Parasitemia Levels in Trypanosoma cruzi Infection in Spain, an Area Where the Disease Is Not Endemic : Trends by Different Molecular Approaches
Flores-Chavez, Maria (Fundación Mundo Sano-España)
Abras, Alba (Universitat de Girona. Departament de Biologia)
Ballart, Cristina (Universitat de Barcelona. Secció de Parasitologia. Departament de Biologia Sanitat i Medi Ambient. Facultat de Farmàcia i Ciències de l'Alimentació)
Ibáñez-Perez, Ismael (National Centre for Microbiology. Instituto de Salud Carlos III)
Perez-Gordillo, Pilar (National Centre for Microbiology. Instituto de Salud Carlos III)
Gállego Culleré, M. (Montserrat) (Centro de Investigación Biomédica en Red de Enfermedades Infecciosas)
Muñoz-Batet, Carmen (Institut d'Investigació Biomèdica Sant Pau)
Moure García, Zaira (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Sulleiro Igual, Elena (Hospital Universitari Vall d'Hebron)
Nieto, Javier (Centro de Investigación Biomédica en Red de Enfermedades Infecciosas)
García Diez, Emilia (National Centre for Microbiology. Instituto de Salud Carlos III)
Simón, Lorena (National Centre of Epidemiology. Instituto de Salud Carlos III)
Cruz, Israel (Foundation for Innovative New Diagnostics (FIND))
Picado, Alberto (Foundation for Innovative New Diagnostics (FIND))
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Trypanosoma cruzi infection has expanded globally through human migration. In Spain, the mother-to-child route is the mode of transmission contributing to autochthonous Chagas disease (CD); however, most people acquired the infection in their country of origin and were diagnosed in the chronic phase (imported chronic CD). In this context, we assessed the quantitative potential of the Loopamp Trypanosoma cruzi detection kit (Sat- TcLAMP) based on satellite DNA (Sat-DNA) to determine parasitemia levels compared to those detected by real-time quantitative PCRs (qPCRs) targeting Sat-DNA (Sat-qPCR) and kinetoplast DNA minicircles (kDNA-qPCR). This study included 173 specimens from 39 autochthonous congenital and 116 imported chronic CD cases diagnosed in Spain. kDNAqPCR showed higher sensitivity than Sat-qPCR and Sat-TcLAMP. According to all quantitative approaches, parasitemia levels were significantly higher in congenital infection than in chronic CD (1 × 10-1 to 5 × 105 versus. 1 × 10-1 to 6 × 103 parasite equivalents/mL, respectively [P < 0. 001]). Sat-TcLAMP, Sat-qPCR, and kDNA-qPCR results were equivalent at high levels of parasitemia (P = 0. 381). Discrepancies were significant for low levels of parasitemia and older individuals. Differences between Sat-TcLAMP and Sat-qPCR were not qualitatively significant, but estimations of parasitemia using Sat-TcLAMP were closer to those by kDNA-qPCR. Parasitemia changes were assessed in 6 individual cases in follow- up, in which trends showed similar patterns by all quantitative approaches. At high levels of parasitemia, Sat-TcLAMP, Sat-qPCR, and kDNA-qPCR worked similarly, but significant differences were found for the low levels characteristic of late chronic CD. A suitable harmonization strategy needs to be developed for low-level parasitemia detection using Sat-DNA- and kDNA-based tests.
Ayudas:	Agència de Gestió d'Ajuts Universitaris i de Recerca 2017SGR00924
Nota:	Altres ajuts: Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland (WO klob-0003); the Surveillance Program of Chagas Disease of the National Centre for Microbiology (CNM), Instituto de Salud Carlos III (ISCIII); Fundación Mundo Sano, Spain (MVP 237/19).
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Chagas disease ; LAMP ; Trypanosoma cruzi ; Acute reactivation ; Chronic infection ; Congenital infection ; Molecular diagnosis ; Parasite load ; Parasitemia quantification ; Qpcr
Publicado en:	Microbiology Spectrum, Vol. 10 Núm. 5 (september 2022) , ISSN 2165-0497

DOI: 10.1128/spectrum.02628-22
PMID: 36190410

15 p, 2.5 MB

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