Maternal Anti-Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate
Authors
Guegan, HeleneŠtajner, Tijana

Bobić, Branko

Press, Cindy
Olariu, Rares T.
Olson, Kjerstie
Srbljanović, Jelena

Montoya, Jose G.
Đurković-Đaković, Olgica

Robert-Gangneux, Florence

Article (Accepted Version)
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Neonatal diagnosis of congenital toxoplasmosis is based on a combination of serological and molecular tests. Maternal screening and treatment differ according to national policies and may impact the sensitivity of diagnostic methods in infants at birth. In this multicenter study, 115 neonates born to 61 treated (53%) and 54 (47%) untreated women were retrospectively included in three centers (France, Serbia, and the United States) to assess the impact of maternal anti-Toxoplasma treatment on the performance of neonatal workup at birth (neosynthesized anti-Toxoplasma IgM, IgA, and IgG and quantitative PCR [qPCR]) using univariate and multivariate approaches. Independently of the time of maternal seroconversion, the serological techniques were impacted differently by maternal treatment. The detection of IgM by immunosorbent agglutination assay (ISAGA) and Western blotting (WB) dropped from 90.7% and 88.2% in untreated neonates to 533% and 51.9% in treated neonates (P lt 0.05), whereas ...IgM enzyme-linked immunosorbent assay (ELISA) and IgA ISAGA were not significantly affected by maternal treatment. A 2-fold reduction in the sensitivity of neosynthesized IgG by WB was also observed in the case of treatment during pregnancy (37.7% versus 82.3%). Interestingly, the effect of treatment was shown to be duration dependent, especially for IgM detection, when the treatment course exceeded 8 weeks, whatever the therapy. The sensitivity of Toxoplasma PCR in blood was also lowered by maternal treatment from 39.1% to 23.2%. These results highlight that anti-Toxoplasma therapy during pregnancy may set back biological evidence of neonatal infection at birth and underline the need for a careful serological follow-up of infants with normal workup.
Keywords:
congenital toxoplasmosis / Toxoplasma gondii / serology / IgM / IgA / Western blot / maternal treatment / neonatal diagnosis / qPCRSource:
Journal of Clinical Microbiology, 2021, 59, 2Publisher:
- Amer Soc Microbiology, Washington
Funding / projects:
- Control of infections by Apicomplexan pathogens: from novel drug targets to prediction (RS-41019)
- Ministry of Education, Science and Technological Development, Republic of Serbia, Grant no. 200015 (University of Belgrade, Institute for Medical Research) (RS-200015)
- Campus France (PHC Pavle Savic) [40734WC, 451-03-01963/2017-09/15]
Note:
- This is the peer-reviewed version of the article: Guegan, H.; Štajner, T.; Bobić, B.; Press, C.; Olariu, R. T.; Olson, K.; Srbljanović, J.; Montoya, J. G.; Đurković-Đaković, O.; Robert-Gangneux, F. Maternal Anti-Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate. Journal of Clinical Microbiology 2021, 59 (2). https://doi.org/10.1128/JCM.01368-20
Related info:
- Version of
https://doi.org/10.1128/JCM.01368-20
DOI: 10.1128/JCM.01368-20
ISSN: 0095-1137
PubMed: 33208476
WoS: 000610235700009
Scopus: 2-s2.0-85099949164
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Institut za medicinska istraživanjaTY - JOUR AU - Guegan, Helene AU - Štajner, Tijana AU - Bobić, Branko AU - Press, Cindy AU - Olariu, Rares T. AU - Olson, Kjerstie AU - Srbljanović, Jelena AU - Montoya, Jose G. AU - Đurković-Đaković, Olgica AU - Robert-Gangneux, Florence PY - 2021 UR - http://rimi.imi.bg.ac.rs/handle/123456789/1129 AB - Neonatal diagnosis of congenital toxoplasmosis is based on a combination of serological and molecular tests. Maternal screening and treatment differ according to national policies and may impact the sensitivity of diagnostic methods in infants at birth. In this multicenter study, 115 neonates born to 61 treated (53%) and 54 (47%) untreated women were retrospectively included in three centers (France, Serbia, and the United States) to assess the impact of maternal anti-Toxoplasma treatment on the performance of neonatal workup at birth (neosynthesized anti-Toxoplasma IgM, IgA, and IgG and quantitative PCR [qPCR]) using univariate and multivariate approaches. Independently of the time of maternal seroconversion, the serological techniques were impacted differently by maternal treatment. The detection of IgM by immunosorbent agglutination assay (ISAGA) and Western blotting (WB) dropped from 90.7% and 88.2% in untreated neonates to 533% and 51.9% in treated neonates (P lt 0.05), whereas IgM enzyme-linked immunosorbent assay (ELISA) and IgA ISAGA were not significantly affected by maternal treatment. A 2-fold reduction in the sensitivity of neosynthesized IgG by WB was also observed in the case of treatment during pregnancy (37.7% versus 82.3%). Interestingly, the effect of treatment was shown to be duration dependent, especially for IgM detection, when the treatment course exceeded 8 weeks, whatever the therapy. The sensitivity of Toxoplasma PCR in blood was also lowered by maternal treatment from 39.1% to 23.2%. These results highlight that anti-Toxoplasma therapy during pregnancy may set back biological evidence of neonatal infection at birth and underline the need for a careful serological follow-up of infants with normal workup. PB - Amer Soc Microbiology, Washington T2 - Journal of Clinical Microbiology T1 - Maternal Anti-Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate IS - 2 VL - 59 DO - 10.1128/JCM.01368-20 ER -
@article{ author = "Guegan, Helene and Štajner, Tijana and Bobić, Branko and Press, Cindy and Olariu, Rares T. and Olson, Kjerstie and Srbljanović, Jelena and Montoya, Jose G. and Đurković-Đaković, Olgica and Robert-Gangneux, Florence", year = "2021", abstract = "Neonatal diagnosis of congenital toxoplasmosis is based on a combination of serological and molecular tests. Maternal screening and treatment differ according to national policies and may impact the sensitivity of diagnostic methods in infants at birth. In this multicenter study, 115 neonates born to 61 treated (53%) and 54 (47%) untreated women were retrospectively included in three centers (France, Serbia, and the United States) to assess the impact of maternal anti-Toxoplasma treatment on the performance of neonatal workup at birth (neosynthesized anti-Toxoplasma IgM, IgA, and IgG and quantitative PCR [qPCR]) using univariate and multivariate approaches. Independently of the time of maternal seroconversion, the serological techniques were impacted differently by maternal treatment. The detection of IgM by immunosorbent agglutination assay (ISAGA) and Western blotting (WB) dropped from 90.7% and 88.2% in untreated neonates to 533% and 51.9% in treated neonates (P lt 0.05), whereas IgM enzyme-linked immunosorbent assay (ELISA) and IgA ISAGA were not significantly affected by maternal treatment. A 2-fold reduction in the sensitivity of neosynthesized IgG by WB was also observed in the case of treatment during pregnancy (37.7% versus 82.3%). Interestingly, the effect of treatment was shown to be duration dependent, especially for IgM detection, when the treatment course exceeded 8 weeks, whatever the therapy. The sensitivity of Toxoplasma PCR in blood was also lowered by maternal treatment from 39.1% to 23.2%. These results highlight that anti-Toxoplasma therapy during pregnancy may set back biological evidence of neonatal infection at birth and underline the need for a careful serological follow-up of infants with normal workup.", publisher = "Amer Soc Microbiology, Washington", journal = "Journal of Clinical Microbiology", title = "Maternal Anti-Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate", number = "2", volume = "59", doi = "10.1128/JCM.01368-20" }
Guegan, H., Štajner, T., Bobić, B., Press, C., Olariu, R. T., Olson, K., Srbljanović, J., Montoya, J. G., Đurković-Đaković, O.,& Robert-Gangneux, F.. (2021). Maternal Anti-Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate. in Journal of Clinical Microbiology Amer Soc Microbiology, Washington., 59(2). https://doi.org/10.1128/JCM.01368-20
Guegan H, Štajner T, Bobić B, Press C, Olariu RT, Olson K, Srbljanović J, Montoya JG, Đurković-Đaković O, Robert-Gangneux F. Maternal Anti-Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate. in Journal of Clinical Microbiology. 2021;59(2). doi:10.1128/JCM.01368-20 .
Guegan, Helene, Štajner, Tijana, Bobić, Branko, Press, Cindy, Olariu, Rares T., Olson, Kjerstie, Srbljanović, Jelena, Montoya, Jose G., Đurković-Đaković, Olgica, Robert-Gangneux, Florence, "Maternal Anti-Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate" in Journal of Clinical Microbiology, 59, no. 2 (2021), https://doi.org/10.1128/JCM.01368-20 . .