Will we miss specific IgA detection for the diagnosis of congenital toxoplasmosis? A French retrospective monocenter study on 483 infants.

IF 5.4 2区 医学 Q1 MICROBIOLOGY
Journal of Clinical Microbiology Pub Date : 2025-09-10 Epub Date: 2025-08-11 DOI:10.1128/jcm.00379-25
Lya Hamet, Hélène Guegan, Sorya Belaz, Jean-Pierre Gangneux, Florence Robert-Gangneux
{"title":"Will we miss specific IgA detection for the diagnosis of congenital toxoplasmosis? A French retrospective monocenter study on 483 infants.","authors":"Lya Hamet, Hélène Guegan, Sorya Belaz, Jean-Pierre Gangneux, Florence Robert-Gangneux","doi":"10.1128/jcm.00379-25","DOIUrl":null,"url":null,"abstract":"<p><p>To estimate the performance of anti-<i>Toxoplasma</i> IgA assay for the diagnosis of congenital toxoplasmosis, a retrospective monocenter study was conducted comparing serological results obtained in the framework of routine diagnosis workup. All infants born to mothers infected with <i>Toxoplasma gondii</i> during pregnancy from 2010 to 2023 with at least 6 months of serological follow-up were included. Four hundred and eighty-three cases (1,171 sera) were included, of which 56 infants (11.6%) were infected. Twenty out of 60 infants (33.3%) with positive IgA were not infected. The sensitivity to detect IgA antibodies in infected neonates was 71.4%. The specificity was 97.3%. The mean time to detect IgA was 7.7 ± 13.0 days in infected neonates. Anti-<i>Toxoplasma</i> IgA was the earliest positive serological test in only two cases (5.0%) but turned negative at 1 month in the absence of specific treatment, suggesting non-specific detection. IgA was associated with anti-<i>Toxoplasma</i> IgM, neosynthetized IgG or IgM on comparative Western blotting (WB), or both IgM and neosynthetized IgG or IgM on WB, in 12 cases (30.0%), 2 cases (5.0%), and 19 cases (47.5%), respectively. Sixteen infants with no IgA after birth were diagnosed via neosynthetized IgG or IgM on comparative WB and/or IgM (<i>n</i> = 10), or via PCR on amniotic fluid (<i>n</i> = 5), or persistent IgG (<i>n</i> = 1). Our study suggests that anti-<i>Toxoplasma</i> IgA is not a critical serological parameter for the diagnosis of congenital toxoplasmosis, and the recent withdrawal of commercialized reference anti-<i>Toxoplasma</i> IgA assays should not affect patient care.IMPORTANCEThis study will help clinical microbiologists estimate the impact of the withdrawal of anti-<i>Toxoplasma</i> IgA reference assays for the diagnosis of congenital toxoplasmosis and will contribute to actualize the recommendations for laboratory diagnosis.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0037925"},"PeriodicalIF":5.4000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421870/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Microbiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1128/jcm.00379-25","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/11 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

To estimate the performance of anti-Toxoplasma IgA assay for the diagnosis of congenital toxoplasmosis, a retrospective monocenter study was conducted comparing serological results obtained in the framework of routine diagnosis workup. All infants born to mothers infected with Toxoplasma gondii during pregnancy from 2010 to 2023 with at least 6 months of serological follow-up were included. Four hundred and eighty-three cases (1,171 sera) were included, of which 56 infants (11.6%) were infected. Twenty out of 60 infants (33.3%) with positive IgA were not infected. The sensitivity to detect IgA antibodies in infected neonates was 71.4%. The specificity was 97.3%. The mean time to detect IgA was 7.7 ± 13.0 days in infected neonates. Anti-Toxoplasma IgA was the earliest positive serological test in only two cases (5.0%) but turned negative at 1 month in the absence of specific treatment, suggesting non-specific detection. IgA was associated with anti-Toxoplasma IgM, neosynthetized IgG or IgM on comparative Western blotting (WB), or both IgM and neosynthetized IgG or IgM on WB, in 12 cases (30.0%), 2 cases (5.0%), and 19 cases (47.5%), respectively. Sixteen infants with no IgA after birth were diagnosed via neosynthetized IgG or IgM on comparative WB and/or IgM (n = 10), or via PCR on amniotic fluid (n = 5), or persistent IgG (n = 1). Our study suggests that anti-Toxoplasma IgA is not a critical serological parameter for the diagnosis of congenital toxoplasmosis, and the recent withdrawal of commercialized reference anti-Toxoplasma IgA assays should not affect patient care.IMPORTANCEThis study will help clinical microbiologists estimate the impact of the withdrawal of anti-Toxoplasma IgA reference assays for the diagnosis of congenital toxoplasmosis and will contribute to actualize the recommendations for laboratory diagnosis.

Abstract Image

Abstract Image

Abstract Image

在先天性弓形虫病的诊断中,我们会错过特异性的IgA检测吗?法国对483名婴儿的回顾性单中心研究。
为了评估抗弓形虫IgA检测对先天性弓形虫病的诊断价值,我们采用回顾性单中心研究,比较常规诊断检查框架下的血清学结果。所有在2010年至2023年怀孕期间感染刚地弓形虫的母亲所生的婴儿均纳入研究,并进行了至少6个月的血清学随访。包括483例(1171例血清),其中56名婴儿(11.6%)被感染。60例IgA阳性婴儿中有20例(33.3%)未感染。对感染新生儿IgA抗体的检测灵敏度为71.4%。特异性为97.3%。感染新生儿IgA检测平均时间为7.7±13.0天。抗弓形虫IgA血清学检测最早阳性的仅有2例(5.0%),但在未进行特异性治疗的情况下,1个月后转为阴性,提示未进行特异性检测。IgA与抗弓形虫IgM、WB新合成IgG或IgM、WB上IgM和新合成IgG或IgM均相关的病例分别为12例(30.0%)、2例(5.0%)和19例(47.5%)。16名出生后无IgA的婴儿通过比较WB和/或IgM的新合成IgG或IgM (n = 10),或羊水的PCR (n = 5)或持续IgG (n = 1)进行诊断。我们的研究表明,抗弓形虫IgA不是先天性弓形虫病诊断的关键血清学参数,最近商业化的参考抗弓形虫IgA检测的退出应该不会影响患者的护理。本研究将帮助临床微生物学家评估取消抗弓形虫IgA参考检测对先天性弓形虫病诊断的影响,并将有助于实现实验室诊断的建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Clinical Microbiology
Journal of Clinical Microbiology 医学-微生物学
CiteScore
17.10
自引率
4.30%
发文量
347
审稿时长
3 months
期刊介绍: The Journal of Clinical Microbiology® disseminates the latest research concerning the laboratory diagnosis of human and animal infections, along with the laboratory's role in epidemiology and the management of infectious diseases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信