{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:30:58Z","timestamp":1789500658251,"version":"build-2803163510"},"reference-count":51,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context.\u2014<\/jats:title>\n                    <jats:p>Infections are the leading cause of perinatal and infant mortality in low-income and low-resource countries, which have a higher prevalence of infections. Definitive diagnosis of congenital and perinatal infections is largely dependent upon the results of laboratory tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective.\u2014<\/jats:title>\n                    <jats:p>To develop a multiplex nested polymerase chain reaction (PCR) technique for the simultaneous detection of 7 pathogens containing DNA in their genomes in suspected cases of congenital infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design.\u2014<\/jats:title>\n                    <jats:p>Eligible participants were pregnant women with positive immunoglobulin M antibodies raised to one of the pathogens in the prenatal serologic screening, associated or not with fetal ultrasound abnormalities or positive fetal serology. Neonates whose mothers did not attend prenatal care were included when they presented with symptomatology and laboratory parameters suggestive of infection. The detection rate of the multiplex nested PCR was compared with maternal, fetal, and neonatal serology, as well as placental immunohistochemistry and noncommercial amplifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.\u2014<\/jats:title>\n                    <jats:p>Of 161 suspected cases, the multiplex nested PCR detected 60 (37.3%), whereas the tests available in hospital laboratories detected 13 of 60 (21.7%) of the cases detected by the multiplex nested PCR, demonstrating a 4.6 times higher detection rate for the multiplex nested PCR (Fisher exact test, P &amp;lt; .001). Positive amplifications were to Toxoplasma gondii (32 cases), cytomegalovirus (14 cases), parvovirus B19 (5 cases), and adenovirus (5 cases). In 4 cases, 2 pathogens were simultaneously detected. All types of biological matrices were suitable for amplification. Sequencing of multiplex nested PCR products confirmed the molecular findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.\u2014<\/jats:title>\n                    <jats:p>The multiplex nested PCR significantly increased the number of diagnosed congenital infections. Given the scarcity of DNA recovered from amniotic fluid and some neonatal samples, this multiplex nested PCR allows the simultaneous detection of 7 pathogens associated with congenital infections in a reliable, faster, cost-effective, and more sensitive way.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5858\/arpa.2018-0544-oa","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T11:19:13Z","timestamp":1561029553000},"page":"99-106","source":"Crossref","is-referenced-by-count":6,"title":["Performance of a Multiplex Nested Polymerase Chain Reaction in Detecting 7 Pathogens Containing DNA in Their Genomes Associated With Congenital Infections"],"prefix":"10.5858","volume":"144","author":[{"given":"Lidia","family":"Yamamoto","sequence":"first","affiliation":[{"name":"From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio G. Amorim","family":"Filho","sequence":"additional","affiliation":[{"name":"From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelma A.","family":"Queiroz","sequence":"additional","affiliation":[{"name":"From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario H. B.","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonatas C.","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly A.","family":"Kanunfre","sequence":"additional","affiliation":[{"name":"From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana P. V.","family":"Francisco","sequence":"additional","affiliation":[{"name":"From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thelma Suely","family":"Okay","sequence":"additional","affiliation":[{"name":"From the Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine (Drs Yamamoto, Rodrigues, Kanunfre, and Okay), the Department of Obstetrics and Gynecology, School of Medicine (Drs Amorim Filho, Queiroz, Carvalho, and Francisco), and LIM 48, Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine (Dr Kanunfre), University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","published-online":{"date-parts":[[2019,6,20]]},"reference":[{"key":"2020081300314882400_i1543-2165-144-1-99-b01","article-title":"Neonatal health in the context of maternal, newborn and child health for the attainment of the Millennium Development Goals of the United Nations Millennium Declaration","author":"Pan American Health Organization","year":"2006"},{"issue":"3","key":"2020081300314882400_i1543-2165-144-1-99-b02","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/ije\/dyl043","article-title":"Estimating the causes of 4 million neonatal deaths in the year 2000","volume":"35","author":"Lawn","year":"2006","journal-title":"Int J Epidemiol"},{"issue":"14","key":"2020081300314882400_i1543-2165-144-1-99-b03","first-page":"1","article-title":"Infant mortality statistics from the 2004 period linked birth\/infant death data set","volume":"55","author":"Mathews","year":"2007","journal-title":"Natl Vital Stat Rep"},{"key":"2020081300314882400_i1543-2165-144-1-99-b04","doi-asserted-by":"crossref","article-title":"The state of the world's children 2009: maternal and newborn health: where we stand","author":"UNICEF. 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