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A Genetic Screen to Isolate Toxoplasma gondii Host-cell Egress Mutants
Published on: February 8, 2012
Evaluation of serological prenatal screening to detect Toxoplasma gondii infections in Austria
Andrea-Romana Prusa1, David C Kasper, Monika Olischar
1Division of Pediatric Neonatology, Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria.
Insights
Adding maternal and fetal cord blood testing at birth significantly improves congenital toxoplasmosis detection. This enhances prenatal screening accuracy for Toxoplasma gondii infection, benefiting infant outcomes.
Area of Science:
- Medical Research
- Infectious Diseases
- Public Health
Background:
- Austria implemented national prenatal congenital toxoplasmosis screening in 1974 due to high infant infection rates (7.8 per 1,000).
- Early detection and treatment of maternal and infant toxoplasmosis are crucial for improving outcomes.
Purpose of the Study:
- To evaluate the effectiveness of additional maternal and fetal cord blood serology at birth in enhancing congenital toxoplasmosis detection.
- To assess the impact of combined testing strategies on current prenatal screening protocols.
Main Methods:
- A prospective observational study involving 5,545 women over 19 months.
- Routine prenatal maternal toxoplasmosis serology was combined with fetal cord blood serology (Sabin-Feldman dye and IgM immunosorbent agglutination assay) at delivery.
Main Results:
- Of 5,545 women, 1,830 (33.0%) showed prior chronic infection, and 3,708 (66.9%) were uninfected.
- Seven cases (0.13%) of acute toxoplasmosis were diagnosed via seroconversion; 4 involved transmission.
- Routine prenatal screening identified only 2 acute infections, while additional cord blood testing identified 5 more women with potential fetal infection.
Conclusions:
- Maternal and fetal serological testing at birth significantly enhances the identification of Toxoplasma gondii infection.
- Integrating cord blood testing into screening programs improves the detection rate of congenital toxoplasmosis.
Background:
In Austria, a nationally mandated prenatal serological congenital toxoplasmosis screening program was introduced in 1974 in response to a high incidence of 7.8 per 1,000 infected infants. Maternal prenatal recognition of acute gestational infection and early treatment of infants with congenital infection are important because prenatal and accurate postnatal antibiotic therapy improves the outcomes of infected infants.
Objective:
To determine the impact of additional maternal and/or fetal cord blood serology at birth on improving current prenatal maternal screening in detecting congenital toxoplasmosis.
Methods:
In this prospective observational study, 5,545 consecutive women were included over a 19-month period. Routine prenatal maternal toxoplasmosis serology screening was performed along with additional cord blood serology screening at delivery. Fetal cord blood serology included Sabin-Feldman dye and IgM immunosorbent agglutination assay testing.
Results:
Based on the initial prenatal maternal screening serology results, there was evidence of a prior chronic infection manifest in 1,830 (33.0%) women and 3,708 (66.9%) were not infected. Seven (0.13%) were diagnosed with acute toxoplasma infection based on seroconversion. Of these, 4 manifested transmission, and 3 did not. Of the seven infected women, routine prenatal maternal screening identified acute infection in only 2 of the women, 1 of whom had an infected fetus with abnormal prenatal ultrasound. Fetal cord blood serology screening identified an additional 5 women, 3 with infected fetuses.
Conclusions:
Identification of Toxoplasma gondii infection by prenatal maternal serological testing is significantly improved by the addition of maternal and/or fetal serological testing at birth.