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. 2019 May;33(4):e22828.
doi: 10.1002/jcla.22828. Epub 2019 Jan 21.

Seasonal influence on TORCH infection and analysis of multi-positive samples with indirect immunofluorescence assay

Lu Chen  1 , Jingrui Liu  1 , Lei Shi  2 , Yang Song  1 , Yujie Song  1 , Yang Gao  1 , Ying Dong  1 , Lin Li  3 , Min Shen  4 , Yanhong Zhai  1 , Zheng Cao  1
Affiliations

Seasonal influence on TORCH infection and analysis of multi-positive samples with indirect immunofluorescence assay

Lu Chen et al. J Clin Lab Anal. 2019 May.

Abstract

Background: TORCH including the pathogens of Toxoplasma gondii (TOX), rubella virus (RV), cytomegalovirus (CMV), and herpes simplex virus (HSV) causes intrauterine infections and poses a worldwide threat to women especially in pregnancy. In this study, we described the seasonal difference in TORCH infection and analyzed the anti-TORCH IgM multipositive serum samples by the indirect immunofluorescence assays (IFA).

Methods: To observe the seasonal influence of the anti-TORCH IgG and IgM antibodies, a retrospective study was conducted with 10 669 women (20-40 y old) before pregnancy from August 2016 to July 2017. Totally 199 ELISA anti-TORCH IgM multipositive serum samples were further tested by IFAs for false-positive analysis.

Results: The prevalence of positive HSV1-IgM, RV-IgM, HSV2-IgM, CMV-IgM, and TOX-IgM in the present population was 6.30%, 2.55%, 1.94%, 1.24%, and 0.67%, respectively. Additionally, the prevalence of positive RV-IgM, CMV-IgM, and HSV1-IgM was statistically different among four seasons, with the highest positive rates of RV-IgM (4.12%) in autumn, CMV-IgM (1.75%) in summer, and HSV1-IgM (7.53%) in winter. The confirmatory IFAs showed that the positive rates of RUV-IgM, CMV-IgM, and HSV2-IgM were significantly different from those in ELISA screening experiments. Interestingly, only 32.7% (65/199) of the TORCH IgM multipositive results were consistent with those by the IFA, indicating that cross-reaction caused false positives were common in ELISA IgM antibody screening.

Conclusion: The TORCH infection displayed different prevalence among four seasons in our 12-month retrospective study. The IgM multipositives by ELISA screening may need further confirmation analysis due to its relatively high cross-reaction rate.

Keywords: IFA; TORCH; multipositive; prevalence; season.

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Figures

Figure 1
Figure 1
Examples of the positive TORCH IFA results from our patients at the magnification of 500‐fold. A, B, C, D, and E are anti‐TOX‐IgM, anti‐RV‐IgM, anti‐CMV‐IgM, anti‐HSV1‐IgM, and anti‐HSV2‐IgM‐positive IFA images, respectively
See this image and copyright information in PMC

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