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Rudzińska M, Sikorska K. Epidemiology of Blastocystis Infection: A Review of Data from Poland in Relation to Other Reports. Pathogens 2023; 12:1050. [PMID: 37624010 PMCID: PMC10458783 DOI: 10.3390/pathogens12081050] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 08/26/2023] Open
Abstract
Blastocystis is a common gut protist of humans and various animals worldwide, with a high level of genetic diversity. Neither its zoonotic potential and transmission routes nor its pathogenicity are fully known. This fact, and the fact that Blastocystis is the most abundant eukaryote in human faeces, raises the question of its relevance to public health. Here, we summarise (in relation to other reports) the results of studies on the prevalence and genotypic variation of Blastocystis, which were carried out in animals, humans, and in water environments in Poland. In humans, the prevalence ranged between 0.14 and 23.6%, in some animals reached 58.97%, and in water environments was 5.1%. Seven subtypes were identified in humans (ST1-ST4, ST6, ST7, and ST9), of which ST3 was the most common. Among animals (wild, livestock, and pet animals), eleven STs were identified, with differential host specificity. Humans and animals shared ST1, ST2, ST3, ST6, and ST7, while ST1 and ST3 were present in humans, animals, and water sources. These observations indicate the possibility of Blastocystis transmission between animals and humans. Further studies should be continued in search of the sources and transmission routes of Blastocystis in order to prevent the spread of infections among humans and animals.
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Affiliation(s)
- Monika Rudzińska
- Department of Tropical Medicine and Epidemiology, Faculty of Health Sciences, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
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Basuony GA, M.A.Basyoni M, Negm MSI, Mostafa EAM, El-Wakil ES, Shemis MA, Gouda AE, Saftawy EAE. Influence of Blastocystis hominis on the small intestine and lactase enzyme activity. J Parasit Dis 2022; 46:243-253. [PMID: 35299913 PMCID: PMC8901820 DOI: 10.1007/s12639-021-01442-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/07/2021] [Indexed: 11/29/2022] Open
Abstract
Blastocystis hominis is a cosmopolitan protozoan that has been associated with several gastrointestinal disturbances involving lactose intolerance. However, the underlying pathogenic factors remain indistinct. 20 Swiss albino mice were utilized and assembled into four groups, each of five mice: group-I: received neither infection nor lactose (healthy control), group-II: received a single dose of 10,000 cysts of Blastocystis and lactose diets in a dose of 12.5 g/day/mouse for 7 consecutive days starting from day 14 p.i., group-III: non-infected mice with oral doses of lactose (12.5 g/day/mouse) for 7 consecutive days (positive control), group-IV: infected mice on lactose free diet (negative control). We investigated the histopathological changes using H&E stain.s Also, lactase enzyme activity was measured using spectrophotometry and the production of TNF-α and apoptotic events were explored via immunohistochemistry and compared in the small intestine of all groups. The active inflammatory changes in the infected animals were moderate in the form of loss of villous architecture, increased ILC (P-value > 0.001) besides scattered forms of the parasite as compared to non-infected mice. There was a reduction in lactase enzyme activity p.i. The TNF-α levels were induced p.i. as compared to non-infected mice (P-value > 0.001). The expression of Bax protein was upgraded, while Bcl-2 expression decreased significantly with a reverse in Bax/Bcl2 ratio in infected animals. Blastocystis infection appears to humble lactase enzyme activity via the induction of apoptosis in the epithelial cells of the small intestinal brush border in a TNF-α associative pathway.
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Affiliation(s)
- Gehad A. Basuony
- Parasitology Department, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Maha M.A.Basyoni
- Parasitology Department, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | | | | | | | - Mohamed A. Shemis
- Biochemistry and Molecular Biology Department, Theodore Bilharz Research Institute, Giza, Egypt
| | - Abdullah E. Gouda
- Biochemistry and Molecular Biology Department, Theodore Bilharz Research Institute, Giza, Egypt
| | - Enas A. El Saftawy
- Parasitology Department, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt ,Medical Parasitology Department, College of Medicine, Armed Forces College of Medicine (AFCM), Cairo, Egypt
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Popruk S, Adao DEV, Rivera WL. Epidemiology and subtype distribution of Blastocystis in humans: A review. INFECTION GENETICS AND EVOLUTION 2021; 95:105085. [PMID: 34530156 DOI: 10.1016/j.meegid.2021.105085] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 12/19/2022]
Abstract
Blastocystis is a commonly encountered gastrointestinal protozoan in humans and animals with uncertain pathogenicity. Despite its potential public health impact, epidemiological data regarding the prevalence and molecular subtype (ST) distribution of Blastocystis have been rarely reported. Among Blastocystis STs, ST1-ST4 are common in humans, including healthy and immunodeficient populations. According to the Chi-squared (χ2) association based on the data compiled for this cross-sectional study, the presence of ST1 is associated with asymptomatic infection, whereas the presence of ST4 is associated with symptomatic infection. However, cross-sectional studies cannot clarify the potential pathogenicity of Blastocystis, unlike in vivo and in vitro studies. Poor hygiene, poor sanitation and zoonotic transmission are possible factors associated with high Blastocystis prevalence, although this protozoan may be part of the normal healthy human gastrointestinal microbiota. This review covers the prevalence, STs and distribution of Blastocystis infection in humans. Thus, future epidemiological and subtyping studies could reveal new STs in humans as well as possible associations of STs with disease, drug resistance and related mechanisms such as protease activity. These associations with proper ST identification may facilitate the control of potential threats to host health, including the direct pathogenic effects of Blastocystis or alterations of the gastrointestinal microbiome.
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Affiliation(s)
- Supaluk Popruk
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok 10400, Thailand
| | - Davin Edric V Adao
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines
| | - Windell L Rivera
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines.
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Asghari A, Sadrebazzaz A, Shamsi L, Shams M. Global prevalence, subtypes distribution, zoonotic potential, and associated risk factors of Blastocystis sp. in domestic pigs (Sus domesticus) and wild boars (Sus scrofa): A systematic review and meta-analysis. Microb Pathog 2021; 160:105183. [PMID: 34517066 DOI: 10.1016/j.micpath.2021.105183] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/02/2021] [Accepted: 09/06/2021] [Indexed: 12/30/2022]
Abstract
The intestinal parasite Blastocystis sp. is a widely distributed protist among humans and various animal hosts, with significant prevalence in developing countries. Due to the zoonotic nature of its subtypes (STs), we aimed at global estimation of the prevalence, STs distribution, zoonotic potential, and associated risk factors of Blastocystis sp. infection in domestic pigs (Sus domesticus) and wild pigs/wild boars (Sus scrofa). The study was designed and conducted in 2021 via searching articles in PubMed, Scopus, Google Scholar, and Web of Science databases, based on the PRISMA checklist, and meta-analysis was done using a random-effects model to calculate the weighted estimates and 95% confidence intervals (95% CIs). Totally, 43 papers (47 datasets) reported data on 7977 examined pigs in 24 countries with a total prevalence of 50.9% (95% CI: 42.8-59%). In details, prevalence was higher among domestic pigs [52.4% (95% CI: 43.9-60.7%)] than wild boars [31.2% (95% CI: 11.2-62%)], but is poorly statistically supported as far as the CIs largely overlap. Out of 28 reported STs, nine (ST1-ST7, ST10, and ST15) were reported from domestic pigs, while six (ST1, ST3-ST5, ST8, and ST15) had been isolated from wild boars. Among nine zoonotic STs (ST1-ST8, and ST12), all were identified in examined swine populations, except for ST12. As well, ST1 and ST5 were probably the most frequently circulating STs among these animals. In addition, male and older pigs showed higher Blastocystis sp. infection. Altogether, Blastocystis epidemiology and the distribution of its related STs in pigs is still open to question and requires more extensive studies, especially in the neglected regions of the world.
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Affiliation(s)
- Ali Asghari
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Alireza Sadrebazzaz
- Razi Vaccine & Serum Research Institute, Agricultural Research, Education and Extension Organization, Mashhad, Iran.
| | - Laya Shamsi
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
| | - Morteza Shams
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.
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Mormile I, Petraroli A, Loffredo S, Rossi FW, Mormile M, Del Mastro A, Spadaro G, de Paulis A, Bova M. Episodic Angioedema with Hypereosinophilia (Gleich's Syndrome): A Case Report and Extensive Review of the Literature. J Clin Med 2021; 10:jcm10071442. [PMID: 33916211 PMCID: PMC8037656 DOI: 10.3390/jcm10071442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/19/2021] [Accepted: 03/27/2021] [Indexed: 02/07/2023] Open
Abstract
Episodic angioedema with eosinophilia (EAE) (Gleich's syndrome) is a rare disease characterized by hypereosinophilia (up to 95 × 109 cells/L), recurrent episodes of angioedema, urticaria, weight gain, and fever, that occur at periodical intervals (usually every 3-4 weeks). The exact etiology of EAE is still unclear, but both eosinophils and abnormalities of cytokines homeostasis seem to play a pivotal role in the pathogenesis of the disease. In particular, the cyclic elevation of serum interleukin-5 before the increase in eosinophil count has been reported. Herein, we performed a broad literature review and report the case of a thirty-two-year-old woman with a two-year history of cyclic angioedema attacks, urticaria, periodic weight gain, and severe hypereosinophilia, diagnosed with EAE and treated with oral corticosteroids. Describing the most relevant clinical features of EAE reported so far in the literature, we aim to provide physicians with some useful tools to help them deal with this disease. In addition, we aim to raise awareness about this rare condition in which approved diagnostic classification criteria are currently missing.
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Affiliation(s)
- Ilaria Mormile
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (I.M.); (S.L.); (F.W.R.); (G.S.); (A.d.P.); (M.B.)
| | - Angelica Petraroli
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (I.M.); (S.L.); (F.W.R.); (G.S.); (A.d.P.); (M.B.)
- Correspondence: ; Tel.: +39-393-705-1956; Fax: +39-081-746-4671
| | - Stefania Loffredo
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (I.M.); (S.L.); (F.W.R.); (G.S.); (A.d.P.); (M.B.)
- Institute of Experimental Endocrinology and Oncology “G. Salvatore” (IEOS), National Research Council (CNR), Via S. Pansini 5, 80131 Naples, Italy
| | - Francesca Wanda Rossi
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (I.M.); (S.L.); (F.W.R.); (G.S.); (A.d.P.); (M.B.)
| | - Mauro Mormile
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy;
| | - Andrea Del Mastro
- Emergency Division, A.O.R.N. “Antonio Cardarelli”, Via Antonio Cardarelli, 9, 80131 Naples, Italy;
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (I.M.); (S.L.); (F.W.R.); (G.S.); (A.d.P.); (M.B.)
| | - Amato de Paulis
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (I.M.); (S.L.); (F.W.R.); (G.S.); (A.d.P.); (M.B.)
| | - Maria Bova
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), WAO Center of Excellence, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (I.M.); (S.L.); (F.W.R.); (G.S.); (A.d.P.); (M.B.)
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Bhat Yellanthoor R. Acute gastroenteritis due to Blastocystis hominis in an adolescent boy. BMJ Case Rep 2020; 13:13/12/e237810. [PMID: 33370946 PMCID: PMC7754653 DOI: 10.1136/bcr-2020-237810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Acute gastroenteritis with persistent vomiting, high degree fever and blood streaking stools often suggests bacterial aetiology in children. Authors report a 13-year-old boy presenting with acute watery diarrhoea with persistent vomiting, fever of 103°F, abdominal cramps and blood streaking stools who failed to show any response to parenteral third-generation cephalosporin for 72 hours. The stool examination revealed numerous cystic and amoeboid forms of Blastocystis hominis Metronidazole was started and the boy promptly responded within 24 hours. There was no recurrence of symptoms then onwards. The case highlights the crucial stool examination in case of acute diarrhoeal disease for rare aetiology.
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Abstract
Background: Blastocystis hominis is recognized as a common intestinal parasite. Some studies have reported the effect of phenotypic, serologic, and biochemical indices on the parasites’ pathogenic characteristics. Objectives: This study aimed to introduce B. hominis as a pathogen, trying to change views about this parasite and introduce it as a parasite important in medical sciences. Methods: An open-ended, language-restricted (English) search was conducted in MEDLINE (PubMed), CINAHL, Scopus, and the Cochrane Library databases (from 1990 to 2018) using specific search criteria to identify Blastocystis spp. Results: The search of the literature retrieved 158 published articles on Blastocystis spp. Among these articles, the ones related to the pathogenicity of B. hominis were selected for further investigations. Results obtained in this study showed that the number of articles within five-year periods had an increasing trend. Also, studies of B. hominis have mainly investigated its pathogenic characteristics, accounting for 37.34% of the studies. Conclusions: This study showed comprehensive reasons for proving the pathogenesis of the parasite. It is hoped that further studies would fill the existing gaps regarding this parasite and identify its true identity as a medically important parasite.
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Bahrami F, Babaei E, Badirzadeh A, Riabi TR, Abdoli A. Blastocystis, urticaria, and skin disorders: review of the current evidences. Eur J Clin Microbiol Infect Dis 2020; 39:1027-1042. [PMID: 31873864 DOI: 10.1007/s10096-019-03793-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/05/2019] [Indexed: 12/17/2022]
Abstract
Blastocystis is one of the most common intestinal protozoan parasites worldwide, which is linked to cutaneous lesions and urticaria. In a setting of systematic review, the data on the association of Blastocystis infection with cutaneous lesions were searched in order to summarize the main clinical symptoms, diagnostic methods, treatment, and outcome of the patients. The search identified 28 eligible articles, including 12 cross-sectional studies and 16 case reports/case series (including 23 cases). A diverse spectrum of skin symptoms, mainly urticaria, rash, and itching, was reported from the studies. Of the 23 infected cases with the skin symptoms, gastrointestinal symptoms were reported from the 16 cases, whereas 7 cases with urticaria had asymptomatic infection. The most frequent subtypes were ST1, ST2, and ST3, respectively. Metronidazole, paromomycin, and tinidazole were the most prescribed drugs in patients with single Blastocystis infection. Notably, urticaria and other cutaneous symptoms of all treated patients were resolved after treatment. In conclusion, this study indicates that Blastocystis infection can be a neglected cause of urticaria and skin disorders. Since the treatment of Blastocystis infection is simple, screening and treatment of this infection should be considered in patients with urticaria and other skin disorders.
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Affiliation(s)
- Fares Bahrami
- Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Erfan Babaei
- Department of Immunology & Hematology, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Alireza Badirzadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Rezaei Riabi
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abdoli
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran.
- Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, 74148-46199, Ostad Motahari Ave, Jahrom, Iran.
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Zanetti ADS, Malheiros AF, de Matos TA, Longhi FG, Moreira LM, Silva SL, Castrillon SKI, Ferreira SMB, Ignotti E, Espinosa OA. Prevalence of Blastocystis sp. infection in several hosts in Brazil: a systematic review and meta-analysis. Parasit Vectors 2020; 13:30. [PMID: 31937366 PMCID: PMC6961275 DOI: 10.1186/s13071-020-3900-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/08/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Blastocystis sp. affects a wide variety of animals and is the most common protozoan in human fecal samples with potential pandemic distribution. In the present study, a systematic review and meta-analysis were conducted to determine the prevalence and distribution of Blastocystis sp. in different classes of hosts in Brazil. METHODS Studies that analyzed hosts of various classes, including humans, domestic animals, wild animals or captive animals, were considered. The pooled prevalence of Blastocystis sp. infection was estimated by random effects models. RESULTS For humans, similar prevalence rates were found for males (31.0%, 95% CI: 17.0-45.0%; weight 10%) and females (28.0%, 95% CI: 16.0-41.0%; weight 10%); the state of Mato Grosso do Sul showed the highest prevalence, with 41.0% positivity (95% CI: 36.0-46.0%; weight 2.9%). The prevalence among immunocompromised patients was 5.0% (95% CI: 3.0-7.0%; weight 10%), and the most common cause of immunosuppression was hemodialysis, with 23.0% (95% CI: 17.0-29.0%; weight 12.4%). Among classifications according to interaction with humans, wild and domestic animals presented values of 19.0% (95% CI: 7.0-31.0%; weight 42.6%) and 17.0% (95% CI: 13.0-21.0%; weight 29.6%), respectively. Among these animals, mammals (39.0%, 95% CI: 21.0-56.0%; weight 47.3%) and birds (18.0%, 95% CI: 10.0-27.0%; weight 39.3%) exhibited the highest prevalence. Phylogenetic analysis of Blastocystis sp. revealed greater genetic diversity for clades of subtypes (STs) ST1, ST2 and ST3. CONCLUSIONS The overall prevalence of Blastocystis sp. in the Brazilian human population was 24%, which reflects the reality in the South, Southeast and Midwest regions, where prevalence rates of up to 40% were found. Among animals, mammals and birds exhibited the highest prevalence.
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Affiliation(s)
- Andernice Dos Santos Zanetti
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil
| | - Antonio Francisco Malheiros
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil
| | - Tatiane Amorim de Matos
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil
| | - Fabiana Gulin Longhi
- The Brazilian Centre for Evidence-based Healthcare: A Joanna Briggs Institute Centre of Excellence, São Paulo, São Paulo, Brazil
| | - Luciana Melhorança Moreira
- Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil
| | - Samuel Laudelino Silva
- Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil
| | - Solange Kimie Ikeda Castrillon
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil
| | - Silvana Margarida Benevides Ferreira
- The Brazilian Centre for Evidence-based Healthcare: A Joanna Briggs Institute Centre of Excellence, São Paulo, São Paulo, Brazil.,Post-Graduation Program in Nursing, Federal University of Mato Grosso (UFMT), Cuiabá, Mato Grosso, Brazil
| | - Eliane Ignotti
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil.,Department of Nursing, Faculty of Health Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil
| | - Omar Ariel Espinosa
- Department of Medicine, Faculty of Health Sciences, State University of Mato Grosso (UNEMAT), Cáceres, Mato Grosso, Brazil.
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Abbaszadeh Afshar MJ, Barkhori Mehni M, Rezaeian M, Mohebali M, Baigi V, Amiri S, Amirshekari MB, Hamidinia R, Samimi M. Prevalence and associated risk factors of human intestinal parasitic infections: a population-based study in the southeast of Kerman province, southeastern Iran. BMC Infect Dis 2020; 20:12. [PMID: 31906872 PMCID: PMC6945597 DOI: 10.1186/s12879-019-4730-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/23/2019] [Indexed: 11/19/2022] Open
Abstract
Background Determination of the prevalence and distribution pattern of intestinal parasites is a fundamental step to set up an effective control program to improve the health status. This study aimed to determine the prevalence of intestinal parasitic infections and associated risk factors among inhabitants of Rudbar-e Jonub county, southeast of Kerman province, southeastern Iran. Methods In this cross-sectional study, 861 stool specimens were collected from inhabitants of Rudbar-e Jonub county through a multistage cluster sampling method in 2018. The collected specimens were examined by parasitological methods including, direct wet-mounting (for the fresh specimens with a watery consistency), formalin-ethyl acetate sedimentation and agar plate culture. Results The prevalence of intestinal parasites was 34.2% (95% CI 30.1 to 38.2). The prevalence of protozoan parasites 32.3% (95% CI 28.4 to 36.5) was significantly higher than helminthic parasites 3.2% (95% CI 2.1 to 4.7). Blastocystis sp. (13.3%), Entamoeba coli (11.4%) and Giardia lamblia (10.6%) as protozoan parasite and Hymenolepis nana (2.4%) as helminthic parasite were the most common detected intestinal parasites in the study. Entamoeba histolytica/dispar (1.5%), Iodamoeba bütschlii (1.0%), Chilomastix mesnili (0.5%), Entamoeba hartmanni (0.4%), Enterobius vermicularis (0.3%) and Ascaris lambercoides (0.3%) were other detected parasites. Multiple logistic regression revealed a significant association of intestinal parasitic infections with source of drinking water and residency status (rural/urban). Multiple infections with 2 or 3 parasitic agents constituted 22.7% of 295 infected cases. Conclusions This study revealed a high prevalence of intestinal protozoan infections among inhabitants of Rudbar-e Jonub county. Intestinal parasites especially protozoans remain a challenging public health problem wherever sanitation and health measures are limited in Iran.
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Affiliation(s)
| | | | - Mostafa Rezaeian
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Vali Baigi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Amiri
- Health Affairs, Jiroft University of Medical Sciences, Jiroft, Iran
| | | | | | - Mohammad Samimi
- Health Affairs, Jiroft University of Medical Sciences, Jiroft, Iran
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Blastocystis Colonization Is Associated with Increased Diversity and Altered Gut Bacterial Communities in Healthy Malian Children. Microorganisms 2019; 7:microorganisms7120649. [PMID: 31817168 PMCID: PMC6956266 DOI: 10.3390/microorganisms7120649] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 12/21/2022] Open
Abstract
Blastocystis is the most common protozoan colonizing the gut of vertebrates. It modulates the human digestive microbiota in the absence of inflammation and gastrointestinal disease. Although it has been associated with human diseases, including inflammatory bowel disease, its pathogenicity remains controversial. This study aimed to assess the influence of Blastocystis on the gut bacterial communities in healthy children. We conducted a cross-sectional study on 147 Blastocystis-colonized and 149 Blastocystis-noncolonized Malian children, with Blastocystis colonization assessed by real-time PCR and gut microbial communities characterized via 16S rRNA gene (Illumina MiSeq) sequencing and bioinformatics analysis. The gut microbiota diversity was higher in Blastocystis-colonized compared to Blastocystis-noncolonized children. The phyla Firmicutes, Elusimicrobia, Lentisphaerae, and Euryarchaeota were higher in Blastocystis-colonized children, whereas Actinobacteria, Proteobacteria, unassigned bacteria, and Deinococcus-Thermus were higher in Blastocystis-noncolonized children. Moreover, Faecalibacterium prausnitzii (family Ruminococcaceae) and Roseburia sp. (family Lachnospiraceae) abundance was higher in Blastocystis-colonized children. We conclude that Blastocystis colonization is significantly associated with a higher diversity of the gut bacterial communities in healthy children, while it is not associated with the presence of potentially pathogenic bacteria in the human gut.
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Melo GBD, Malta FDM, Maruta CW, Criado PR, Castilho VLP, Gonçalves EMDN, Espirito-Santo MCDCD, Paula FMD, Gryschek RCB. Characterization of subtypes of Blastocystis sp. isolated from patients with urticaria, São Paulo, Brazil. Parasite Epidemiol Control 2019; 7:e00124. [PMID: 31872093 PMCID: PMC6911935 DOI: 10.1016/j.parepi.2019.e00124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/18/2019] [Accepted: 11/05/2019] [Indexed: 01/01/2023] Open
Abstract
Blastocystis sp. is described as an enteric protist prevalent in fecal samples from humans and animals; its pathogenicity and epidemiology are still controversial. Currently, it has been associated with intestinal diseases such as irritable bowel syndrome and clinical manifestations of allergic skin, such as chronic urticaria. In the context of urticaria, it is still uncertain whether this organism is directly related to the allergic manifestation or just a common component of the intestinal microbiota. This study aimed to evaluate the occurrence and molecular diversity of Blastocystis sp. in individuals with urticaria from a dermatology outpatient clinic, São Paulo, Brazil. Fecal samples of 58 patients with urticaria were examined using parasitological methods; and subsequently tested by polymerase chain reaction using Blastocystis-specific primers. The subtypes (STs) and alleles (a) were determined using BLASTn and MLST tools. ST1, ST2, ST3, ST4, ST6 and mixed infection (ST1 + ST3) were identified in the patients with urticaria; ST1 (a4), ST3 (a34 and a36) and ST4 (a42) were the most prevalent. Our molecular analyses allowed an initial description of Blastocystis subtypes in patients with urticaria from São Paulo city, Brazil.
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Affiliation(s)
- Gessica Baptista de Melo
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Corresponding author.
| | - Fernanda de Mello Malta
- Laboratório de Gastroenterologia e Hepatologia Tropical (LIM-07), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Celina Wakisaka Maruta
- Departamento de Dermatologia, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Ricardo Criado
- Departamento de Dermatologia, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Faculdade de Medicina Do ABC, São Paulo, Brazil
| | - Vera Lucia Pagliusi Castilho
- Seção de Parasitologia, Divisão Do Laboratório Central, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Fabiana Martins de Paula
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ronaldo Cesar Borges Gryschek
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Determination the Subtypes of Blastocystis sp. and Evaluate the Effect of These Subtypes on Pathogenicity. Acta Parasitol 2019; 64:7-12. [PMID: 30649701 DOI: 10.2478/s11686-018-00002-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/22/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE The present study aimed to determine the frequency of subtypes of Blastocystis sp. in the immunosuppressed individuals, in patients with chronic urticaria, and in patients with GIS complaints to investigate the difference of Blastocystis sp. subtype distribution between patient and control groups. METHODS A total of 345 stool samples were collected from the patients and samples were studied by native-Lugol, trichrome staining, and Jones medium culture method. Positively detected samples were subjected to PCR to determine the subtypes. RESULTS This is the first study of nine subtypes of Blastocystis sp. investigated in our country and the most frequently found subtype was ST3, and then, the other subtypes were ST1, ST2, ST5, and ST6, respectively. Mix subtype was detected in the 11.6% and no subtype was detected in the 17.4% of the samples. The ST5 was detected first time in the control group and ST6, which is reported limitedly in our country, was found in patients with GIS complaints. ST1 and ST2 were found higher in the patient group. CONCLUSION This study confirmed that the subtype (ST) differences are an important factor affecting the pathogenesis of Blastocystis sp.
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Valença-Barbosa C, do Bomfim TCB, Teixeira BR, Gentile R, Neto SFDC, Magalhães BSN, Balthazar DDA, da Silva FA, Biot R, d’Avila Levy CM, Santos HLC. Molecular epidemiology of Blastocystis isolated from animals in the state of Rio de Janeiro, Brazil. PLoS One 2019; 14:e0210740. [PMID: 30682075 PMCID: PMC6347289 DOI: 10.1371/journal.pone.0210740] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 12/31/2018] [Indexed: 01/25/2023] Open
Abstract
The enteric protist Blastocystis is one of the most frequently reported parasites infecting both humans and many other animal hosts worldwide. A remarkable genetic diversity has been observed in the species, with 17 different subtypes (STs) on a molecular phylogeny based on small subunit RNA genes (SSU rDNA). Nonetheless, information regarding its distribution, diversity and zoonotic potential remains still scarce, especially in groups other than primates. In Brazil, only a few surveys limited to human isolates have so far been conducted on Blastocystis STs. The aim of this study is to determine the occurrence of Blastocystis subtypes in non-human vertebrate and invertebrate animal groups in different areas of the state of Rio de Janeiro, Brazil. A total of 334 stool samples were collected from animals representing 28 different genera. Blastocystis cultivated samples were subtyped using nuclear small subunit ribosomal DNA (SSU rDNA) sequencing. Phylogenetic analyses and BLAST searches revealed six subtypes: ST5 (28.8%), ST2 (21.1%), ST1 and ST8 (19.2%), ST3 (7.7%) and ST4 (3.8%). Our findings indicate a considerable overlap between STs in humans and other animals. This highlights the importance of investigating a range of hosts for Blastocystis to understand the eco-epidemiological aspects of the parasite and its host specificity.
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Affiliation(s)
- Carolina Valença-Barbosa
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Bernardo Rodrigues Teixeira
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Rosana Gentile
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Sócrates Fraga da Costa Neto
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Daniel de Almeida Balthazar
- Fundação Jardim Zoológico da cidade do Rio de Janeiro, Parque da Quinta da Boa Vista, Rio de Janeiro, Brazil
| | | | - Renata Biot
- Laboratório de Parasitologia do Departamento de Patologia do Hospital Universitário Antônio Pedro/Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Claudia Masini d’Avila Levy
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
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Paulos S, Köster PC, de Lucio A, Hernández-de-Mingo M, Cardona GA, Fernández-Crespo JC, Stensvold CR, Carmena D. Occurrence and subtype distribution of Blastocystis
sp. in humans, dogs and cats sharing household in northern Spain and assessment of zoonotic transmission risk. Zoonoses Public Health 2018; 65:993-1002. [DOI: 10.1111/zph.12522] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Silvia Paulos
- Microbiology Service; Quirón Madrid University Hospital; Madrid Spain
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | - Aida de Lucio
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | - Marta Hernández-de-Mingo
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | | | - Juan C. Fernández-Crespo
- Sub-Direction of Public Health of Álava, Department of Health; Basque Government; Vitoria-Gasteiz Spain
| | - Christen R. Stensvold
- Department of Bacteria, Parasites and Fungi; Statens Serum Institut; Copenhagen Denmark
| | - David Carmena
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
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Javanmard E, Niyyati M, Ghasemi E, Mirjalali H, Asadzadeh Aghdaei H, Zali MR. Impacts of human development index and climate conditions on prevalence of Blastocystis: A systematic review and meta-analysis. Acta Trop 2018; 185:193-203. [PMID: 29802845 DOI: 10.1016/j.actatropica.2018.05.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/11/2018] [Accepted: 05/19/2018] [Indexed: 01/14/2023]
Abstract
Blastocystis is a prevalent eukaryotic microorganism that has been frequently reported from the stool samples of human and animals, all over the world. The prevalence of this parasite has close correlation with the climate and hygiene situation of studied populations. For the current study, English and Persian databases were searched for the following terms: "Blastocystis hominis", "Blastocystis sp.", "Intestinal Parasites", "Prevalence" and "Iran". In order to data analysis and assess the possibility of publication bias, STATA v11 and Begg's Funnel plot were employed respectively. From 605 searched cases, 86 publications met our criteria for the analysis. The pooled prevalence of Blastocystis was 9.1% (95%CI: 8.2%, 10.1%). The results represented that the prevalence of the parasite using molecular techniques or cultivation followed by molecular techniques (20.89%) was higher than only microscopical examination (8.96%). The prevalence rate of Blastocystis according to human development index was 7.6%, 7.2%, 11.9%, 13.4%, and 3.3% for ranks 1 to 5, respectively. This is the first study signifying the prevalence of Blastocystis regarding the human development index and climate conditions. The findings represented that although human development index, low levels of socioeconomic situations together with appropriate climate such as sufficient humidity and high temperature increase the chance of transmission of Blastocystis in a society.
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Toro Monjaraz EM, Vichido Luna MA, Montijo Barrios E, Cervantes Bustamante R, Zárate Mondragón F, Huante Anaya A, Cadena León J, Mendez MC, López Ugalde M, Ramirez Mayans JA. Blastocystis Hominis and Chronic Abdominal Pain in Children: Is there an Association between Them? J Trop Pediatr 2018; 64:279-283. [PMID: 28985427 DOI: 10.1093/tropej/fmx060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Chronic abdominal pain has many etiologies, one of them being parasites. The aim of this study was to find an association between chronic abdominal pain in children and Blastocystis hominis (Bh). Clinical files of patients with Bh and functional abdominal pain were reviewed. A comparison was made between patients who showed an improvement of their symptoms and those who did not. Out of the 138 patients who had functional abdominal pain and Bh, 37 patients did not receive any treatment (26.8%), while 101 received it and were treated with different antimicrobial agents (73.2%); regarding the improvement of symptoms, a statistically significant difference (p < 0.001) was observed. Chronic abdominal pain in children has different etiologies; however, we have documented through this work that it is appropriate to provide antimicrobial treatment for patients with Bh and chronic abdominal pain.
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Affiliation(s)
- Erick Manuel Toro Monjaraz
- Department of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, 04300 México City, México
| | - Miguel Angel Vichido Luna
- Instituto Nacional de Pediatría, Fellow of Pediatric Gastroenterology and Nutrition, 04300 México City, México
| | - Ericka Montijo Barrios
- Department of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, 04300 México City, México
| | - Roberto Cervantes Bustamante
- Chief of Service Department of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, 04300 México City, México
| | - Flora Zárate Mondragón
- Department of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, 04300 México City, México
| | | | - José Cadena León
- Department of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, 04300 México City, México
| | - Monserrat Cazares Mendez
- Department of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, 04300 México City, México
| | - Martha López Ugalde
- Department of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, 04300 México City, México
| | - Jaime A Ramirez Mayans
- Chief of Department of Pediatric Gastroenterology and Nutrition, Instituto Nacional de Pediatría, 04300 México City, México
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Asymptomatic Intestinal Colonization with Protist Blastocystis Is Strongly Associated with Distinct Microbiome Ecological Patterns. mSystems 2018; 3:mSystems00007-18. [PMID: 29963639 PMCID: PMC6020473 DOI: 10.1128/msystems.00007-18] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/02/2018] [Indexed: 12/25/2022] Open
Abstract
Given the results of our study and other reports of the effects of the most common human gut protist on the diversity and composition of the bacterial microbiome, Blastocystis and, possibly, other gut protists should be studied as ecosystem engineers that drive community diversity and composition. Blastocystis is the most prevalent protist of the human intestine, colonizing approximately 20% of the North American population and up to 100% in some nonindustrialized settings. Blastocystis is associated with gastrointestinal and systemic disease but can also be an asymptomatic colonizer in large populations. While recent findings in humans have shown bacterial microbiota changes associated with this protist, it is unknown whether these occur due to the presence of Blastocystis or as a result of inflammation. To explore this, we evaluated the fecal bacterial and eukaryotic microbiota in 156 asymptomatic adult subjects from a rural population in Xoxocotla, Mexico. Colonization with Blastocystis was strongly associated with an increase in bacterial alpha diversity and broad changes in beta diversity and with more discrete changes to the microbial eukaryome. More than 230 operational taxonomic units (OTUs), including those of dominant species Prevotella copri and Ruminococcus bromii, were differentially abundant in Blastocystis-colonized individuals. Large functional changes accompanied these observations, with differential abundances of 202 (out of 266) predicted metabolic pathways (PICRUSt), as well as lower fecal concentrations of acetate, butyrate, and propionate in colonized individuals. Fecal calprotectin was markedly decreased in association with Blastocystis colonization, suggesting that this ecological shift induces subclinical immune consequences to the asymptomatic host. This work is the first to show a direct association between the presence of Blastocystis and shifts in the gut bacterial and eukaryotic microbiome in the absence of gastrointestinal disease or inflammation. These results prompt further investigation of the role Blastocystis and other eukaryotes play within the human microbiome. IMPORTANCE Given the results of our study and other reports of the effects of the most common human gut protist on the diversity and composition of the bacterial microbiome, Blastocystis and, possibly, other gut protists should be studied as ecosystem engineers that drive community diversity and composition.
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Barbosa CV, Barreto MM, Andrade RDJ, Sodré F, d’Avila-Levy CM, Peralta JM, Igreja RP, de Macedo HW, Santos HLC. Intestinal parasite infections in a rural community of Rio de Janeiro (Brazil): Prevalence and genetic diversity of Blastocystis subtypes. PLoS One 2018. [PMID: 29522552 PMCID: PMC5844535 DOI: 10.1371/journal.pone.0193860] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Intestinal parasitic infections are considered a serious public health problem and widely distributed worldwide, mainly in urban and rural environments of tropical and subtropical countries. Globally, soil-transmitted helminths and protozoa are the most common intestinal parasites. Blastocystis sp. is a highly prevalent suspected pathogenic protozoan, and considered an unusual protist due to its significant genetic diversity and host plasticity. Methodology/main findings A total of 294 stool samples were collected from inhabitants of three rural valleys in Rio de Janeiro, Brazil. The stool samples were evaluated by parasitological methods, fecal culture, nested PCR and PCR/Sequencing. Overall prevalence by parasitological analyses was 64.3% (189 out of 294 cases). Blastocystis sp. (55.8%) was the most prevalent, followed by Endolimax nana (18.7%), Entamoeba histolytica complex (7.1%), hookworm infection (7.1%), Entomoeba coli (5.8%), Giardia intestinalis (4.1%), Iodamoeba butchilii (1.0%), Trichuris trichiura (1.0%), Pentatrichomonas hominis (0.7%), Enterobius vermicularis (0.7%), Ascaris lumbricoides (0.7%) and Strongyloides stercoralis (0.7%). Prevalence of IPIs was significantly different by gender. Phylogenetic analysis of Blastocystis sp. and BLAST search revealed five different subtypes: ST3 (34.0%), ST1 (27.0%), ST2 (27.0%), ST4 (3.5%), ST8 (7.0%) and a non-identified subtype. Conclusions/significance Our findings demonstrate that intestinal parasite infection rates in rural areas of the Sumidouro municipality of Rio de Janeiro, Brazil are still high and remain a challenge to public health. Moreover, our data reveals significant genetic heterogeneity of Blastocystis sp. subtypes and a possible novel subtype, whose confirmation will require additional data. Our study contributes to the understanding of potential routes of transmission, epidemiology, and genetic diversity of Blastocystis sp. in rural areas both at a regional and global scale.
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Affiliation(s)
- Carolina Valença Barbosa
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Magali Muniz Barreto
- Laboratório de Avaliação e Promoção da Saúde Ambiental, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Brazil
| | - Rosemary de Jesus Andrade
- Departamento de Ginecologia e Obstetrícia, Instituto Fernandes Figueira/FIOCRUZ, Rio de Janeiro, Brazil
| | - Fernando Sodré
- Laboratório de Parasitologia, Departamento de Patologia, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Claudia Masini d’Avila-Levy
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | | | - Ricardo Pereira Igreja
- Departamento de Medicina Preventiva da Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Heloisa Werneck de Macedo
- Laboratório de Parasitologia, Departamento de Patologia, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Helena Lucia Carneiro Santos
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- * E-mail:
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Valença Barbosa C, de Jesus Batista R, Pereira Igreja R, d'Avila Levy CM, Werneck de Macedo H, Carneiro Santos HL. Distribution of Blastocystis subtypes isolated from humans from an urban community in Rio de Janeiro, Brazil. Parasit Vectors 2017; 10:518. [PMID: 29070053 PMCID: PMC5657060 DOI: 10.1186/s13071-017-2458-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 10/06/2017] [Indexed: 12/13/2022] Open
Abstract
Background Blastocystis is a cosmopolitan protist parasite found in the human gastrointestinal tract and is highly prevalent in developing countries. Recent molecular studies have revealed extensive genetic diversity, which has been classified into different subtypes (STs) based on sequence analysis of small subunit ribosomal RNA gene. Blastocystis is one of the most common fecal parasites in Brazil, but the diversity of subtypes remains unknown in the country. This study aimed to determine the distribution of Blastocystis STs in an urban community in Duque de Caxias, Rio de Janeiro, Brazil. Methods A total of 64 stool samples positive for Blastocystis in Pavlova’s medium were subtyped by PCR and sequenced using primers targeting the small subunit rRNA gene, in addition to phylogenetic analysis and subtype-specific PCR using sequence-tagged-site (STS) primers. Results Endolimax nana (14%), Entamoeba complex (10.5%), Taenia sp. (0.6%), Trichuris trichiura (1.3%) and Enterobius vermicularis (1.3%) were detected in Blastocystis-positive samples. Of the 64 samples tested by PCR/DNA sequencing, 55 were identified as ST1 (42%), ST3 (49%), ST2 (7%) and ST4 (2%), and the presence of mixed ST (ST1 + ST3) infection was detected in nine samples (14%). Conclusions DNA sequencing and phylogenetic analysis of Brazilian Blastocystis isolates identified four different subtypes. To our knowledge, this study provided the first genetic characterization of Blastocystis subtypes in an urban area of Rio de Janeiro, Brazil. We also identified ST4 for the first time in Brazil. Further studies are necessary to determine the distribution of STs across human populations in Rio de Janeiro.
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Affiliation(s)
- Carolina Valença Barbosa
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Av. Brasil, 4365 Pavilhão Arthur Neiva, Rio de Janeiro, 21.045-900, Brazil
| | - Rosemary de Jesus Batista
- Departamento de Ginecologia e Obstetrícia, IFF/Fiocruz, Rio de Janeiro, Brasil, Av. Rui Barbosa, 716, Flamengo, Rio de Janeiro, 22250-020, Brazil
| | - Ricardo Pereira Igreja
- Departamento de Medicina Preventiva da Faculdade de Medicina da UFRJ , Av. Carlos Chagas Filho, 373, Edifício do Centro de Ciências da Saúde Bloco K, 2° andar, Sala 49 - Cidade Universitária - Ilha do Fundão, Rio de Janeiro, 21.941-902, Brazil
| | - Claudia Masini d'Avila Levy
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Av. Brasil, 4365 Pavilhão Arthur Neiva, Rio de Janeiro, 21.045-900, Brazil
| | - Heloisa Werneck de Macedo
- Laboratório de Parasitologia do Departamento de Patologia, Hospital Universitário Antônio Pedro/Universidade Federal Fluminense, Niterói, RJ, Rua Marquês do Paraná, 303. 4º andar, sala 12, Niterói, Rio de Janeiro, 24033 900, Brazil
| | - Helena Lúcia Carneiro Santos
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Av. Brasil, 4365 Pavilhão Arthur Neiva, Rio de Janeiro, 21.045-900, Brazil.
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Lepczyńska M, Białkowska J, Dzika E, Piskorz-Ogórek K, Korycińska J. Blastocystis: how do specific diets and human gut microbiota affect its development and pathogenicity? Eur J Clin Microbiol Infect Dis 2017; 36:1531-1540. [PMID: 28326446 PMCID: PMC5554277 DOI: 10.1007/s10096-017-2965-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/08/2017] [Indexed: 12/31/2022]
Abstract
Blastocystis is an enteric parasite that inhabits the gastrointestinal tract of humans and many animals. This emerging parasite has a worldwide distribution. It is often identified as the most common eukaryotic organism reported in human fecal samples. This parasite is recognized and diagnosed more often than ever before. Furthermore, some strains develop resistance against currently recommended drugs, such as metronidazole; therefore, the use of natural remedies or special diets has many positive aspects that may address this problem. The goal of this review is to compare natural treatments and various diets against the efficacy of drugs, and describe their influence on the composition of the gut microbiota, which affects Blastocystis growth and the occurrence of symptoms. This article reviews important work in the literature, including the classification, life cycle, epidemiology, pathogenesis, pathogenicity, genetics, biology, and treatment of Blastocystis. It also includes a review of the current knowledge about human gut microbiota and various diets proposed for Blastocystis eradication. The literature has revealed that garlic, ginger, some medical plants, and many spices contain the most effective organic compounds for parasite eradication. They work by inhibiting parasitic enzymes and nucleic acids, as well as by inhibiting protein synthesis. The efficacy of any specific organic compound depends on the Blastocystis subtype, and, consequently, on its immunity to treatment. In conclusion, the article discusses the findings that human gut microbiota composition triggers important mechanisms at the molecular level, and, thus, has a crucial influence on the parasitic pathogenicity.
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Affiliation(s)
- M Lepczyńska
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland.
| | - J Białkowska
- Department of Neurology and Neurosurgery, Faculty of Medical Sciences, University of Warmia and Mazury, Warszawska 30, Olsztyn, Poland
| | - E Dzika
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland
| | - K Piskorz-Ogórek
- Department of Nursing, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, Poland
- Regional Specialized Children's Hospital in Olsztyn, Żołnierska 18A, Olsztyn, Poland
| | - J Korycińska
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland
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Distribution and phylogenetic analysis of Blastocystis sp. subtypes isolated from IBD patients and healthy individuals in Iran. Eur J Clin Microbiol Infect Dis 2017; 36:2335-2342. [PMID: 28741097 DOI: 10.1007/s10096-017-3065-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/04/2017] [Indexed: 12/19/2022]
Abstract
Blastocystis is a single-celled intestinal parasite commonly found in humans and a broad range of animals all over the world. In humans, its role in health and disease remains unsettled. The aim of our study was to investigate the distribution of Blastocystis and Blastocystis subtypes (ST) in patients with inflammatory bowel disease (IBD) and control subjects. A total of 71 stool samples were collected from IBD patients, 69 and 2 of whom had ulcerative colitis (UC) and Crohn's Disease (CD), respectively. Moreover, 166 stool samples from healthy subjects were included as control samples. All stool samples were cultivated, and 550-bp fragments of the small subunit ribosomal RNA gene was amplified from Blastocystis-positive cultures. All PCR-positive samples were sequenced. Blastocystis was observed in 9 (12.67%) and 35 (21.1%) IBD patients and healthy controls, respectively. There was no statistically significant correlation between IBD and presence of Blastocystis (P = 0.147). There was a statistically significant correlation between age and Blastocystis colonization in the IBD group (P < 0.05), but not among healthy controls. No significant correlation between gender and colonization was observed. ST1 and ST3 were obtained from 1 (12.5%) and 7 (87.5%) IBD patients, respectively, while in the healthy control group, subtypes 1, 2, and 3 were found in 14 (40%), 12 (34.28%), and 9 (25.72%), respectively. Phylogenetic analysis showed no variation in the distribution of subtypes nor intra-subtype genetic diversity between samples acquired from IBD patients and healthy controls. This study showed a trend towards a lower prevalence of Blastocystis in IBD patients than in control subjects. ST3 sequences isolated from IBD patients and control individuals did not appear to differ genetically.
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Salvador F, Sulleiro E, Sánchez-Montalvá A, Alonso C, Santos J, Fuentes I, Molina I. Epidemiological and clinical profile of adult patients with Blastocystis sp. infection in Barcelona, Spain. Parasit Vectors 2016; 9:548. [PMID: 27741951 PMCID: PMC5064914 DOI: 10.1186/s13071-016-1827-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/02/2016] [Indexed: 12/14/2022] Open
Abstract
Background Blastocystis spp. are among the most frequently observed intestinal parasites in humans. Despite the discovery of Blastocystis approximately 100 years ago, limited information is available regarding its pathogenesis, genetic diversity, and available treatment options. The aim of this study was to describe the epidemiological and clinical characteristics of patients with Blastocystis sp. infections diagnosed at Vall d’Hebron University Hospital (Barcelona, Spain). Methods A retrospective observational study was performed which included all adult patients who attended Vall d’Hebron University Hospital from February 2009 to March 2014 that had Blastocystis sp. detected in their stool. Results Four hundred eighteen patients were included, the median age was 36 (18–86) years and 236 (56.5 %) were men. Regarding patient symptoms, 234 (56 %) patients were completely asymptomatic, 92 (22 %) patients had symptoms, and 92 (22 %) patients had symptoms that could be attributed to other causes. Of the 92 patients with symptoms not attributable to other etiologies except for Blastocystis infection, the most frequent symptoms were diarrhea (61 patients, 66.3 %) and abdominal pain (34 patients, 37 %). Additionally, nine (9.8 %) patients had cutaneous manifestations. Thirty-one (7.4 %) patients received specific treatment for Blastocystis infection. The clinical response of treated patients was varied. Five patients experienced complete resolution of symptoms, 12 patients reported improvement of clinical symptoms, eight patients described no clinical improvement, and information was unavailable for six patients. Conclusions Blastocystis infection was detected in 418 patients, most of them foreign-born. Although the vast majority of patients were asymptomatic, 22 % of patients had gastrointestinal symptoms or cutaneous manifestations in the absence of other causes. Despite the scarce information available, given the safety of antiparasitic treatment, and the percentage of patients who experienced resolution or improvement of symptoms, treatment should be considered in patients with chronic symptoms.
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain.
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Carmen Alonso
- Gastroenterology Department, Vall d' Hebron Research Institute, Digestive Diseases Research Unit, Vall d'Hebron University Hospital, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain
| | - Javier Santos
- Gastroenterology Department, Vall d' Hebron Research Institute, Digestive Diseases Research Unit, Vall d'Hebron University Hospital, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain
| | - Isabel Fuentes
- Instituto de Salud Carlos III, National Centre of Microbiology, Madrid, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
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Kolkhir P, Balakirski G, Merk HF, Olisova O, Maurer M. Chronic spontaneous urticaria and internal parasites--a systematic review. Allergy 2016; 71:308-22. [PMID: 26648083 DOI: 10.1111/all.12818] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2015] [Indexed: 01/09/2023]
Abstract
Chronic spontaneous urticaria (CSU) is defined as persistent wheals, angioedema, or both lasting for >6 weeks due to known or unknown causes. Some epidemiological studies and case reports suggest that internal parasite infections (PI) can cause CSU. Here, we provide a systematic overview of published findings on the prevalence and relevance of PI in CSU and we discuss possible pathomechanisms. The prevalence of PI in CSU was investigated by 39 independent studies and comorbidity reportedly ranged from 0 to 75.4% (two-thirds of these studies reported infection rates of 10% or less). The prevalence of PI in adult and pediatric CSU patients ranged from 0% to 75.4% and from 0% to 37.8%, respectively. CSU patients were more often diagnosed with protozoa and had a significantly higher risk of toxocariasis seropositivity and Anisakis simplex sensitization when compared to healthy controls. Patients with chronic urticaria more frequently had seropositivity of fasciolosis, Anisakis simplex sensitization, and the presence of Blastocystis hominis allele 34 (ST3) as compared with control subjects. In 21 studies, efficacy of treatment with antiparasitic drugs ranged from 0 to 100% (35.7% of 269 CSU patients benefitted). In 9 (42.8%) of 21 studies, more than 50% of efficacy was observed. The reported rate of urticaria comorbidity in PI patients in 18 independent studies is 1-66.7%. Urticaria including CSU might be a quite common symptom of strongyloidiasis and blastocystosis. Pathogenic mechanisms in CSU due to PI may include specific IgE, Th2 cytokine skewing, eosinophils, activation of the complement, and the coagulation systems.
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Affiliation(s)
- P. Kolkhir
- Department of Dermatology and Venereology; Sechenov First Moscow State Medical University; Moscow Russia
| | - G. Balakirski
- Department of Dermatology and Allergology; University Hospital of Aachen; Aachen Germany
| | - H. F. Merk
- Department of Dermatology and Allergology; University Hospital of Aachen; Aachen Germany
| | - O. Olisova
- Department of Dermatology and Venereology; Sechenov First Moscow State Medical University; Moscow Russia
| | - M. Maurer
- Department of Dermatology and Allergy; Charité-Universitätsmedizin Berlin; Berlin Germany
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Predominance of Blastocystis sp. Infection among School Children in Peninsular Malaysia. PLoS One 2016; 11:e0136709. [PMID: 26914483 PMCID: PMC4767405 DOI: 10.1371/journal.pone.0136709] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 08/08/2015] [Indexed: 01/01/2023] Open
Abstract
Background One of the largest cross-sectional study in recent years was carried out to investigate the prevalence of intestinal parasitic infections among urban and rural school children from five states namely Selangor, Perak, Pahang, Kedah and Johor in Peninsula Malaysia. This information would be vital for school authorities to influence strategies for providing better health especially in terms of reducing intestinal parasitism. Methods and Principal Findings A total of 3776 stool cups was distributed to 26 schools throughout the country. 1760 (46.61%) responded. The overall prevalence of intestinal parasitic infection in both rural and urban areas was 13.3%, with Blastocystis sp (10.6%) being the most predominant, followed by Trichuris trichiura (3.4%), Ascaris lumbricoides (1.5%) and hook worm infection (0.9%). Only rural school children had helminthic infection. In general Perak had the highest infection (37.2%, total, n = 317), followed by Selangor (10.4%, total, n = 729), Pahang (8.6%, total, n = 221), Kedah (6.2%, total, n = 195) and Johor (3.4%, total, n = 298). School children from rural schools had higher infection (13.7%, total, n = 922) than urban school children (7.2%, total, n = 838). Subtype (ST) 3 (54.3%) is the most predominant ST with persons infected with only ST1 and ST3 showing symptoms. Blastocystis sp infection significantly associated with low household income, low parent’s education and presence of symptoms (p<0.05). Conclusion It is critical that we institute deworming and treatment to eradicate the parasite especially in rural school children.
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Kurt Ö, Doğruman Al F, Tanyüksel M. Eradication of Blastocystis in humans: Really necessary for all? Parasitol Int 2016; 65:797-801. [PMID: 26780545 DOI: 10.1016/j.parint.2016.01.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 12/30/2015] [Accepted: 01/14/2016] [Indexed: 02/01/2023]
Abstract
Blastocystis (initially named as Blastocystis hominis) has long been known as a protist without any clinical significance. However, there is now a huge pile of case reports where Blastocystis is blamed for the symptoms and the infection described in the patients. Introduction of the presence of as many as 17 Blastocystis subtypes while many infected individuals are non-symptomatic initially brought about the correlation between the subtypes and pathogenicity; however, the outcomes of these trials were not consistent and did not explain its pathogenicity. Today, it is mostly acknowledged that Blastocystis may colonize many individuals but the infection's onset depends on the interaction between the virulence of parasites and host's immune competence. Eradication of Blastocystis is essential in some cases where it is the only infectious agent and patient is suffering from some symptoms. In such cases, metronidazole is the drug of choice but its efficacy is relatively low in some cases. Other agents used include trimethoprim-sulfamethoxazole, paromomycin, and furazolidone. Recent studies on the interactions between human health and the role of gut microbiota introduces new data which may significantly change our point of view against some protists, which we tend to see as "parasites requiring urgent eradication for cure". May the presence or absence of some Blastocystis subtypes necessary for human health, or is the absence or presence of certain Blastocystis subtypes in human gut is associated with certain diseases/infections? The answers of these questions will surely guide us to select patients requiring treatment against Blastocystis infection in future.
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Affiliation(s)
- Özgür Kurt
- Faculty of Medicine, Department of Medical Microbiology, Acibadem University, Istanbul, Turkey.
| | - Funda Doğruman Al
- Faculty of Medicine, Department of Medical Microbiology, Gazi University, Ankara, Turkey.
| | - Mehmet Tanyüksel
- Faculty of Medicine, Department of Medical Microbiology, Gülhane Military Medical Academy, Ankara, Turkey.
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Lepczyńska M, Chen WC, Dzika E. Mysterious chronic urticaria caused by Blastocystis spp.? Int J Dermatol 2015; 55:259-66; quiz 263-4, 266. [PMID: 26469206 DOI: 10.1111/ijd.13064] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 03/09/2015] [Accepted: 04/08/2015] [Indexed: 01/18/2023]
Abstract
Species of the genus Blastocystis, which are single-cell, intestinal protozoan parasites of humans and animals, remain mysterious, with unclear clinical and epidemiologic significance. In recent years, many researchers have suggested a possible connection between Blastocystis spp. infection and chronic urticaria. In the present article, we review the literature and discuss the possible associations between the clinical symptomatology and pathogenicity of this organism in terms of its subtypes, morphologic forms, genetic diversity, and interactions with other intestinal microbiota.
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Affiliation(s)
- Małgorzata Lepczyńska
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland
| | - Wen-Chieh Chen
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Women's Health Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ewa Dzika
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland
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Downs JW, Putnam SD, Rockabrand DM, El Okla G, Mostafa M, Monteville MR, Antosek LE, Herbst J, Tribble DR, Riddle MS, Sanders JW. A cross-sectional analysis of clinical presentations of and risk factors for enteric protozoan Infections in an Active Duty Population during Operation Iraqi Freedom. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2015; 1:2. [PMID: 28883934 PMCID: PMC5526365 DOI: 10.1186/s40794-015-0005-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/27/2015] [Indexed: 12/02/2022]
Abstract
Background Infectious travelers’ diarrhea (TD) is a well-appreciated problem among service members serving abroad, particularly where infrastructure is limited due to ongoing combat operations, and efforts at sanitation and hygiene may not be considered an immediate priority. Bacterial and viral causes of travelers’ diarrhea are well-described among deployed service members, however, gastrointestinal protozoan infections among deployed service members are less well documented. This study’s purpose was to identify potential risk factors for, and clinical presentations of, enteric protozoan infections in an active duty military population deployed to combat operations in the Southwest Asia. Methods A cross-sectional study of enteric protozoan infections among US service members deployed in Al-Asad Air Base, Iraq in support of Operation Iraqi Freedom (OIF) was conducted in summer 2004. Subjects were obtained through a randomized sector sampling scheme, and through presentations for care at the air base medical facilities. All study participants provided a stool sample, either diarrhea or solid, upon study entry and completed a questionnaire documenting demographic information, clinical symptoms of any prior diarrheal episodes, and health risk behaviors. Basic diagnostic microscopy for protozoa was conducted to include acid-fast and modified trichrome staining. Results Four hundred thirty-seven subjects were included in the analysis, and 75 (17.1 %) subjects were found to have enteric protozoan infections as identified by diagnostic stool microscopy. Blastocystis hominis (n = 36), Entamoeba coli (n = 25), Endolimax nana (n = 20), and Entamoeba histolytica (n = 5) were the predominant organisms isolated. Crude incidence of prior episodes of diarrhea was greater among subjects from whom enteric protozoa were isolated compared to those without (IRR 1.66, 95 % CI 1.47-1.87). Bivariate analysis of health risk and hygiene behaviors found increased odds for presence of Blastocystis hominis among those service members who reported off base ice (OR 3.61, 95 % CI 1.40-9.28) and raw vegetable consumption (OR 8.18, 95 % CI 1.40-47.5). Conclusions This study suggests that US service members deployed to the early stages of OIF were at greater risk of acquiring enteric protozoa than previously understood. The noted prevalence of enteric protozoa among US service members in this study is higher than in prior reports, approaching prevalence expected in the general host nation population, suggesting that US service members operating at Al-Asad Air Base in early OIF were exposed to greater degrees of fecally contaminated food and water, and poor hygienic and sanitation practices. Consumption of food and water prepared by host nation parties in Southwest Asia may place US service members at risk for acquiring intestinal protozoa.
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Affiliation(s)
- John W Downs
- Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | | | | | | | | | | | | | - James Herbst
- Forward Deployable Preventive Medicine Unit East, Al Asad Airbase, Iraq
| | - David R Tribble
- Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - Mark S Riddle
- Naval Medical Research Center, Silver Spring, MD USA
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Roberts T, Stark D, Harkness J, Ellis J. Update on the pathogenic potential and treatment options for Blastocystis sp. Gut Pathog 2014; 6:17. [PMID: 24883113 PMCID: PMC4039988 DOI: 10.1186/1757-4749-6-17] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 05/15/2014] [Indexed: 12/23/2022] Open
Abstract
Although Blastocystis is one of the most common enteric parasites, there is still much controversy surrounding the pathogenicity and potential treatment options for this parasite. In this review we look at the evidence supporting Blastocystis as an intestinal pathogen as shown by numerous case studies and several in vivo studies and the evidence against. We describe the chronic nature of some infections and show the role of Blastocystis in immunocompromised patients and the relationship between irritable bowel syndrome and Blastocystis infection. There have been several studies that have suggested that pathogenicity may be subtype related. Metronidazole is the most widely accepted treatment for Blastocystis but several cases of treatment failure and resistance have been described. Other treatment options which have been suggested include paromomycin and trimethroprim- sulfamethoxazole.
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Affiliation(s)
- Tamalee Roberts
- Department of Microbiology, St. Vincent's Hospital, Victoria St, Darlinghurst 2010, NSW, Australia ; School of Medical and Molecular Biosciences, University of Technology, Sydney, Ultimo, NSW 2007, Australia
| | - Damien Stark
- Department of Microbiology, St. Vincent's Hospital, Victoria St, Darlinghurst 2010, NSW, Australia
| | - John Harkness
- Department of Microbiology, St. Vincent's Hospital, Victoria St, Darlinghurst 2010, NSW, Australia
| | - John Ellis
- School of Medical and Molecular Biosciences, University of Technology, Sydney, Ultimo, NSW 2007, Australia
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