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Multidisciplinary approach to congenital Toxoplasma infection: an Italian nationwide survey.
[congenital toxoplasmosis]
Italy
provides
a
free
voluntary
serological
screening
for
toxoplasmosis
in
pregnancy
supported
by
public
health
system
,
as
there
is
an
estimated
congenital
toxoplasmosis
rate
of
1
-
2
/
10
,
000
.
The
aim
of
this
study
was
to
make
an
inventory
of
diagnostic
and
therapeutic
protocols
in
use
in
Italy
in
the
absence
of
a
national
guideline
.
A
semistructured
questionnaire
was
distributed
to
AMCLI
(
Italian
Association
of
Clinical
Microbiologists
)
members
who
were
asked
to
involve
other
specialists
to
fill
in
the
form
.
Data
from
26
centers
show
:
a
)
a
general
use
of
the
IgG
avidity
test
to
solve
diagnosis
in
IgG
/
IgM
positive
,
pregnant
women
;
b
)
a
widespread
attitude
to
spyramicin
antenatal
treatment
in
suspected
,
unconfirmed
maternal
infection
;
c
)
avoidance
of
invasive
antenatal
diagnosis
only
in
suspected
early
or
late
(
>
24
weeks
)
,
even
confirmed
,
maternal
infection
d
)
fetal
diagnosis
performed
by
PCR
assays
on
amniotic
fluid
;
e
)
variability
of
both
indications
and
dosage
of
pyrimethamine-sulfadiazine
(
P-S
)
as
fetal
treatment
;
f
)
use
of
comparative
mother
and
newborn
IgG
/
IgM
Immuneblot
in
most
centers
;
g
)
no
diagnostic
tests
performed
on
placenta
and
cord
blood
;
h
)
spyramicin
is
no
longer
used
in
congenital
infections
;
i
)
no
P-S-based
treatment
for
children
at
high
risk
of
congenital
infection
(
late
maternal
infection
)
in
the
absence
of
diagnosis
.
As
there
is
the
opportunity
to
test
pregnant
women
for
Toxoplasma
gondii
infection
in
Italy
free
of
charge
,
standardized
diagnostic
and
therapeutic
national
guidelines
would
focus
on
a
more
uniform
approach
.
