Toxoplasma DNA detection by PCR

General Information

Lab Name

Toxoplasma DNA detection by PCR

Lab Code

TOXDNA

Epic Name

Toxoplasma DNA detection by PCR

Description

Detection of Toxoplasma gondii DNA.

The protozoan Toxoplasma gondii is estimated to be carried by one third of the world's population with infection typically occurring by eating infected meat, contact with a cat that has itself recently been infected, or by transmission from mother to fetus. During acute toxoplasmosis, symptoms are often influenza-like: swollen lymph nodes, or muscle aches and pains that last for a month or more. Rarely, a patient with a fully functioning immune system may develop eye damage from toxoplasmosis.

Toxoplasmosis can be difficult to distinguish from that of primary central nervous system lymphoma, and as a result, the diagnosis is made by a trial of therapy (pyrimethamine, sulfadiazine + leucovorin), or a brain biopsy if the drugs produce no effect. Serologic testing for both IgG and IgM can determine if and when individual is/was infected. Additionally, PCR has been successfully used to diagnose congenital, ocular, cerebral and disseminated toxoplasmosis. PCR performed on amniotic fluid has revolutionized the diagnosis of fetal T. gondii infection by enabling an early diagnosis to be made, thereby avoiding the use of more invasive procedures on the fetus. PCR has allowed detection of T. gondii DNA in brain tissue, CSF, vitreous and aqueous fluid, BAL, urine, amniotic fluid and peripheral blood.

Among PCR assays, the B1 gene is consistently determined to be a useful target. B1 is a tandem-arrayed 35-fold-repetitive gene which has been used for both detection and typing of Toxoplasma strains in clinical samples. The UWMC Molecular Diagnosis laboratory utilizes a 2-step, hemi-nested PCR approach to amplify a region of the B1 gene. Identification of Toxoplasma gondii depends on SYBR-green melting curve and evaluation of the sequenced product.

Synonyms

molecular Toxoplasma, molecular Toxoplasma gondii, Parasite identification, Parasite PCR, Synonyms: Toxoplasma PCR, Toxoplasma detection, Toxoplasma gondii detection, Toxoplasma gondii identification, Toxoplasma gondii PCR, Toxoplasma gondii sequencing, Toxoplasma identification, Toxoplasma sequencing, Toxoplasmosis, universal PCR

Components

Code Name
TOXRS Toxoplasma PCR: Detection, B1
TOXID Toxoplasma PCR: Identification, B1
TOXSI Toxoplasma PCR: Specimen Description
TOXSPI Toxoplasma PCR: External Identifier
TOXSR Toxoplasma PCR: Special Requests
TOXSC Toxoplasma PCR: Specimen Comments
TOXNAE Toxoplasma PCR: Specimen DNA Extraction
TOXREV Toxoplasma PCR: Pathologist Review
TOXME Toxoplasma PCR: Method Note

Interpretation

Method

DNA extraction, nucleic acid purification, polymerase chain reaction (PCR), sequencing

Reference Range

See individual components

Guidelines

Ordering & Collection

Specimen Type

Tissue (Fresh frozen or paraffin-embedded), Fluid (see Acceptable Specimens for details)

Collection

Acceptable specimens are listed below. Please see Molecular Microbiology Specimen Submission for complete specimen collection and handling instructions.

Shipping/Handling

  • Fresh frozen tissue/fluid specimens should be collected into a DNA free container labeled with at least two identifiers and be submitted and maintained on dry ice.
  • Formalin Fixed Paraffin-embedded tissues (FFPE, PET) can be sent ambient or with ice packs during warmer summer months to prevent melting.

Acceptable Specimens

*Mycobacterium avium complex DNA Detection [MAVDNA] can be ordered on sputum

**Fungal PCR reflex NGS [FUNDNA] and Fungal DNA Detection by PCR (without reflex to NGS) [NRFDNA] may have interference due to some lots of eSwabs which have been found to contain Saccharomyces cerevisiae DNA, resulting in false positive detection. Clinical correlation and/or retesting with a different collection method is advised. The detection of S. cerevisiae from eSwab specimens can interfere with our ability to rule out other fungal DNA.

    Unacceptable Specimens

    • Blood, serum, plasma, stool/rectal swabs
    • No citrated or heparinized solutions
    • Tissues floating in formalin
    • Swab/fluid collected in tube containing agar

    Optimal Quantity:

    • Fresh Tissue: 0.3-1.0 cm^3
    • Fluid: 0.2-1 mL
    • Formalin Fixed Paraffin-embedded Tissue (FFPE/PET): blocks are preferred and will be sent back to client upon completion of testing
    • Scrolls/unstained slides: cross-sectional area >1cm^2 send 10 sections of 10µm thickness, if <1cm^2 send 20 sections if available

    Please note: We do not need a separate specimen aliquot for each test ordered. Only a single specimen aliquot or block of optimal quantity is necessary for performing multiple tests. If multiple aliquots or blocks of optimal quantity are sent, up to 2 will be pooled.

Forms & Requisitions

Molecular Microbiology Order Form

Handling Instructions

Please see Molecular Microbiology Specimen Submission for complete specimen collection and handling instructions.

Quantity

requested: See "Collection" for Optimal Quantity
minimum: Specimens below optimal quantity are acceptable for testing, however, diagnostic yield is generally proportional to specimen size.

Processing

UWMC/HMC: Store and send fresh tissue/fluid specimens refrigerated, if specimen storage and transport will exceed 8 hours, freeze at -20°C. Freeze all fresh tissue/fluid specimens at -20°C upon arrival in UW Molecular Microbiology.

Performance

LIS Dept Code

Micro Molecular Diag (MMD)

Performing Location(s)

UW-MT Microbiology, Molecular Diagnostics
206-520-4600

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Shipping Address

Attn: Molecular Microbiology
UW CLSPS
1601 Lind Ave SW Room 117
Renton, WA 98057
Phone: 206-520-4600
Alternate phone: 206-598-6147

Performing Lab Address

Clinical Microbiology Lab, NW177
University of Washington Medical Center
1959 NE Pacific Street
Seattle, WA 98195
Phone: 206-598-5735
Alternate phone: 206-598-6147

Contact Information

Please e-mail us with any questions or comments you may have. Your inquiry will be answered as soon as possible.

email: molmicdx@uw.edu

The Molecular Microbiology lab is open from Monday-Friday, 7am-4pm PDT.

Billing inquiries and requests for faxed reports can be made to our Client Services Department at (206) 520-4600 or (800) 713-5198.

For results or other inquiries, we can be reached by phone at the following numbers:

  • Phone: (206) 598-5735
  • Alternate phone: (206) 598-6147
  • FAX: (206) 520-4903

For assistance during weekends, holidays and after hours, please contact Lab Medicine Resident at (206) 598-6190

Frequency

Fresh frozen tissues/fluids result in 2-3 business days after receipt of specimen. Formalin Fixed Paraffin-embedded tissues result in 3-4 business days after receipt of specimen.

Available STAT?

No

Billing & Coding

CPT codes

87798

LOINC

29904-0

Interfaced Order Code

UOW4464