Toxoplasma DNA detection by PCR
General Information
- Lab Name
- Toxoplasma DNA detection by PCR
- Lab Code
- TOXDNA
- Epic Ordering
- 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.
- Forms & Requisitions
- 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
- Fresh frozen tissue
- Fresh frozen fluid: any body fluid is acceptable if it is not listed under Unacceptable Specimens.
- Common examples include: cerebrospinal fluid, pleural fluid, pericardial fluid, urine, bronchial lavage, joint fluid, bone marrow, vitreous fluid, etc.
- Formalin Fixed Paraffin-embedded tissues (FFPE, PET): blocks, scrolls, and unstained slides
- Sputum: acceptable - except for Bacterial PCR reflex NGS [BCTDNA]/Bacterial DNA Detection by PCR (without reflex to NGS) [NRBDNA], Fungal PCR reflex NGS [FUNDNA]/Fungal DNA Detection by PCR (without reflex to NGS) [NRFDNA], and Nontuberculous Mycobacteria DNA Detection [NTMDNA]* assays
- eSwabs**, UTM (universal transport media), body fluid/bone marrow in EDTA (not including blood)
- Sodium polyanethol sulfonate (SPS, Wampole Isolator Tubes) acceptable with disclaimer
*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
- 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
- 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----------------------------------------
Shipping Address
Attn: Molecular Microbiology
UW CLSPS
1601 Lind Ave SW Room 117
Renton, WA 98057
Phone: 206-520-4600
Alternate phone: 206-598-6147Performing Lab Address
Clinical Microbiology Lab, NW177
University of Washington Medical Center
1959 NE Pacific Street
Seattle, WA 98195
Phone: 206-598-5735
Alternate phone: 206-598-6147Contact 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