Strategy for Diagnosis of Congenital Toxoplasmosis: Evaluation of Methods Comparing Mothers and Newborns and Standard Methods for Postnatal Detection of Immunoglobulin G, M, and A Antibodies

doi:10.1128/JCM.39.6.2267-2271.2001

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Journal of Clinical Microbiology, June 2001, p. 2267-2271, Vol. 39, No. 6
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.6.2267-2271.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Strategy for Diagnosis of Congenital Toxoplasmosis: Evaluation of Methods Comparing Mothers and Newborns and Standard Methods for Postnatal Detection of Immunoglobulin G, M, and A Antibodies

J. M. Pinon,¹ H. Dumon,² C. Chemla,¹ J. Franck,² E. Petersen,³ M. Lebech,⁴ J. Zufferey,⁵ M.-H. Bessieres,⁶ P. Marty,⁷ R. Holliman,⁸ J. Johnson,⁸ V. Luyasu,⁹ B. Lecolier,¹⁰ E. Guy,¹¹ D. H. M. Joynson,¹¹ A. Decoster,¹² G. Enders,¹³ H. Pelloux,¹⁴ and E. Candolfi¹⁵^,^*

Service de Parasitologie-Mycologie, CHU Hôpital Maison Blanche, UPRES EA 2070, IFR53, 51092, Reims,¹ Service de Parasitologie-Mycologie, Groupe Hospitalier de la Timone, 13385, Marseille,² Laboratoire de Parasitologie-Mycologie, CHU Rangueil, 31054, Toulouse,⁶ Laboratoire de Parasitologie-Mycologie, Hôpital de I'Archet, 06202, Nice,⁷ Laboratoires d'analyses de Biologie Médicale Levy, 75014 Paris,¹⁰ Laboratoire de Microbiologie, CH Saint Philibert, 59462, Lomme,¹² Service de Parasitologie-Mycologie, CHU A. Michallon, 38043, Grenoble,¹⁴ and Institut de Parasitologie et de Pathologie Tropicale, INSERM U 392, 67000, Strasbourg,¹⁵ France; Staten Serum Institut 5 Artillerivej, 2300 Copenhagen,³ and Department of Gynecology and Obstetrics, University Hospital Hvidovre, 2650 Copenhagen,⁴ Denmark; Institut de Microbiologie, 1011 Lausanne, Switzerland⁵; Department of Medical Microbiology, St. George's Hospital, London,⁸ and Public Health Laboratory, Singleton Hospital, Swansea SA2 80A,¹¹ United Kingdom; Clinique ParaUnivers Saint Pierre, 1340 Ottignies, Belgium⁹; and Institut für Virologie, Infektiologie und Epidemiologie, 70193 Stuttgart, Germany¹³

Received 15 December 2000/Returned for modification 1 February 2001/Accepted 2 April 2001

In a study involving 14 laboratories supported by the European Community Biomed 2 program, we evaluated immunologic methodsfor the postnatal diagnosis of congenital toxoplasmosis (CT).Among babies born to mothers who seroconverted to positivity fortoxoplasmosis during pregnancy, we analyzed 55 babies with CTon the basis of persistent anti-Toxoplasma immunoglobulin G (IgG)at 1 year of life and 50 control babies without anti-ToxoplasmaIgG at 1 year of life in the absence of curative treatment withpyrimethamine-sulfonamides. We tested in-house methods such asthe enzyme-linked immunofiltration assay (ELIFA) or Immunoblotting(IB) for the detection of IgG or IgM; these methods allowed comparisonof the immunologic profiles of the mothers and the infants. Wecompared ELIFA and IB with a commercial enzyme immunoassay (EIA)or in-house immunosorbent agglutination assay (ISAGA) for thedetection of IgM or IgA. The performances of combinations of methodswere also assessed. A cumulative sensitivity of 98% during a 1-yearfollow-up was obtained with the ELIFA plus ISAGA combination.Only one case of CT was missed by the ELIFA plus ISAGA combination,whereas three cases were missed by the IB plus ISAGA combination,even though 48% of patients with CT were treated with pyrimethamine-sulfonamides,which are known to inhibit antibody neosynthesis. A similar performancewas obtained with either ELIFA or IB in combination with EIA.The difference in performance between ELIFA plus ISAGA and IBplus ISAGA was not statistically significant (P = 0.31), and weconclude that both combinations of tests can be used for the diagnosisof CT innewborns.

^* Corresponding author. Mailing address: Institut de Parasitologie et de Pathologie Tropicale, INSERM U 392, 3 rue Koeberle,67000, Strasbourg, France. Phone: 00 33 (0) 388 35 35 55. Fax:00 33 (0) 388 36 42 02. E-mail: ermanno.candolfi{at}medecine.u-strasbg.fr.

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