals of Montpellier, Nîmes, and Toulouse. For IgM, the four assays appeared to be sufficiently informative to be used for congenital toxoplasmosis diagnosis (area under the curve [AUC] > 0.8, receiver operating characteristic [ROC] analysis), with Platelia showing the best performance, similar to ISAGA with regard to accuracy (83%). For the Vidas (76%), Abbott (75%), and Liaison (74%) assays, the accuracy was significantly lower. Maternal treatment significantly decreased the sensitivity of all the assays. For IgG, the four evaluated assays showed a sensitivity of over 90%, with Abbott (95%) and Liaison (94%), exhibiting a significantly higher sensitivity than Platelia (90%). Furthermore, Abbott showed its superiority in the cases of maternal infection during the third trimester. In the context of the newborns of mothers infected by Toxoplasma gondii during pregnancy, to ensure efficient care, Platelia and Abbott seemed to be the most suitable reference tests for the detection of IgM for the former and IgG for the latter.
对于先天性弓形虫病(CT)的产后诊断,检测新生儿抗 IgM 的金标准依赖于免疫吸附凝集检测(ISAGA),该检测方法由难以维持的完整寄生虫制成。对于 IgG,只有 Platelia 检测法根据制造商的要求为脐血提供了经过验证的检测方法,允许在这种情况下使用。我们比较了四种商业化的自动化检测法(Platelia、Abbott、Vidas 和 Liaison)在检测妊娠期间感染的孕妇的新生儿脐血或外周血中的 IgG 和 IgM 的分析性能。该检测法在蒙彼利埃、尼姆和图卢兹的大学附属医院采集的 509 名新生儿的样本上进行。对于 IgM,这四种检测法似乎足以用于先天性弓形虫病的诊断(曲线下面积 [AUC] > 0.8,接收者操作特征 [ROC] 分析),Platelia 的表现最好,与 ISAGA 的准确性相似(83%)。对于 Vidas(76%)、Abbott(75%)和 Liaison(74%)检测法,准确性显著降低。母体治疗显著降低了所有检测法的灵敏度。对于 IgG,四种评估的检测法的灵敏度均超过 90%,Abbott(95%)和 Liaison(94%)的灵敏度明显高于 Platelia(90%)。此外,Abbott 在母体感染的情况下在第三个孕期显示出其优越性。在孕妇感染弓形虫的新生儿背景下,为了确保有效的护理,Platelia 和 Abbott 似乎是最适合用于检测 IgM 的参考检测法,前者用于后者的 IgG。