EARLY DIAGNOSIS OF CONGENITAL TRYPANOSOMA CRUZI INFECTION USING PCR, HEMOCULTURE, AND CAPILLARY CONCENTRATION, AS COMPARED WITH DELAYED SEROLOGY

• Published in: The Journal of parasitology Vol. 91; no. 6; pp. 1468 - 1473
• Main Authors: Mora, María Celia, Negrette, Olga Sanchez, Marco, Diego, Barrio, Alejandra, Ciaccio, Mirella, Segura, María Asunción, Basombrío, Miguel A
• Format: Journal Article
• Language: English
• Published: Lawrence, KS American Society of Parasitologists 01.12.2005; Allen Press Inc
• Subjects: Animals; Antibodies; Antibodies, Protozoan - blood; Biological and medical sciences; Blood; Chagas disease; Chagas Disease - congenital; Chagas Disease - diagnosis; Congenital diseases; Congenital infection; DNA, Protozoan - blood; Enzyme-Linked Immunosorbent Assay; False Negative Reactions; Fetal Blood - parasitology; Fundamental and applied biological sciences. Psychology; General aspects; General aspects and techniques. Study of several systematic groups. Models; Hematocrit; Humans; Infant, Newborn; Infants; Infections; Invertebrates; Laboratories; Methods; Mothers; Neonates; Parasitemia - parasitology; Parasites; Parasitism; Parasitology; Polymerase chain reaction; Polymerase Chain Reaction - methods; Predictive Value of Tests; Protozoa; Public health; Sensitivity and Specificity; Serology; THERAPEUTICS-DIAGNOSTICS; Trypanosoma cruzi - genetics; Trypanosoma cruzi - immunology; Trypanosoma cruzi - isolation & purification; Argentina; Kinetoplastida; Infection; Polymerase chain reaction; Protozoa; Congenital; Parasite; Serology; Diagnosis; Trypanosoma cruzi
• ISSN: 0022-3395; 1937-2345
• DOI: 10.1645/GE-549R.1

Congenital Trypanosoma cruzi infection is a highly pathogenic and underreported condition. Early recognition is essential for effective treatment. Umbilical chord blood from newborns (n = 302) to infected mothers was analyzed with microhematocrit, hemoculture, and PCR methods. Each subject was then followed serologically. In calibrated suspensions of T. cruzi in blood, the sensitivity of PCR was 27-fold higher than hemoculture. However, this advantage was not reflected during routine testing of samples from maternities, partly because of the uneven distribution of few parasites in small samples. Levels of detection of congenital infection were 2.9% (8/272) for microhematocrit, 6.3% (18/287) for hemoculture, 6.4% (15/235) for PCR, and 8.9% (27/302) for cumulated results. Evaluation against the standard of delayed serology indicates that the regular application of PCR, hemoculture, and microhematocrit to blood samples allows the rapid detection of about 90% of the congenitally infected newborns, in samples that can be obtained before the mother and child leave the maternity ward.