In Italy, screening for pregnant toxoplasmosis, although not mandatory, is expected and recommended by the 2010/11 physiological pregnancy guidelines. The NHS provides a first test for the measurement of anti-Toxoplasma IgG and IgM antibodies at the beginning of pregnancy and a monthly follow-up for free seronegative pregnants because over the years numerous studies have demonstrated the effectiveness of screening (mandatory in France and Austria). On the other hand, the decrease in seroprevalence of infection in pregnant women registered anywhere in Europe has questioned the cost-benefit ratio of screening itself. With this study we wanted to evaluate the diagnostic efficacy of a new rapid test (TOXOPLASMA ICT IgG-IgM LDBIO Diagnostic Lyon France) to be performed on whole blood taken by finger puncture. This test could become an alternative to the tests used in routine with the authorization of the ethics committee of the Polycyclic IRCCS San Matteo (Pavia). To the pregnant women belonging to the single withdrawals center and to the clinic of the Infectious Diseases Clinic of the IRCCS Policlinico San Matteo Pavia Foundation for the screening of toxoplasmosis, a drop of blood was suggested from the finger for the rapid test. At the same time they were subjected to the Routine exam (IgG-IgM and possibly IgG Avidity Diasorin, Elfa IgG and IgG avidity, Isaga IgM-Biomerieux, Mercy l'Etoile France). To date, 70 patients out of the 270 patients have been evaluated to define the specificity and sensitivity of the test. 25 were positive and the positivity was confirmed by routine tests. Of the negative tests in 4 cases the result of routine tests was positive. In 4 cases the test was considered invalid, but repeated gave a correct result. 8 patients refused to perform the test. These preliminary data suggest that the use of the rapid test can be an alternative to traditional tests for ease of execution, rapid response, reduced cost. The test is easily accepted by the patients, but must always be supported in cases of positivity from routine tests able to discriminate the different antibody classes.
In Italia lo screening per la toxoplasmosi in gravidanza anche se non obbligatorio è previsto e consigliato dalle linee guida per la gravidanza fisiologica del 2010/11. Il SSN prevede un primo test per il dosaggio degli anticorpi IgG e IgM anti-Toxoplasma all’inizio della gravidanza e un follow-up mensile per le gravide sieronegative gratuiti poiché nel corso degli anni numerosi studi hanno dimostrato l’efficacia dello screening (obbligatorio in Francia e in Austria). D’altra parte la diminuzione della sieroprevalenza dell’infezione nelle gravide registrata ovunque in Europa, ha messo in discussione il rapporto costo beneficio dello screening stesso. Con questo studio abbiamo voluto valutare l’efficacia diagnostica di un nuovo test rapido (TOXOPLASMA ICT IgG-IgM LDBIO Diagnostic Lyon France) da effettuare sul sangue intero prelevato mediante puntura del dito. Tale test potrebbe diventare un’alternativa ai test utilizzati in routine previa autorizzazione del comitato etico dell’IRCCS policlinico San Matteo (Pavia) Alle Gravide afferenti al centro unico prelievi e all’Ambulatorio della Clinica di Malattie Infettive della fondazione IRCCS Policlinico San Matteo Pavia per lo screening della toxoplasmosi è stato proposto il prelievo di una goccia di sangue dal dito per l’esecuzione del test rapido. Contestualmente sono state sottoposte al prelievo per gli esami di Routine (IgG –IgM e eventualmente IgG Avidity Diasorin , Elfa IgG e IgG avidity , Isaga IgM –Biomerieux , Mercy l’Etoile France) Ad oggi sono state valutate 70 pazienti delle 270 necessarie per definire la specificità e sensibilità del test. 25 sono risultate positive e la positività è stata confermata dai test di routine. Dei test negativi in 4 casi il risultato dei test di routine era positivo. In 4 casi il test è stato ritenuto non valido , ma ripetuto ha dato un risultato corretto. 8 pazienti hanno rifiutato l’esecuzione del test. Conclusioni Questi dati preliminari suggeriscono che l’utilizzo del test rapido può costituire un‘alternativa ai test tradizionali per la facilità di esecuzione, la rapidità della risposta, il costo ridotto. Il test è facilmente accettato dalle pazienti, ma va sempre affiancato nei casi di positività dai test di routine in grado di discriminare le diverse classi anticorpali
VALUTAZIONE DI UN NUOVO TEST RAPIDO SU SANGUE INTERO PER LO SCREENING DELLA TOXOPLASMOSI IN GRAVIDANZA
FERRARI, GUGLIELMO
2017/2018
Abstract
In Italy, screening for pregnant toxoplasmosis, although not mandatory, is expected and recommended by the 2010/11 physiological pregnancy guidelines. The NHS provides a first test for the measurement of anti-Toxoplasma IgG and IgM antibodies at the beginning of pregnancy and a monthly follow-up for free seronegative pregnants because over the years numerous studies have demonstrated the effectiveness of screening (mandatory in France and Austria). On the other hand, the decrease in seroprevalence of infection in pregnant women registered anywhere in Europe has questioned the cost-benefit ratio of screening itself. With this study we wanted to evaluate the diagnostic efficacy of a new rapid test (TOXOPLASMA ICT IgG-IgM LDBIO Diagnostic Lyon France) to be performed on whole blood taken by finger puncture. This test could become an alternative to the tests used in routine with the authorization of the ethics committee of the Polycyclic IRCCS San Matteo (Pavia). To the pregnant women belonging to the single withdrawals center and to the clinic of the Infectious Diseases Clinic of the IRCCS Policlinico San Matteo Pavia Foundation for the screening of toxoplasmosis, a drop of blood was suggested from the finger for the rapid test. At the same time they were subjected to the Routine exam (IgG-IgM and possibly IgG Avidity Diasorin, Elfa IgG and IgG avidity, Isaga IgM-Biomerieux, Mercy l'Etoile France). To date, 70 patients out of the 270 patients have been evaluated to define the specificity and sensitivity of the test. 25 were positive and the positivity was confirmed by routine tests. Of the negative tests in 4 cases the result of routine tests was positive. In 4 cases the test was considered invalid, but repeated gave a correct result. 8 patients refused to perform the test. These preliminary data suggest that the use of the rapid test can be an alternative to traditional tests for ease of execution, rapid response, reduced cost. The test is easily accepted by the patients, but must always be supported in cases of positivity from routine tests able to discriminate the different antibody classes.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/22163