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在马来西亚一家三级教学医院,采用配对样本血清学诊断法检测疑似病例中的先天性弓形虫病和巨细胞病毒感染。

Detection of Congenital Toxoplasmosis and Cytomegalovirus Infections Using Paired Sample Serodiagnosis from Suspected Cases at a Tertiary Teaching Hospital in Malaysia.

作者信息

Elmi Abdirahman Hussein, Irekeola Ahmad Adebayo, Abdullah Muhammad Amiruddin, Mohamed Zeehaida

机构信息

Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.

Department of Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu, Somalia.

出版信息

Malays J Med Sci. 2024 Aug;31(4):101-110. doi: 10.21315/mjms2024.31.4.8. Epub 2024 Aug 27.

Abstract

BACKGROUND

Congenital toxoplasmosis and congenital cytomegalovirus (cCMV) infections are noteworthy in Malaysia and can cause serious health problems in neonates. The prompt and effective detection and treatment related to both illnesses may mitigate the possibility of adverse consequences from both infections.

METHODS

A total of 219 neonates with suspected clinical indications of congenital toxoplasmosis and/or cCMV infections from January 2022 to December 2022 were enrolled. The first samples for IgM and IgG antibodies were screened by electrochemiluminescence immunoassay. For positive results indicative of congenital toxoplasmosis and cCMV infections, second serum samples were requested and tested within a period of 2-4 weeks after testing the first sample.

RESULTS

From the 219 first serum samples, the overall seroprevalence of congenital toxoplasmosis antibodies in suspected cases was 53%; meanwhile, the overall seroprevalence of cCMV in the suspected cases was 98.6%. The results of the paired serum sample collected for investigating congenital toxoplasmosis cases revealed that 47% of the cases presented no serological evidence of exposure while the remaining 53% of cases might have acquired passive immunity from the mother. For cCMV, the number of cases with no serological evidence of exposure was 1.4%, whereas acute infection was 1.8% and possible passive immunity from the mother represented 96.8%.

CONCLUSION

This study found a high seroprevalence of congenital toxoplasmosis and cCMV infections, probably because they are suspected cases. This study also indicates that using paired sample analysis in the categorisation of cases can aid in accurate diagnosis and more effective treatment.

摘要

背景

先天性弓形虫病和先天性巨细胞病毒(cCMV)感染在马来西亚值得关注,可导致新生儿出现严重健康问题。对这两种疾病进行及时有效的检测和治疗可能会降低两种感染产生不良后果的可能性。

方法

纳入2022年1月至2022年12月期间219例有先天性弓形虫病和/或cCMV感染疑似临床指征的新生儿。通过电化学发光免疫分析法筛查IgM和IgG抗体的首批样本。对于指示先天性弓形虫病和cCMV感染的阳性结果,在检测首批样本后的2 - 4周内要求采集第二批血清样本并进行检测。

结果

在219份首批血清样本中,疑似病例中先天性弓形虫病抗体的总体血清阳性率为53%;同时,疑似病例中cCMV的总体血清阳性率为98.6%。对用于调查先天性弓形虫病病例的配对血清样本检测结果显示,47%的病例没有血清学暴露证据,而其余53%的病例可能从母亲那里获得了被动免疫。对于cCMV,没有血清学暴露证据的病例数为1.4%,急性感染为1.8%,可能从母亲获得的被动免疫占96.8%。

结论

本研究发现先天性弓形虫病和cCMV感染的血清阳性率较高,可能是因为这些都是疑似病例。本研究还表明,在病例分类中使用配对样本分析有助于准确诊断和更有效的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1137/11377005/ed4b745debf5/08mjms3104_raf1.jpg

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