Results of the REIV-TOXO national survey on prenatal screening for toxoplasmosis in Spain.

INTRODUCTION: Currently, the status of serological screening for toxoplasmosis in pregnant women in Spain is unknown, and there is no official recommendation. The objective of this study is to show the current practice of gestational screening for toxoplasmosis in hospitals belonging to the Spanish Network for Research on Congenital Toxoplasmosis (REIV-TOXO). METHODS: An electronic survey was sent between April 2021 and September 2021 to investigators from 118 hospitals of REIV-TOXO, representing all Spanish regions. Nine items related to gestational screening for toxoplasmosis were collected. This information was compared with cases of congenital toxoplasmosis (CT) identified in REIV-TOXO to determine if these were diagnosed in the presence of gestational screening. RESULTS: During the study period, serological screening was performed in 53.3% (63/118) hospitals, with variations between regions and even among hospitals within the same region. Testing performed in each trimester was the most common practice (57.7%), followed by a single determination (24.4%). 89.4% of CT cases between January 2015 and September 2021 were diagnosed due to gestational screening. CONCLUSION: The decision to perform gestational screening for toxoplasmosis in Spain is highly heterogeneous, with significant local and regional differences. Despite this, screening still allows the diagnosis of most CT cases. It is urgent to have current epidemiological data to inform decision-making in public health.

Prevalence of Toxoplasma gondii in Endangered Wild Felines (Felis silvestris and Lynx pardinus) in Spain.

The wildcat (Felis silvestris) and the Iberian lynx (Lynx pardinus) are important species in Spain, considered as near-threatened and endangered, respectively. Both can be infected by Toxoplasma gondii, a parasite that can cause morbidity and mortality in transplacentally-infected or immunocompromised mammals. The data on the prevalence of this parasite in wild populations of these species in Spain are outdated. The objective of this study was to update information and evaluate the role of these felines in parasite epidemiology and the potential impact of the parasite on their conservation. Blood and fecal samples were collected from captured animals, as well as the tongue, diaphragm, and spleen, from animals killed in road accidents in central Spain. An indirect fluorescent antibody test (IFAT) was used to detect parasite antibodies in serum, microscopy and molecular analysis were used to detect oocysts in feces, and molecular analysis was used to determine the existence of tissue cysts. Seroprevalence was 85% in wildcats and 45% in lynx, and parasite DNA was detected in the feces of one wildcat and in tissue samples from 10 wildcats and 11 Iberian lynxes. These results highlight the epidemiological importance and high risk of T. gondii infection in animals and humans in the studied areas. Considering feline susceptibility to infection, monitoring programs are needed to assess the health status of wild felines.

[Toxoplasmosis in Spain, analysis of hospitalizations during the period 1997-2018.] / Toxoplasmosis en España, aná-lisis de las hospitalizaciones en el periodo 1997-2018.

OBJECTIVE: Toxoplasmosis is a systemic infectious disease. Infection is acquired by ingestion of Toxoplasma gondii cysts or by vertical transmission mother-to-child during pregnancy (congenital toxoplasmosis). In Spain, the prevalence shows wide variability depending on the region and the study. The incidence in other European countries evidences a decline in recent years. The aim of this study was to characterize the presence and the epidemiological patterns of the disease in the Spanish population with information obtained of hospitalized cases with a diagnosis of toxoplasmosis at discharge. METHODS: The interactive platform of the Specialized Registry (RAE-MBD) of the Ministry of Health was used to obtain data on hospital discharges with "toxoplasmosis" diagnosis. Frequencies and rates of hospital discharges were calculated according to sex, age groups, region and diagnosis at discharge. Sequence graphs were generated to analysed the temporal evolution of the number of hospitalizations. The trends and slopes of the RHs were analyzed using "joinpoint" regression models, estimating the mean annual percentage change (PCAM) in the RHs and its 95% confidence interval. RESULTS: There were 13,704 cases with toxoplasmosis diagnosis at discharge, (58%) were men. The highest hospitalization rate (RH) was in the 15-44-year-old men group (5,804 discharges and HT=2.52). During the period studied a decrease in the number of discharges was observed, it was progressive and affected all the autonomous regions, being more pronounced in men (81.9% vs 63.9%). CONCLUSIONS: The number of hospitalizations in Spain decreased substantially during the studied period (1997-2018), similar to other European studies reported. The decrease was progressive and mainly affected men between 15-44 years.

OBJETIVO: La toxoplasmosis es una enfermedad infecciosa sistémica. Se contrae principalmente por ingestión de quistes y ooquistes de Toxoplasma gondii o por afectación fetal tras la primoinfección de la madre embarazada (toxoplasmosis congénita). La prevalencia en España presenta una gran variabilidad, dependiendo de la región y el estudio. La incidencia en otros países europeos refleja un descenso en los últimos años. El objetivo de este estudio fue caracterizar la presencia y el patrón epidemiológico de la enfermedad en la población española a partir de los casos hospitalizados con un diagnóstico de toxoplasmosis al alta. METODOS: A través de la plataforma interactiva del Registro de Atención Sanitaria Especializada (RAE-CMBD) del Ministerio de Sanidad se obtuvieron los datos de altas hospitalarias con diagnóstico "toxoplasmosis". Se calcularon frecuencias y tasas de altas hospitalarias (TH) según sexo, grupos de edad, comunidad autónoma y diagnóstico al alta. Se analizó la evolución temporal del número de hospitalizaciones a través de gráficos de secuencia. Las tendencias y las pendientes de las TH se analizaron mediante modelos de regresión "joinpoint", estimándose el porcentaje de cambio anual medio (PCAM) en las TH y su intervalo de confianza al 95%. RESULTADOS: Se contabilizaron 13.704 casos con diagnóstico toxoplasmosis al alta, el 58% hombres. La tasa de hospitalización (TH) más elevada se dio en hombres, en el grupo de 15-44 años (5.804 altas y TH=2,52). Se observa un descenso del 76,8% en el número de altas a lo largo del periodo estudiado, éste fue progresivo y afectó a todas las comunidades autónomas; siendo más acusado en hombres (81,9% vs 63,9%). CONCLUSIONES: El número de hospitalizaciones por toxoplasmosis en España se redujo notablemente a lo largo del periodo estudiado (1997-2018), mostrando una tendencia similar a la referida en otros estudios europeos. El descenso en los ingresos fue progresivo y afectó fundamentalmente a hombres de 15 a 44 años.

Multi-Laboratory Evaluation of a Lateral Flow Rapid Test for Detection of Amebic Liver Abscess.

Independent evaluations of XEh Rapid®, an IgG4-based rapid dipstick test, were performed to assess its diagnostic performance to detect amebic liver abscess (ALA) using 405 samples at seven laboratories in four countries. The test showed high diagnostic specificity (97-100%) when tested with samples from healthy individuals (n = 100) and patients with other diseases (n = 151). The diagnostic sensitivity was tested with a total of 154 samples, and the results were variable. It was high in three laboratories (89-94%), and moderate (72%) and low (38%) in two other laboratories. Challenges and issues faced in the evaluation process are discussed. Nevertheless, XEh Rapid is promising to be developed into a point-of-care test in particular for resource-limited settings, and thus merits further confirmation of its diagnostic sensitivity.

Helmintosis y eosinofilia en España (1990-2015) / Helminthosis and eosinophilia in Spain (1990-2015)

La detección de eosinofilia periférica es un motivo relativamente frecuente para la remisión de un paciente a una Unidad/Servicio de Enfermedades Infecciosas. En general, se pretende descartar una enfermedad parasitaria, tanto en personas autóctonas como en viajeros o inmigrantes. Excepcionalmente la eosinofilia relacionada con parásitos corresponde a una protozoosis, siendo los helmintos los principales agentes causales de este hallazgo hematológico. La eosinofilia puede ser el único hallazgo anormal o formar parte del cuadro clínico-biológico del paciente. Por otro lado, no todas las helmintosis se asocian de forma sistemática a eosinofilia, y el grado de la misma difiere entre las fases de la infección y el tipo de helminto. El propósito de esta revisión es un estudio sistemático de la relación entre helmintosis y eosinofilia en la literatura española, distinguiendo los casos autóctonos e importados, así como la relación con situaciones de inmunodepresión (AU)

The finding of blood eosinophilia in a patient is a relatively frequent reason to refer him/her to a Clinical Department of Infectious Diseases. The doctor usually intends to rule out a parasitic disease in the autochthonous population, travelers or immigrants. It is uncommon for an eosinophilia to be produced by protozoa infection, whereas helminth parasites are more frequently associated with an increase of eosinophil counts in the infected patient. Eosinophilia can be the only abnormal finding, or it could be part of more complex clinical manifestations suffered by the patient. Furthermore, many, but not all, helminth infections are associated with eosinophilia, and the eosinophil level (low, high) differs according to parasite stages, helminth species, and worm co-infections. The purpose of the present article is to carry out a systematic review of cases and case series on helminth infections and eosinophilia reported in Spain from 1990 to 2015, making a distinction between autochthonous and imported (immigrants and travelers) cases, and studying their relationship with immunodepression situations (AU)

Helminthosis and eosinophilia in Spain (1990-2015). / Helmintosis y eosinofilia en España (1990-2015).

The finding of blood eosinophilia in a patient is a relatively frequent reason to refer him/her to a Clinical Department of Infectious Diseases. The doctor usually intends to rule out a parasitic disease in the autochthonous population, travelers or immigrants. It is uncommon for an eosinophilia to be produced by protozoa infection, whereas helminth parasites are more frequently associated with an increase of eosinophil counts in the infected patient. Eosinophilia can be the only abnormal finding, or it could be part of more complex clinical manifestations suffered by the patient. Furthermore, many, but not all, helminth infections are associated with eosinophilia, and the eosinophil level (low, high) differs according to parasite stages, helminth species, and worm co-infections. The purpose of the present article is to carry out a systematic review of cases and case series on helminth infections and eosinophilia reported in Spain from 1990 to 2015, making a distinction between autochthonous and imported (immigrants and travelers) cases, and studying their relationship with immunodepression situations.

Diagnóstico de las parasitosis intestinales mediante detección de coproantígenos / Diagnostic of intestinal parasitosis by coproantigen detection

Las parasitosis intestinales presentan una alta prevalencia en áreas tropicales y países en desarrollo, pero también son frecuentes en países industrializados. Tradicionalmente, su diagnóstico se ha realizado por el examen microscópico de las heces del paciente. Estas determinaciones muestran una sensibilidad pobre, exigen la toma de muestras seriadas, son muy laboriosas y requieren especialización técnica. En los últimos años, el avance en el estudio molecular de estos parásitos y la investigación de la respuesta inmune específica del paciente, junto con el empleo de las nuevas metodologías diagnósticas, han posibilitado el desarrollo de sistemas de detección más eficaces que apoyan al clínico, permiten el seguimiento de los tratamientos y facilitan los estudios epidemiológicos. Entre ellos, cabe destacar los métodos de detección de coproantígenos, que, en general, presentan buena especificidad y sensibilidad, y además se desarrollan en formatos sencillos, unas propiedades que los convierten en una herramienta útil en los laboratorios de microbiología

Intestinal parasites are highly prevalent in tropical areas and developing countries, but are also common in industrialised countries as well. Traditionally, their diagnosis has been made by microscopic examinations of the faeces of the patient. These have been shown to have poor sensitivity, require serial samples, are very time-consuming and require a specialised technique. In the last few years, advances in the molecular biology of these parasites and research into the specific immune response of the patient, has made it possible to develop more efficient detection systems that help the clinician, allow treatments to be followed up and make it easier to carry out epidemiological studies. Among these systems are the methods for detecting faecal antigens, which, in general, have good specificity and sensitivity; properties which make them a useful tool in microbiology laboratorios

Absceso hepático amebiano autóctono: diagnóstico microbiológico por PCR / Autochthonous amebic liver abscess: Microbiological diagnosis by PCR

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