1887

Abstract

Acute infection in early pregnancy carries the risk of transmitting the infection to the fetus with serious sequelae. However, serological testing for IgG/IgM anti- antibodies may fail to differentiate between a recent and past infection. Two hundred and twenty-four Kuwaiti women in their first trimester were screened for IgG/IgM antibodies by the Vitek Immuno Diagnostic Assay System (VIDAS) and VIDAS IgG-avidity tests. On serological screening, 119 (53.1 %) women were positive for IgG antibodies and 31 (13.8 %) for IgM antibodies. Nine of the IgM-positive and 7 IgM-negative women had low-avidity antibodies. However, the IgG-avidity test detected low-avidity antibodies only in 9 (29 %) of the 31 IgM-positive women, suggesting a recent infection; 19 (61.3 %) women had high-avidity antibodies, indicating that the infection was acquired in the distant past. Based on IgM serology alone, at least 31 IgM-positive women may have been wrongly labelled as having acute infection thus warranting appropriate therapeutic intervention. All the 19 IgM-positive women with high-avidity antibodies were confirmed negative for DNA on PCR analysis. Compared with PCR analysis, the VIDAS avidity test was a helpful tool for the diagnosis of recent infection in IgM-negative women with low-avidity antibodies and IgM-positive women with high-avidity antibodies; the specificity was >85 –100 %. It is concluded that the VIDAS avidity test when used in combination with VIDAS IgG/IgM tests is a valuable assay for the exclusion of ongoing or recently acquired infection in pregnant women in their first trimester and that it decreases significantly the necessity for follow-up testing and unnecessary therapeutic intervention.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.47260-0
2007-11-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/56/11/1495.html?itemId=/content/journal/jmm/10.1099/jmm.0.47260-0&mimeType=html&fmt=ahah

References

  1. Akoijam B. S., Shashikant Singh S., Kapoor S. K. 2002; Seroprevalence of Toxoplasma infection among primigravid women attending antenatal clinic at a secondary level hospital in north India. J Indian Med Assoc 100:591–602
    [Google Scholar]
  2. Asthana S. P., Macpherson C. N., Weiss S. H., Stephens R., Denny T. N., Sharma R. N., Dubey J. P. 2006; Seroprevalence of Toxoplasma gondii in pregnant women and cats in Grenada, West Indies. J Parasitol 92:644–645 [CrossRef]
    [Google Scholar]
  3. Bahia-Oliveira L. M., Jones J. L., Azevedo-Silva J., Alves C. C., Orefice F., Addiss D. G. 2003; Highly endemic, waterborne toxoplasmosis in north Rio de Janeiro state. Brazil. Emerg Infect Dis 9:55–62 [CrossRef]
    [Google Scholar]
  4. Behbehani K., Al-Karmi T. 1980; Epidemiology of toxoplasmosis in Kuwait. Detection of antibodies to Toxoplasma gondii and percentage distribution among the inhabitants. Trans R Soc Trop Med Hyg 74:209–212 [CrossRef]
    [Google Scholar]
  5. Burg J. L., Grover C. M., Poulety P., Boothroyd J. C. 1989; Direct and sensitive detection of a pathogenic protozoan, Toxoplasma gondii by polymerase chain reaction. J Clin Microbiol 27:1787–1792
    [Google Scholar]
  6. Chabbert E., Lachaud L., Crobu L., Bastien P. 2004; Comparison of two widely used PCR primer systems for detection of Toxoplasma in amniotic fluid, blood, and tissues. J Clin Microbiol 42:1719–1722 [CrossRef]
    [Google Scholar]
  7. Emna S., Karim A., Mohammed K., Aida B. 2006; Difficulty in dating primary infections by Toxoplasma gondii in pregnant women in Tunisia. Tunis Med 84:85–87
    [Google Scholar]
  8. Gras L., Gilbert R. E., Wallon M., Peyron F., Cortina-Borja M. 2004; Duration of the IgM response in women acquiring Toxoplasma gondii during pregnancy: implications for clinical practices and cross sectional incidence studies. Epidemiol Infect 132:541–548 [CrossRef]
    [Google Scholar]
  9. Guy E. C., Joynson D. H. M. 1995; Potential of the polymerase chain reaction in the diagnosis of active Toxoplasma infection by detection of parasite in blood. J Infect Dis 172:319–322 [CrossRef]
    [Google Scholar]
  10. Lachaud L., Dereure J., Chabbert E., Reynes J., Mauboussin J. M., Oziol E., Dedet J. P., Bastien P. 2000; Optimized PCR using patient blood samples for diagnosis and follow-up of visceral leishmaniasis, with special reference to AIDS patients. J Clin Microbiol 38:236–240
    [Google Scholar]
  11. Lecolier B., Pucheu B. 1993; Intérêt de l'étude de l'avidité des IgG pour le diagnostic de la toxoplasmose. Pathol Biol 41:155–158
    [Google Scholar]
  12. Montoya J. G., Liesenfeld O., Kinney S., Press C., Remington J. S. 2002; VIDAS test for avidity of Toxoplasma -specific immunoglobulin G for confirmatory testing of pregnant women. J Clin Microbiol 40:2504–2508 [CrossRef]
    [Google Scholar]
  13. Petersen E., Borobio M. V., Guy E., Liesenfeld O., Meroni V., Naessens A., Spranzi E., Thulliez P. 2005; European multicenter study of the LIAISON automated diagnostic system for determination of Toxoplasma gondii -specific immunoglobulin G (IgG) and IgM and the IgG avidity index. J Clin Microbiol 43:1570–1574 [CrossRef]
    [Google Scholar]
  14. Press C., Montoya J. G., Remington J. S. 2005; Use of a single serum sample for diagnosis of acute toxoplasmosis in pregnant women and other adults. J Clin Microbiol 43:3481–3483 [CrossRef]
    [Google Scholar]
  15. Reis M. M., Tessaro M. M., D'Azevedo P. A. 2006; Toxoplasma -IgM and IgG-avidity in single samples from areas with a high infection rate can determine the risk of mother-to-child transmission. Rev Inst Med Trop Sao Paulo 48:93–98 [CrossRef]
    [Google Scholar]
  16. Singh S. 2003; Mother-to-child transmission and diagnosis of Toxoplasma gondii infection during pregnancy. Indian J Med Microbiol 21:69–76
    [Google Scholar]
  17. Singh S., Pandit A. J. 2004; Incidence and prevalence of toxoplasmosis in Indian pregnant women: a prospective study. Am J Reprod Immunol 52:276–283 [CrossRef]
    [Google Scholar]
  18. Slawska H., Czuba B., Gola J., Mazurek U., Wloch A., Wilczok T., Kaminski K. 2005; Diagnostic difficulties of Toxoplasma gondii infection in pregnant women. Is it possible to explain doubts by polymerase chain reaction?. Ginekol Pol 76:536–542
    [Google Scholar]
  19. Thiebaut R., Leproust S., Chene G., Gilbert R. 2007; Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data. SYROCOT (Systematic Review on Congenital Toxoplasmosis) Study Group. Lancet 369:115–122 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.47260-0
Loading
/content/journal/jmm/10.1099/jmm.0.47260-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error