The performance of four molecular methods for the laboratory diagnosis of congenital toxoplasmosis in amniotic fluid samples

Introduction Toxoplasmosis may be life-threatening in fetuses and in immune-deficient patients. Conventional laboratory diagnosis of toxoplasmosis is based on the presence of IgM and IgG anti-Toxoplasma gondii antibodies; however, molecular techniques have emerged as alternative tools due to their increased sensitivity. The aim of this study was to compare the performance of 4 PCR-based methods for the laboratory diagnosis of toxoplasmosis. One hundred pregnant women who seroconverted during pregnancy were included in the study. The definition of cases was based on a 12-month follow-up of the infants. Methods Amniotic fluid samples were submitted to DNA extraction and amplification by the following 4 Toxoplasma techniques performed with parasite B1 gene primers: conventional PCR, nested-PCR, multiplex-nested-PCR, and real-time PCR. Seven parameters were analyzed, sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and efficiency (Ef). Results Fifty-nine of the 100 infants had toxoplasmosis; 42 (71.2%) had IgM antibodies at birth but were asymptomatic, and the remaining 17 cases had non-detectable IgM antibodies but high IgG antibody titers that were associated with retinochoroiditis in 8 (13.5%) cases, abnormal cranial ultrasound in 5 (8.5%) cases, and signs/symptoms suggestive of infection in 4 (6.8%) cases. The conventional PCR assay detected 50 cases (9 false-negatives), nested-PCR detected 58 cases (1 false-negative and 4 false-positives), multiplex-nested-PCR detected 57 cases (2 false-negatives), and real-time-PCR detected 58 cases (1 false-negative). Conclusions The real-time PCR assay was the best-performing technique based on the parameters of Se (98.3%), Sp (100%), PPV (100%), NPV (97.6%), PLR (â^ž), NLR (0.017), and Ef (99%).

APPLICABILITY OF kDNA-PCR FOR ROUTINE DIAGNOSIS OF AMERICAN TEGUMENTARY LEISHMANIASIS IN A TERTIARY REFERENCE HOSPITAL.

This study evaluated the applicability of kDNA-PCR as a prospective routine diagnosis method for American tegumentary leishmaniasis (ATL) in patients from the Instituto de Infectologia Emílio Ribas (IIER), a reference center for infectious diseases in São Paulo - SP, Brazil. The kDNA-PCR method detected Leishmania DNA in 87.5% (112/128) of the clinically suspected ATL patients, while the traditional methods demonstrated the following percentages of positivity: 62.8% (49/78) for the Montenegro skin test, 61.8% (47/76) for direct investigation, and 19.3% (22/114) for in vitro culture. The molecular method was able to confirm the disease in samples considered negative or inconclusive by traditional laboratory methods, contributing to the final clinical diagnosis and therapy of ATL in this hospital. Thus, we strongly recommend the inclusion of kDNA-PCR amplification as an alternative diagnostic method for ATL, suggesting a new algorithm routine to be followed to help the diagnosis and treatment of ATL in IIER.

USEFULNESS OF kDNA PCR IN THE DIAGNOSIS OF VISCERAL LEISHMANIASIS REACTIVATION IN CO-INFECTED PATIENTS

It is important to develop new methods for diagnosing relapses in the co-infection of visceral leishmaniasis (VL) and HIV to enable earlier detection using less invasive methods. We report a case of a co-infected patient who had relapses after VL treatment, where the qualitative kDNA PCR showed a good performance. The kDNA PCR seems to be a useful tool for diagnosing VL and may be a good marker for predicting VL relapses after treatment of co-infected patients with clinical symptoms of the disease.

Comparison of flow cytometry and indirect immunofluorescence assay in the diagnosis and cure criterion after therapy of American tegumentary leishmaniasis by anti-live Leishmania (Viannia) braziliensis immunoglobulin G

The aim of this study was to compare the techniques of indirect immunofluorescence assay (IFA) and flow cytometry to clinical and laboratorial evaluation of patients before and after clinical cure and to evaluate the applicability of flow cytometry in post-therapeutic monitoring of patients with American tegumentary leishmaniasis (ATL). Sera from 14 patients before treatment (BT), 13 patients 1 year after treatment (AT), 10 patients 2 and 5 years AT were evaluated. The results from flow cytometry were expressed as levels of IgG reactivity, based on the percentage of positive fluorescent parasites (PPFP). The 1:256 sample dilution allowed us to differentiate individuals BT and AT. Comparative analysis of IFA and flow cytometry by ROC (receiver operating characteristic curve) showed, respectively, AUC (area under curve) = 0.8 (95% CI = 0.64–0.89) and AUC = 0.90 (95% CI = 0.75–0.95), demonstrating that the flow cytometry had equivalent accuracy. Our data demonstrated that 20% was the best cut-off point identified by the ROC curve for the flow cytometry assay. This test showed a sensitivity of 86% and specificity of 77% while the IFA had a sensitivity of 78% and specificity of 85%. The after-treatment screening, through comparative analysis of the technique performance indexes, 1, 2 and 5 years AT, showed an equal performance of the flow cytometry compared with the IFA. However, flow cytometry shows to be a better diagnostic alternative when applied to the study of ATL in the cure criterion. The information obtained in this work opens perspectives to monitor cure after treatment of ATL.

Diagnosis of rabies and eastern and western equine viral encephalitides in equids by multiplex Hemi-Nested RT-PCR technique

Financial support: CNPq and Pasteur Institute of São Paulo

Diagnosis de la pesquería artesanal en el Puerto de Mogán (Gran Canaria)

Máster en Gestión Costera

Regional and temporal variability of sinking organic matter in the subtropical northeast Atlantic Ocean: a biomarker diagnosis

Sinking particles through the pelagic ocean have been traditionally considered the most important vehicle by which the biological pump sequesters carbon in the ocean interior. Nevertheless, regional scale variability in particle flux is a major outstanding issue in oceanography. 5 Here, we have studied the regional and temporal variability of total particulate organic matter fluxes, as well as chloropigment and total hydrolyzed amino acid (THAA) compositions and fluxes in the Canary Current region, between 20–30 N, during two contrasting periods: August 2006, characterized by warm and stratified waters, but also intense winds which enhanced eddy development south of the Canary Islands, 10 and February 2007, characterized by colder waters, less stratification and higher productivity. We found that the eddy-field generated south of the Canary Islands enhanced by >2 times particulate organic carbon (POC) export with respect to stations (FF; farfield) outside the eddy-field influence. We also observed flux increases of one order of magnitude in chloropigment and 70% in THAA in the eddy-field relative to FF stations. 15 Principal Components Analysis (PCA) was performed to assess changes in particulate organic matter composition between stations. At eddy-field stations, higher chlorophyll enrichment reflected “fresher” material, while at FF stations a higher proportion of pheophytin indicated greater degradation due to microbes and microzooplankton. PCA also suggests that phytoplankton community structure, particularly the dominance of 20 diatoms versus carbonate-rich plankton, is the major factor influencing the POC export within the eddy field. In February, POC export fluxes were the highest ever reported for this area, reaching values of 15 mmolCm−2 d−1 at 200m depth. Compositional changes in pigments and THAA indicate that the source of sinking particles varies zonally and meridionally and suggest that sinking particles were more degraded at 25 near-coastal stations relative to open ocean stations.

Algoritmos genéticos aplicados a la diagnosis espectroscópica en plasmas de fusión

Este trabajo expone el desarrollo de un método basado en algoritmos genéticos para realizar diagnosis espectroscópica de plasmas de interés en el área de la fusión nuclear por confinamiento inercial.

Regional and temporal variability of sinking organic matter in the subtropical northeast Atlantic Ocean: A biomarker diagnosis

[EN] Sinking particles through the pelagic ocean have been traditionally considered the most important vehicle by which the biological pump sequesters carbon in the ocean interior. Nevertheless, regional scale variability in particle flux is a major outstanding issue in oceanography. Here, we have studied the regional and temporal variability of total particulate organic matter fluxes, as well as chloropigment and total hydrolyzed amino acid (THAA) compositions and fluxes in the Canary Current region, between 20?30_ N, during two contrasting periods: August 2006, characterized by warm and stratified waters, but also intense winds which enhanced eddy development south of the Canary Islands, and February 2007, characterized by colder waters, less stratification and higher productivity. We found that the eddyfield generated south of the Canary Islands enhanced by >2 times particulate organic carbon (POC) export with respect to stations (FF; far-field) outside the eddy-field influence. We also observed flux increases of one order of magnitude in chloropigment and 2 times in THAA in the eddy-field relative to FF stations. Principal Components Analysis (PCA) was performed to assess changes in particulate organic matter composition between stations. At eddy-field stations, higher chlorophyll enrichment reflected ?fresher? material, while at FF stations a higher proportion of pheophytin indicated greater degradation due to microbes and microzooplankton. PCA also suggests that phytoplankton community structure, particularly the dominance of diatoms versus carbonate-rich plankton, is the major factor influencing the POC export within the eddy field. In February, POC export POC export within the eddy field. In February, POC export fluxes were the highest ever reported for this area, reaching values of _15 mmolCm?2 d?1 at 200m depth. Compositional changes in pigments and THAA indicate that the source of sinking particles varies zonally and meridionally and suggest that sinking particles were more degraded at near-coastal stations relative to open ocean stations.