Jaqueline Dario Capobiango

Factors associated with seropositivity for anti-Toxoplasma gondii antibodies in pregnant women of Londrina, Paraná, Brazil

The aim of this study was to evaluate associations between seropositivity for IgG and IgM anti-Toxoplasma gondii antibodies and socio-economic and environmental variables in pregnant women of Londrina, state of Paraná, Brazil. We interviewed 492 pregnant women, each of whom answered an epidemiological questionnaire, and collected blood samples for measurement of IgG and IgM anti-T. gondii antibodies by chemiluminescence. A confirmatory diagnosis of acute infection was made by an IgG avidity test. Titres of specific IgG anti-T. gondii were obtained by IFAT. Seropositivity for IgG anti-T. gondii antibodies was observed in 242 women (49.2%) and, of these, six pregnant women (1.2%) showed seropositivity for IgM. Age group, level of education, per capita income, presence of a cat in the house and a habit of eating green vegetables were all factors associated with a greater chance of infection with T. gondii. This study showed that 250 (50.8%) pregnant women were susceptible to T. gondii and considered to be at high risk for toxoplasmosis during pregnancy. Based on the results obtained, is critical to establish a program of health surveillance for toxoplasmosis, in order to contribute to diagnosis and early treatment during the prenatal period. It is also necessary to introduce measures to prevent the Toxoplasma infection in seronegative pregnant women.

Congenital toxoplasmosis in a reference center of Paraná, Southern Brazil

This study describes the characteristics of 31 children with congenital toxoplasmosis children admitted to the University Hospital of Londrina, Southern Brazil, from 2000 to 2010. In total, 23 (85.2%) of the mothers received prenatal care but only four (13.0%) were treated for toxoplasmosis. Birth weight was <2500g in 37.9% of the infants. During the first month of life, physical examination was normal in 34.5%, and for those with clinical signs and symptoms, the main manifestations were hepatomegaly and/or splenomegaly (62.1%), jaundice (13.8%), and microcephaly (6.9%). During ophthalmic examination, 74.2% of the children exhibited injuries, 58.1% chorioretinitis, 32.3% strabismus, 19.4% microphthalmia, and 16.2% vitreitis. Anti-Toxoplasma gondii IgM antibodies were detected in 48.3% of the children. Imaging brain evaluation was normal in 44.8%; brain calcifications, hydrocephaly, or both conditions were observed in 27.6%, 10.3%, and 17.2%, respectively, of the patients. Patients with cerebrospinal fluid protein≥200mg/dL presented more brain calcifications (p=0.0325). Other sequelae were visual impairment (55.2% of the cases), developmental delay (31.0%), motor deficit (13.8%), convulsion (27.5%), and attention deficit (10.3%). All patients were treated with sulfadiazine, pyrimethamine, and folinic acid, and 55.2% of them exhibited adverse effects. The results demonstrate the significance of the early diagnosis and treatment of toxoplasmosis during pregnancy to reduce congenital toxoplasmosis and its consequences.

Gestational toxoplasmosis in Paraná State, Brazil: prevalence of IgG antibodies and associated risk factors

The aim of the present study was to verify the association between seropositivity for IgG anti-Toxoplasma gondii antibodies and social, economic and environmental variables of pregnant women attending the public health centers of Paraná, Brazil. From January 2007 to July 2010, 2226 pregnant women were interviewed and detection of anti-T. gondii specific IgG and IgM antibodies was performed by chemiluminescence test. Seropositivity for anti-T. gondii IgG was observed in 1151 (51.7%) pregnant women, 29 of which (1.3%) presented IgM reagent with IgG of high avidity. The variables associated with the presence of IgG were residency in the rural area, more than one pregnancy, less than or equal to eight years schooling, low per capita income, age group, raw or poorly cooked meat ingestion, and contact with the soil. There was neither association with raw fruit and vegetable ingestion nor with the presence of cats in the residencies.

Evaluation of the Western blotting method for the diagnosis of congenital toxoplasmosis

OBJECTIVE To evaluate the Western blotting method for the detection of IgG anti-Toxoplasma gondii (T. gondii) (IgG-WB) in the serum of children with suspected congenital toxoplasmosis. METHODS We accompanied 47 mothers with acquired toxoplasmosis in pregnancy and their children, between June of 2011 and June of 2014. The IgG-WB was done in house and the test was considered positive if the child had antibodies that recognized at least one band on IgG blots different from the mothers or with greater intensity than the corresponding maternal band, during the first three months of life. RESULTS 15 children (15.1%) met the criteria for congenital toxoplasmosis and 32 (32.3%) had the diagnosis excluded. The symptoms were observed in 12 (80.0%) children and the most frequent were cerebral calcification in 9 (60.0%), chorioretinitis in 8 (53.3%), and hydrocephalus in 4 (26.6%). IgM antibodies anti-T. gondii detected by chemiluminescence (CL) were found in 6 (40.0%) children and the polymerase chain reaction (PCR) for detection of T. gondii DNA was positive in 5 of 7 performed (71.4%). The sensitivity of IgG-WB was of 60.0% [95% confidence interval (CI) 32.3-83.7%] and specificity 43.7% (95% CI 26.7-62.3%). The sensitivity of IgG-WB increased to 76.0 and 89.1% when associated to the research of IgM anti-T. gondii or PCR, respectively. CONCLUSIONS The IgG-WB showed greater sensitivity than the detection of IgM anti-T. gondii; therefore, it can be used for the diagnosis of congenital toxoplasmosis in association with other congenital infection markers.

Evaluation of a recombinant rhoptry protein 2 enzyme-linked immunoassay for the diagnosis of toxoplasmosis acquired during pregnancy

The aim of this study was to evaluate an enzyme-linked immunoassay with recombinant rhoptry protein 2 (ELISA-rROP2) for its ability to detectToxoplasma gondii ROP2-specific IgG in samples from pregnant women. The study included 236 samples that were divided into groups according to serological screening profiles for toxoplasmosis: unexposed (n = 65), probable acute infection (n = 48), possible acute infection (n = 58) and exposed to the parasite (n = 65). When an indirect immunofluorescence assay forT. gondii-specific IgG was considered as a reference test, the ELISA-rROP2 had a sensitivity of 61.8%, specificity of 62.8%, predictive positive value of 76.6% and predictive negative value of 45.4% (p = 0.0002). The ELISA-rROP2 reacted with 62.5% of the samples from pregnant women with probable acute infection and 40% of the samples from pregnant women with previous exposure (p = 0.0180). Seropositivity was observed in 50/57 (87.7%) pregnant women with possible infection. The results underscored that T. gondii rROP2 is recognised by specific IgG antibodies in both the acute and chronic phases of toxoplasmosis acquired during pregnancy. However, the sensitivity of the ELISA-rROP2 was higher in the pregnant women with probable and possible acute infections and IgM reactivity.

ACUTE TOXOPLASMOSIS IN A BREASTFED INFANT WITH POSSIBLE TRANSMISSION BY WATER.

Toxoplasma gondii transmission via breastfeeding has been discussed; however, no cases have been confirmed to date. This article describes a case of acute toxoplasmosis diagnosed in a mother and her six-month-old breastfed infant. The study accounts for the possibility of breast milk transmission and directs both clinicians and pediatricians to the hypothesis that both patients acquired toxoplasmosis via water ingestion.

Prevalence and antimicrobial susceptibility profile of Streptococcus agalactiae in pregnant women seen at the University Hospital of Londrina, Paraná, Brazil

1 Mestranda do Programa de Pós-Graduação em Microbiologia da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. Departamento de Microbiologia do Centro de Ciências Biológicas da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 2 Doutoranda em Microbiologia pela Universidade Estadual de Londrina, Londrina, Paraná, Brasil. Departamento de Microbiologia do Centro de Ciências Biológicas da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 3 Doutorado em Doenças Infecciosas e Parasitárias pela Universidade de São Paulo, São Paulo, Brasil. Professor associado do Laboratório de Análises Clínicas, Setor de Microbiologia do Hospital Universitário da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 4 Mestrado em Microbiologia pela Universidade Estadual de Londrina, Londrina, Paraná, Brasil. Departamento de Patologia, Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 5 Doutorado em Microbiologia pela Universidade Estadual de Londrina, Londrina, Paraná, Brasil. Professor adjunto do Departamento de Patologia, Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 6 Doutorado em Microbiologia pela Universidade Estadual de Londrina, Londrina, Paraná, Brasil. Departamento de Patologia, Análises Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 7 Doutorado em Educação pela Universidade Estadual Paulista Júlio de Mesquita Filho, Marília, São Paulo, Brasil. Departamento de Enfermagem, Centro de Ciências da Saúde da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 8 Doutorado em Microbiologia pela Universidade Estadual de Londrina, Londrina, Paraná, Brasil. Professor adjunto do Departamento de Enfermagem do Centro de Ciências da Saúde da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 9 Doutorado em Ciências da Saúde pela Universidade Estadual de Londrina, Londrina, Paraná, Brasil. Departamento de Clínica Médica do Centro de Ciências da Saúde da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 10 Doutorado em Imunologia Básica e Aplicada pela Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil. Departamento de Microbiologia do Centro de Ciências Biológicas da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. 11 Doutorado em Biologia Celular e Molecular pela Fundação Oswaldo Cruz, Curitiba, Paraná, Brasil. Departamento de Microbiologia do Centro de Ciências Biológicas da Universidade Estadual de Londrina, Londrina, Paraná, Brasil. E-mail: ogatta@uel.br DOI: 10.5433/1679-0367.2018v39n1p77 Um estudo retrospectivo foi realizado com gestantes atendidas no Hospital Universitário de Londrina, Paraná, Brasil para determinar a prevalência de colonização vaginal-retal por estreptococos do Grupo B (EGB) e o perfil de sensibilidade de EGB aos antimicrobianos utilizados para a antibioticoterapia profilática intraparto. Swabs vaginais-retais foram coletados de 2.901 mulheres entre a 35a e 37a semana de gestação. Destes, 527 (18,2%) apresentaram cultura positiva para EGB, e 0,4%, 10,2% e 10% dos ARTIGOS / ARTICLES C ÊN C AS IO LÓ G IC AS E D A AÚ D E A retrospective study of pregnant women seen at the University Hospital of Londrina, Paraná, Brazil was performed to determine the prevalence of Group B Streptococcus (GBS) vaginal-rectal colonization, and the GBS susceptibility for antimicrobials used in intrapartum antibiotic prophylaxis. A vaginal-rectal swab was collected from 2,901 women between 35 and 37 weeks of gestation. Of these, 527 (18.2%) had a positive culture for GBS, and 0.4%, 10.2% and 10% of the isolates were resistant to penicillin, erythromycin and clindamycin, respectively. These results highlight the importance of continuous surveillance of GBS colonization in pregnant women for preventing GBS infections in neonates. Resumo

Toxoplasmose adquirida na gestação e toxoplasmose congênita: uma abordagem prática na notificação da doença

OBJETIVO: relatar la experiencia de implementacion de la notificacion de toxoplasmosis durante el embarazo y toxoplasmosis congenita en una Unidad Centinela (US) y describir los casos reportados. METODOS: se realizo un estudio descriptivo, mediante la creacion de un flujo de notificacion y un registro de notificacion especifica para los casos sospechosos de toxoplasmosis en mujeres embarazadas y toxoplasmosis congenita en un centro de referencia en el estado de Parana, Brasil, de agosto 2013 a agosto 2014. RESULTADOS: todos los 64 casos sospechososfueron notificados y la investigacion se complemento por elNucleo de Epidemiologia del US; de estos63 recibieron atencion prenatal y 51 recibieron tratamiento durante el embarazo; entre los ninos seguidos ambulatoriamente, 7 fueron diagnosticados con toxoplasmosis congenita confirmada. CONCLUSION: la puesta en practica de la notificacion de toxoplasmosis proporciono datos epidemiologicos, clinicos y de diagnostico de la enfermedad que contribuyeron a la evaluacion de la evolucion clinica de los ninos expuestos al Toxoplasma gondii.OBJECTIVE to demonstrate the experience of implanting toxoplasmosis notification during pregnancy and congenital toxoplasmosis in a Sentinel Unit (SU) and describe reported cases. METHODS this was a descriptive study of the implantation of a notification protocol using a specific notification form for suspected cases of toxoplasmosis in pregnant women and congenital toxoplasmosis in a reference center in Paraná State, Brazil, from August 2013 to August 2014. RESULTS all 64 suspected cases were notified and case investigation was completed by the SU Epidemiology Sector; 63 received prenatal care and 51 received treatment during pregnancy; 7 of the children being clinically monitored had confirmed diagnosis of congenital toxoplasmosis. CONCLUSION implanting toxoplasmosis notification afforded epidemiological, clinical and diagnostic data on the disease that contributed to the assessment of the clinical evolution of children exposed to Toxoplasma gondii.