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      Toxoplasma gondii infection and a history of surgery: A case control seroprevalence study

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          Abstract

          We determined the association between having a history of surgery and the seroreactivity to T. gondii. An age- and gender-matched case-control study of 391 subjects with a history of surgery and 391 subjects without this history was performed. Sera of subjects were analyzed for detection of anti- T. gondii immunoglobulin G (IgG) and M (IgM) antibodies using enzyme-linked immunoassays. Anti- T. gondii IgG antibodies were found in 25 (6.4%) of the 391 cases and in 21 (5.4%) of the 391 controls (odds ratio [OR] = 1.29; 95% confidence interval [CI]: 0.66–2.18; P = 0.54). The frequency of cases with high IgG antibody levels (10/25: 40.0%) was equal to that found in controls (8/21: 38.1%) (OR = 1.08; 95% CI: 0.32–3.56; P = 0.89). Of the 25 anti- T. gondii IgG antibody seropositive cases, 5 (16.0%) were also positive for anti- T. gondii IgM antibodies. Meanwhile, of the 21 anti- T. gondii IgG antibody seropositive controls, 4 (19.0%) were also positive for anti- T. gondii IgM antibodies (OR = 0.81; 95% CI: 0.17–3.72; P = 0.80). Logistic regression showed that only the variable “hysterectomy” was associated with T. gondii seropositivity (OR = 4.6; 95% CI: 1.6–13.4; P = 0.005). Results suggest that having a history of surgery is not an important risk factor for infection with T. gondii. However, the link between T. gondii infection and hysterectomy should be further investigated.

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          Prevention of toxoplasmosis in transplant patients.

          Toxoplasmosis is a life-threatening opportunistic infection that affects haematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients. Its incidence in these patients is closely related to the prevalence of toxoplasmosis in the general population, which is high in Europe. In SOT recipients, toxoplasmosis results mainly from transmission of the parasite with the transplanted organ from a Toxoplasma-seropositive donor to a Toxoplasma-seronegative recipient. This risk is high in cases of transplantation of organs that are recognized sites of encystation of the parasite, e.g. the heart, and is markedly lower in other SOT recipients. Clinical symptoms usually occur within the first 3 months after transplantation, sometimes as early as 2 weeks post transplant, and involve febrile myocarditis, encephalitis or pneumonitis. In HSCT recipients, the major risk of toxoplasmosis results from the reactivation of a pre-transplant latent infection in seropositive recipients. The median point of disease onset is estimated at 2 months post transplant, with <10% of cases occurring before 30 days and 15-20% later than day 100. Toxoplasmosis usually manifests as encephalitis or pneumonitis, and frequently disseminates with multiple organ involvement. Diagnosis of toxoplasmosis is based on the demonstration of parasites or parasitic DNA in blood, bone marrow, cerebrospinal fluid, bronchoalveolar lavage fluid or biopsy specimens, and serological tests do not often contribute to the diagnosis. For prevention of toxoplasmosis, serological screening of donors and recipients before transplantation allows the identification of patients at higher risk of toxoplasmosis, i.e. seropositive HSCT recipients and mismatched (seropositive donor/seronegative recipients) SOT recipients. Preventing toxoplasmosis disease in those patients presently relies on prophylaxis via prescription of co-trimoxazole.
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            Seroepidemiology of Toxoplasma gondii infection in general population in a northern Mexican city.

            There is a lack of information about the seroepidemiology of T. gondii infection in the general population of Durango City, Mexico. Anti- Toxoplasma gondii IgG and IgM antibodies were sought in 974 inhabitants in Durango City, Mexico with the use of enzyme-linked immunoassays. in total, 59 (6.1%) of 974 participants (mean age 37 ± 16.1 yr) had IgG anti- T. gondii antibodies. Twenty (2.1%) of them also had IgM anti- T. gondii antibodies. IgG levels of 13-99, 100-150, and >150 International Units (IU)/ml were found in 14 (23.7%), 3 (5.1%), and 42 (71.2%) anti- T. gondii IgG-positive participants, respectively. Prevalence of infection increased with age (P < 0.05), and was significantly lower in participants born in Durango State than those born in other Mexican states (P < 0.01). Toxoplasma gondii infection was significantly associated with consumption of boar meat (adjusted odds ratio [OR]  =  3.02; 95% confidence interval [CI]: 1.49-6.13), and squirrel meat (adjusted OR  =  2.18; 95% CI: 1.17-4.09). in addition, infection was negatively associated with travel abroad (adjusted OR  =  0.42; 95% CI: 0.23-0.77), and salami consumption (adjusted OR  =  0.57; 95% CI: 0.32-0.99). This is the first report of seroprevalence and contributing factors for T. gondii infection in general population in Durango City, and of an association of the consumption of boar meat with T. gondii infection. This study provides a basis for the design of successful preventive measures against T. gondii infection.
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              Seroepidemiology of Toxoplasma gondii infection in psychiatric inpatients in a northern Mexican city

              Background Patients with psychiatric disorders were found to show a high seroprevalence of Toxoplasma gondii infection. There is scarce information about the epidemiology of T. gondii infection in psychiatric patients in Mexico. Therefore, we sought to determine the prevalence of T. gondii infection and associated socio-demographic, clinical and behavioural characteristics in a population of psychiatric patients in Durango City, Mexico. Seroprevalence in patients was compared with that obtained in a control population. Methods One hundred and thirty seven inpatients of a public psychiatric hospital and 180 controls were examined for the presence of IgG and IgM antibodies against T. gondii by enzyme-linked immunoassay (Diagnostic Automation Inc., Calabasas, CA, USA). The control population consisted of blood donors of a public blood bank and elderly persons attending a senior center in the same city. Age in controls (42 years +/- 20.2) was comparable with that of the psychiatric patients (43.7 years +/-13.8) (p = 0.42). Socio-demographic, clinical and behavioral characteristics from the patients were also obtained. Results Anti-T. gondii IgG antibodies indicating latent infection with T. gondii was found in 25 (18.2%) of 137 psychiatric inpatients and 16 (8.9%) of 180 controls (p = 0.02). Ten (26.3%) of 38 schizophrenic patients had latent infection and this prevalence was also significantly higher than that observed in controls (p = 0.005). Prevalence of anti-T. gondii IgM antibodies was comparable among patients and controls (4.4% vs 2.2%, respectively, p = 0.22). Multivariate analysis showed that T. gondii infection in inpatients was positively associated with sexual promiscuity (adjusted OR = 15.8; 95% CI: 3.8–64.8), unwashed raw fruit consumption (adjusted OR = 5.19; 95% CI: 2.3–11.3), and a history of surgery (adjusted OR = 6.5; 95% CI: 2.6–16), and negatively associated with lamb meat consumption (adjusted OR = 0.26; 95% CI: 0.10–0.63). Conclusion In the present study, psychiatric inpatients in Durango, Mexico, in general and schizophrenia inpatients in particular had a significantly higher prevalence of T. gondii infection than the control group. Results suggest that unwashed raw fruit consumption might be the most important route of T. gondii transmission in our psychiatric inpatients while lamb meat consumption the less important. Additional studies will have to elucidate the causative relation between infection with T. gondii and psychiatric disorders.
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                Author and article information

                Journal
                1886
                European Journal of Microbiology and Immunology
                EuJMI
                Akadémiai Kiadó
                2062-8633
                December 2018
                : 8
                : 4
                : 155-158
                Affiliations
                [ 1 ]Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State , Avenida Universidad S/N, 34000 Durango, Mexico
                [ 2 ]Institute for Scientific Research “Dr. Roberto Rivera-Damm”, Juárez University of Durango State , Avenida Universidad S/N, 34000 Durango, Mexico
                [ 3 ]Clínica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado , Predio Canoas S/N, 34079 Durango, Mexico
                [ 4 ]Facultad de Enfermería y Obstetricia, Juárez University of Durango State , Cuauhtémoc 223 norte, 34000 Durango, Mexico
                [ 5 ] Hospital General, Secretaría de Salud , Avenida 5 de febrero y Norman Fuentes, 34000 Durango, Mexico
                Author notes
                [*]

                Author for correspondence: Laboratorio de Investigación Biomédica. Facultad de Medicina y Nutrición. Avenida Universidad S/N. 34000 Durango, Dgo, México; E-mail: alvaradocosme@ 123456yahoo.com ; Tel/Fax: 0052-618-8130527.

                Article
                10.1556/1886.2018.00021
                82a2a2c7-fe00-4c1e-9346-f3896e58e7ff
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes - if any - are indicated.

                History
                : 9 August 2018
                : 14 October 2018
                : 15 November 2018
                Page count
                Pages: 4
                Categories
                Original Research Paper

                Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                case-control study,epidemiology, Toxoplasma gondii ,seroprevalence,infection,surgery,Mexico

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