Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fiocruz, Rio de Janeiro, RJ, Brazil.
Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fiocruz, Rio de Janeiro, RJ, Brazil.
Braz J Infect Dis. 2023 Sep-Oct;27(5):102804. doi: 10.1016/j.bjid.2023.102804. Epub 2023 Sep 21.
The diagnosis of congenital toxoplasmosis presents limitations and therefore new options are necessary. The analysis of amniotic fluid by real-time PCR has already proved effective for confirmation of fetal infection. However, its performance in other biological samples is not clear yet. The aim of this study is to better understand the role of real-time PCR in the blood of the mother and newborn as well as in the amniotic fluid and placenta in the diagnosis of congenital toxoplasmosis. This is a descriptive cohort study of pregnant women with toxoplasmosis followed up in Rio de Janeiro, Brazil. Real-time PCR was performed in samples of maternal blood, amniotic fluid, placenta, and blood of newborns. In addition, histopathological examination of placentas was performed, and data collected from babies were collected. 116 pregnant women were followed up and 298 samples were analyzed. One (0.9%) pregnant woman presented positive PCR in the blood, 3 (3.5%) in the amniotic fluid, 1 (2.3%) in the placenta and no newborn had positive PCR in the blood. Histopathological study was suggestive of toxoplasmosis infection in 24 (49%) placentas. Six (5.2%) newborns were diagnosed with congenital toxoplasmosis, and only cases with positive PCR in the amniotic fluid had correlation of the PCR result with the diagnosis of congenital infection. Both maternal and blood samples of newborns and placenta did not prove to be promising in the diagnosis of congenital toxoplasmosis. Further studies are needed to evaluate the real role of molecular diagnosis in other biological materials rather than the amniotic fluid.
先天性弓形虫病的诊断存在局限性，因此需要新的方法。实时 PCR 分析已被证明可有效确认胎儿感染。然而，其在其他生物样本中的性能尚不清楚。本研究旨在更好地了解实时 PCR 在母亲和新生儿血液以及羊膜和胎盘在先天性弓形虫病诊断中的作用。这是一项在巴西里约热内卢进行的患有弓形虫病的孕妇的描述性队列研究。对母亲血液、羊水、胎盘和新生儿血液样本进行了实时 PCR 检测。此外，还对胎盘进行了组织病理学检查，并收集了婴儿的数据。共随访了 116 名孕妇，分析了 298 个样本。1 名（0.9%）孕妇血液 PCR 阳性，3 名（3.5%）羊水阳性，1 名（2.3%）胎盘阳性，新生儿血液无阳性 PCR。组织病理学研究提示 24 例（49%）胎盘存在弓形虫感染。6 例（5.2%）新生儿诊断为先天性弓形虫病，只有羊水 PCR 阳性的病例与先天性感染的诊断结果相关。母亲和新生儿血液样本以及胎盘均未证明在诊断先天性弓形虫病方面有前景。需要进一步研究以评估分子诊断在其他生物材料（而非羊水）中的实际作用。
