The first case of congenital Chagas’ disease analyzed by AP-PCR in Colombia
Keywords:
Chagas disease, Trypanosoma cruzi, maternal-fetal exchange, polymerase chain reaction, Colombia, AP-PCR.
Abstract
Introduction. The main route of Chagas disease transmission is through vectors of the insect family Reduviidae. However, the parasite can also be transmitted from infected mothers to their fetus in utero. Until now, no cases of congenital Chagas disease have been reported in Colombia.Objective. A congenital Chagas disease case occurred in Moniquirá County, Boyacá, Colombia. It was confirmed by comparing strains isolated from the mother and her baby using polymerase chain reaction (PCR) with arbitrary primers.
Materials and methods. The parasite DNA was extracted from positive blood cultures of the aflicted mother and her son. The species confirmation and group detection were performed by PCR. The strain genotypes were determined by AP-PCR with two oligonucleotides based on the genes for the b-globin (5’-CCTCACCTTCTTTCATGGAG-3’) and 16S RrNA (5’-ACGGGCAGTGTGTACAAGACC-3’), in differente reactions.
Results. The T. cruzi strains isolated from the blood cultures of the mother and her son showed the same amplification profile by the two AP-PCR tests; this corresponded with profiles of the T.cruzi I strains used as controls. However, T. cruzi II was also found in the blood culture from the newborn.
Conclusions. This is the first case of Chagas disease transmission reported in Moniquirá, demonstrating that this form of transmission occurs in Colombia. The presence of both groups of T. cruzi in the newborn sample suggests mixed infection in the mother as well, with a higher prevalence of T. cruzi I, at least in the mother’s blood culture.
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References
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2. Schofield CJ, Jannin J, Salvatella R. The future of Chagas disease control. Trends Parasitol. 2006;22: 583-8.
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4. Blanco SB, Segura EL, Cura EN, Chuit R, Tulián L, Flores I, et al. Congenital transmission of Trypanosoma cruzi: an operacional outline for detecting and treating infected infants in north-western Argentina. Trop Med Int Health. 2000;5:293-301.
5. Luquetti AO, Dias JC, Prata, A. Diagnosis and treatment of congenital infection caused by Trypanosoma cruzi in Brazil. Parasitol Res. 2006;99:379-83.
6. Rosa R, Basnadjian Y, González MM, González M, Salvatella R. Actualización clínico-epidemiológica y terapéutica de la enfermedad de Chagas en Uruguay. Rev Med Uruguay. 2001;17:125-32.
7. Moncayo A. Chagas disease: current epidemiological trends after the interruption of vectorial and transfusional transmission in the Southern Cone countries. Mem Inst Oswaldo Cruz. 2003;98:577-91.
8. Guhl F, Nicholls RS. Manual de procedimientos para el diagnóstico de la enfermedad de Chagas. Bogotá, D.C.: Quebecor Impresores; 2001.
9. Pavía P, Cuervo C, Montilla M, Nicholls S, Puerta C. Diseño y estandarización de una prueba de PCR para la detección específica de Trypanosoma cruzi. Infectio. 2003;7:129-36.
10. Pavia P, Vallejo GA, Montilla M, Nicholls RS, Puerta CJ. Detection of Trypanosoma cruzi and Trypanosma rangeli infection in triatomine vectors by amplification histone H2A and sno-RNA-CL1 genes. Rev Inst Med Trop Sao Paulo. 2007;49:23-30.
11. Duque S, Peláez D, Corredor A. Normas para cultivo in vitro de parásitos de la familia trypanosomatidae. Manual de procedimientos. Bogotá, D.C.: Instituto Nacional de Salud; 1993.
12. Sturm NR, Degrave W, Morel C, Simpson L. Sensitive detection and schizodeme classification of Trypanosoma cruzi cells by amplification of kinetoplast minicircle DNA sequences: use in diagnosis of Chagas disease. Mol Biochem Parasitol. 1989;33:205-14.
13. Yeo M, Acosta N, Llewellyn M, Sánchez H, Adamson S, Miles GA, et al. Origins of Chagas disease: Didelphis species are natural hosts of Trypanosoma cruzi I and armadillos hosts of Trypanosoma cruzi II, including hybrids. Int J Parasitol. 2005;35:225-33.
14. Saldaña CH, Cordova OP, Vargas FV. Utilización de Lepidium peruvianum (Maca), como medio de cultivo para el crecimiento de T. cruzi. Rev Peru Med Exp Salud Pública. 2006;23:137-40.
15. Virreira M, Torrico F, Truyens C, Alonso-Vega C, Solano M, Carlier Y, et al. Comparison of polymerase chain reaction methods for reliable and easy detection of congenital Trypanosoma cruzi infection. Am J Trop Med Hyg. 2003;68:574-82.
16. Hypsa V, Dale C. In vitro culture and phylogenetic analysis of “Candidatus Arsenophorus triatominarum,” an intracellular bacterium from the triatomine bug, Triatoma infestans. Int J Syst Bacteriol. 1997;47:1140-4.
17. Welsh J, McClelland M. Fingerpriting genomes using PCR with arbitrary primers. Nucleic Acids Res. 1990;18:7213-8.
18. Triquell MF, Díaz-Luján C, Freilij H, Paglini P, Fretes RE. Placental infection by two subpopulations of Trypanosoma cruzi is conditioned by differential survival of the parasite in a deleterious placental medium and not by tissue reproduction. Trans R Soc Trop Med Hyg. 2009 Mar 30. [Epub ahead of print]
19. Franco DJ, Vago AR, Chiari E, Meira FC, Galvao LM, Machado CR. Trypanosoma cruzi: mixture of two populations can modify virulence and tissue tropism in rat. Exp Parasitol. 2003;104:54-61.
20. Liarte DB, Murta SM, Steindel M, Romanha AJ. Trypanosoma cruzi: Multiplex PCR to detect and classify strains according to groups I and II. Exp Parasitol. 2008. doi 10.1016/j.exppara.2008.12.005. [Epub ahead of print].
21. Botero LA, Mejía AM, Triana O. Caracterización biológica y genética de dos clones pertenecientes a los grupos I y II de Trypanosoma cruzi de Colombia. Biomédica. 2007;27(Suppl.1)1:64-74.
22. Neto EC, Rubin R, Schulte J, Giugliani R. Newborn screening for congenital infectious disease. Emerg Infect Dis. 2004;10:1068-73.
23. Freilij H, Altcheh J. Congenital Chagas disease: diagnostic and clinical aspects. Clin Infect Dis. 1995;21;551-5.
24. Carlier Y, Torrico F. Congenital infection with Trypanosoma cruzi: from mechanisms of transmission to strategies for diagnosis and control. Rev Soc Brasil Med Trop. 2003;6:767-71.
2. Schofield CJ, Jannin J, Salvatella R. The future of Chagas disease control. Trends Parasitol. 2006;22: 583-8.
3. World Health Organization. Control of Chagas disease. Report of a WHO Expert Committee. Technical Report Series 811. Geneva: WHO; 1991. p. 1-95.
4. Blanco SB, Segura EL, Cura EN, Chuit R, Tulián L, Flores I, et al. Congenital transmission of Trypanosoma cruzi: an operacional outline for detecting and treating infected infants in north-western Argentina. Trop Med Int Health. 2000;5:293-301.
5. Luquetti AO, Dias JC, Prata, A. Diagnosis and treatment of congenital infection caused by Trypanosoma cruzi in Brazil. Parasitol Res. 2006;99:379-83.
6. Rosa R, Basnadjian Y, González MM, González M, Salvatella R. Actualización clínico-epidemiológica y terapéutica de la enfermedad de Chagas en Uruguay. Rev Med Uruguay. 2001;17:125-32.
7. Moncayo A. Chagas disease: current epidemiological trends after the interruption of vectorial and transfusional transmission in the Southern Cone countries. Mem Inst Oswaldo Cruz. 2003;98:577-91.
8. Guhl F, Nicholls RS. Manual de procedimientos para el diagnóstico de la enfermedad de Chagas. Bogotá, D.C.: Quebecor Impresores; 2001.
9. Pavía P, Cuervo C, Montilla M, Nicholls S, Puerta C. Diseño y estandarización de una prueba de PCR para la detección específica de Trypanosoma cruzi. Infectio. 2003;7:129-36.
10. Pavia P, Vallejo GA, Montilla M, Nicholls RS, Puerta CJ. Detection of Trypanosoma cruzi and Trypanosma rangeli infection in triatomine vectors by amplification histone H2A and sno-RNA-CL1 genes. Rev Inst Med Trop Sao Paulo. 2007;49:23-30.
11. Duque S, Peláez D, Corredor A. Normas para cultivo in vitro de parásitos de la familia trypanosomatidae. Manual de procedimientos. Bogotá, D.C.: Instituto Nacional de Salud; 1993.
12. Sturm NR, Degrave W, Morel C, Simpson L. Sensitive detection and schizodeme classification of Trypanosoma cruzi cells by amplification of kinetoplast minicircle DNA sequences: use in diagnosis of Chagas disease. Mol Biochem Parasitol. 1989;33:205-14.
13. Yeo M, Acosta N, Llewellyn M, Sánchez H, Adamson S, Miles GA, et al. Origins of Chagas disease: Didelphis species are natural hosts of Trypanosoma cruzi I and armadillos hosts of Trypanosoma cruzi II, including hybrids. Int J Parasitol. 2005;35:225-33.
14. Saldaña CH, Cordova OP, Vargas FV. Utilización de Lepidium peruvianum (Maca), como medio de cultivo para el crecimiento de T. cruzi. Rev Peru Med Exp Salud Pública. 2006;23:137-40.
15. Virreira M, Torrico F, Truyens C, Alonso-Vega C, Solano M, Carlier Y, et al. Comparison of polymerase chain reaction methods for reliable and easy detection of congenital Trypanosoma cruzi infection. Am J Trop Med Hyg. 2003;68:574-82.
16. Hypsa V, Dale C. In vitro culture and phylogenetic analysis of “Candidatus Arsenophorus triatominarum,” an intracellular bacterium from the triatomine bug, Triatoma infestans. Int J Syst Bacteriol. 1997;47:1140-4.
17. Welsh J, McClelland M. Fingerpriting genomes using PCR with arbitrary primers. Nucleic Acids Res. 1990;18:7213-8.
18. Triquell MF, Díaz-Luján C, Freilij H, Paglini P, Fretes RE. Placental infection by two subpopulations of Trypanosoma cruzi is conditioned by differential survival of the parasite in a deleterious placental medium and not by tissue reproduction. Trans R Soc Trop Med Hyg. 2009 Mar 30. [Epub ahead of print]
19. Franco DJ, Vago AR, Chiari E, Meira FC, Galvao LM, Machado CR. Trypanosoma cruzi: mixture of two populations can modify virulence and tissue tropism in rat. Exp Parasitol. 2003;104:54-61.
20. Liarte DB, Murta SM, Steindel M, Romanha AJ. Trypanosoma cruzi: Multiplex PCR to detect and classify strains according to groups I and II. Exp Parasitol. 2008. doi 10.1016/j.exppara.2008.12.005. [Epub ahead of print].
21. Botero LA, Mejía AM, Triana O. Caracterización biológica y genética de dos clones pertenecientes a los grupos I y II de Trypanosoma cruzi de Colombia. Biomédica. 2007;27(Suppl.1)1:64-74.
22. Neto EC, Rubin R, Schulte J, Giugliani R. Newborn screening for congenital infectious disease. Emerg Infect Dis. 2004;10:1068-73.
23. Freilij H, Altcheh J. Congenital Chagas disease: diagnostic and clinical aspects. Clin Infect Dis. 1995;21;551-5.
24. Carlier Y, Torrico F. Congenital infection with Trypanosoma cruzi: from mechanisms of transmission to strategies for diagnosis and control. Rev Soc Brasil Med Trop. 2003;6:767-71.
How to Cite
1.
Puerta CJ, Pavia PX, Montilla M, Flórez C, Herrera G, Ospina JM, et al. The first case of congenital Chagas’ disease analyzed by AP-PCR in Colombia. Biomed. [Internet]. 2009 Dec. 1 [cited 2025 Apr. 5];29(4):513-22. Available from: https://revistabiomedicaorg.biteca.online/index.php/biomedica/article/view/125
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Published
2009-12-01
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Section
Case presentation
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