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先天性弓形虫病

Congenital Toxoplasmosis.

作者信息

McAuley James B

机构信息

Rush University Medical Center, Chicago, Illinois.

出版信息

J Pediatric Infect Dis Soc. 2014 Sep;3 Suppl 1(Suppl 1):S30-5. doi: 10.1093/jpids/piu077.

Abstract

Toxoplasmosis is caused by infection with the parasite Toxoplasma gondii. It is one of the most common parasitic infections in humans and is most typically asymptomatic. However, primary infection in a pregnant woman can cause severe and disabling disease in the developing fetus. Recent developments have included increased understanding of the role of parasite genotype in determining infectivity and disease severity. Risk factors for acquisition of infection have been better defined, and the important role of foodborne transmission has been further delineated. In addition, strategies have emerged to decrease mother-to-child transmission through prompt identification of acutely infected pregnant women followed by appropriate treatment. Refined diagnostic tools, particularly the addition of immunoglobulin G avidity testing, allow for more accurate timing of maternal infection and hence better decision making during pregnancy. Congenitally infected children can be treated, beginning in utero and continuing through the first year of life, to ameliorate the severity of disease. However, despite these many advances in our understanding of congenital toxoplasmosis prevention and treatment, significant areas of study remain: we need better drugs, well defined strategies for screening of pregnant women, improved food safety, and improved diagnostic tests.

摘要

弓形虫病由感染寄生虫刚地弓形虫引起。它是人类最常见的寄生虫感染之一,通常没有症状。然而,孕妇的初次感染可导致发育中的胎儿患上严重且致残的疾病。最近的进展包括对寄生虫基因型在决定传染性和疾病严重程度方面的作用有了更多了解。感染的危险因素已得到更明确的界定,食源性传播的重要作用也得到了进一步阐述。此外,已出现一些策略,通过及时识别急性感染的孕妇并随后进行适当治疗来减少母婴传播。改进后的诊断工具,特别是增加了免疫球蛋白G亲和力检测,能够更准确地确定母体感染时间,从而在孕期做出更好的决策。先天性感染的儿童可以在子宫内开始并持续到出生后第一年进行治疗,以减轻疾病的严重程度。然而,尽管我们在先天性弓形虫病的预防和治疗方面取得了许多进展,但仍有重要的研究领域有待探索:我们需要更好的药物、明确的孕妇筛查策略、改善食品安全以及改进诊断测试。

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