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Maghsood AH, Kayedimajd S, Motavallihaghi S, Abedian R, Kordi S, Davoodi L, Faizi F, Soleymani E. Irritable Bowel Syndrome Associated with Blastocystis hominis or Without Relationship to It? A Case-Control Study and Minireview. Acta Parasitol 2024; 69:639-647. [PMID: 38300499 DOI: 10.1007/s11686-023-00787-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/21/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Blastocystis hominis (B. hominis) is a protozoan parasite that has a worldwide distribution. Some studies have suggested a link between B. hominis and the development of irritable bowel syndrome (IBS). The objective of this study was to determine the prevalence of B. hominis in patients with IBS compared to healthy individuals. MATERIAL AND METHODS A total of 65 stool samples from patients with IBS and 65 samples from healthy individuals in northern Iran were examined. The samples were tested using various methods including direct smear, formalin ether sedimentation and culture to detect the presence of B. hominis. Additionally, polymerase chain reaction (PCR) was performed on all culture-positive isolates to confirm the results and identify the genotype. RESULTS B. hominis was detected in 15.38% of IBS patients and 9.2% of the healthy group. The culture in RPMI1640 was found to be better than the formalin ether and direct smear methods. Positive samples were confirmed using the molecular method. No significant difference was observed in the order of B. hominis infection between the two groups. CONCLUSIONS The results of our study indicate that no significant difference was observed in the order of B. hominis infection between IBS patients and healthy groups. Therefore, further study is necessary to determine the potential pathogenic effects of this parasite and its role in causing IBS.
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Affiliation(s)
- Amir Hossein Maghsood
- Department of Medical Mycology and Parasitology, School of Medicine, Hamadan University of Medical Science, Hamadan, Iran
| | | | - Seyedmousa Motavallihaghi
- Department of Medical Mycology and Parasitology, School of Medicine, Hamadan University of Medical Science, Hamadan, Iran
| | - Rohallah Abedian
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shirafkan Kordi
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Lotfollah Davoodi
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fariba Faizi
- Department of Medical Mycology and Parasitology, School of Medicine, Hamadan University of Medical Science, Hamadan, Iran
| | - Eissa Soleymani
- Department of Medical Mycology and Parasitology, School of Medicine, Hamadan University of Medical Science, Hamadan, Iran.
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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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3
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Rondón S, Cavallero S, Link A, González C, D'Amelio S. Prevalence and Molecular Characterisation of Blastocystis sp. Infecting Free-Ranging Primates in Colombia. Pathogens 2023; 12:pathogens12040569. [PMID: 37111455 PMCID: PMC10143058 DOI: 10.3390/pathogens12040569] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Infection with Blastocystis sp. has been reported in free-living and captive non-human primates (NHPs); however, surveys on Blastocystis sp. from north-western South America are scarce. This study aimed to identify Blastocystis sp. in free-ranging NHPs living in Colombia. A total of 212 faecal samples were collected from Ateles hybridus, Cebus versicolor, Alouatta seniculus, Aotus griseimembra, Sapajus apella, and Saimiri cassiquiarensis. Smears and flotation were used for morphological identification. For samples microscopically classified as positive for Blastocystis sp., we used conventional PCR to amplify and sequence two regions of the SSU rRNA gene and used Maximum Likelihood methods and Median Joining Network analyses for phylogenetic analyses. Via microscopy, 64 samples were Blastocystis sp. positive. Through molecular analyses, 18 sequences of Blastocystis sp. subtype 8 (ST8) were obtained. Strain and allele assignment together with a comparative phylogenetic approach confirmed that the sequences were ST8. Alleles 21, 156, and 157 were detected. Median Joining network analyses showed one highly frequent haplotype shared by specimens from Colombia and Peru and close relationships between haplotypes circulating in NHPs from Colombia, Ecuador, Brazil, and Mexico. This survey could support the elaboration of a more accurate epidemiological picture of the Blastocystis sp. infecting NHPs.
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Affiliation(s)
- Silvia Rondón
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Serena Cavallero
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Andrés Link
- Laboratorio de Ecología de Bosques Tropicales y Primatología (LEBTYP), Departamento de Ciencias Biológicas, Universidad de los Andes, Cra. 1 N° 18a-12, Bogotá 111711, Colombia
| | - Camila González
- Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Departamento de Ciencias Biológicas, Universidad de los Andes, Cra. 1 N° 18a-12, Bogotá 111711, Colombia
| | - Stefano D'Amelio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
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Beyhan YE, Güven İ, Aydın M. Detection of Blastocystis sp. in ulcerative colitis, Crohn's and chronic diarrheal patients by microscopy, culture and real-time polymerase chain reaction. Microb Pathog 2023; 177:106039. [PMID: 36863418 DOI: 10.1016/j.micpath.2023.106039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 03/04/2023]
Abstract
Blastocystis sp. is a zoonotic parasite that is common in humans and animals and settles in the large intestine. The parasite can cause various gastrointestinal system complaints such as indigestion, diarrhea, abdominal pain, bloating, nausea and vomiting. The aim of this study is to determine the distribution of Blastocystis in patients diagnosed with ulcerative colitis, Crohn's and diarrhea from the gastroenterology outpatient clinic and to compare the diagnostic value of the most preferred methods. A total of 100 patients, 47 men and 53 women, were included in the study. Of the cases, 61 had diarrhea, 35 had ulcerative colitis (UC) and four had Crohn's disease. Stool samples of the patients were analyzed by as direct microscopic examination (DM), culture and real-time polymerase chain reaction (qPCR). A total of 42% positivity was detected, 29% positivity in DM and trichrome staining, 28% in culture and 41% in qPCR. 40.4% (20/47) of men and 37.7% (22/53) of women were found to be infected. Blastocystis sp. was found in 75% of Crohn's, 42.6% of diarrheal and 37.1% of UC patients. Diarrhea cases are more common with UC and there is a close relationship between Crohn's and Blastocystis positivity. While DM and trichrome staining showed a sensitivity of 69%, PCR test was found to be the most sensitive diagnostic method with approximately 98%. Diarrhea and UC are often seen together. A close relationship was detected between Crohn's disease and Blastocystis. High prevalence of Blastocystis in cases with clinical symptoms reveals the importance of the parasite. There is a need for studies on the pathogenicity of Blastocystis sp. in various gastrointestinal cases, and it is thought that molecular techniques should be used since PCR is seen to be a much more sensitive.
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Affiliation(s)
- Yunus Emre Beyhan
- Department of Medical Parasitology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Turkey.
| | - İrem Güven
- Department of Medical Parasitology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Mesut Aydın
- Department of Gastroenterology, Van Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
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Martín-Escolano R, Ng GC, Tan KSW, Stensvold CR, Gentekaki E, Tsaousis AD. Resistance of Blastocystis to chlorine and hydrogen peroxide. Parasitol Res 2023; 122:167-176. [PMID: 36378332 PMCID: PMC9816239 DOI: 10.1007/s00436-022-07713-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022]
Abstract
Blastocystis is a ubiquitous, widely distributed protist inhabiting the gastrointestinal tract of humans and other animals. The organism is genetically diverse, and so far, at least 28 subtypes (STs) have been identified with ST1-ST9 being the most common in humans. The pathogenicity of Blastocystis is controversial. Several routes of transmission have been proposed including fecal-oral (e.g., zoonotic, anthroponotic) and waterborne. Research on the latter has gained traction in the last few years with the organism having been identified in various bodies of water, tap water, and rainwater collection containers including water that has been previously filtered and/or chlorinated. Herein, we assessed the resistance of 11 strains maintained in culture, spanning ST1-ST9 to various chlorine and hydrogen peroxide concentrations for 24 h, and performed recovery assays along with re-exposure. Following the treatment with both compounds, all subtypes showed increased resistance, and viability could be visualized at the cellular level. These results are hinting at the presence of mechanism of resistance to both chlorine and hydrogen peroxide. As such, this pilot study can be the platform for developing guidelines for water treatment processes.
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Affiliation(s)
- Rubén Martín-Escolano
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury, CT2 7NJ, UK
| | - Geok Choo Ng
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore, 117545, Singapore
| | - Kevin S W Tan
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore, 117545, Singapore
| | - C Rune Stensvold
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - Eleni Gentekaki
- Gut Microbiome Research Group, Mae Fah Luang University, Chiang Rai, 57100, Thailand. .,School of Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand.
| | - Anastasios D Tsaousis
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury, CT2 7NJ, UK.
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Franklin F, Rajamanikam A, Raju CS, Gill JS, Francis B, Sy-Cherng LW, Kumar S. Higher amoebic and metronidazole resistant forms of Blastocystis sp. seen in schizophrenic patients. Parasit Vectors 2022; 15:313. [PMID: 36064639 PMCID: PMC9446727 DOI: 10.1186/s13071-022-05418-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background Blastocystis sp. is one of the most common colonisers of the intestinal tract that demonstrate strong interaction with accompanying gut bacteria. Previously, the protozoan isolated from individuals with irritable bowel syndrome (IBS) showed altered phenotypic features suggesting that it can be triggered to become pathogenic. Previous studies reported altered gut microbiota and high prevalence of Blastocystis sp. in schizophrenia patients. However, the phenotypic characteristics of Blastocystis sp. isolated from individuals with SZ have yet to be described. Methods In this study, faecal samples from 50 patients with severe schizophrenia (SZ) and 100 non-schizophrenic (NS) individuals were screened for Blastocystis sp. infection. Positive isolates were subjected to genotypic and phenotypic characterization. Results We found that 12 out of 50 (24%) SZ and 5 out of 100 (5%) NS individuals were detected Blastocystis sp. positive using both in vitro culture and PCR method with no significant association to age and gender. Out of the 15 sequenced isolates, ST3 was the most prevalent subtype (66.7%) followed by ST1 (20%) and ST6 (13.3%). The isolates from SZ individuals demonstrated significant slower growth rate (34.9 ± 15.6 h) and larger range of cell diameter (3.3–140 µm). We detected higher amoebic forms and metronidazole resistance among SZ isolates with variation in cell surface glycoprotein where 98% of cells from SZ showed consistent medium to high binding affinity (+ 2 to + 3) to Concavalin A staining compared to NS isolates that demonstrated only 76% high lectin (+ 3) binding affinity. Cysteine and serine protease levels were predominantly found among SZ isolates. We also demonstrate the presence of metalloprotease in Blastocystis sp. especially among NS isolates. Introduction of solubilised antigens from SZ isolates increased the cell proliferation of HCT116 cells by two fold when compared to NS isolates. Conclusion Our findings demonstrated Blastocystis sp. isolated from SZ individuals showed variation in phenotype specifically in morphology and drug resistance. The findings indicate that the gut environment (SZ and NS) and treatment of SZ could have influenced the phenotype of Blastocystis sp. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05418-0.
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Affiliation(s)
- Freddy Franklin
- Department of Parasitology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia.,Department of Medical Microbiology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia
| | - Arutchelvan Rajamanikam
- Department of Parasitology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia.,Department of Medical Microbiology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia
| | | | - Jesjeet Singh Gill
- Department of Phycological Medicine, Pusat Perubatan Universiti Malaya (PPUM), Kuala Lumpur, 50603, Malaysia
| | - Benedict Francis
- Department of Phycological Medicine, Pusat Perubatan Universiti Malaya (PPUM), Kuala Lumpur, 50603, Malaysia
| | - Luke Woon Sy-Cherng
- Department of Psychiatry, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, 50603, Malaysia
| | - Suresh Kumar
- Department of Parasitology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia.
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Wakid MH, Aldahhasi WT, Alsulami MN, El-Kady AM, Elshabrawy HA. Identification and Genetic Characterization of Blastocystis Species in Patients from Makkah, Saudi Arabia. Infect Drug Resist 2022; 15:491-501. [PMID: 35360371 PMCID: PMC8963194 DOI: 10.2147/idr.s347220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Blastocystis species (sp.) are gastrointestinal protozoan parasites with high prevalence rates worldwide. Blastocystis sp. show extensive genetic diversity with 17 different subtypes (STs) described to date. A few studies have investigated the prevalence and STs of Blastocystis sp. in Makkah, Saudi Arabia. Therefore, we aimed in this study to identify and characterize subtypes of Blastocystis sp. in the City of Makkah, Saudi Arabia. Methods Stool samples were collected from 140 patients who presented to King Abdulaziz Hospital, Hera General Hospital and Modern Medical Center in Saudi Arabia. Different microscopic examination methods of patients’ stools and molecular analyses (using primers targeting SSU rRNA gene) were performed to identify and characterize STs of Blastocystis sp. Results Our microscopic examination of stool samples showed that 96/140 patients (68.6%) had Blastocystis sp. infection. Clinical examination of infected patients revealed that 81 patients were symptomatic, whereas 15 were asymptomatic. Next, we isolated DNA from Blastocystis sp.-positive stool samples followed by PCR amplification of small-subunit ribosomal RNA (SSU rRNA) gene and sequence analysis. Our sequence analysis showed that subtype 3 (ST3) was the most prevalent (53.13%) followed by subtype 1 (ST1) (45.83%), whereas subtype 2 (ST2) was the least prevalent (1.04%). Moreover, our results showed that all three STs resulted in more symptomatic than asymptomatic cases. Finally, we identified novel haplotypes which comprised of 8 ST3, 6 ST1, and one ST2 haplotypes. Conclusion Our identification of several haplotypes in patients’ stools confirms the genetic diversity of Blastocystis sp. and may explain the reported low host specificity and differential pathogenicity of Blastocystis sp. We believe that additional molecular epidemiological and genomic studies are needed to understand the prevalence and pathogenicity of different subtypes in humans and animal hosts.
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Affiliation(s)
- Majed H Wakid
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Waad T Aldahhasi
- Department of Biology, College of Science, University of Jeddah, Jeddah, 21493, Saudi Arabia
| | - Muslimah N Alsulami
- Department of Biology, College of Science, University of Jeddah, Jeddah, 21493, Saudi Arabia
| | - Asmaa M El-Kady
- Department of Medical Parasitology, Faculty of Medicine, South Valley University, Qena, 83523, Egypt
- Correspondence: Asmaa M El-Kady; Hatem A Elshabrawy, Email ;
| | - Hatem A Elshabrawy
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX, 77304, USA
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Nemati S, Zali MR, Johnson P, Mirjalali H, Karanis P. Molecular prevalence and subtype distribution of Blastocystis sp. in Asia and in Australia. JOURNAL OF WATER AND HEALTH 2021; 19:687-704. [PMID: 34665764 DOI: 10.2166/wh.2021.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Blastocystis is a prevalent protozoan parasite reported in humans, animals, and environmental samples. Over the past decade, numerous studies have investigated the prevalence and subtype distribution of Blastocystis sp. alongside with its genetic and biochemical features. However, studies on subtype distribution of this protozoan in humans, animals, and environmental samples represent the potential transmission routes. In this review, we evaluated studies performed in Asian countries and in Australia to provide an overview of environmental factors on the prevalence and subtype distribution of Blastocystis sp. among humans, animals, and the environment.
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Affiliation(s)
- Sara Nemati
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail:
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Paul Johnson
- Department of Basic and Clinical Sciences, Nicosia University Medical School, Nicosia 2408, Cyprus
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail:
| | - Panagiotis Karanis
- Department of Basic and Clinical Sciences, Nicosia University Medical School, Nicosia 2408, Cyprus; Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Maloney JG, da Cunha MJR, Molokin A, Cury MC, Santin M. Next-generation sequencing reveals wide genetic diversity of Blastocystis subtypes in chickens including potentially zoonotic subtypes. Parasitol Res 2021; 120:2219-2231. [PMID: 33904983 DOI: 10.1007/s00436-021-07170-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022]
Abstract
Blastocystis sp. is an intestinal protist parasite commonly found in the feces of humans and animals worldwide. Blastocystis exhibits extensive genetic diversity and has been identified in humans and a variety of animals including other mammals and birds. Blastocystis subtypes do not exhibit strict host specificity which raises the possibility of zoonotic transmission through either direct contact or fecal contamination of food or water. However, reports detailing the subtypes and prevalence of Blastocystis in avian species are limited. Therefore, this study investigated the presence of Blastocystis in chickens by molecular characterization of the small subunit rRNA (SSU rRNA) gene. Fecal samples from 130 chickens were collected from local markets in Uberlândia and Belo Horizonte in the state of Minas Gerais, Brazil. To detect and identify subtypes of Blastocystis, a next-generation amplicon sequencing protocol was used. Forty-four of the 130 (33.8%) chickens examined were positive for Blastocystis. Blastocystis subtypes ST6 (23/130; 17.7%), ST7 (43/130; 33.1%), ST10 (1/130; 0.8%), ST14 (5/130; 3.8%), ST25 (1/130; 0.8%), and a novel subtype (ST29) (2/130; 1.5%) were observed. A nanopore sequencing strategy was used to obtain the near full-length SSU rRNA gene nucleotide sequence and validate novel subtype ST29. Mixed infections containing multiple subtypes were common and identified in 63.6% of Blastocystis-positive chickens. All positive samples contained one or both potentially zoonotic subtypes ST6 and ST7. The prevalence of Blastocystis in chickens was high, and molecular characterization mostly identified subtypes previously found in humans. Thus, chickens may be a source of human infection and environmental contamination.
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Affiliation(s)
- Jenny G Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - Maria J R da Cunha
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA.,Laboratório de Parasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Av. Pará, 1720, Campus Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil.,CAPES Foundation, Ministry of Education of Brazil, Caixa Postal 250, Brasília, DF, 70040-020, Brazil
| | - Aleksey Molokin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - Márcia C Cury
- Laboratório de Parasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Av. Pará, 1720, Campus Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil
| | - Monica Santin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA.
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Salvador F, Lobo B, Goterris L, Alonso-Cotoner C, Santos J, Sulleiro E, Bailo B, Carmena D, Sánchez-Montalvá A, Bosch-Nicolau P, Espinosa-Pereiro J, Fuentes I, Molina I. Blastocystis sp. Carriage and Irritable Bowel Syndrome: Is the Association Already Established? BIOLOGY 2021; 10:biology10040340. [PMID: 33921803 PMCID: PMC8072823 DOI: 10.3390/biology10040340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022]
Abstract
Simple Summary The intestinal protist Blastocystis sp. is one of the most common intestinal parasites observed in humans, and has a worldwide distribution, being more prevalent in developing countries. Although this parasite has been described decades ago, the pathogenic potential it is still not understood completely. It has been suggested that Blastocystis sp. could be related with irritable bowel syndrome, a functional gastrointestinal disorder characterized by abdominal pain, discomfort with defecation, and changes in the frequency or form of stool. In our study, we compare a group of patients with irritable bowel syndrome with a group of healthy volunteers; no differences regarding the occurrence of Blastocystis sp. detection was found between both groups. Abstract Background: The aim of the present study is to describe the occurrence of Blastocystis sp. detection among asymptomatic subjects and patients with irritable bowel syndrome in order to evaluate the potential association between irritable bowel syndrome and the parasitic infection. Methods: Cross-sectional study where adult patients with irritable bowel syndrome diagnosed according to Rome IV criteria were included. A control group was formed by asymptomatic subjects older than 18 years. Exclusion criteria were: immunosuppressive condition or having received any drug with demonstrated activity against Blastocystis sp. within the last 6 months before study inclusion. Epidemiological and clinical information was collected from all included participants. Two stool samples were obtained from all participants: one sample for microscopic examination and one sample for Blastocystis sp. PCR detection. Blastocystis sp. infection was defined by the positivity of any of the diagnostic techniques. Results: Seventy-two participants were included (36 asymptomatic subjects and 36 patients with irritable bowel syndrome). Thirty-five (48.6%) were men, and median age of participants was 34 (IQR 29–49) years. The overall rate of Blastocystis sp. carriage was 27.8% (20/72). The prevalence assessed through microscopic examination was 22.2% (16/72), while the prevalence measured by PCR was 15.3% (11/72). When comparing the presence of Blastocystis sp. between asymptomatic subjects and IBS patients, we did not find any statistically significant difference (36.1% vs. 19.4% respectively, p = 0.114). Conclusions: regarding the occurrence of Blastocystis sp., no differences were found between asymptomatic participants and patients with irritable bowel disease irrespective of the diagnostic technique performed.
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, Pº Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.S.-M.); (P.B.-N.); (J.E.-P.); (I.M.)
- Correspondence: ; Tel.: +34-93-274-60-90; Fax: +34-93-489-40-91
| | - Beatriz Lobo
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd); Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (B.L.); (C.A.-C.); (J.S.)
| | - Lidia Goterris
- Department of Microbiology, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (L.G.); (E.S.)
| | - Carmen Alonso-Cotoner
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd); Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (B.L.); (C.A.-C.); (J.S.)
| | - Javier Santos
- Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd); Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain; (B.L.); (C.A.-C.); (J.S.)
| | - Elena Sulleiro
- Department of Microbiology, Vall d’Hebron University Hospital, PROSICS Barcelona, 08035 Barcelona, Spain; (L.G.); (E.S.)
| | - Begoña Bailo
- National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (B.B.); (D.C.); (I.F.)
| | - David Carmena
- National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (B.B.); (D.C.); (I.F.)
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, Pº Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.S.-M.); (P.B.-N.); (J.E.-P.); (I.M.)
| | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, Pº Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.S.-M.); (P.B.-N.); (J.E.-P.); (I.M.)
| | - Juan Espinosa-Pereiro
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, Pº Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.S.-M.); (P.B.-N.); (J.E.-P.); (I.M.)
| | - Isabel Fuentes
- National Centre of Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (B.B.); (D.C.); (I.F.)
| | - Israel Molina
- Department of Infectious Diseases, Vall d’Hebron University Hospital, PROSICS Barcelona, Pº Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.S.-M.); (P.B.-N.); (J.E.-P.); (I.M.)
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Mossallam SF, El- Mansoury SA, Tolba MM, Kohla AA, Khedr SI. In vitro susceptibility of human Blastocystis subtypes to simeprevir. Saudi J Biol Sci 2021; 28:2491-2501. [PMID: 33935570 PMCID: PMC8071969 DOI: 10.1016/j.sjbs.2021.01.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction and aim Blastocystis is a common enteric parasite, having a worldwide distribution. Many antimicrobial agents are effective against it, yet side effects and drug resistance have been reported. Thus, ongoing trials are being conducted for exploring anti-Blastocystis alternatives. Proteases are attractive anti-protozoal drug targets, having documented roles in Blastocystis. Serine proteases are present in both hepatitis C virus and Blastocystis. Since drug repositioning is quite trendy, the in vitro efficacy of simeprevir (SMV), an anti-hepatitis serine protease inhibitor, against Blastocystis was investigated in the current study. Methods Stool samples were collected from patients, Alexandria, Egypt. Concentrated stools were screened using direct smears, trichrome, and modified Ziehl-Neelsen stains to exclude parasitic co-infections. Positive stool isolates were cultivated, molecularly subtyped for assessing the efficacy of three SMV doses (100,150, and 200 μg/ml) along 72 hours (h), on the most common subtype, through monitoring parasite growth, viability, re-culture, and also via ultrastructure verification. The most efficient dose and duration were later tested on other subtypes. Results Results revealed that Blastocystis was detected in 54.17% of examined samples. Molecularly, ST3 predominated (62%), followed by ST1 (8.6%) and ST2 (3.4%). Ascending concentrations of SMV progressively inhibited growth, viability, and re-culture of treated Blastocystis, with a non-statistically significant difference when compared to the therapeutic control metronidazole (MTZ). The most efficient dose and duration against ST3 was 150 µg/ml for 72 h. This dose inhibited the growth of ST3, ST1, and ST2 with percentages of 95.19%, 94.83%, and 94.74%, successively and viability with percentages of 98.30%, 98.09%, and 97.96%, successively. This dose abolished Blastocystis upon re-culturing. Ultra-structurally, SMV induced rupture of Blastocystis cell membrane leading to necrotic death, versus the reported apoptotic death caused by MTZ. In conclusion, 150 µg/ml SMV for 72 h proved its efficacy against ST1, ST2, and ST3 Blastocystis, thus sparing the need for pre-treatment molecular subtyping in developing countries.
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Key Words
- Blastocystis subtypes
- CV, central vacuole
- DMSO, Dimethyl Sulfoxide
- IBS, irritable bowel syndrome
- In vitro
- MLO, Mitochondrion-like organelle
- MTZ, Metronidazole
- PCR, Polymerase chain reaction
- Re-culture
- SEM, Scanning electron microscopy
- SMV, Simeprevir
- ST, subtypes
- Simeprevir
- TEM, Transmission electron microscopy
- Ultrastructure
- Viability
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Affiliation(s)
- Shereen F. Mossallam
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Corresponding author at: Medical Parasitology Department, El Mowasah Medical and Educational Complex, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Salwa A.T. El- Mansoury
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mona M. Tolba
- Department of Parasitology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Asmaa A. Kohla
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Safaa I. Khedr
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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12
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Succinate dehydrogenase gene as a marker for studying Blastocystis genetic diversity. Heliyon 2020; 6:e05387. [PMID: 33163680 PMCID: PMC7609450 DOI: 10.1016/j.heliyon.2020.e05387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/01/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022] Open
Abstract
Blastocystis has been reported as the most common eukaryotic microorganism residing in the intestines of both humans and animals, with a prevalence of up to 100% in some populations. Since this is a cryptic species, sequence polymorphism are the single strategy to analyses its genetic diversity, being traditionally used the analysis of ssu rRNA gene sequence to determine alleles and subtypes (STs) for this species. This multicopy gene has shown high diversity among different STs, making necessary to explore other genes to assess intraspecific diversity. This study evaluated the use of a novel genetic marker, succinate dehydrogenase (SDHA), for the typing and evaluation of the genetic diversity and genetic population structure of Blastocystis. In total, 375 human fecal samples were collected and subjected to PCR, subtyped using the ssu rRNA marker, and then the SDHA gene was amplified via PCR for 117 samples. We found some incongruences between tree topologies for both molecular markers. However, the clustering by ST previously established for Blastocystis was congruent in the concatenated sequence. SDHA showed lower reticulation (The origination of a lineage through the partial merging of two ancestor lineages) signals and better intra ST clustering ability. Clusters with geographical associations were observed intra ST. The genetic diversity was lower in the marker evaluated compared to that of the ssu rRNA gene (nucleotide diversity = 0.03344 and 0.16986, respectively) and the sequences analyzed showed population expansion with genetic differentiation principally among STs. The ssu rRNA gene was useful to explore interspecific diversity but together with the SDHA gene the resolution power to evaluate intra ST diversity was higher. These results showed the potential of the SDHA marker for studying the intra ST genetic diversity of Blastocystis related with geographical location and the inter ST diversity using the concatenated sequences.
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13
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Not A, Salvador F, Goterris L, Sulleiro E, López I, Balladares M, García E, Paz C, Sánchez-Montalvá A, Bosch-Nicolau P, Sao-Avilés A, Molina I. Microscopic examination after concentration techniques for Blastocystis sp. detection in serial faecal samples: How many samples are needed? Parasite Epidemiol Control 2020; 9:e00137. [PMID: 32055721 PMCID: PMC7005442 DOI: 10.1016/j.parepi.2020.e00137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/02/2022] Open
Abstract
Objective Blastocystis sp. is one of the most frequently observed intestinal parasites in humans. It is suggested that sensitivity of classical parasitological tests for the Blastocystis sp. diagnosis increases when increasing the number of investigated samples, although there is a lack of information. The aim of the study is to evaluate the sensitivity of classical parasitological tests for the Blastocystis sp. diagnosis depending on the number of investigated samples and to determine risk factors associated to high parasite burden. Methods Retrospective study where patients in whom three consecutive stool samples were examined for parasitic diagnosis through microscopic examination at Vall d'Hebron University Hospital (Barcelona, Spain) from January to April 2019 were included. To determine risk factors associated to high parasite burden, a case-control study was performed including patients with at least one positive stool sample for Blastocystis sp.: cases were those patients with only one or two positive stool samples, and controls were those with all three stool positive samples). Clinical records were reviewed from included patients to collect clinical and demographic information. Results In 2771 patients three consecutive stool samples were examined for parasitic diagnosis, with an overall prevalence of Blastocystis sp. detection of 23.3%. The proportions of positive cases depending on the number of investigated samples were: 22.3% when taking into account the first sample, 22.9% when taking into account the first and second samples, and 23.3% when taking into account the three samples, with no statistically significant differences among them. For the case-control study we finally included 63 cases and 133 controls. No differences were found regarding clinical and demographic characteristics among groups. Conclusion Prevalence of Blastocystis sp. infection was high in our study (23.3%). The sensitivity of classical parasitological methods for Blastocystis sp. diagnosis did not increase when increasing the number of investigated samples, and no risk factors associated to high parasite burden were identified.
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Affiliation(s)
- Anna Not
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Lidia Goterris
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Isabel López
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Martha Balladares
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Elena García
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Carmen Paz
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Augusto Sao-Avilés
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS, Barcelona, Barcelona, Spain
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Mardani Kataki M, Tavalla M, Beiromvand M. Higher prevalence of Blastocystis hominis in healthy individuals than patients with gastrointestinal symptoms from Ahvaz, southwestern Iran. Comp Immunol Microbiol Infect Dis 2019; 65:160-164. [PMID: 31300108 DOI: 10.1016/j.cimid.2019.05.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/17/2019] [Accepted: 05/21/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Blastocystis, a common intestinal protozoan of humans and animals, infected more than 1 billion people around the world. This enteric protozoan is frequently reported in both healthy individuals and patients with gastrointestinal (GI) symptoms. METHODS Three hundred and forty-five fecal samples including 151 GI patients and 194 healthy individuals were examined by microscopy, culture and PCR-sequencing techniques to determine Blastocystis frequency and subtype (ST) variation. RESULTS The occurrence of Blastocystis was detected 56 (16.2%) and 85 (24.6%) by microscopy, culture and PCR methods, respectively. Out of the 85 positive patients, 60 (70.6%) were asymptomatic and 25 (29.4%) were symptomatic. The results of 41 successfully sequenced isolates identified 8 (19.5%), 8 (19.5%), and 25 (61.0%) ST1, ST2, and ST3, respectively. CONCLUSION This study has found that Blastocystis was more common in healthy individuals than GI patients. Another finding was that no correlation was found between clinical symptoms and Blastocystis STs.
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Affiliation(s)
- Masoumeh Mardani Kataki
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Tavalla
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Infectious and Tropical Diseases Research Center, Health Research Institute; Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of MedicalSciences, Ahvaz, Iran
| | - Molouk Beiromvand
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Infectious and Tropical Diseases Research Center, Health Research Institute; Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of MedicalSciences, Ahvaz, Iran.
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15
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Srichaipon N, Nuchprayoon S, Charuchaibovorn S, Sukkapan P, Sanprasert V. A Simple Genotyping Method for Rapid Differentiation of Blastocystis Subtypes and Subtype Distribution of Blastocystis spp. in Thailand. Pathogens 2019; 8:pathogens8010038. [PMID: 30901902 PMCID: PMC6471993 DOI: 10.3390/pathogens8010038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 01/12/2023] Open
Abstract
Blastocystis spp. is one of the most common protozoa of humans and animals worldwide. The genetic diversity of Blastocystis spp. might be associated with a wide range of symptoms. However, the prevalence of each subtype is different in each country. Until now, there is no standard method for subtyping of Blastocystis spp. We developed a sequential restriction fragment length polymorphism (RFLP) analysis for the rapid differentiation of human Blastocystis subtypes. A large-scale study was also conducted to determine the subtype distribution of Blastocystis spp. in Thailand. Stool samples were collected from 1025 school-age students in four regions of Thailand. Blastocystis infections were identified by direct smear, formalin ethyl-acetate concentration technique (FECT), Boeck and Drbohlav’s Locke-Egg-Serum (LES) medium culture, and polymerase chain reaction (PCR) of small-subunit ribosomal DNA (SSU rDNA). Subtypes of Blastocystis spp. were determined by RFLP. Phylogenetic tree of partial SSU rDNA sequences of Blastocystis spp. was constructed using the Maximum Likelihood (ML) method. Out of 1025 students, 416 (40.6%) were positive for Blastocystis spp. Using two steps of RFLP reactions, we could determine subtype one–three among these students. Subtype 3 was the most common subtype (58.72%) in Thai students, followed by subtype 1 (31.2%), and subtype 2 (10.1%). Blastocystis subtype 3 was the most prevalent in all regions of Thailand. The subtype distribution of Blastocystis spp. in Thailand was different from other countries.
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Affiliation(s)
- Nittaya Srichaipon
- Lymphatic Filariasis and Tropical Medicine Research Unit, Chulalongkorn Medical Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
| | - Surang Nuchprayoon
- Lymphatic Filariasis and Tropical Medicine Research Unit, Chulalongkorn Medical Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
- Department of Parasitology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
| | - Sarit Charuchaibovorn
- Lymphatic Filariasis and Tropical Medicine Research Unit, Chulalongkorn Medical Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
| | - Pattadon Sukkapan
- Program of Biology, Faculty of Science, Chandrakasem Rajabhat University, Bangkok 10900, Thailand.
| | - Vivornpun Sanprasert
- Lymphatic Filariasis and Tropical Medicine Research Unit, Chulalongkorn Medical Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
- Department of Parasitology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
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16
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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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Vaughn BP, Rank KM, Khoruts A. Fecal Microbiota Transplantation: Current Status in Treatment of GI and Liver Disease. Clin Gastroenterol Hepatol 2019; 17:353-361. [PMID: 30055267 DOI: 10.1016/j.cgh.2018.07.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/03/2018] [Accepted: 07/18/2018] [Indexed: 02/07/2023]
Abstract
Fecal microbiota transplantation was originally introduced as a method to repair intestinal microbiota following failure of multiple treatments of recurrent Clostridiumdifficile infection with antibiotics. However, it is hypothesized that intestinal dysbiosis may contribute to the pathogenesis of many diseases, especially those involving the gastrointestinal tract. Therefore, fecal microbiota transplantation is increasingly being explored as a potential treatment that aims to optimize microbiota composition and functionality. Here, we review the current state of fecal microbiota transplantation development and applications in conditions of greatest interest to a gastroenterologist.
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Affiliation(s)
- Byron P Vaughn
- Department of Medicine, Division of Gastroenterology, University of Minnesota, Minneapolis, Minnesota
| | - Kevin M Rank
- Department of Medicine, Division of Gastroenterology, University of Minnesota, Minneapolis, Minnesota
| | - Alexander Khoruts
- Department of Medicine, Division of Gastroenterology, University of Minnesota, Minneapolis, Minnesota; Center for Immunology and the BioTechnology Institute, University of Minnesota, Minneapolis, Minnesota.
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18
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Růžková J, Květoňová D, Jirků M, Lhotská Z, Stensvold CR, Parfrey LW, Jirků Pomajbíková K. Evaluating rodent experimental models for studies of Blastocystis ST1. Exp Parasitol 2018; 191:55-61. [PMID: 29959915 DOI: 10.1016/j.exppara.2018.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/18/2018] [Accepted: 06/26/2018] [Indexed: 01/30/2023]
Abstract
Blastocystis is a common inhabitant of the human gut, colonizing at least one billion people at a prevalence ranging from <10% to 100% in healthy human populations globally. The majority of carriers remain asymptomatic, suggesting that Blastocystis is largely a commensal, though Blastocystis has also been implicated in disease in some people. However, there are no in vivo model systems in which to experimentally test the impact of Blastocystis on mammalian hosts and the gut ecosystem and determine which factors underlie these variable clinical outcomes. We evaluated a rat model for sustaining of a human-derived Blastocystis ST1 and assess colonization success and longevity. Because of the broad host range of Blastocystis, we compared the rat with three other rodent species to establish the reproducibility of our method. Blastocystis was introduced by esophageal gavage and colonization success evaluated by Blastocystis culture. Culture was also used to determine that all animals were negative prior to colonization and negative controls remain Blastocystis-free. In this study, Blastocystis ST1 established in 100% of the outbred rats (Rattus norvegicus) and gerbils (Meriones unguiculatus) challenged. Rats were colonized asymptomatically for more than one year, but Blastocystis ST1 was not transmitted between rats. Mus musculus strain CD1 and Mastomys coucha were not susceptible to Blastocystis ST1. Thus, rats appear to be a suitable in vivo model for studies of Blastocystis ST1, as do gerbils though testing was less extensive. This work lays the foundation for experimental work on the role of Blastocystis in health and disease.
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Affiliation(s)
- Jiřina Růžková
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, České Budějovice, Branišovská 31, 370 05, Czech Republic.
| | - Dana Květoňová
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, České Budějovice, Branišovská 31, 370 05, Czech Republic.
| | - Milan Jirků
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, České Budějovice, Branišovská 31, 370 05, Czech Republic.
| | - Zuzana Lhotská
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, České Budějovice, Branišovská 31, 370 05, Czech Republic.
| | | | - Laura Wegener Parfrey
- Department of Botany and Biodiversity Research Centre, University of British Columbia, Vancouver, British Columbia, V6T 1Z4, Canada; Department of Zoology, University of British Columbia, Vancouver, British Columbia, V6T 1Z4, Canada.
| | - Kateřina Jirků Pomajbíková
- Biology Centre, Czech Academy of Sciences, Institute of Parasitology, České Budějovice, Branišovská 31, 370 05, Czech Republic; Department of Medical Biology, Faculty of Science, University of South-Bohemia, Branišovská 31, 370 05, České Budějovice, Czech Republic.
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Koloren Z, Gulabi BB, Karanis P. Molecular identification of Blastocystis sp. subtypes in water samples collected from Black sea, Turkey. Acta Trop 2018; 180:58-68. [PMID: 29317171 DOI: 10.1016/j.actatropica.2017.12.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/12/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to identify the subtypes of Blastocystis sp. and complete a phylogenetic analysis of 268 water samples that were collected from the Samsun, Amasya and Sinop Provinces of the Black Sea in Turkey, between the years 2011 and 2014. Blastocystis sp. was investigated in 48 uncultured sea water samples that were collected from 4 sites within the Sinop Province. A total of 100 river water samples were collected from 37 sites in the Samsun Province and 120 river water samples were collected from 10 sampling sites within the Amasya Province. The small subunit (SSU) rDNA gene Polymerase chain reaction (PCR) were performed for the detection of Blastocytis sp. and the PCR-positive samples were sequenced. Subsequently, the (SSU) rDNA sequences were aligned by Bioedit and phylogenetic trees were constructed for Blastocystis with reference to the genotypes from GenBank. Blastocystis sp. were found in 3 out of the 75 (4%) river water samples that were collected from the Samsun Province. Six of the 120 (5%) river water samples and 1 out of the 48 (2%) seawater samples were positive for Blastocystis in the Amasya and Sinop Provinces. There were two different subtypes (ST; 1 and 3) found from sequencing all of the samples from the investigated sites. Two and one PCR products were found to be positive for ST1 and ST3 from the different samples collected within the Samsun Province. Two and 4 PCR products from the Amasya Province were ST1 and ST3, respectively and only one sample from the Sinop Province was found to be positive for ST1. This is the first report to identify and report the occurrence of Blastocystis subtypes within the Black Sea of Turkey.
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Clinical and epidemiological characteristics of intestinal parasite infection by Blastocystis hominis. Rev Clin Esp 2018. [DOI: 10.1016/j.rceng.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Características clínicas y epidemiológicas de la parasitación intestinal por Blastocystis hominis. Rev Clin Esp 2018; 218:115-120. [DOI: 10.1016/j.rce.2018.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 01/14/2018] [Accepted: 01/15/2018] [Indexed: 12/13/2022]
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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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O' Leary JK, Blake L, Corcoran D, Sleator RD, Lucey B. Trials and Tribulations of Enteric Parasitology in the Molecular Era. J Med Microbiol 2018; 67:145-147. [PMID: 29265996 DOI: 10.1099/jmm.0.000670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jennifer K O' Leary
- Department of Biological Sciences, Cork Institute of Technology, Bishopstown, Cork, Ireland
| | - Liam Blake
- Department of Medical Microbiology, Cork University Hospital, Wilton, Cork, Ireland
| | - Dan Corcoran
- Department of Medical Microbiology, Cork University Hospital, Wilton, Cork, Ireland
| | - Roy D Sleator
- APC Microbiome Institute, University College Cork, Cork, Ireland
- Department of Biological Sciences, Cork Institute of Technology, Bishopstown, Cork, Ireland
| | - Brigid Lucey
- Department of Biological Sciences, Cork Institute of Technology, Bishopstown, Cork, Ireland
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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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25
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Comparative Prevalence of Blastocystis in Patients with the Irritable Bowel Syndrome and Healthy Individuals: A Case Control Study. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.13572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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26
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Khademvatan S, Masjedizadeh R, Yousefi-Razin E, Mahbodfar H, Rahim F, Yousefi E, Foroutan M. PCR-based molecular characterization of Blastocystis hominis subtypes in southwest of Iran. J Infect Public Health 2017; 11:43-47. [PMID: 28404232 DOI: 10.1016/j.jiph.2017.03.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/06/2017] [Accepted: 03/25/2017] [Indexed: 01/02/2023] Open
Abstract
Blastocystis hominis is the most common intestinal parasite found in humans and many other hosts. Pathogenicity of Blastocystis sp. remains controversial and it has been suggested that it may be associated with certain subtypes of organism. The aim of this study was to evaluate the molecular epidemiology of B. hominis and its subtype distribution in Ahvaz, southwest of Iran. During 2012-2014, a total of 481 samples were collected from patients referred to the medical laboratory centers in Ahvaz for stool examination. Samples were examined by wet mount, and genomic DNA was extracted from 50 positive samples. PCR was performed using seven primer pairs targeting the SSU rDNA gene and sequenced. 69 (14.35%) samples were found to be positive for B. hominis and the subtypes of 50 samples were identified. Five subtypes (STs) were identified, including: ST1 (22%), ST2 (6%), ST3 (40%), ST4 (2%), and ST5 (8%). 11 (22%) mixed infections were found, of which 5 were a mixture of ST3/ST4. Mixtures of ST1/ST3 and ST1/ST4 were 3, respectively. In this study people infected with ST3 showed the most gastrointestinal symptoms. This is the first study in the population of Ahvaz and indicates the high prevalence of ST3 in this area. The results suggest a possible association between this subtype and pathogenic potential of parasite.
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Affiliation(s)
- Shahram Khademvatan
- Research Institute for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Medical Parasitology and Mycology & Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Rahim Masjedizadeh
- Research Institute for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Yousefi-Razin
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, and Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Mahbodfar
- Research Institute for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- Research Institute for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Elham Yousefi
- Research Institute for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoud Foroutan
- Research Institute for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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27
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Ramírez JD, Flórez C, Olivera M, Bernal MC, Giraldo JC. Blastocystis subtyping and its association with intestinal parasites in children from different geographical regions of Colombia. PLoS One 2017; 12:e0172586. [PMID: 28222192 PMCID: PMC5319748 DOI: 10.1371/journal.pone.0172586] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 02/07/2017] [Indexed: 11/18/2022] Open
Abstract
Blastocystis is a common enteric protist colonizing probably more than 1 billion people with a large variety of non-human hosts. Remarkable genetic diversity has been observed, leading to the subdivision of the genus into multiple subtypes (ST), some of which are exclusively found in non-human hosts. The aim of this study was to determine the distribution of Blastocystis STs/18S alleles in symptomatic (abdominal pain, anal pruritus, diarrhea, headache, nauseas and/or vomit) and asymptomatic children from nine geographical regions of Colombia. A total of 2026 fecal samples were collected as part of a national survey to estimate the frequency of intestinal parasites in children. A set of 256 samples that were Blastocystis positive was finally selected. The samples were submitted to DNA extraction, Real Time PCR and sequencing using Blastocystis-specific primers targeting the small subunit rRNA gene for ST identification. DNA of Ascaris lumbricoides (16.4%), Trichuris trichiura (8.2%), hookworms (Necator americanus/Ancylostoma duodenale) (7.3%), Giardia duodenalis (23.1%), Entamoeba complex (82%), Entamoeba coli (55%), Hymenolepis nana (0.8%), Endolimax nana (33.2%) and Neobalantidium coli (2.7%) was detected in the Blastocystis-positive samples. We detected ST1 (21.4%), ST2 (19.5%), ST3 (55.5%), ST4 (0.8%), ST6 (2%) and ST7 (0.8%); alleles 1, 2, 4, 81, 82 and 83 for ST1; alleles 9, 11, 12, 15, 67, 71 and 73 for ST2; alleles 34, 36, 38, 45, 49, 55, 134 and 128 for ST3; allele 42 for ST4; allele 122 for ST6, and allele 142 for ST7. Further studies implementing high-resolution molecular markers are necessary to understand the dynamics of Blastocystis transmission and the role of this Stramenopila in health and disease.
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MESH Headings
- Adolescent
- Alleles
- Asymptomatic Diseases
- Blastocystis/classification
- Blastocystis/genetics
- Blastocystis Infections/epidemiology
- Blastocystis Infections/parasitology
- Child
- Child, Preschool
- Coinfection
- Colombia/epidemiology
- DNA Barcoding, Taxonomic
- DNA, Protozoan/analysis
- DNA, Protozoan/isolation & purification
- DNA, Ribosomal/analysis
- DNA, Ribosomal/isolation & purification
- Feces/parasitology
- Female
- Genetic Variation
- Geography, Medical
- Health Surveys
- Humans
- Intestinal Diseases, Parasitic/parasitology
- Male
- RNA, Protozoan/genetics
- RNA, Ribosomal, 18S/genetics
- Real-Time Polymerase Chain Reaction
- Ribotyping
- Species Specificity
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Affiliation(s)
- Juan David Ramírez
- Grupo de Investigaciones Microbiológicas – UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá – Colombia
- * E-mail:
| | - Carolina Flórez
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá – Colombia
| | - Mario Olivera
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá – Colombia
| | - María Consuelo Bernal
- Programa profesional de Biología, Grupo de Investigación en Parasitología y Microbiología tropical – GIPAMT, Universidad Incca de Colombia, Bogotá – Colombia
| | - Julio Cesar Giraldo
- Programa profesional de Biología, Grupo de Investigación en Parasitología y Microbiología tropical – GIPAMT, Universidad Incca de Colombia, Bogotá – Colombia
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28
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Del Coco VF, Molina NB, Basualdo JA, Córdoba MA. [Blastocystis spp.: Advances, controversies and future challenges]. Rev Argent Microbiol 2017; 49:110-118. [PMID: 28189279 DOI: 10.1016/j.ram.2016.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/09/2016] [Accepted: 08/29/2016] [Indexed: 01/24/2023] Open
Abstract
Blastocystis spp. is the most common protozoan detected in human stool samples. In developing countries, infection rates are higher than 20%. The presence of this parasite in the feces of several host species suggests its zoonotic potential. The clinical relevance and the pathogenic role of Blastocystis spp. in the intestinal tract remain unclear. There are several clinical reports that recognize it as the etiologic agent of several intestinal disorders such as diarrhea, inflammatory bowel disease and ulcerative colitis, although the pathogenicity of this parasite has not been proved yet. This wide range of clinical manifestations could be related to the genetic diversity exhibited by this parasite.
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Affiliation(s)
- Valeria F Del Coco
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Sede Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, CABA, Argentina.
| | - Nora B Molina
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Sede Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina
| | - Juan A Basualdo
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Sede Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina
| | - María A Córdoba
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Sede Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina; Comisión de Investigaciones Científicas de la Provincia de Buenos Aires, La Plata, Argentina
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29
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Dogan N, Aydin M, Tuzemen NU, Dinleyici EC, Oguz I, Dogruman-Al F. Subtype distribution of Blastocystis spp. isolated from children in Eskisehir, Turkey. Parasitol Int 2016; 66:948-951. [PMID: 27989831 DOI: 10.1016/j.parint.2016.10.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 09/04/2016] [Accepted: 10/17/2016] [Indexed: 12/11/2022]
Abstract
Blastocystis spp. is the most common enteric protist found in human feces. The pathogenic role of Blastocystis remains controversial and it has been suggested that the symptomatology of Blastocystis is associated with its subtypes (ST). However, only few studies have investigated the relationship between the symptomatology and subtypes of Blastocystis in children. This study aimed to investigate the prevalence of Blastocystis in children aged 3 to 13years with or without gastrointestinal complaints and determine the distribution of the subtypes of Blastocystis. A total of 303 stool samples obtained from symptomatic (n=84) and asymptomatic (n=219) children were included in the study. The presence of Blastocystis was investigated using native-lugol examination, trichrome staining and real-time PCR method. Using the real-time PCR method, 115 samples were found positive for Blastocystis. Subtyping was successfully performed on 46 samples using sequenced-tagged site (STS) primers and PCR. The remaining 69 samples could not be subtyped. The most frequently detected subtype was ST3 (43.4%) followed by ST1 (26.1%), ST4 (10.9%) and ST2 (8.7%). The mixed subtypes were identified in five samples (10.9%) as; ST1+ST3 (n=3), ST1+ST2 (n=1) and ST2+ST3 (n=1). None of the samples had ST5, ST6 or ST7. No statistically significant difference was found between the symptomatic and asymptomatic groups in terms of the Blastocystis positivity and the distribution of subtypes (p>0.05). To our knowledge, this is the first study to investigate the subtype distribution of Blastocystis in children in Turkey and the results are in agreement with the related data available in Turkey.
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Affiliation(s)
- Nihal Dogan
- Department of Medical Microbiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
| | - Merve Aydin
- Department of Medical Microbiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
| | - Nazmiye Ulku Tuzemen
- Department of Medical Microbiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Ener Cagri Dinleyici
- Department of Pediatric Intensive Care, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Ilkiz Oguz
- Department of Medical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Funda Dogruman-Al
- Department of Medical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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30
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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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31
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Koltas IS, Eroglu F. Subtype analysis of Blastocystis isolates using SSU rRNA-DNA sequencing in rural and urban population in southern Turkey. Exp Parasitol 2016; 170:247-251. [PMID: 27725159 DOI: 10.1016/j.exppara.2016.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/29/2016] [Accepted: 10/06/2016] [Indexed: 11/30/2022]
Abstract
Blastocystis is a common and emerging parasite often seen in many studies conducted in urban population, with scanty reports on rural communities. However, little is known about the public health significance of Blastocystis infection. A total of 28 Blastocystis isolates from 17 (17/28, 60.71%) patients living in rural area and 11 (11/28, 39.29%) patients living in urban area were screened with seven kinds of sequenced-tagged site primers for identification of subtype. PCR products were sequenced with same combination of primers using the BigDye Terminator V 3.1 cycle sequencing kit, as per the manufacturers' protocol on the 3730 DNA analyzer (Applied Biosystems, Carlsbad CA, USA). The cross-comparison of the Blastocystis sequences of samples were determined by the neighbor-joining method based on a distance matrix between sequence pairs to generate dendograms. The following subtypes were identified; subtype 1 (10/28, 35.7%), subtype 3 (7/28, 25.0%), subtype 2 (5/28, 17.8%), subtype 4 (3/28, 10.7%), subtype 5 (1/28, 3.6%), subtype 6 (1/28, 3.6%), and subtype 7 (1/28, 3.6%) in all DNA samples. The comparison of Blastocystis subtypes distribution among the patients from rural and urban area revealed subtype 5 (1/17, 5.9%), subtype 6 (1/17, 5.9%) and subtype 7 (1/17, 5.9%) from patients of rural area but not any of these subtypes in patients living urban area. This study is the first large-scale study to examine the occurrence of Blastocystis in Turkey to shed lights on the cosmopolitan distribution of Blastocystis subtypes in southern part of Turkey. Subtype 5, subtype 6 and subtype 7 were determined in only rural area. The findings of this study suggest that Blastocystis is transmitted from animal to human and possess a zoonotic potential.
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Affiliation(s)
- Ismail Soner Koltas
- Department of Medical Parasitology, Faculty of Medicine, Cukurova University, 01330 Balcali, Saricam, Adana, Turkey.
| | - Fadime Eroglu
- Department of Medical Parasitology, Faculty of Medicine, Cukurova University, 01330 Balcali, Saricam, Adana, Turkey.
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32
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Descriptive epidemiology of infectious gastrointestinal illnesses in Sydney, Australia, 2007-2010. Western Pac Surveill Response J 2015; 6:7-16. [PMID: 26798556 DOI: 10.5365/wpsar.2015.6.2.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE There is a lack of information about the prevalence of gastrointestinal illnesses in Australia. Current disease surveillance systems capture only a few pathogens. The aim of this study is to describe the epidemiology of infectious gastrointestinal illnesses in Sydney, Australia. METHODS A retrospective cross-sectional study of patients with gastrointestinal symptoms who visited tertiary public hospitals in Sydney was conducted between 2007 and 2010. Patients with diarrhoea or loose stools with an enteric pathogen detected were identified. Demographic, clinical and potential risk factor data were collected from their medical records. Measures of association, descriptive and inferential statistics were analysed. RESULTS In total, 1722 patients were included in this study. Campylobacter (22.0%) and Clostridium difficile (19.2%) were the most frequently detected pathogens. Stratified analysis showed that rotavirus (22.4%), norovirus (20.7%) and adenovirus (18.1%) mainly affected children under 5 years; older children (5-12 years) were frequently infected with Campylobacter spp. (29.8%) and non-typhoid Salmonella spp. (24.4%); infections with C. difficile increased with age.Campylobacter and non-typhoid Salmonella spp. showed increased incidence in summer months (December to February), while rotavirus infections peaked in the cooler months (June to November). DISCUSSION This study revealed that gastrointestinal illness remains a major public health issue in Sydney. Improvement of current disease surveillance and prevention and control measures are required. This study emphasizes the importance of laboratory diagnosis of enteric infections and the need for better clinical data collection to improve management of disease risk factors in the community.
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Casero RD, Mongi F, Sánchez A, Ramírez JD. Blastocystis and urticaria: Examination of subtypes and morphotypes in an unusual clinical manifestation. Acta Trop 2015; 148:156-61. [PMID: 25976414 DOI: 10.1016/j.actatropica.2015.05.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/27/2015] [Accepted: 05/04/2015] [Indexed: 01/09/2023]
Abstract
Blastocystis is a human common enteric protist that may colonize a large variety of non-human hosts linked to symptoms and diseases such as abdominal pain, constipation, diarrhea, urticaria, flatulence and irritable bowel syndrome (IBS). Blastocystis exhibits remarkable genetic diversity and multiple subtypes (STs) within the genus with no absolute associations with clinical symptomatology. Here we analyzed fecal samples from Argentinean patients (n=270) belonging to symptomatic (urticaria and non-specific gastrointestinal symptoms, n=39) and asymptomatic control (n=28). Those patients infected with Blastocystis (n=67) were submitted for morphological analysis, DNA extraction, 18S PCR, sequencing and STs identification according to DNA barcoding. Blastocystis vacuolar forms were the predominant morphotype (75%), ameboid-like forms were evidenced in 1.5% of samples. Blastocystis ST3 was detected in 71.6% (n=48), of which 71.4%, (n=35) and 28.6% (n=14) belonged to symptomatic and asymptomatic respectively. Other subtypes identified were ST1 (14.9%), ST6 (7.5%) and ST2 (5.9%). Blastocystis 18S barcoding evidenced in non-urticaria symptomatic patients and asymptomatic control group the presence of allele 134 (ST3) (p<0.0001), while allele 34 (ST3) was detected in 85.7% (18/21) of symptomatic uricaria as compared with control group (1/21) (p<0.0001). The presence of a particular allele (a34) significantly associated with urticaria patients was detected and the clinical implications of these findings are herein discussed.
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In Vitro Antimicrobial Susceptibility Patterns of Blastocystis. Antimicrob Agents Chemother 2015; 59:4417-23. [PMID: 25987633 DOI: 10.1128/aac.04832-14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/04/2015] [Indexed: 02/07/2023] Open
Abstract
Blastocystis is the most common human enteric protist with controversial clinical significance. Metronidazole is considered a first-line treatment for Blastocystis infection; however, there has been increasing evidence for the lack of efficacy of this treatment. Treatment failure has been reported in several clinical cases, and recent in vitro studies have suggested the occurrence of metronidazole-resistant strains. In this study, we tested 12 Blastocystis isolates from 4 common Blastocystis subtypes (ST1, ST3, ST4, and ST8) against 12 commonly used antimicrobials (metronidazole, paromomycin, ornidazole, albendazole, ivermectin, trimethoprim-sulfamethoxazole [TMP-SMX], furazolidone, nitazoxanide, secnidazole, fluconazole, nystatin, and itraconazole) at 10 different concentrations in vitro. It was found that each subtype showed little sensitivity to the commonly used metronidazole, paromomycin, and triple therapy (furazolidone, nitazoxanide, and secnidazole). This study highlights the efficacy of other potential drug treatments, including trimethoprim-sulfamethoxazole and ivermectin, and suggests that current treatment regimens be revised.
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In Vitro Activity of Curcumin and Silver Nanoparticles Against Blastocystis hominis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2015. [DOI: 10.1097/ipc.0000000000000242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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El-Taweel HA. Understanding drug resistance in human intestinal protozoa. Parasitol Res 2015; 114:1647-59. [DOI: 10.1007/s00436-015-4423-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 03/05/2015] [Indexed: 01/07/2023]
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Popruk S, Udonsom R, Koompapong K, Mahittikorn A, Kusolsuk T, Ruangsittichai J, Palasuwan A. Subtype distribution of Blastocystis in Thai-Myanmar border, Thailand. THE KOREAN JOURNAL OF PARASITOLOGY 2015; 53:13-9. [PMID: 25748704 PMCID: PMC4384802 DOI: 10.3347/kjp.2015.53.1.13] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/14/2014] [Accepted: 10/23/2014] [Indexed: 11/23/2022]
Abstract
Blastocystis sp. is a common zoonotic intestinal protozoa which has been classified into 17 subtypes (STs). A cross-sectional study was conducted to determine the prevalence and subtype distribution of Blastocystis in villagers living on the Thai-Myanmar border, where the risk of parasitic infection is high. A total of 207 stool samples were collected and DNA was extracted. PCR and sequencing using primers targeting small-subunit ribosomal RNA (SSU rRNA) gene were performed. The prevalence of Blastocystis infection was 37.2% (77/207). ST3 (19.8%; 41/207) was the predominant subtype, followed by ST1 (11.6%; 24/207), ST2 (5.3%; 11/207), and ST4 (0.5%; 1/207). A phylogenetic tree was reconstructed using the maximum likelihood (ML) method based on the Hasegawa-Kishino-Yano + G + I model. The percentage of bootstrapped trees in which the associated taxa clustered together was relatively high. Some sequences of Blastocystis positive samples (TK18, 39, 46, 71, and 90) were closely related to animals (pig and cattle) indicating zoonotic risks. Therefore, proper health education in parasitic prevention for the villagers should be promoted to improve their personal hygiene. Further longitudinal studies are required to monitor the prevalence of parasitic infections after providing health education and to investigate Blastocystis ST in animals living in these villages.
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Affiliation(s)
- Supaluk Popruk
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok, 10400, Thailand
| | - Ruenruetai Udonsom
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok, 10400, Thailand
| | - Khuanchai Koompapong
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok, 10400, Thailand
| | - Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok, 10400, Thailand
| | - Teera Kusolsuk
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok, 10400, Thailand
| | - Jiraporn Ruangsittichai
- Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok, 10400, Thailand
| | - Attakorn Palasuwan
- Department of Clinical Microscopy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama I Road, Bangkok, Thailand
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Dogruman-Al F, Turk S, Adiyaman-Korkmaz G, Hananel A, Levi L, Kopelowitz J, Babai O, Gross S, Greenberg Z, Herschkovitz Y, Mumcuoglu I. A novel ELISA test for laboratory diagnosis of Blastocystis spp. in human stool specimens. Parasitol Res 2014; 114:495-500. [DOI: 10.1007/s00436-014-4208-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 10/23/2014] [Indexed: 12/01/2022]
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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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Santos HLC, Sodré FC, de Macedo HW. Blastocystis sp. in splenic cysts: causative agent or accidental association? A unique case report. Parasit Vectors 2014; 7:207. [PMID: 24779380 PMCID: PMC4026114 DOI: 10.1186/1756-3305-7-207] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 04/16/2014] [Indexed: 11/10/2022] Open
Abstract
Background Blastocystis sp. is one of the most prevalent parasites found in human stool and has been recently considered an opportunistic emerging pathogen in immunocompromised individuals. However, cases of invasive intestinal infections and skin rashes have been attributed to infection by Blastocystis sp in immunocompetent individuals, suggesting that it is an emerging parasite with pathogenic potential. Findings We present a case of a 22 year old female patient who complained of pain in the left hypochondrium. Ultrasonography and abdominal computed tomography scans showed two splenic cysts. The cyst fluid analysis demonstrated numerous Blastocystis sp.; PCR and DNA sequencing analyses confirmed the presence of Blastocystis subtype 3. Conclusions This is, to our knowledge, the first case report of the presence of Blastocystis subtype 3 in extra-intestinal organs and is strong evidence that Blastocystis sp. is potentially pathogenic and invasive. However, further studies are required to determine the pathogenicity of the parasite.
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Affiliation(s)
- Helena Lúcia Carneiro Santos
- Laboratório de Avaliação e Promoção da Saúde Ambiental, Instituto Oswaldo Cruz/FIOCRUZ, Av, Brasil, 4365-Pavilhão Lauro Travassos, Manguinhos, Rio de Janeiro, RJ 21,045-900, Brazil.
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El Safadi D, Gaayeb L, Meloni D, Cian A, Poirier P, Wawrzyniak I, Delbac F, Dabboussi F, Delhaes L, Seck M, Hamze M, Riveau G, Viscogliosi E. Children of Senegal River Basin show the highest prevalence of Blastocystis sp. ever observed worldwide. BMC Infect Dis 2014; 14:164. [PMID: 24666632 PMCID: PMC3987649 DOI: 10.1186/1471-2334-14-164] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 03/19/2014] [Indexed: 02/09/2024] Open
Abstract
Background Blastocystis sp. is currently the most common intestinal protist found in human feces and considered an emerging parasite with a worldwide distribution. Because of its potential impact in public health, we reinforced the picture of Blastocystis sp. prevalence and molecular subtype distribution in Africa by performing the first survey of this parasite in Senegal. Methods Stool samples from 93 symptomatic presenting with various gastrointestinal disorders or asymptomatic children living in three villages of the Senegal River Basin were tested for the presence of Blastocystis sp. by non-quantitative and quantitative PCR using primer pairs targeting the SSU rDNA gene. Positive samples were subtyped to investigate the frequency of Blastocystis sp. subtypes in our cohort and the distribution of subtypes in the symptomatic and asymptomatic groups of children. Results By the use of molecular tools, all 93 samples were found to be positive for Blastocystis sp. indicating a striking parasite prevalence of 100%. Mixed infections by two or three subtypes were identified in eight individuals. Among a total of 103 subtyped isolates, subtype 3 was most abundant (49.5%) followed by subtype 1 (28.2%), subtype 2 (20.4%) and subtype 4 (1.9%). Subtype 3 was dominant in the symptomatic group while subtypes 1 and 2 were detected with equal frequency in both symptomatic and asymptomatic groups. The distribution of subtypes was compared with those available in other African countries and worldwide. Comparison confirmed that subtype 4 is much less frequently detected or absent in Africa while it is commonly found in Europe. Potential sources of Blastocystis sp. infection including human-to-human, zoonotic, and waterborne transmissions were also discussed. Conclusions The prevalence of Blastocystis sp. in our Senegalese population was the highest prevalence ever recovered worldwide for this parasite by reaching 100%. All cases were caused by subtypes 1, 2, 3 and 4 with a predominance of subtype 3. More than half of the children infected by Blastocystis sp. presented various gastrointestinal disorders. Such high prevalence of blastocystosis in developing countries makes its control a real challenge for public health authorities.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Eric Viscogliosi
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille (CIIL), Inserm U1019, CNRS UMR 8204, Université Lille Nord de France, 1 rue du Professeur Calmette, BP 245, 59019 Lille cedex, France.
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Subtype distribution of Blastocystis isolates in Sebha, Libya. PLoS One 2013; 8:e84372. [PMID: 24376805 PMCID: PMC3869855 DOI: 10.1371/journal.pone.0084372] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 11/22/2013] [Indexed: 01/07/2023] Open
Abstract
Background Blastocystis is a genetically diverse and a common intestinal parasite of humans with a controversial pathogenic potential. This study was carried out to identify the Blastocystis subtypes and their association with demographic and socioeconomic factors among outpatients living in Sebha city, Libya. Methods/Findings Blastocystis in stool samples were cultured followed by isolation, PCR amplification of a partial SSU rDNA gene, cloning, and sequencing. The DNA sequences of isolated clones showed 98.3% to 100% identity with the reference Blastocystis isolates from the Genbank. Multiple sequence alignment showed polymorphism from one to seven base substitution and/or insertion/deletion in several groups of non-identical nucleotides clones. Phylogenetic analysis revealed three assemblage subtypes (ST) with ST1 as the most prevalent (51.1%) followed by ST2 (24.4%), ST3 (17.8%) and mixed infections of two concurrent subtypes (6.7%). Blastocystis ST1 infection was significantly associated with female (P = 0.009) and low educational level (P = 0.034). ST2 was also significantly associated with low educational level (P= 0.008) and ST3 with diarrhoea (P = 0.008). Conclusion Phylogenetic analysis of Libyan Blastocystis isolates identified three different subtypes; with ST1 being the predominant subtype and its infection was significantly associated with female gender and low educational level. More extensive studies are needed in order to relate each Blastocystis subtype with clinical symptoms and potential transmission sources in this community.
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Roberts T, Ellis J, Harkness J, Marriott D, Stark D. Treatment failure in patients with chronic Blastocystis infection. J Med Microbiol 2013; 63:252-257. [PMID: 24243286 DOI: 10.1099/jmm.0.065508-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This article reports long-term infection and treatment failure in 18 symptomatic individuals infected with Blastocystis spp. Patients were initially treated with either metronidazole, iodoquinol or triple combination therapy consisting of nitazoxanide, furazolidone and secnidazole. Following treatment, resolution of clinical symptoms did not occur and follow-up testing revealed ongoing infection with the same subtype. Patients then underwent secondary treatment with a variety of antimicrobial agents but remained symptomatic with Blastocystis spp. still present in faeces. Sequencing of the SSU rDNA was completed on all isolates and four subtypes were identified in this group: ST1, ST3, ST4 and ST5. This study highlights the lack of efficacy of several commonly used antimicrobial regimens in the treatment of Blastocystis and the chronic nature of some infections. It also demonstrates the need for further research into treatment options for Blastocystis infection.
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Affiliation(s)
- Tamalee Roberts
- i3 Institute, School of Medical and Molecular Sciences, University of Technology, Sydney, Ultimo, NSW, Australia.,Department of Microbiology, SydPath, St Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia
| | - John Ellis
- i3 Institute, School of Medical and Molecular Sciences, University of Technology, Sydney, Ultimo, NSW, Australia
| | - John Harkness
- Department of Microbiology, SydPath, St Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia
| | - Deborah Marriott
- Department of Microbiology, SydPath, St Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia
| | - Damien Stark
- Department of Microbiology, SydPath, St Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia
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Jex AR, Koehler AV, Ansell BR, Baker L, Karunajeewa H, Gasser RB. Getting to the guts of the matter: The status and potential of ‘omics’ research of parasitic protists of the human gastrointestinal system. Int J Parasitol 2013; 43:971-82. [DOI: 10.1016/j.ijpara.2013.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 06/07/2013] [Accepted: 06/07/2013] [Indexed: 11/17/2022]
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Evaluation of the EasyScreen™ enteric parasite detection kit for the detection of Blastocystis spp., Cryptosporidium spp., Dientamoeba fragilis, Entamoeba complex, and Giardia intestinalis from clinical stool samples. Diagn Microbiol Infect Dis 2013; 78:149-52. [PMID: 24286625 DOI: 10.1016/j.diagmicrobio.2013.10.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/14/2013] [Accepted: 10/15/2013] [Indexed: 11/23/2022]
Abstract
The aim of this study was to evaluate the EasyScreen™ Enteric Parasite Detection Kit (Genetic Signatures, Sydney, Australia) for the detection and identification of 5 common enteric parasites: Blastocystis spp., Cryptosporidium spp., Dientamoeba fragilis, Entamoeba complex, and Giardia intestinalis in human clinical samples. A total of 358 faecal samples were included in the study. When compared to real-time PCR and microscopy, the EasyScreen™ Enteric Parasite Detection Kit exhibited 92-100% sensitivity and 100% specificity and detected all commonly found genotypes and subtypes of clinically important human parasites. No cross reactivity was detected in stool samples containing various other bacterial, viral, and/or protozoan species. The EasyScreen™ PCR assay was able to provide rapid, sensitive, and specific simultaneous detection and identification of the 5 most important diarrhoea-causing enteric parasites that infect humans. It should be noted, however, that the EasyScreen™ Kit does not substitute for microscopy or for additional PCRs as it does not detect the pathogenic Coccidia spp. Cystoisospora belli or Cyclospora cayetanensis and it does not differentiate between pathogenic and nonpathogenic Entamoeba spp. This study also highlights the lack of sensitivity demonstrated by microscopy; as such, molecular methods should be considered the diagnostic method of choice for enteric parasites.
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Bart A, Wentink-Bonnema EMS, Gilis H, Verhaar N, Wassenaar CJA, van Vugt M, Goorhuis A, van Gool T. Diagnosis and subtype analysis of Blastocystis sp. in 442 patients in a hospital setting in the Netherlands. BMC Infect Dis 2013; 13:389. [PMID: 23972160 PMCID: PMC3765316 DOI: 10.1186/1471-2334-13-389] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 08/19/2013] [Indexed: 12/05/2022] Open
Abstract
Background Blastocystis sp. are among the most commonly observed intestinal parasites in routine clinical parasitology. Blastocystis in humans consists of at least 9 genetic subtypes. Different subtypes of Blastocystis may be associated with differences in pathogenicity and symptomatology. Methods Advanced microscopy on two samples and sequence-confirmed PCR on a third sample from the same individual were used for Blastocystis diagnosis and subtype analyses on routine clinical samples in a university hospital. Results With a combined gold standard of sequence-confirmed PCR and positive advanced microscopy, 107 out of 442 (24.2%) patients were diagnosed with Blastocystis. infection, which is a high frequency of detection in comparison to previous reports from industrialized countries. The sensitivity of microscopy and sequence-confirmed PCR was 99.1% (106/107) and 96.3% (103/107), respectively. Among 103 typable samples, subtype 3 was most abundant (n = 43, 42%), followed by subtypes 1 and 2 (both n = 23, 22%), subtype 4 (n = 12, 12%), and single samples with subtypes 6 (1%) and subtype 7 (1%). The prevalence of Blastocystis infection was 38% in patients from the Department of Tropical Medicine and 18% in patients from other departments. Conclusions A high prevalence of Blastocystis infection was found with both advanced microscopy and sequence-confirmed PCR in our patient population. Most cases were caused by subtypes ST1, ST2, ST3 and ST4. A significantly higher prevalence was found among patients with a history of recent travel to tropical countries.
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Affiliation(s)
- Aldert Bart
- Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, The Netherlands.
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Stensvold CR. Blastocystis: Genetic diversity and molecular methods for diagnosis and epidemiology. Trop Parasitol 2013; 3:26-34. [PMID: 23961438 PMCID: PMC3745667 DOI: 10.4103/2229-5070.113896] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 06/24/2013] [Indexed: 12/21/2022] Open
Abstract
Blastocystis, an unusual anaerobic, single-celled stramenopile, is a remarkably successful intestinal parasite of a vast array of host species including humans. Fecal Deoxyribonucleic acid (DNA) analysis by nucleic-acid based methods in particular has led to significant advances in Blastocystis diagnostics and research over the past few years enabling accurate identification of carriers and molecular characterization by high discriminatory power. Moreover, Blastocystis comprises a multitude of subtypes (STs) (arguably species) many of which have been identified only recently and molecular epidemiological studies have revealed a significant difference in the distribution of STs across host species and geographical regions. Having a cosmopolitan distribution, the parasite is a common laboratory finding in the stools of individuals with and without intestinal symptoms across the entire globe and while the parasite remains extremely difficult to eradicate and isolate in culture, appropriate molecular tools are now available to resolve important questions such as whether the clinical outcome of colonization is linked to ST and whether Blastocystis is transmitted zoonotically. This review summarizes some of the recent advances in the molecular diagnosis of Blastocystis and gives an introduction to Blastocystis STs, including a recommendation of subtyping methodology based on recent data and method comparisons. A few suggestions for future directions and research areas are given in the light of relevant technological advances and the availability of mitochondrial and nuclear genomes.
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Affiliation(s)
- Christen Rune Stensvold
- Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
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A rat model to study Blastocytis subtype 1 infections. Parasitol Res 2013; 112:3537-41. [PMID: 23892480 DOI: 10.1007/s00436-013-3536-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 07/05/2013] [Indexed: 10/26/2022]
Abstract
Blastocytis sp. is the most common enteric protozoan in human, but its pathogenesis is still unclear. To study the infectious effects of Blastocytis sp. on tissue damage, we orally challenged the Sprague Dawley (SD) rats with different doses of Blastocytis subtype1 (ST1) and examined the histological changes. We found that there was no difference of disease incidence among the Blastocytis ST1-infected groups challenged with different doses of the protozoan. Histological results showed that the lamina propria was infected by Blastocytis ST1 in the vacuolar form, along with the mucus membrane slough and inflammatory cell infiltration into the lamina propria. Compared to the uninfected group, the histological scores were significantly higher in the infected groups. However, groups infected with various doses of Blastocystis ST1 showed no difference in terms of histological scores. In conclusion, this study indicates that the SD rats can be easily infected with Blastocytis ST1 even with low dose of cysts, and the histopathological effects of the infection in the intestine of the infected rats show individual differences.
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Fletcher SM, McLaws ML, Ellis JT. Prevalence of gastrointestinal pathogens in developed and developing countries: systematic review and meta-analysis. J Public Health Res 2013; 2:42-53. [PMID: 25170480 PMCID: PMC4140330 DOI: 10.4081/jphr.2013.e9] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 05/14/2013] [Indexed: 12/13/2022] Open
Abstract
ABSTRACT Diarrhoeal illness is a leading cause of child mortality and morbidity worldwide. There are no precise or current estimates of the types and prevalence of pathogens associated with diarrheal illnesses in developed and developing settings. This systematic review assessed data from 60 studies published in the English language from five developing regions and developed countries worldwide to provide regional estimates of enteric pathogens affecting children. The random-effect method was used to establish the weighted average prevalence of pathogens in adults and children for each region. Significantly more pathogens were reported by studies from developing regions compared with Organisation for Economic Co-operation and Development countries (P<0.016). The identification rates of pathogens from community based and hospital based studies were similar (58.5% and 58.1% respectively, P<0.619). The overall detection of enteric pathogens in developing countries was higher in adults (74.8%; 95% CI 63.1-83.8%) compared with children (56.7%; 95% CI 53.0-60.4%) (P<0.001). Rotavirus was the most frequently detected pathogen in all regions with the highest rate, 24.8% (95% CI 18.0-33.1%), detected in the developed countries. This systematic review is the first to provide an estimate of the prevalence of enteric pathogens associated with diarrhoeal illnesses in adults and children in developed and developing settings. While pathogen detection rate is greater in developing regions the consistently high prevalence of rotavirus in both developed and developing settings underscores the urgent need for access to rotavirus vaccines. Increased travel between developing and developed countries increases disease risk, and hence developed countries have a vested interest in supporting vaccine accessibility in developing settings.
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Affiliation(s)
- Stephanie M. Fletcher
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney
| | | | - John T. Ellis
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney
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