{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:41:56Z","timestamp":1782877316299,"version":"3.54.5"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>\n                    Occupationally acquired cases of the intracellular parasite\n                    <jats:italic>Toxoplasma gondii<\/jats:italic>\n                    have been reported, even though there is uncertainty on which infection prevention measures should be implemented in such event. We report a clinical case of laboratory-acquired toxoplasmosis and propose a protocol for post-exposure prophylaxis, given there are no formal guidelines. In this community case study, we describe the management and prevention protocol following an occupational laboratory exposure by a healthy 30-year-old\n                    <jats:italic>Toxoplasma<\/jats:italic>\n                    -seronegative female researcher who suffered an accidental needle puncture with a sample containing a genetically modified hypervirulent\n                    <jats:italic>Toxoplasma gondii<\/jats:italic>\n                    strain. Post-exposure prophylaxis (PEP) with trimethoprim-sulfamethoxazole was implemented for 4 weeks, during which seroconversion occurred, without any accompanying symptoms.\n                    <jats:italic>Toxoplasma<\/jats:italic>\n                    IgM and IgG positivity was observed 21 and 50\u202fdays after exposure, respectively, using a validated commercial electrochemiluminescence immunoassay (ECLIA, Roche). Follow-up was maintained for 1 year, during which the patient remained asymptomatic. This report highlights the importance of special care, surveillance and decision on the need for PEP upon occupational laboratory accidental exposure to\n                    <jats:italic>Toxoplasma gondii<\/jats:italic>\n                    . Since there are no guidelines on what the optimal PEP regimen should be, after a literature review, we propose a PEP occupational safety protocol to be implemented in laboratories that handle samples containing\n                    <jats:italic>Toxoplasma gondii<\/jats:italic>\n                    , either in clinical or research setting.\n                  <\/jats:p>","DOI":"10.3389\/fpubh.2025.1728709","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T06:40:33Z","timestamp":1768977633000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Preventing laboratory-acquired Toxoplasma gondii infection: literature review and case-based post-exposure prophylaxis proposal"],"prefix":"10.3389","volume":"13","author":[{"given":"Diana","family":"P\u00f3voas","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Hospital de Curry Cabral, Unidade Local de Sa\u00fade S\u00e3o Jos\u00e9","place":["Lisbon, Portugal"]},{"name":"Lymphocyte Physiology, Gulbenkian Institute for Molecular Medicine","place":["Oeiras, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyne","family":"Demengeot","sequence":"additional","affiliation":[{"name":"Lymphocyte Physiology, Gulbenkian Institute for Molecular Medicine","place":["Oeiras, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Maltez","sequence":"additional","affiliation":[{"name":"Instituto de Sa\u00fade Ambiental, Faculdade de Medicina, Universidade de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1128\/CMR.14.3.659-688.2001","article-title":"Laboratory-acquired parasitic infections from accidental exposures","volume":"14","author":"Herwaldt","year":"2001","journal-title":"Clin Microbiol Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/01652176.2024.2396577","article-title":"The global seroprevalence of toxoplasma gondii infection in workers occupationally exposed to animals (1972-2023): a systematic review and meta-analysis","volume":"44","author":"Mohammed","year":"2024","journal-title":"Vet Q"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"12102","DOI":"10.1038\/s41598-020-69078-9","article-title":"Global, regional, and country seroprevalence of toxoplasma gondii in pregnant women: a systematic review, modelling and meta-analysis","volume":"10","author":"Bigna","year":"2020","journal-title":"Sci Rep"},{"key":"ref4","volume-title":"Biosafety in microbiological and biomedical laboratories (BMBL) 6th edition","year":"2024"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"20C.1.1","DOI":"10.1002\/cpmc.26","article-title":"Toxoplasma gondii: laboratory maintenance and growth","volume":"44","author":"Khan","year":"2017","journal-title":"Curr Protoc Microbiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"14010","DOI":"10.1074\/jbc.271.24.14010","article-title":"Insertional tagging, cloning, and expression of the toxoplasma gondii hypoxanthine-xanthine-guanine phosphoribosyltransferase gene. Use as a selectable marker for stable transformation","volume":"271","author":"Donald","year":"1996","journal-title":"J Biol Chem"},{"key":"ref7","article-title":"Toxoplasma gondii Biological Agent Reference Sheet (BARS)","year":"2023"},{"key":"ref8","article-title":"Safety Precautions for Working with Toxoplasma gondii","year":""},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1016\/j.ijid.2009.11.015","article-title":"Treatment of toxoplasmic lymphadenitis with co-trimoxazole: double-blind, randomized clinical trial","volume":"14","author":"Alavi","year":"2010","journal-title":"Int J Infect Dis"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1179\/2047773213Y.0000000094","article-title":"Antibiotics for human toxoplasmosis: a systematic review of randomized trials","volume":"107","author":"Rajapakse","year":"2013","journal-title":"Pathog Glob Health"},{"key":"ref11","article-title":"Biological safety manual - chapter 08: agent summary statements (section III: parasitic agents)","year":"2021"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1016\/j.ijpara.2009.01.005","article-title":"History of the discovery of the life cycle of toxoplasma gondii","volume":"39","author":"Dubey","year":"2009","journal-title":"Int J Parasitol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"762","DOI":"10.3855\/jidc.9428","article-title":"Laboratory associated zoonotic parasitic infections: a review of main agents and biosecurity measures","volume":"17","author":"Sini","year":"2023","journal-title":"J Infect Dev Ctries"},{"key":"ref14","first-page":"e194","article-title":"Laboratory-acquired infections and pathogen escapes worldwide between 2000 and 2021: a scoping review","volume-title":"Lancet Microbe","author":"Blacksell","year":"2024"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1829","DOI":"10.1017\/S0031182011001478","article-title":"Toxoplasma gondii: the changing paradigm of congenital toxoplasmosis","volume":"138","author":"Lindsay","year":"2011","journal-title":"Parasitology"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1097\/00005792-199411000-00004","article-title":"Extracerebral toxoplasmosis in patients infected with HIV. A French national survey","volume":"73","author":"Rabaud","year":"1994","journal-title":"Medicine (Baltimore)"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1080\/20477724.2017.1370528","article-title":"Prophylaxis of human toxoplasmosis: a systematic review","volume":"111","author":"Rajapakse","year":"2017","journal-title":"Pathog Glob Health"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1111\/hiv.12402","article-title":"A systematic review and meta-analysis of the relative efficacy and safety of treatment regimens for HIV-associated cerebral toxoplasmosis: is trimethoprim-sulfamethoxazole a real option?","volume":"18","author":"Hernandez","year":"2017","journal-title":"HIV Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/BF01967063","article-title":"Cotrimoxazole therapy of toxoplasma gondii encephalitis in AIDS patients","volume":"11","author":"Canessa","year":"1992","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.1128\/AAC.42.6.1346","article-title":"Randomized trial of trimethoprim-sulfamethoxazole versus Pyrimethamine-sulfadiazine for therapy of Toxoplasmic encephalitis in patients with AIDS","volume":"42","author":"Torre","year":"1998","journal-title":"Antimicrob Agents Chemother"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s40268-017-0206-8","article-title":"Adverse event profile of Pyrimethamine-based therapy in toxoplasmosis: a systematic review","volume":"17","author":"Ben-Harari","year":"2017","journal-title":"Drugs RD"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1728709\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T06:40:34Z","timestamp":1768977634000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1728709\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":21,"alternative-id":["10.3389\/fpubh.2025.1728709"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1728709","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"article-number":"1728709"}}