Experience from a low-prevalence area

Nancy P. Nenonen, Tomas Bergström, and Sigvard Olofsson

Polymerase chain reaction (PCR) technology has provided the clinician with a new tool, enabling rapid and improved, early and adequate diagnosis of Toxoplasma gondii infections. We report on the use of PCR-based diagnosis of T. gondii infections in the Göteborg region, a typical low-prevalence area. The PCR-based diagnosis for toxoplasma infections in Göteborg was introduced in 1993 and to date (December 2001) 842 clinical specimens have been analysed using primers based on the P30 (SAG1) gene. In our hands the sensitivity of the P30 system approached that obtained by using primers targeting the B1 region. The frequency of toxoplasma PCR positive samples was 1.2%, representing cases of congenital toxoplasmosis, toxoplasmosis during pregnancy, toxoplasmosis in immunocompromised patients, and retinochoroiditis. Based on reports using different PCR systems for toxoplasma diagnosis, we recommend that standardization programmes of Nordic PCR-based diagnosis of T. gondii infections should focus on the exchange of specimens and standards rather than striving towards a consensus PCR protocol.

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