Seropositivity incidence of anti-Toxoplasma gondii antibodies in critically ill intensive care unit patients

Introduction

Toxoplasma gondii, a worldwide-distributed parasite, could cause opportunistic infection with high mortality in immuno-suppressive individuals. Its association with severe manifestations of immunosuppression has been known for several decades, and the occurrence of encephalitis and disseminated disease has since been observed in different clinical conditions such as lympho-reticular neoplasias, solid organ transplants, and mainly in patients with AIDS [1]. To our knowledge, the toxoplasmosis seropositivity rate in ICU patients who have critical illness induced immuno-suppression is not yet investigated. We studied the seropositivity incidence of T. gondii in ICU patients by assessing IgG and IgM antibodies.

Materials and methods

One hundred and three ICU patients with the mean age of 53.9 ± 13.9 years (51 men, 52 women) and 78 healthy volunteers with the mean age of 51.4 ± 9.2 years (39 men, 29 women) as a control group were included in the study. Anti-T. gondii IgG and IgM antibodies were determined by ELISA. Statistical analyses were done with the chi-square test and Kolmogorov–Smirnov one-sample test. P < 0.05 was considered as statistical significance.

Results

T. gondii IgG antibodies were positive in 56.3% of ICU patients (n = 58) and in 24.3% of healthy volunteers (n = 19) (P < 0.031). IgM antibodies were positive in 13.8% of ICU patients (n = 15) and in 6.4% of healthy volunteers (n = 5); however, this difference could not reach statistical significance.

Conclusion

The results of the study reveal that toxoplasma seropositivity is not uncommon in ICU patients. Therefore, to prevent the possibility of toxoplasmosis, seropositivity should be periodically assessed in critically ill immunocompromised ICU patients. It is clear that further studies are required to evaluate the effects of seropositivity on ICU outcome.