Jorge Enrique Gómez-Marín

Herein, we report the first case of confirmed maternal reinfection in an immunocompetent woman, resulting in congenital toxoplasmosis in Colombia. The child was referred to an infectious disease pediatrician at 17 months of age because of strabismus and typical bilateral chorioretinitis scars with elevated immunoglobulin (Ig)G anti- Toxoplasma . The mother tested positive for Toxoplasma antibodies (IgG-positive and IgM-negative) in 2020. Four months before becoming pregnant in 2023, both IgG and IgM were positive. Serotyping indicated that the mother had antibodies against GRA6 types I and III strains, but the child only had antibodies against type I, suggesting that the mother was reinfected with a different strain during the periconceptional period, which was transmitted to the child.

Background: No analyses have explored the differential clinical characteristics of cyclosporiasis compared with other diarrheal etiologies. Methods: We conducted a prospective study of 118 children with diarrheal illnesses. Stool samples were analyzed using Ziehl–Neelsen (ZN) staining and polymerase chain reaction (PCR) targeting the ssu rRNA gene. Positive PCR samples were sequenced to identify phylogroups (A, B and C). Quantitative variables were compared using the Mann–Whitney U test. Qualitative associations were analyzed using odds ratios (ORs) and Fisher exact or χ ² tests. A parsimonious multivariate logistic regression identified independent predictors while controlling for sample size effects. Results: Cyclosporiasis was identified in 18.6% (n = 22) by ZN and 19.5% (n = 23) by PCR. Diagnostic agreement was substantial (kappa = 0.81). Stool pH was significantly more alkaline in the ZN-positive group (median: 7.5, range: 4.0–9.0) than in the negative group (median: 6.0, range: 4.0–9.0; P = 0.0206). High-output diarrhea (OR = 3.58; 95% confidence interval: 1.29–9.94; P = 0.011) and abdominal pain (OR = 3.05; 95% confidence interval: 1.16–7.99; P = 0.020) were the primary clinical hallmarks of cyclosporiasis. Lineage B was the endemic strain, causing most acute, high-output secretory diarrhea cases. The parasite was found in domestic water and food (coriander) with 100% identity with lineage B. Conclusions: Pediatric Cyclospora infection presents with a distinct clinical triad: high-volume watery diarrhea, abdominal pain and alkaline stool Ph. Lineage B is the drive core of cases with waterborne transmission as a primary pathway.

Background. Congenital toxoplasmosis, a vertical infection caused by Toxoplasma gondii, can result in neurological and ocular sequelae that may manifest even years postnatally. Although standardized postnatal treatments have been implemented, clinical recurrences, particularly ocular ones, are anticipated to persist during extended follow-up periods. Consequently, prenatal treatment may potentially mitigate these recurrences; however, the evidence supporting this is currently limited and dispersed. Aim: To conduct a meta-analysis on the recurrence rate in children with congenital toxoplasmosis, considering their history of prenatal and postnatal treatment (spanning at least one year), and incorporating long-term clinical follow-up (extending for a minimum of two years). Methods. The databases utilized for the study selection process included PubMed, Web of Science, and Google Scholar. The Medical Subject Headings (MeSH) terms employed were “Toxoplasmosis AND Congenital” and "Toxoplasmosis AND Ocular.” The search was refined using the filters “clinical trial” and “randomized controlled trial.” Additionally, the references of the identified articles were scrutinized to identify other pertinent studies, employing the snowball technique. Experts in the field were consulted to provide relevant published or unpublished data. Studies were included if they reported a minimum of two years of follow-up and presented the results of ophthalmological follow-up. Data concerning prenatal treatment were extracted and systematically organized in an Excel database. The recurrence rate was determined by dividing the number of relapses among untreated patients over the follow-up period by 100. Results. Following revision, only three studies documented the incidence of new retinochoroiditis episodes during extended ophthalmological follow-up. All children in these cohorts received a minimum of one year, with some receiving up to two years of postnatal anti-Toxoplasma treatment. The adjusted recurrence rate in prenatally treated children was 2.6 (n = 229), whereas in untreated children, it was 16.2 (n = 185). The overall adjusted risk of recurrence in prenatally treated children was 0.23 (95% CI: 0.09–0.56; p = 0.001). Conclusions. There is a paucity of research concerning the impact of prenatal treatment on the ocular recurrence of congenital toxoplasmosis. A meta-analysis of three studies revealed that the absence of prenatal treatment heightened the risk of new episodes, even after one year of comprehensive postnatal treatment.

Concurrent evaluation of the antiparasitic efficacy of synthetic and natural compounds can provide novel insights into the development of anti-Toxoplasma drugs. We assessed 16 synthetic compounds and two fractions derived from the leaves of Tabebuia rosea and Tabebuia chrysantha tree species for their in vitro activity against live parasites, employing strains that express green fluorescent protein and specific identification of bradyzoites using an anti-BAG1 monoclonal antibody. This study successfully identified several promising synthetic compounds with potent anti-Toxoplasma activity and favorable in vitro selectivity profiles, notably pyrazoline 2 and thiazolidinone 9. One thiazolidinone compound exhibited significant activity against extracellular tachyzoites, whereas one tree fraction demonstrated excellent activity against both tachyzoites and bradyzoites. Additionally, their in silico ADMET properties suggest their potential for good in vivo performance and CNS penetration. Although the natural extracts showed less potency in their crude form, they provide a basis for future purification efforts. The simultaneous evaluation of compounds sourced from diverse discovery pipelines can offer valuable insights into the development of drugs that target various biological pathways.

Concurrent evaluation of the antiparasitic efficacy of synthetic and natural compounds can provide novel insights into the development of anti-Toxoplasma drugs. We assessed 16 synthetic compounds and fractions derived from the leaves of two Tabebuia tree species for their in vitro activity against live parasites, employing strains that express green fluorescent protein and specific identification of bradyzoites with an anti-BAG1 monoclonal antibody. This study successfully identified several promising synthetic compounds with potent anti-Toxoplasma activity and favorable in vitro selectivity profiles, notably pyrazoline 2 and thiazolidinone 9. One thiazolidinone compound exhibited significant activity against extracellular tachyzoites, whereas one tree fraction demonstrated excellent activity against both tachyzoites and bradyzoites. Additionally, their in silico ADMET properties suggest their potential for good in vivo performance and CNS penetration. Although the natural extracts showed less potency in their crude form, they provide a basis for future purification efforts. The simultaneous evaluation of compounds sourced from diverse discovery pipelines can offer valuable insights into the development of drugs that target various biological pathways.

La revista Infectio es el órgano oficial de divulgación científica de la Asociación Colombiana de Infectología. Durante sus 30 años de vida ha desarrollado un papel fundamental en la difusión de nuevo conocimiento en la especialidad. Un ejemplo importante de ello fue la publicación de las guías de práctica clínica para prevención, diagnóstico, manejo y vacunación para COVID-19, las cuales se convirtieron en la herramienta fundamental que definieron las conductas médicas y de prevención, durante la pandemia. Otras guías e informaciones fundamentales sobre enfermedades infecciosas han aparecido a lo largo de la historia de la revista, convirtiéndola en un faro para la práctica médica en Colombia y una fuente fundamental sobre al epidemiologia y la clínica de las enfermedades infecciosas en Colombia. Esto la ha convertido en fuente de referencia para conocer el estado de infecciones de zona tropical, sobre las cuales las revistas internacionales no cubren los aspectos particulares, que

Background: Congenital toxoplasmosis results from infection with the parasite Toxoplasma gondii, which is transmitted from mother to child during pregnancy. Although Western blot is considered the most sensitive diagnostic tool for congenital toxoplasmosis, its diagnostic performance has not been subjected to meta-analysis. Methods: We conducted a systematic review and meta-analysis by performing literature searches across PubMed, Scopus, and Web of Science. The search strategy included the terms "western blot OR immunoblot" AND "congenital toxoplasmosis." The selected studies were required to meet specific inclusion criteria, which involved comparing the performance of the western blot test against the gold standard criteria for permanence of IgG after 10 months of age. These studies had to be case and control studies. The data obtained from the studies were then organized into an evidence synthesis table and the sensitivity, specificity, and Diagnostic Odds Ratio (DOR) index were calculated. This meta-analysis was performed in compliance with the recommendations of PRISMA guidelines. Results: After evaluating the selection criteria, we identified 44 articles; however, only 10 were selected for the meta-analysis. Western blot assay demonstrated a pooled sensitivity of 93.8% (95% CI: 79.2-98.4) and a pooled specificity of 96.6% (95% CI: 89.8-98.9) for the diagnosis of congenital toxoplasmosis. Six of the 10 studies had a DOR higher than 300, whereas the in-house method yielded a lower DOR of 1.2. Conclusions: This meta-analysis confirmed the utility of well-standardized western blot tests as a dependable diagnostic approach for congenital toxoplasmosis in terms of both sensitivity and specificity.