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Guilane A, Haleche I, Tazerouti F, Ziam H, Kernif T, Boutellis A. New Haplotypes of Blastocystis sp. Identified in Faeces from Various Animal Groups in Algeria. Acta Parasitol 2024:10.1007/s11686-024-00857-4. [PMID: 38829474 DOI: 10.1007/s11686-024-00857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/13/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE Blastocystis sp. is a single-celled, anaerobic, parasitic protozoan commonly found in the intestinal tract of animals and humans globally. Genetic analysis has revealed significant diversity within its species, leading to the identification of at least 40 subtypes (ST1-ST40). This study aimed to identify and differentiate Blastocystis in faeces samples from various animal hosts in Algeria. METHODS A total of 403 fecal samples, collected from both domestic and zoo animals, were subjected to PCR amplification and sequencing of Blastocystis-specific small subunit ribosomal RNA (SSU-RNA) gene. RESULTS The overall prevalence of Blastocystis in animals was found to be 38.9%. Through comprehensive phylogenetic and phylogeographic analyses, we identified four distinct subtypes (ST1 in both domestic and zoo animals, and ST3, ST4, and ST5 exclusively in zoo animals), encompassing nine different haplotypes, including five that appear original to Algeria. CONCLUSION This study represents the first epidemiological molecular investigation of Blastocystis sp. in animals in Algeria.
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Affiliation(s)
- Asma Guilane
- Laboratory of Biodiversity and Environment: Interactions, Genome, Biology Faculty, University of Science and Technology Houari Boumediene, Algiers, Algeria
- Laboratory of Parasitic Eco-Epidemiology and Population Genetics, Pasteur Institute of Algeria, Dely-Brahim, 16000, Algiers, Algeria
| | - Ikram Haleche
- Laboratory of Parasitic Eco-Epidemiology and Population Genetics, Pasteur Institute of Algeria, Dely-Brahim, 16000, Algiers, Algeria
- Laboratory of Biotechnology, Environment and Health, University of Blida 1, Blida, Algeria
| | - Fadila Tazerouti
- Laboratory of Biodiversity and Environment: Interactions, Genome, Biology Faculty, University of Science and Technology Houari Boumediene, Algiers, Algeria
| | - Hocine Ziam
- Laboratory of Biotechnology, Environment and Health, University of Blida 1, Blida, Algeria
| | - Tahar Kernif
- Laboratory of Parasitic Eco-Epidemiology and Population Genetics, Pasteur Institute of Algeria, Dely-Brahim, 16000, Algiers, Algeria
| | - Amina Boutellis
- Laboratory of Biodiversity and Environment: Interactions, Genome, Biology Faculty, University of Science and Technology Houari Boumediene, Algiers, Algeria.
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Boutahar M, Belaouni M, Ibrahimi A, Eljaoudi R, Aanniz T, Er-Rami M. Prevalence of Blastocystis sp. in Morocco: Comparative assessment of three diagnostic methods and characterization of parasite forms in Jones' culture medium. Parasite 2023; 30:64. [PMID: 38117274 PMCID: PMC10732137 DOI: 10.1051/parasite/2023065] [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: 09/23/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
Blastocystosis is an infection caused by Blastocystis sp., which colonizes the digestive tract of various hosts, including humans, although its pathogenicity is debated. It is crucial to detect and distinguish the different forms of Blastocystis to understand better its impact on human health and its epidemiological evolution. This study evaluated three diagnostic methods on 105 stool samples: direct examination, culture in Jones' medium, and conventional PCR. PCR is considered the gold standard and revealed a high prevalence of Blastocystis (67.62%) compared to direct examination (20.95%) and culture in Jones' medium (51.43%). Although the sensitivity of direct examination and culture was 31% and 76.1%, respectively, their specificity was 100%. No significant risk factors were identified. A statistically significant association was observed between Blastocystis infection and abdominal pain. Microscopic analysis revealed various morphological forms. Molecular diagnosis is an essential tool to determine the true prevalence of Blastocystis, and studying the different forms of this microorganism will contribute to a better understanding of its biological cycle and, therefore, the impact of this emerging infection on human health.
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Affiliation(s)
- Mounia Boutahar
- Human Pathology, Biomedicine and Environment Laboratory, Faculty of Science and Technology of Fez, B.P. 2202 - Route d'Imouzzer, Fez, Morocco
| | - Mourad Belaouni
- Parasitology-Mycology Laboratory, Moulay Ismaïl Military Hospital, Meknes 50007, Morocco
| | - Azeddine Ibrahimi
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, Rabat 10100, Morocco - Mohammed VI Center for Research & Innovation (CM6), Rabat 10000, Morocco - Mohammed VI University of Health Sciences, Casablanca 20000, Morocco
| | - Rachid Eljaoudi
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, Rabat 10100, Morocco - Mohammed VI Center for Research & Innovation (CM6), Rabat 10000, Morocco - Emergency Department, Military Hospital Mohammed V, Rabat 10000, Morocco
| | - Tarik Aanniz
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, Rabat 10100, Morocco
| | - Mohammed Er-Rami
- Parasitology-Mycology Laboratory, Moulay Ismaïl Military Hospital, Meknes 50007, Morocco - Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine and Pharmacy, Fez 30070, Morocco
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Kumarasamy V, Rajamanikam A, Anbazhagan D, Atroosh WM, Azzani M, Subramaniyan V, Abdullah SR. Systematic Review and Meta-Analysis: Epidemiology of Human Blastocystis spp. Infection in Malaysia. Trop Med Infect Dis 2023; 8:415. [PMID: 37624353 PMCID: PMC10457748 DOI: 10.3390/tropicalmed8080415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/26/2023] Open
Abstract
Blastocystis spp. is a unicellular enteric protozoan parasite in humans with a controversial role in disease etiology. It is common in developing countries among immunocompromised patients and people who have close contact with animals. In this study, we have systematically reviewed previous studies on the distribution and genotypes of human Blastocystis infection in Peninsular Malaysia. Studies examining the prevalence of Blastocystis in diverse demographics, including rural, urban, comorbid conditions, and high-risk populations, were taken into consideration. The infection has been reported in nine states; the total percentage of infection was 17.8% (1671/9397), with the most cases in Pahang (27.3%) and the least in Johor (3.4%). Molecular studies revealed the presence of six subtypes: ST1, ST2, ST3, ST4, ST5, and ST6. ST3 was reported as the predominant subtype in all the states, with a prevalence of 54.7% (338/618). The findings provide greater clarity on the epidemiology of Blastocystis in Malaysia, which will help in policy making towards planning and strategizing control measures against the parasite.
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Affiliation(s)
- Vinoth Kumarasamy
- Department of Parasitology & Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia;
| | - Arutchelvan Rajamanikam
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Deepa Anbazhagan
- Department of Medical Microbiology, International Medical School (IMS), Management & Science University (MSU), Shah Alam 40100, Selangor, Malaysia
| | - Wahib Mohammed Atroosh
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Meram Azzani
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
| | - Vetriselvan Subramaniyan
- Pharmacology Unit, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor, Malaysia
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Syamsa Rizal Abdullah
- Department of Parasitology & Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia;
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Soleimani Jevinani S, Mohammad Rahimi H, Asri N, Rostami-Nejad M, Ahmadipour S, Mirjalali H. Molecular epidemiology and subtyping of Blastocystis sp. and its subtypes in celiac patients; a case control study. Microb Pathog 2023; 179:106086. [PMID: 36963704 DOI: 10.1016/j.micpath.2023.106086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/28/2023] [Accepted: 03/21/2023] [Indexed: 03/26/2023]
Abstract
Blastocystis sp. is a common intestinal protist, reported from symptomatic and asymptomatic subjects. Blastocystis sp. has been reported from a broad spectrum of gastrointestinal disorders. Celiac disease (CD) is an autoimmune disorder of the small intestine, which leads to the lack of tolerance against gluten. Long-term following of gluten-free diet in CD patients decreases the gut microbiota restoration and probably decreases the chance of Blastocystis sp. colonization. The current study aimed to investigate the prevalence of Blastocystis sp. and its subtypes in CD patients in comparison to healthy subjects. Stool samples were collected from 238 participants including 92 confirmed CD patients and 146 healthy subjects. upon DNA extraction, the presence of Blastocystis sp. was evaluated using amplification of discriminative regions of the small ribosomal RNA (ssu rRNA) gene. To characterize subtypes and alleles, amplified fragments were sequenced. Phylogenetic trees were constructed to visualize subtype correlation. Our findings showed that 21% (50) of samples including 16.3% (15/92) and 23.97% (35/146) were positive for Blastocystis sp. in CD patients and healthy controls, respectively. Except family relationship, other variables were not statistical correlated with the presence of Blastocystis sp.. Totally, 25 samples were successfully sequenced. Accordingly, ST1, ST2, and ST3 were present in 8 (32%), 9 (36%), and 8 (32%) of the samples, respectively. Allele discrimination showed that all ST1 were allele 4; alleles 11, 9, and 12 were retrieved from ST2, and alleles 34, 36, and 38 were observed in ST3. The relationship between colonization of Blastocystis sp. and alteration in the gut microbiota composition is indeterminate, however, this hypothesis that lower prevalence of Blastocystis sp. in CD patients who follow a gluten-free diet affect the colonization of Blastocystis sp. via alteration in the gut microbiota composition could be interesting for further investigations.
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Affiliation(s)
| | - Hanieh Mohammad Rahimi
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Asri
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Rostami-Nejad
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shokoufeh Ahmadipour
- Department of Pediatric, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Örsten S, Baysal İ, Akdoğan N, İnal N, Bostan E, Çiftçi SY, Akyön Y. Possible microRNA-based mechanism underlying relationship between chronic spontaneous urticaria and Blastocystis. Exp Parasitol 2023; 245:108453. [PMID: 36584787 DOI: 10.1016/j.exppara.2022.108453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/08/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Blastocystis spp. has been proposed as a possible cause of extraintestinal clinical signs such as urticaria pathogenesis. OBJECTIVES The aim of this study was to investigate the differences between microRNA (miRNA) expression profiles of Chronic spontaneous urticaria (CSU) patients in the presence or absence of Blastocystis spp. as well as healthy controls. Additionally, cellular pathways which are affected in the presence of Blastocystis spp. were identified. METHODS Twenty patients diagnosed with CSU were enrolled in the study and divided into equally two groups according to the presence of Blastocystis spp. Besides, six healthy individuals were included in the study. The expression profiles of 372 human-derived miRNAs have been investigated in serum samples from CSU patients and healthy controls with miScript miRNA PCR Array Human miRBase Profiler. RESULTS Compared to Blastocystis-negative (BN)-CSU patients, expression of 3 miRNAs (hsa-miR-3183, hsa-miR-4469, hsa-miR-5191) were found to be downregulated by at least two-fold (p < 0.05) in Blastocystis-positive (BP)-CSU patients. Additionally, the miRNA expression profiles of six healthy individuals (n = 3 Blastocystis-positive, n = 3 Blastocystis-negative) were analyzed and it was determined that the expressions of 7 miRNAs (hsa-miR-4661-5p, hsa-miR-4666a-5p, hsa-miR-4803, hsa-miR-5587-5p, hsa-miR-4500, hsa-miR-5680, hsa-miR-382-3p) increased at least 3-fold in the serum of individuals with Blastocystis-positive compared to Blastocystis-negative subjects. Most down-regulated miRNAs, in BP-CSU patients, affect cell adhesion molecules (CAMs), and signaling pathways therefore, Blastocystis spp. presence may influence the clinical presentation of urticaria by leading to unbalanced immunity. In addition, Blastocystis spp. presence may be influenced TGF- β signaling pathway through altered miRNAs and may be laying the groundwork for the development of CSU in healthy individuals. CONCLUSIONS As a consequence, this is the first report to show that the miRNA expression profile is affected by the presence of Blastocystis spp. Further miRNA-based studies are needed in order to enlighten the exact underlying molecular mechanisms of the relationship between Blastocystis spp. and CSU.
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Affiliation(s)
- Serra Örsten
- Hacettepe University, Vocational School of Health Services, Ankara, Turkey.
| | - İpek Baysal
- Hacettepe University, Vocational School of Health Services, Ankara, Turkey
| | - Neslihan Akdoğan
- Hacettepe University, Faculty of Medicine Department of Dermatology and Venereology, Ankara, Turkey
| | - Neşe İnal
- Hacettepe University, Faculty of Medicine Department of Medical Microbiology, Ankara, Turkey
| | - Ecem Bostan
- Hacettepe University, Faculty of Medicine Department of Dermatology and Venereology, Ankara, Turkey
| | | | - Yakut Akyön
- Hacettepe University, Faculty of Medicine Department of Medical Microbiology, Ankara, Turkey
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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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Velásquez JN, Astudillo OG, Vittar N, Pantano ML, Carnevale S. Diagnostic Features of Blastocystis Life Cycle Forms in the Small Intestine in an HIV-Infected Patient. Acta Parasitol 2022; 67:102-109. [PMID: 34143399 DOI: 10.1007/s11686-021-00435-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/03/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Blastocystis spp. are parasites of the intestinal tract found in many hosts including humans. This pathogen is commonly found in immunocompetent in asymptomatic individuals and in patients with gastrointestinal and extra-intestinal symptoms. Recently, it has been implicated as an important cause of diarrheal illness in immunocompromised individuals, including HIV-infected patients. At least six life cycle stages have been described in faeces and cultures, namely vacuolar, granular, multi-vacuolar, avacuolar, ameboid and cyst forms. The aim of the present study was to describe the histological findings of Blastocystis infection in an adult HIV-infected patient with gastrointestinal symptoms. METHODS Parasitological techniques and PCR were applied to stool samples. Histological analysis was performed on duodenal biopsy specimens. RESULTS Standard parasitological methods revealed vacuolar, granular, cyst and multi-vacuolar forms of Blastocystis in faecal samples with the presence of Blastocystis DNA being confirmed by PCR. DNA sequencing revealed Blastocystis subtype ST1. Histological findings in duodenal samples showed an inflammatory infiltrate with plasma cells and lymphocytes. We identified cyst, granular, ameboid and multi-vacuolar forms in the lumen. CONCLUSION To our knowledge, there are no previous peer review reports describing these four different forms of Blastocystis in histological sections from the lumen and the brush border of the enterocytes.
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Boutellis A, Aissi M, Harhoura K, Drali R, Kernif T, Tazerouti F. First molecular characterization of Blastocystis subtypes from animals and animal-keepers stool in Algeria. Comp Immunol Microbiol Infect Dis 2021; 78:101695. [PMID: 34416484 DOI: 10.1016/j.cimid.2021.101695] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 07/28/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
Blastocystis sp. is one of the most common enteric parasites found in humans and many non-human hosts. It is an anaerobic protozoan that belongs to the group of Stramenopiles. Based on phylogenetic analysis of ribosomal DNA genes, at least 17 subtypes (ST1-ST17) are described. The aim of this study was to identify and characterize Blastocystis sp. in stool samples from various animal groups and animal-keepers. Overall, 29/70 (41.43%) animals and 7/60 (11.66%) humans sampled were positive for Blastocystis sp. using microscopy. The sequencing of the partial 18S small subunit ribosomal DNA gene (SSU rDNA) revealed the presence of five haplotypes corresponding to ST2 and ST3 in humans, and ST2, ST3, ST7, and ST10 in animals. This is the first report of Blastocystis subtypes in animals in Algeria.
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Affiliation(s)
- Amina Boutellis
- Laboratoire de Biodiversité et Environnement: Interaction, Génome, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumediene, Alger, Algeria.
| | - Miriem Aissi
- Laboratoire de Santé et Production Animale. Ecole Nationale Supérieure Vétérinaire Rabie Bouchama, Oued Smar, Alger, Algeria
| | - Khaled Harhoura
- Laboratoire de Santé et Production Animale. Ecole Nationale Supérieure Vétérinaire Rabie Bouchama, Oued Smar, Alger, Algeria
| | - Rezak Drali
- Plateforme Génomique - Bioinformatique, Institut Pasteur d'Algérie, 16302, Algiers, Algeria
| | - Tahar Kernif
- Laboratoire d'Eco-Epidémiologie Parasitaire et Génétique des Populations, Institut Pasteur d'Algérie, Dély Brahim, Alger, Algeria
| | - Fadila Tazerouti
- Laboratoire de Biodiversité et Environnement: Interaction, Génome, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumediene, Alger, Algeria
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Abstract
Background: Blastocystis hominis is recognized as a common intestinal parasite. Some studies have reported the effect of phenotypic, serologic, and biochemical indices on the parasites’ pathogenic characteristics. Objectives: This study aimed to introduce B. hominis as a pathogen, trying to change views about this parasite and introduce it as a parasite important in medical sciences. Methods: An open-ended, language-restricted (English) search was conducted in MEDLINE (PubMed), CINAHL, Scopus, and the Cochrane Library databases (from 1990 to 2018) using specific search criteria to identify Blastocystis spp. Results: The search of the literature retrieved 158 published articles on Blastocystis spp. Among these articles, the ones related to the pathogenicity of B. hominis were selected for further investigations. Results obtained in this study showed that the number of articles within five-year periods had an increasing trend. Also, studies of B. hominis have mainly investigated its pathogenic characteristics, accounting for 37.34% of the studies. Conclusions: This study showed comprehensive reasons for proving the pathogenesis of the parasite. It is hoped that further studies would fill the existing gaps regarding this parasite and identify its true identity as a medically important parasite.
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Current status of Blastocystis sp. in animals from Southeast Asia: a review. Parasitol Res 2020; 119:3559-3570. [PMID: 32951145 PMCID: PMC7502158 DOI: 10.1007/s00436-020-06828-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 07/21/2020] [Indexed: 11/05/2022]
Abstract
Blastocystis is the most frequently observed eukaryotic gastrointestinal symbiont in humans and animals. Its low host specificity and zoonotic potential suggest that animals might serve as possible reservoirs for transmission. The prevalence and subtype distributions of Blastocystis sp. in animal populations in Southeast Asia, a hotspot for zoonotic diseases, are reviewed. Recommendations for future research aimed at understanding the zoonotic role of Blastocystis are also included. Seven countries have, so far, reported Blastocystis infection in various animals, such as livestock, poultry, companion animals, and non-human primates. Pigs were the most studied animals, and there were records of 100% prevalence in pigs, cattle, and ostriches. Using polymerase chain reaction (PCR)-based approaches, twelve Blastocystis sp. subtypes (STs), namely ST1, ST2, ST3, ST4, ST5, ST6, ST7, ST8, ST9, ST10, ST12, and ST14 have been recognised infecting animals of Southeast Asia. ST1 and ST5 were the most frequently identified, and Malaysia observed the most diverse distribution of subtypes. Further investigations on Blastocystis sp. in various animal hosts, using adequate sample sizes and uniform detection methods, are essential for a better understanding of the distribution of this organism. Detailed genome studies, especially on STs shared by humans and animals, are also recommended.
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Bahrami F, Babaei E, Badirzadeh A, Riabi TR, Abdoli A. Blastocystis, urticaria, and skin disorders: review of the current evidences. Eur J Clin Microbiol Infect Dis 2020; 39:1027-1042. [PMID: 31873864 DOI: 10.1007/s10096-019-03793-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/05/2019] [Indexed: 12/17/2022]
Abstract
Blastocystis is one of the most common intestinal protozoan parasites worldwide, which is linked to cutaneous lesions and urticaria. In a setting of systematic review, the data on the association of Blastocystis infection with cutaneous lesions were searched in order to summarize the main clinical symptoms, diagnostic methods, treatment, and outcome of the patients. The search identified 28 eligible articles, including 12 cross-sectional studies and 16 case reports/case series (including 23 cases). A diverse spectrum of skin symptoms, mainly urticaria, rash, and itching, was reported from the studies. Of the 23 infected cases with the skin symptoms, gastrointestinal symptoms were reported from the 16 cases, whereas 7 cases with urticaria had asymptomatic infection. The most frequent subtypes were ST1, ST2, and ST3, respectively. Metronidazole, paromomycin, and tinidazole were the most prescribed drugs in patients with single Blastocystis infection. Notably, urticaria and other cutaneous symptoms of all treated patients were resolved after treatment. In conclusion, this study indicates that Blastocystis infection can be a neglected cause of urticaria and skin disorders. Since the treatment of Blastocystis infection is simple, screening and treatment of this infection should be considered in patients with urticaria and other skin disorders.
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Affiliation(s)
- Fares Bahrami
- Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Erfan Babaei
- Department of Immunology & Hematology, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Alireza Badirzadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Rezaei Riabi
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abdoli
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran.
- Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, 74148-46199, Ostad Motahari Ave, Jahrom, Iran.
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Abstract
Human stool contains a myriad of microorganisms, of which the vast majority are nonpathogenic and represent an important component of the healthy microbiome. The increasing use of molecular techniques has allowed the rapid identification of bacteria, viruses and parasites in human stool. This review focuses on the 3 main classes of parasite responsible for human disease, helminths, protozoa and ectoparasites, and highlights the importance of differentiating between pathogenic and nonpathogenic parasites.
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Mokhtar AB, Ahmed SA, Eltamany EE, Karanis P. Anti- Blastocystis Activity In Vitro of Egyptian Herbal Extracts (Family: Asteraceae) with Emphasis on Artemisia judaica. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091555. [PMID: 31058875 PMCID: PMC6539629 DOI: 10.3390/ijerph16091555] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/28/2019] [Accepted: 04/30/2019] [Indexed: 01/12/2023]
Abstract
Achillea fragrantissima (Forssk.) Sch. Bip. (known as Qaysoom), Echinops spinosus L. (known as Shoak Elgamal) and Artemisia judaica L.(known Shih Baladi) are members of the Asteraceae family known for their traditional medical use in Egypt. The ethanol extracts of these plants were evaluated for their efficacy against a protozoan parasite (Blastocystis). Two different molecular subtypes of Blastocystis were used (ST1 and ST3). Significant growth inhibition of Blastocystis was observed when exposed to both A. judaica (99.3%) and A. fragrantissima (95.6%) with minimal inhibitory concentration (MIC90) at 2000 µg/mL. Under the effect of the extracts, changes in Blastocystis morphology were noted, with the complete destruction of Blastocystis forms after 72 h with the dose of 4000 µg/mL. Different subtypes displayed different responses to the herbal extracts tested. ST1 exhibited significantly different responses to the herbal extracts compared to ST3. A. judaica was selected as the herb of choice considering all of its variables and because of its effective action against Blastocystis. It was then exposed to further fractionation and observation of its effect on ST1 and ST3. Solvent portioned fractions (dichloromethane (DCM), ethyl acetate (EtOAc) and n-hexane) in A. judaica were found to be the potent active fractions against both of the Blastocystis subtypes used.
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Affiliation(s)
- Amira B Mokhtar
- Department of Medical Parasitology, Faculty of Medicine, Suez Canal University, Ismailia 45122, Egypt.
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al-Qurayyat 77413, Saudi Arabia.
| | - Shahira A Ahmed
- Department of Medical Parasitology, Faculty of Medicine, Suez Canal University, Ismailia 45122, Egypt.
| | - Enas E Eltamany
- Department of Pharmacognosy, Faculty of Pharmacy, Suez Canal University, Ismailia 45122, Egypt.
| | - Panagiotis Karanis
- University of Cologne, Medical Faculty and University Hospital, 50937 Cologne, Germany.
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Thergarajan G, Govind SK, Bhassu S. In vitro and in vivo thermal stress induces proliferation of Blastocystis sp. Parasitol Res 2017; 117:177-187. [PMID: 29188368 DOI: 10.1007/s00436-017-5688-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/17/2017] [Indexed: 11/30/2022]
Abstract
Blastocystis sp. is known to be the most commonly found intestinal protozoan parasite in human fecal surveys and has been incriminated to cause diarrhea and abdominal bloating. Binary fission has been widely accepted as the plausible mode of reproduction for this parasite. The present study demonstrates that subjecting the parasites in vitro to higher temperature shows the proliferation of parasite numbers in cultures. Transmission electron microscopy was used to compare the morphology of Blastocystis sp. subtype 3 isolated from a dengue patient having high fever (in vivo thermal stress) and Blastocystis sp. 3 maintained at 41 °C (in vitro thermal stress) and 37 °C (control). Fluorescence stains like acridine orange (AO) and 4',6'-diamino-2-phenylindole (DAPI) were used to demonstrate the viability and nuclear content of the parasite for both the in vitro and in vivo thermal stress groups of parasites. Blastocystis sp. at 37 °C was found to be mostly vacuolar whereas the in vitro thermal stressed isolates at 41 °C were granular with electron dense material seen to protect the granules within the central body. Parasites of the in vivo thermal stressed group showed similar ultrastructure as the in vitro ones. AO and DAPI staining provided evidence that these granules are viable which develop into progenies of Blastocystis sp. These granular forms were then observed to rupture and release progenies from the mother cells whilst the peripheral cytoplasmic walls were seen to degrade. Upon exposure to high temperature both in vitro and in vivo, Blastocystis sp. in cultures show higher number of granular forms seen to be protected by the electron dense material within the central body possibly acting as a protective mechanism. This is possibly to ensure the ability to survive for the granules to be developed as viable progenies for release into the host system.
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Affiliation(s)
- Gaythri Thergarajan
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Suresh K Govind
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Subha Bhassu
- Department of Genetics and Molecular Biology, University of Malaya, Kuala Lumpur, Malaysia
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15
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El-Badry AA, Abd El Wahab WM, Hamdy DA, Aboud A. Blastocystis subtypes isolated from irritable bowel syndrome patients and co-infection with Helicobacter pylori. Parasitol Res 2017; 117:127-137. [PMID: 29138961 DOI: 10.1007/s00436-017-5679-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/08/2017] [Indexed: 12/13/2022]
Abstract
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disease presenting clinically by abdominal pain with alteration of bowel habits. Although IBS has uncertain etiology, chronic gut inflammation due to persistent exposure to an infectious agent including Blastocystis sp. was proposed. The aim of this study was to detect the prevalence of Blastocystis sp. subtype (ST) isolated from stool of IBS patients and to assess Blastocystis sp. and H. pylori co-infection in IBS patients from Beni-Suef Governorate, Egypt. Stool samples were collected from 115 IBS patients, following Rome III criteria. All stool samples were microscopically examined by wet mount and permanent trichrome stain, cultured on Jones' medium with further sequencing of positive Blastocystis isolates and screened for detection of H. pylori coproantigen. Blastocystis sp. was the predominant parasite in IBS patients; it had statistical significant association with both rural residence (OR = 10) and flatulence (OR = 8.2). There was a predominance of Blastocystis sp. ST3 (81%) followed by ST1 (19%). Blastocystis culture results (19.1%) were superior than microscopy (16.5%). The majority of Blastocystis-positive IBS patients (72.7%) were co-infected with H. pylori with statistical significance; however, H. pylori was higher in Blastocystis-negative IBS patients (47/64) than in Blastocystis-positive IBS patients (17/64). Interestingly, IBS is usually associated with gut dysbiosis, while the most prevalent parasite in our IBS patients was Blastocystis sp., which is frequently found in asymptomatic individuals. Whether Blastocystis sp. is a cause or a consequence of IBS still needs further investigation, with a particular focus on correlation of IBS with different Blastocystis sp. subtypes and gut microbiomes.
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Affiliation(s)
- Ayman A El-Badry
- Department of Microbiology-Medical Parasitology Section, College of Medicine, Imam Abdulrahman Bin Fasial University (previously University of Dammam), P.O. Box 2114, Dammam, 31451, Saudi Arabia.
| | - Wegdan M Abd El Wahab
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Doaa A Hamdy
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Alaa Aboud
- Department of Tropical Medicine, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
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16
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Lepczyńska M, Białkowska J, Dzika E, Piskorz-Ogórek K, Korycińska J. Blastocystis: how do specific diets and human gut microbiota affect its development and pathogenicity? Eur J Clin Microbiol Infect Dis 2017; 36:1531-1540. [PMID: 28326446 PMCID: PMC5554277 DOI: 10.1007/s10096-017-2965-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/08/2017] [Indexed: 12/31/2022]
Abstract
Blastocystis is an enteric parasite that inhabits the gastrointestinal tract of humans and many animals. This emerging parasite has a worldwide distribution. It is often identified as the most common eukaryotic organism reported in human fecal samples. This parasite is recognized and diagnosed more often than ever before. Furthermore, some strains develop resistance against currently recommended drugs, such as metronidazole; therefore, the use of natural remedies or special diets has many positive aspects that may address this problem. The goal of this review is to compare natural treatments and various diets against the efficacy of drugs, and describe their influence on the composition of the gut microbiota, which affects Blastocystis growth and the occurrence of symptoms. This article reviews important work in the literature, including the classification, life cycle, epidemiology, pathogenesis, pathogenicity, genetics, biology, and treatment of Blastocystis. It also includes a review of the current knowledge about human gut microbiota and various diets proposed for Blastocystis eradication. The literature has revealed that garlic, ginger, some medical plants, and many spices contain the most effective organic compounds for parasite eradication. They work by inhibiting parasitic enzymes and nucleic acids, as well as by inhibiting protein synthesis. The efficacy of any specific organic compound depends on the Blastocystis subtype, and, consequently, on its immunity to treatment. In conclusion, the article discusses the findings that human gut microbiota composition triggers important mechanisms at the molecular level, and, thus, has a crucial influence on the parasitic pathogenicity.
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Affiliation(s)
- M Lepczyńska
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland.
| | - J Białkowska
- Department of Neurology and Neurosurgery, Faculty of Medical Sciences, University of Warmia and Mazury, Warszawska 30, Olsztyn, Poland
| | - E Dzika
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland
| | - K Piskorz-Ogórek
- Department of Nursing, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, Poland
- Regional Specialized Children's Hospital in Olsztyn, Żołnierska 18A, Olsztyn, Poland
| | - J Korycińska
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland
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17
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Irisarri-Gutiérrez MJ, Mingo MHD, de Lucio A, Gil H, Morales L, Seguí R, Nacarapa E, Muñoz-Antolí C, Bornay-Llinares FJ, Esteban JG, Carmena D. Association between enteric protozoan parasites and gastrointestinal illness among HIV- and tuberculosis-infected individuals in the Chowke district, southern Mozambique. Acta Trop 2017; 170:197-203. [PMID: 28302528 DOI: 10.1016/j.actatropica.2017.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/13/2017] [Accepted: 03/10/2017] [Indexed: 11/18/2022]
Abstract
Human immune deficiency virus (HIV) and tuberculosis (TB) infections remain major public health issues globally, particularly in sub-Saharan Africa. Impairment of both cell-mediated and humoral immunity by HIV and/or TB infections may limit the host's defences against other pathogens, including the diarrheagenic protozoan Cryptosporidium spp., Giardia intestinalis, and Entamoeba histolytica. During September-December 2015 a cross-sectional study was conducted to assess the prevalence and molecular diversity of these enteric parasites among HIV- and/or TB-infected patients at a medical reference centre in Chowke district, southern Mozambique. A total of 99 stool specimens were initially screened by direct microscopy and further confirmed and characterised by molecular methods. DNA sequence analyses of the genes encoding the small subunit ribosomal RNA and the 60-kDa glycoprotein were used for the typing and sub-typing of Cryptosporidium isolates, respectively. G. intestinalis-positive isolates by real-time PCR were subsequently typed at the glutamate dehydrogenase locus. Differential diagnosis of E. histolytica/dispar was achieved by real-time PCR. G. intestinalis (8.1%) was the enteric protozoan more frequently detected, followed by Cryptosporidium spp. (7.1%), and Entamoeba histolytica/dispar (6.1%). Two HIV-infected (but not TB-infected) patients harbour G. intestinalis and Cryptosporidium spp. co-infections. Two (29%) G. intestinalis isolates were successfully characterised, revealing the presence of known AII and novel BIV genotypes. Four (57%) Cryptosporidium isolates were unmistakeable assigned to C. hominis, identifying two (IbA10G2 and IdA22) sub-types. Cryptosporidium infections were not associated to diarrhoea in HIV-positive patients, probably because improved immune function in the affected individuals due to antiretroviral therapy. G. intestinalis was considered a non-opportunistic pathogen, whereas the presence of E. histolytica could not be confirmed by molecular methods. Based on their common presence in the studied clinical population, we recommend the effective diagnosis and treatment of these enteropathogens for improving the management of HIV and TB patients.
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Affiliation(s)
- María José Irisarri-Gutiérrez
- Department of Parasitology, Pharmacy Faculty, Valencia University, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Marta Hernández-de Mingo
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Aida de Lucio
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Horacio Gil
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain; European Program for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Granits väg 8, 171 65, Solna, Sweden
| | - Lucía Morales
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Raimundo Seguí
- Department of Parasitology, Pharmacy Faculty, Valencia University, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Edy Nacarapa
- Carmelo Hospital, Av. Trabalho, Chokwe, Gaza, Mozambique
| | - Carla Muñoz-Antolí
- Department of Parasitology, Pharmacy Faculty, Valencia University, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | | | - José Guillermo Esteban
- Department of Parasitology, Pharmacy Faculty, Valencia University, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - David Carmena
- Department of Parasitology, Pharmacy Faculty, Valencia University, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain.
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18
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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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19
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Vitetta L, Saltzman ET, Nikov T, Ibrahim I, Hall S. Modulating the Gut Micro-Environment in the Treatment of Intestinal Parasites. J Clin Med 2016; 5:jcm5110102. [PMID: 27854317 PMCID: PMC5126799 DOI: 10.3390/jcm5110102] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 02/07/2023] Open
Abstract
The interactions of micro-organisms cohabitating with Homo sapiens spans millennia, with microbial communities living in a symbiotic relationship with the host. Interacting to regulate and maintain physiological functions and immunological tolerance, the microbial community is able to exert an influence on host health. An example of micro-organisms contributing to an intestinal disease state is exhibited by a biodiverse range of protozoan and bacterial species that damage the intestinal epithelia and are therefore implicated in the symptoms of diarrhea. As a contentious exemplar, Blastocystis hominis is a ubiquitous enteric protist that can adversely affect the intestines. The symptoms experienced are a consequence of the responses of the innate immune system triggered by the disruption of the intestinal barrier. The infiltration of the intestinal epithelial barrier involves a host of immune receptors, including toll like receptors and IgM/IgG/IgA antibodies as well as CD8+ T cells, macrophages, and neutrophils. Whilst the mechanisms of interactions between the intestinal microbiome and protozoan parasites remain incompletely understood, it is acknowledged that the intestinal microbiota is a key factor in the pathophysiology of parasitic infections. Modulating the intestinal environment through the administration of probiotics has been postulated as a possible therapeutic agent to control the proliferation of intestinal microbes through their capacity to induce competition for occupation of a common biotype. The ultimate goal of this mechanism is to prevent infections of the like of giardiasis and eliminate its symptoms. The differing types of probiotics (i.e., bacteria and yeast) modulate immunity by stimulating the host immune system. Early animal studies support the potential benefits of probiotic administration to prevent intestinal infections, with human clinical studies showing probiotics can reduce the number of parasites and the severity of symptoms. The early clinical indications endorse probiotics as adjuncts in the pharmaceutical treatment of protozoan infections. Currently, the bar is set low for the conduct of well-designed clinical studies that will translate the use of probiotics to ameliorate protozoan infections, therefore the requisite is for further clinical research.
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Affiliation(s)
- Luis Vitetta
- Sydney Medical School, The University of Sydney, Sydney 2006, NSW, Australia.
- Medlab Clinical Ltd., Sydney 2015, NSW, Australia.
| | - Emma Tali Saltzman
- Sydney Medical School, The University of Sydney, Sydney 2006, NSW, Australia.
- Medlab Clinical Ltd., Sydney 2015, NSW, Australia.
| | - Tessa Nikov
- Medlab Clinical Ltd., Sydney 2015, NSW, Australia.
| | | | - Sean Hall
- Medlab Clinical Ltd., Sydney 2015, NSW, Australia.
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20
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Yaghoobi K, Sarkari B, Mansouri M, Motazedian MH. Zoonotic intestinal protozoan of the wild boars, Sus scrofa, in Persian Gulf's coastal area (Bushehr province), Southwestern Iran. Vet World 2016; 9:1047-1050. [PMID: 27847411 PMCID: PMC5104710 DOI: 10.14202/vetworld.2016.1047-1050] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 08/23/2016] [Indexed: 11/19/2022] Open
Abstract
Aim: Wild boars, Sus scrofa, are potential reservoirs of many zoonotic diseases, and there are a possibility of transmission of the zoonotic diseases from these animals to humans and also domestic animals. This study aimed to evaluate the protozoan contamination of wild boars in the Persian Gulf’s coastal area (Bushehr Province), southwestern Iran. Materials and Methods: A total of 25 crossbred boars were collected during a course of vertebrate pest control in Bushehr province, in 2013. Samples were collected from the gastrointestinal tracts of each boar in 5% formalin, Bouin’s solution, sodium acetate-acetic acid-formalin, and polyvinyl alcohol fixatives. Fixed stool smears examined by trichrome and Ziehl–Neelsen staining. Results: Each of the 25 wild boars was infected with at least one of the intestinal protozoans. The rate of contamination with intestinal protozoan was 64% for Balantidium coli, 76% for Iodamoeba sp., 52% for Entamoeba polecki, 44% for Blastocystis sp. and 8% for Chilomastix sp. No intestinal coccidian was detected in studied boars when the stool samples were evaluated by Ziehl–Neelsen staining method. Conclusion: Findings of this study demonstrated that wild boars in the Persian Gulf coastal area are contaminated by many protozoans, including zoonotic protozoan, which poses a potential risk to locals as well as the domestic animals of the area.
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Affiliation(s)
- Kambiz Yaghoobi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahador Sarkari
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Mansouri
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Motazedian
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Cabrine-Santos M, Cintra EDN, do Carmo RA, Nascentes GAN, Pedrosa AL, Correia D, Oliveira-Silva MBD. OCCURRENCE OF Blastocystis spp. IN UBERABA, MINAS GERAIS, BRAZIL. Rev Inst Med Trop Sao Paulo 2016. [PMID: 26200960 PMCID: PMC4544244 DOI: 10.1590/s0036-46652015000300005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Intestinal parasites are a problem for public health all over the world. The
infection with Blastocystis, a protozoan of controversial
pathogenicity, is one of the most common among them all. In this study, the
occurrence of intestinal parasites, with emphasis on Blastocystis,
in patients at the Universidade Federal do Triângulo Mineiro was investigated in
Uberaba (MG) through microscopy of direct smears and fecal concentrates using
Ritchie’s method. Feces of 1,323 patients were examined from April 2011 to May 2012.
In 28.7% of them at least one intestinal parasite was identified, and the most
frequent organisms were Blastocystis spp. (17.8%) and Giardia
intestinalis (7.4%). The occurrence of parasitism was higher in children aged 6 -10
years old, and the infection with Blastocystis spp. was higher above
the age of six (p < 0.001). The exclusive presence of G.
intestinalis and of Blastocystis spp. was observed in
5.4% and 12.2% of the patients, respectively. Regarding patients with diarrheic
feces, 8% revealed unique parasitism of Blastocystis spp. Other
intestinal parasites observed in children were Ascaris
lumbricoides(0.3%) and Entamoeba
histolytica/dispar/moshkovskii (1.4%). The Ritchie’s method was more
sensitive (92.8%) when compared to direct microscopy (89.8%), with high agreement
between them (97.7%, kappa = 0.92). In conclusion, the occurrence of
Blastocystis spp. in Uberaba is high and the presence of
diarrheic feces with exclusive presence of the parasite of
Blastocystis spp. was observed.
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Affiliation(s)
- Marlene Cabrine-Santos
- Instituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
| | | | | | | | - André Luiz Pedrosa
- Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
| | - Dalmo Correia
- Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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22
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Karasartova D, Gureser AS, Zorlu M, Turegun-Atasoy B, Taylan-Ozkan A, Dolapci M. Blastocystosis in post-traumatic splenectomized patients. Parasitol Int 2015; 65:802-805. [PMID: 26697990 DOI: 10.1016/j.parint.2015.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/16/2015] [Accepted: 12/11/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND/AIMS The aim of this study was to determine the prevalence and significance of intestinal protozoa, specially Blastocystis spp., and to perform PCR-based subtype classification for understanding the importance of Blastocystis spp. in the pathogenesis of gastrointestinal disorders in post-traumatic splenectomized patients. MATERIALS AND METHODS A total of 60 stool samples were obtained from 30 post-traumatic splenectomized patients and 30 healthy controls. Wet mounts, trichrome and Kinyoun acid-fast stained slides were prepared from the stool specimens. PCR was used for detecting the presence of Giardia spp., Entamoeba spp., Dientamoeba fragilis, Cryptosporidium spp., Blastocystis spp. Genotyping was realized by using Blastocystis hominis STS primers. RESULTS In both study groups, any helminth eggs and other protozoa except Blastocystis spp. were not detected by microscopy and PCR, and also bacterial cultures were negative. Only stool microscopy was positive for Blastocystis spp. in 30% (9 of 30) of splenectomized patients and in 13% (4/30) of healthy controls. PCR for Blastocystis spp. was positive in 40% (12 of 30), B. hominis genotypes were 20% (6/30): STS1 in 10% (3/30) and STS3 in 10% (3/30) of splenectomized patients. In healthy controls Blastocystis spp. was 13% (4/30) by PCR and genotypes of B. hominis was not detected. The difference between the prevalence of Blastocystis spp. infection in splenectomized patients and control groups was statistically significant (p=0.020). Abdominal pain was the most frequent gastrointestinal symptom (p=0.019) among splenectomized patients positive for Blastocystis spp. CONCLUSION In post-traumatic healthy splenectomized patients, Blastocystis spp. were found to be the most prevalent protozoa and may be responsible for the gastrointestinal disorders.
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Affiliation(s)
- Djursun Karasartova
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - A Semra Gureser
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Musa Zorlu
- Department of Surgery, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Buse Turegun-Atasoy
- Department of Medical Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey.
| | - Mete Dolapci
- Department of Surgery, Faculty of Medicine, Hitit University, Corum, Turkey
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Lepczyńska M, Chen WC, Dzika E. Mysterious chronic urticaria caused by Blastocystis spp.? Int J Dermatol 2015; 55:259-66; quiz 263-4, 266. [PMID: 26469206 DOI: 10.1111/ijd.13064] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 03/09/2015] [Accepted: 04/08/2015] [Indexed: 01/18/2023]
Abstract
Species of the genus Blastocystis, which are single-cell, intestinal protozoan parasites of humans and animals, remain mysterious, with unclear clinical and epidemiologic significance. In recent years, many researchers have suggested a possible connection between Blastocystis spp. infection and chronic urticaria. In the present article, we review the literature and discuss the possible associations between the clinical symptomatology and pathogenicity of this organism in terms of its subtypes, morphologic forms, genetic diversity, and interactions with other intestinal microbiota.
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Affiliation(s)
- Małgorzata Lepczyńska
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland
| | - Wen-Chieh Chen
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Women's Health Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ewa Dzika
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland
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Factors that influence the shedding of Blastocystis cysts in an irritable bowel syndrome (IBS) patient--an evidence-based case study. Parasitol Res 2015; 114:2999-3005. [PMID: 25982571 DOI: 10.1007/s00436-015-4502-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/23/2015] [Indexed: 12/13/2022]
Abstract
Blastocystis is one of the most common gut parasites found in the intestinal tract of humans and animals. We have previously reported the irregular shedding of Blastocystis cysts in stools from infected patients. In the present study, we assess the factors influencing shedding patterns from a Blastocystis ST3-infected IBS patient. The stools samples were voluntarily submitted for examination for a period of 30 days from Blastocystis ST3-infected IBS patient. A questionnaire on the factors that could influence the shedding pattern of the cysts was designed to assess the following information: (a) the frequency of frequenting the toilet in a day, (b) the timing of frequenting the toilet, (c) the stool forms, (d) the type of mood the patient was in when frequenting the toilet and (e) food intake. A total of 79 stool samples were collected for 30 days. The highest number of cysts recorded when the patient visited the toilet three times a day was 22.2 × 10(6) cysts/g. Frequenting the toilet between 6 a.m. to 11.59 a.m. showed the highest number of cysts, i.e. 21.7 × 10(6) cysts/g. Semi-solid forms showed the highest cyst count, i.e. 2.00 × 10(6) cysts/g. Irregular shedding of cysts was seen in 10 out of 30 days where the widest range recorded on day 17 was between 0 to 1.2 × 10(6) cysts/g. The average daily cyst count on days of emotional fluctuations was from 0 to 5.13 × 10(6) cysts/g. In conclusion, the study confirms that there are factors influencing shedding patterns of Blastocystis, and these have important implications when it comes to diagnosis and transmission of the parasite.
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Fletcher S, Caprarelli G, Merif J, Andresen D, Hal SV, Stark D, Ellis J. Epidemiology and geographical distribution of enteric protozoan infections in sydney, australia. J Public Health Res 2014; 3:298. [PMID: 25343139 PMCID: PMC4207027 DOI: 10.4081/jphr.2014.298] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 08/05/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Enteric protozoa are associated with diarrhoeal illnesses in humans; however there are no recent studies on their epidemiology and geographical distribution in Australia. This study describes the epidemiology of enteric protozoa in the state of New South Wales and incorporates spatial analysis to describe their distribution. DESIGN AND METHODS Laboratory and clinical records from four public hospitals in Sydney for 910 patients, who tested positive for enteric protozoa over the period January 2007 - December 2010, were identified, examined and analysed. We selected 580 cases which had residence post code data available, enabling us to examine the geographic distribution of patients, and reviewed the clinical data of 252 patients to examine possible links between protozoa, demographic and clinical features. RESULTS Frequently detected protozoa were Blastocystis spp. (57%), Giardia intestinalis (27%) and Dientamoeba fragilis (12%). The age distribution showed that the prevalence of protozoa decreased with age up to 24 years but increasing with age from 25 years onwards. The geographic provenance of the patients indicates that the majority of cases of Blastocystis (53.1%) are clustered in and around the Sydney City Business District, while pockets of giardiasis were identified in regional/rural areas. The distribution of cases suggests higher risk of protozoan infection may exist for some communities. CONCLUSIONS These findings provide useful information for policy makers to design and tailor interventions to target high risk communities. Follow-up investigation into the risk factors for giardiasis in regional/rural areas is needed. Significance for public healthThis research is significant since it provides the most recent epidemiological update on the common enteric protozoa affecting Australians. It reveals that enteric protozoa cause considerable disease burden in high risk city dwellers, and provides the evidence base for development of targeted interventions for their prevention and control in high risk populations. The prevalence of enteric protozoa in this metropolitan setting underscores that microorganisms do not respect borders and that a collaborative approach is needed to contain the global spread of infectious diseases. Incorporating spatial analysis is valuable in providing a compelling picture of the geographical distribution of these often neglected diseases. Local and State Public Health departments can use this information to support further inves-
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Affiliation(s)
- Stephanie Fletcher
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney
| | - Graziella Caprarelli
- Division of IT, Engineering and the Environment, University of South Australia, Adelaide
| | - Juan Merif
- Microbiology Department, South Eastern Area Laboratory Service (SEALS), Prince of Wales Hospital, Rand wick
| | - David Andresen
- Department of Microbiology, Children’s Hospital Westmead, Darlinghurst, Australia
| | - Sebastian Van Hal
- Department of Microbiology, Liverpool Hospital, Darlinghurst, Australia
| | - Damien Stark
- Division of Microbiology, St. Vincent’s Hospital, Darlinghurst, Australia
| | - John Ellis
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney
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Matiut DS, Hritcu L. The pathogenic role of Blastocystis isolated from patients with irritable bowel syndrome and colitis from Iasi, Romania. Acta Parasitol 2014. [PMID: 26204028 DOI: 10.1515/ap-2015-0015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Blastocystis is a common parasite and regarded as one of the etiologic agents of irritable bowel syndrome, colitis and chronic diarrhea. Our study was undertaken in order to identify different subtypes of Blastocystis isolated in patients with irritable bowel syndrome and colitis, as well as with chronic diarrhea and to evaluate their pathogenic potential. Seventy-three subjects (10 asymptomatic infected subjects, 49 subjects harboring Blastocystis or associated with other etiologic agents like bacteria, yeasts, protozoa, helminthes and 14 subjects with unknown etiologic agents) were investigated by in vitro parasitological and bacteriological stool samples followed by PCR subtyping of Blastocystis using STS primers, immunological markers (total serum IgA and IgE antibody levels), Helicobacter pylori antigen rapid test and fecal occult blood test. Also, among 49 subjects, there were 12 subjects harboring Blastocystis as the single etiologic agent. Subtyping proved that only three subtypes of Blastocystis were identified as following: subtype II (66.66%) in single infected subjects, subtype I (16.66%) in mixed infection with subtype II and subtype IV (8.33%) in single infected subjects. Total serum IgA and IgE antibody levels were in normal range. Subtype II was the most frequent subtype followed by subtype I and subtype IV of Blastocystis isolates in patients with irritable bowel syndrome, colitis, and chronic diarrhea as well as in asymptomatic infected group. Our results suggest that the severity of clinical manifestations depend on factors involving the host and possible parasitic density and not necessarily by isolated subtype.
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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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Martiny D, Bart A, Vandenberg O, Verhaar N, Wentink-Bonnema E, Moens C, van Gool T. Subtype determination of Blastocystis isolates by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Eur J Clin Microbiol Infect Dis 2013; 33:529-36. [PMID: 24078024 DOI: 10.1007/s10096-013-1980-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 09/08/2013] [Indexed: 11/25/2022]
Abstract
The pathogenic role of the enteric parasite Blastocystis remains controversial. Recent studies have suggested that various subtypes (STs) found in human samples could be correlated to the presence or absence and variability of clinical manifestations, and that STs can differ with respect to drug sensitivity. Polymerase chain reaction (PCR) techniques used to determine these STs are expensive and are usually restricted to research laboratory settings. This study evaluates the potential application of the inexpensive matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) technique to discriminate Blastocystis STs. A database of parasitic protein signatures was constructed for five Blastocystis STs, and the reference spectra were challenged with those from 19 axenic cultures of ST1, ST2, ST3, ST4 and ST8 and those from nine xenic liquid cultures of ST3 and ST4. Samples from axenic cultures were prepared using standard formic acid extraction and direct deposition procedures. The reference spectra revealed five distinct spectral profiles, and the database library allowed for discrimination between all of the cultures with reliability indices ranging from 2.038 to greater than 2.8 when an extraction was performed. The direct deposition procedure resulted in greater variability in the discrimination and direct MALDI-TOF MS identification from xenic liquid cultures was effective in 3 out of 9 samples. MALDI-TOF MS proved to be an effective technology for efficiently discriminating Blastocystis STs in axenic cultures.
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Parija SC, Jeremiah S. Blastocystis: Taxonomy, biology and virulence. Trop Parasitol 2013; 3:17-25. [PMID: 23961437 PMCID: PMC3745665 DOI: 10.4103/2229-5070.113894] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 06/24/2013] [Indexed: 11/20/2022] Open
Abstract
The unicellular protist Blastocystis has long been an unsolved puzzle for taxonomists, microbiologists and clinicians. Over the years, the organism has been bounced on and off the different branches of the tree of life due the possession of unique phenotypic characters intermediary to different organisms. The organism is polymorphic with only few of forms such as vacuolar, granular, amoeboid, and the cyst form being commonly known. However it could exist in other forms much more frequently than the widely known forms which could be missed by the unaware observer. Certain older concepts in the life cycle of Blastocystis although has been proven wrong are still being followed in various textbooks and other trustworthy internet sources. The causal role of Blastocystis in human disease has long been a subject of controversy. It is widely believed that certain subtypes of the organism are virulent. But this is not so as other factors are also involved in the clinical outcome of the infection. In these contexts, this review intends to shed light on the past misconceptions and the recent findings on the taxonomy, biology and the virulence of this organism.
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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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Lv S, Tian LG, Liu Q, Qian MB, Fu Q, Steinmann P, Chen JX, Yang GJ, Yang K, Zhou XN. Water-related parasitic diseases in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:1977-2016. [PMID: 23685826 PMCID: PMC3709360 DOI: 10.3390/ijerph10051977] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 05/01/2013] [Accepted: 05/02/2013] [Indexed: 12/17/2022]
Abstract
Water-related parasitic diseases are directly dependent on water bodies for their spread or as a habitat for indispensable intermediate or final hosts. Along with socioeconomic development and improvement of sanitation, overall prevalence is declining in the China. However, the heterogeneity in economic development and the inequity of access to public services result in considerable burden due to parasitic diseases in certain areas and populations across the country. In this review, we demonstrated three aspects of ten major water-related parasitic diseases, i.e., the biology and pathogenicity, epidemiology and recent advances in research in China. General measures for diseases control and special control strategies are summarized.
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Affiliation(s)
- Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Li-Guang Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Qin Liu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Qing Fu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Peter Steinmann
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Basel 4051, Switzerland
| | - Jia-Xu Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
| | - Guo-Jing Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China; E-Mails: (G.-J.Y.); (K.Y.)
- School of Public Health and Primary Care, The Jockey Club Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kun Yang
- Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China; E-Mails: (G.-J.Y.); (K.Y.)
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China; E-Mails: (S.L.); (L.-G.T.); (Q.L.); (M.-B.Q.); (Q.F.); (P.S.); (J.-X.C.)
- WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China
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Subtype distribution of Blastocystis isolates from a variety of animals from New South Wales, Australia. Vet Parasitol 2013; 196:85-9. [PMID: 23398989 DOI: 10.1016/j.vetpar.2013.01.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 01/06/2013] [Accepted: 01/16/2013] [Indexed: 11/22/2022]
Abstract
A total of 438 stool samples from 38 different species of animal from seven different locations were studied for the presence of Blastocystis. PCR analysis was completed on all samples and DNA sequence data from the rDNA were submitted to subtype allocation. There was a total of 80 (18%) sequences from 18 species, and nine different subtypes were identified - ST1, ST2, ST3, ST4, ST5, ST7, ST11, ST12 and ST13. This is the first report of Blastocystis from the eastern grey kangaroo, red kangaroo, wallaroo, snow leopard and ostrich. This study highlights the need for further investigation into the genetic diversity of Blastocystis which could help show the zoonotic potential of Blastocystis.
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Laodim P, Intapan PM, Sawanyawisuth K, Laummaunwai P, Maleewong W. A Hospital-Based Study of Epidemiological and Clinical Data onBlastocystis hominisInfection. Foodborne Pathog Dis 2012; 9:1077-82. [DOI: 10.1089/fpd.2012.1177] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Pongsakorn Laodim
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
| | - Pewpan M. Intapan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
| | - Kittisak Sawanyawisuth
- Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Porntip Laummaunwai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
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Roberts T, Stark D, Harkness J, Ellis J. Subtype distribution of Blastocystis isolates identified in a Sydney population and pathogenic potential of Blastocystis. Eur J Clin Microbiol Infect Dis 2012; 32:335-43. [PMID: 22996007 DOI: 10.1007/s10096-012-1746-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 08/31/2012] [Indexed: 12/01/2022]
Abstract
Blastocystis is one of the most common enteric parasites present in humans. There is still much uncertainty about the pathogenic potential of this parasite, and it was suggested that its pathogenicity could be subtype-related. This report aimed to study 98 Blastocystis isolates found in human stool specimens to identify the subtypes present and carry out phylogenetic analysis on these isolates. This study also aimed to show the relationship between subtype and symptoms. Five-hundred and thirteen stool samples were submitted to five different diagnostic techniques for the detection of Blastocystis. Polymerase chain reaction (PCR)-positive samples were then sequenced and the small subunit (SSU) rDNA sequences were aligned and submitted to phylogenetic analysis. Ninety-eight samples were positive by any of the diagnostic methods for Blastocystis and 96 were positive by PCR. There were seven different subtypes (1, 2, 3, 4, 6, 7 and 8) identified by PCR and sequencing. This is the first large-scale study to examine the occurrence of Blastocystis in Australia. This study reports the high incidence of subtype 3 (44 %) in this population and discusses the emerging idea of subtype-dependent pathogenicity.
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Affiliation(s)
- T Roberts
- Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St., Darlinghurst, 2010 NSW, Australia.
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Fletcher SM, Stark D, Harkness J, Ellis J. Enteric protozoa in the developed world: a public health perspective. Clin Microbiol Rev 2012; 25:420-49. [PMID: 22763633 PMCID: PMC3416492 DOI: 10.1128/cmr.05038-11] [Citation(s) in RCA: 241] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Several enteric protozoa cause severe morbidity and mortality in both humans and animals worldwide. In developed settings, enteric protozoa are often ignored as a cause of diarrheal illness due to better hygiene conditions, and as such, very little effort is used toward laboratory diagnosis. Although these protozoa contribute to the high burden of infectious diseases, estimates of their true prevalence are sometimes affected by the lack of sensitive diagnostic techniques to detect them in clinical and environmental specimens. Despite recent advances in the epidemiology, molecular biology, and treatment of protozoan illnesses, gaps in knowledge still exist, requiring further research. There is evidence that climate-related changes will contribute to their burden due to displacement of ecosystems and human and animal populations, increases in atmospheric temperature, flooding and other environmental conditions suitable for transmission, and the need for the reuse of alternative water sources to meet growing population needs. This review discusses the common enteric protozoa from a public health perspective, highlighting their epidemiology, modes of transmission, prevention, and control. It also discusses the potential impact of climate changes on their epidemiology and the issues surrounding waterborne transmission and suggests a multidisciplinary approach to their prevention and control.
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Affiliation(s)
| | - Damien Stark
- School of Medical and Molecular Biosciences, University of Technology Sydney, Sydney, NSW, Australia
- St. Vincent's Hospital, Sydney, Division of Microbiology, SydPath, Darlinghurst, NSW, Australia
| | - John Harkness
- School of Medical and Molecular Biosciences, University of Technology Sydney, Sydney, NSW, Australia
- St. Vincent's Hospital, Sydney, Division of Microbiology, SydPath, Darlinghurst, NSW, Australia
| | - John Ellis
- The ithree Institute, University of Technology Sydney, Sydney, NSW, Australia
- School of Medical and Molecular Biosciences, University of Technology Sydney, Sydney, NSW, Australia
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Chan KH, Chandramathi S, Suresh K, Chua KH, Kuppusamy UR. Effects of symptomatic and asymptomatic isolates of Blastocystis hominis on colorectal cancer cell line, HCT116. Parasitol Res 2012; 110:2475-80. [DOI: 10.1007/s00436-011-2788-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 12/13/2011] [Indexed: 12/17/2022]
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Blastocystis hominis as a contributing risk factor for development of iron deficiency anemia in pregnant women. Parasitol Res 2011; 110:2167-74. [PMID: 22167376 DOI: 10.1007/s00436-011-2743-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
Abstract
Intestinal parasitic infection increases the risk of developing iron deficiency anemia (IDA) during pregnancy. The objective of this study was to assess Blastocystis hominis as a contributing risk factor for development of IDA in pregnant women. A total of 200 fecal specimens from 120 pregnant women with IDA (mean Hb = 9.6 g/dl), and 80 non-anemic controls were examined for Blastocystis. Fecal specimens were examined by the formalin/ethyl-acetate concentration technique, iron hematoxylin staining, modified Ziehl-Neelsen acid-fast staining, and by the in vitro cultivation technique for Blastocystis. Frequency of Blastocystis infection, detected microscopically and by the in vitro culture technique, was significantly higher in IDA study group (n = 48; 40%) compared to non-anemic controls (n = 5; 6.3%; P < 0.0001), and 26.5% (n = 53) in all study subjects. Among the 48 cases, Blastocystis without other intestinal parasitic infections was detected in 41 cases (34.2%), while seven cases (5.8%) with Blastocystis were coinfected with other intestinal parasites which included Giardia and Cryptosporidium (1.7% each), and Entamoeba sp., Ascaris, and Trichuris (0.8% each). The mean Hb level of the 48 Blastocystis-infected cases was 9.2 g/dl (mild anemia). While the other 72 IDA cases with no infection had mean Hb of 10.0 g/dl (mild anemia), with a significant difference in mean Hb level between Blastocystis-infected and the non-infected IDA cases (P < 0.0001). Furthermore, among the 48 Blastocystis-infected IDA cases, the mean Hb of the 41 Blastocystis-infected cases without other intestinal parasitic co-infection was 9.1 g/dl (mild anemia), while the mean Hb level of the 7 Blastocystis-infected cases with other intestinal parasitic co-infection was 8.7 g/dl (moderate anemia). Findings of the current study showed that B. hominis infection contributes to the development of IDA in pregnant women. Hence, parasitological diagnostic tests are recommended in routine examination at all antenatal clinics.
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Fouad SA, Basyoni MMA, Fahmy RA, Kobaisi MH. The pathogenic role of different Blastocystis hominis genotypes isolated from patients with irritable bowel syndrome. Arab J Gastroenterol 2011; 12:194-200. [PMID: 22305500 DOI: 10.1016/j.ajg.2011.11.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 09/12/2011] [Accepted: 11/18/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND STUDY AIMS The pathogenic role of Blastocystis hominis is still regarded by some as controversial. Studies have been in progress for years to evaluate the role of blastocystosis in irritable bowel syndrome (IBS) and demonstrated that faecal carriage of B. hominis was frequent in these patients. This study attempted to distinguish different genotypes of B. hominis isolates obtained from patients with IBS and to evaluate their pathogenic potentials. PATIENTS AND METHODS One hundred subjects (51 patients with IBS and 49 asymptomatic infected subjects) harbouring B. hominis were investigated by a direct smear examination and in vitro culture of stool samples followed by genotyping of B. hominis by PCR using STS primers. Sigmoidoscopy was done in all subjects and biopsies were taken and subjected to histopathologic examination. RESULTS Genotyping proved that only four genotypes of B. hominis were identified. In patients with IBS, genotypes III, I, and IV were detected (28, 15 and 14 isolates, respectively). On the other hand, genotypes III, IV, and II were identified in asymptomatic infected individuals (21, 19 and 13 isolates, respectively). The degrees of chronic inflammatory changes in sigmoidoscopic biopsies caused by B. hominis genotypes among IBS patients revealed that severe inflammation was present mainly in patients harboring genotype I isolates (4/15) (26.66%), while genotype III caused severe inflammation only in 9.09%. Genotype II isolates were not detected in IBS cases. Asymptomatic infected individuals harboring genotypes II, III and IV exhibited mild to moderate inflammatory changes. Genotype I isolates were not detected in asymptomatic infected group. The correlation between different B. hominis genotypes and degree of inflammation was statistically insignificant. CONCLUSION Genotype I was the most pathogenic genotype of B. hominis isolates in patients with IBS while genotype II was not detected among those patients. Also, our results suggest the presence of pathogenic and non-pathogenic strains among genotypes III and IV.
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Affiliation(s)
- Shawky A Fouad
- Department of Internal Medicine, Cairo University, Cairo, Egypt.
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Zhang X, Qiao J, Wu X, Da R, Zhao L, Wei Z. In vitro culture of blastocystis hominis in three liquid media and its usefulness in the diagnosis of blastocystosis. Int J Infect Dis 2011; 16:e23-8. [PMID: 22047715 DOI: 10.1016/j.ijid.2011.09.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 09/05/2011] [Accepted: 09/22/2011] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Blastocystis hominis is a common protozoan in the human intestinal tract and can cause the so-called blastocystosis characterized by diarrhea. To date, its identification has depended on the discovery of vacuolar, granular, amoebic, or cystic forms in stool samples using wet mount smears, iodine staining, trichrome staining, or iron hematoxylin staining. The permanent staining methods provide more positive findings. However, mercuric chloride (HgCl(2))-based polyvinyl alcohol (PVA) and Schaudinn fixative are potentially toxic and dangerous to laboratory personnel and, as hazardous chemicals, present problems with disposal. METHODS To determine whether in vitro culture could be an environmentally safe alternative, the culture growth of B. hominis in three commercially available liquid media (RPMI 1640, 199 Medium, and Dulbecco's modified Eagle's medium (DMEM)) were observed and compared. The sensitivity and specificity of these culture methods to identify B. hominis were compared with those of existing methods used clinically. RESULTS Conditions for the anaerobic culture of B. hominis in these media were determined as follows: total inoculum sizes no less than 10(5) cells; pH values ranging from 7.0 to 7.5; concentrations of calf or horse serum ranging from 10% to 30% (vol/vol); basic antibiotics added; peaking times at days 3, 6, and 9 (pH 7.5) or days 4 and 8 (or 9) (pH 7.0) at 37°C. No significant differences were noted in multiplication or generation times for the cultivation of B. hominis (p>0.05). In 56 of 398 positive cases, the short-term in vitro culture method achieved the best performance with regard to sensitivity and specificity of the five studied methods. CONCLUSIONS With the advantages of environmental safety, convenience in preparation and storage, facility in morphologic discrimination, and outstanding performance in terms of sensitivity and specificity, the in vitro culture method could be applied to identify B. hominis for both clinical diagnosis and field study purposes.
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Affiliation(s)
- Xu Zhang
- Department of Immunology and Pathogenic Biology, Medical School of Xi'an Jiaotong University, PO Box 64, 205 Scarlet Bird Avenue, Xi'an 710061, PR China.
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Zhang X, Zhang S, Qiao J, Wu X, Zhao L, Liu Y, Fan X. Ultrastructural insights into morphology and reproductive mode of Blastocystis hominis. Parasitol Res 2011; 110:1165-72. [PMID: 21845408 DOI: 10.1007/s00436-011-2607-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 08/04/2011] [Indexed: 01/29/2023]
Abstract
To understand well the morphology and reproductive mode of Blastocystis hominis, with the help of transmission electron microscopy and scanning electron microscopy the ultrastructural details of B. hominis from fresh diarrheal specimens and cultured strains were observed. In both fecal samples and culture conditions, there were vacuolar and granular forms. In diarrhea, it exists in multivacuolar, avacuolar, and amoeboid forms. In the in vitro culture, vacuolar form could transform to granular form. The most commonly noticed structure on the cell surface was surface coat with diversity in appearance (the funiform, lamellar, filiform, and floccose in different thickness) and distributions. Three modes of reproduction were confirmed, they were binary fission, plasmotomy, and budding. Under the impact of host's response, the ultrastructures of surface coat, nucleus, and mitochondrion-like organelle sometimes changed.
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Affiliation(s)
- Xu Zhang
- Department of Immunology and Pathogenic Biology, Medical School of Xi'an Jiaotong University, P.O. Box 64, 205 Scarlet Bird Avenue, Xi'an 710061, People's Republic of China.
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Roberts T, Barratt J, Harkness J, Ellis J, Stark D. Comparison of microscopy, culture, and conventional polymerase chain reaction for detection of blastocystis sp. in clinical stool samples. Am J Trop Med Hyg 2011; 84:308-12. [PMID: 21292905 DOI: 10.4269/ajtmh.2011.10-0447] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We tested 513 stool samples from patients in Sydney, Australia for Blastocystis by using five diagnostic techniques: microscopy of a permanently stained smear using a modified iron-hematoxylin stain, two xenic culture systems (a modified Boeck and Drbohlav's medium and tryptone, yeast extract, glucose, methionine-9 medium), and two published conventional polymerase chain reaction methods specific for the small subunit ribosomal DNA. Ninety-eight (19%) samples were positive for Blastocystis in one or more of the diagnostic techniques. The PCR 2 method was the most sensitive at detecting Blastocystis with a sensitivity of 94%, and the least sensitive was microscopy of the permanent stain (48%). Subtype 3 was the most predominant subtype (present in 43% of samples assigned to this group). This study highlights the low sensitivity of microscopy when used as the sole diagnostic modality for detection of Blastocystis sp.
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Affiliation(s)
- Tamalee Roberts
- Department of Microbiology, SydPath, St. Vincent's Hospital, Sydney, Australia.
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Abdel-Hameed DM, Hassanin OM. Proteaese activity of Blastocystis hominis subtype3 in symptomatic and asymptomatic patients. Parasitol Res 2011; 109:321-7. [DOI: 10.1007/s00436-011-2259-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Accepted: 01/14/2011] [Indexed: 12/16/2022]
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The potential use of 29 kDa protein as a marker of pathogenicity and diagnosis of symptomatic infections with Blastocystis hominis. Parasitol Res 2010; 108:1139-46. [DOI: 10.1007/s00436-010-2156-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 11/03/2010] [Indexed: 11/25/2022]
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Dinleyici EC, Eren M, Dogan N, Reyhanioglu S, Yargic ZA, Vandenplas Y. Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection. Parasitol Res 2010; 108:541-5. [PMID: 20922415 DOI: 10.1007/s00436-010-2095-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 09/16/2010] [Indexed: 02/07/2023]
Abstract
Although many Blastocystis infections remain asymptomatic, recent data suggest it also causes frequent symptoms. Therapy should be limited to patients with persistent symptoms and a complete workup for alternative etiologies. The goal of this study was to compare the natural evolution (no treatment) to the efficacy of Saccharomyces boulardii (S. boulardii) or metronidazole for the duration of diarrhea and the duration of colonization in children with gastrointestinal symptoms and positive stool examination for Blastocystis hominis. This randomized single-blinded clinical trial included children presenting with gastrointestinal symptoms (abdominal pain, diarrhea, nausea-vomiting, flatulence) more than 2 weeks and confirmed B. hominis by stool examination (B. hominis cysts in the stool with microscopic examination of the fresh stool). The primary end points were clinical evaluation and result of microscopic stool examination at day 15. Secondary end points were the same end points at day 30. Randomization was performed by alternating inclusion: group A, S. boulardii (250 mg twice a day, Reflor®) during 10 days; group B, metronidazole (30 mg/kg twice daily) for 10 days; group C, no treatment. At day 15 and 30 after inclusion, the patients were re-evaluated, and stool samples were examined microscopically. On day 15, children that were still symptomatic and/or were still B. hominis-infected in group C were treated with metronidazole for 10 days. There was no statistically significant difference between the three study groups for age, gender, and the presence of diarrhea and abdominal pain. On day 15, clinical cure was observed in 77.7% in group A (n, 18); in 66.6% in group B (n, 15); and 40% in group C (n:15) (p < 0.031, between groups A and C). Disappearance of the cysts from the stools on day 15 was 80% in group B, 72.2% in group A, and 26.6% in group C (p = 0.011, between group B and group C; p = 0.013, between group A and group C). At the end of the first month after inclusion, clinical cure rate was 94.4% in group A and 73.3% in group B (p = 0.11). Parasitological cure rate for B. hominis was very comparable between both groups (94.4% vs. 93.3%, p = 0.43). Metronidazole or S. boulardii has potential beneficial effects in B. hominis infection (symptoms, presence of parasites). These findings challenge the actual guidelines.
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Affiliation(s)
- Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
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Association of Blastocystis hominis genetic subtypes with urticaria. Parasitol Res 2010; 108:553-60. [PMID: 20922413 DOI: 10.1007/s00436-010-2097-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2010] [Accepted: 09/16/2010] [Indexed: 10/19/2022]
Abstract
Although intestinal parasites are a possible cause of skin disorders, there are few case reports concerning the role of Blastocystis hominis in urticaria. To clarify this association, we determined the frequency of B. hominis genetic subtype in urticarial patients by stool culture and polymerase chain reaction (PCR) and evaluated the clinical and parasitological recovery of urticarial patients after treatment with metronidazole. Of 54 urticarial patients (group I), 18 (33.3%) were diagnosed as acute urticaria (group IA) and 36 (66.7%) were diagnosed as chronic (group IB). Thirty-three (61.1%) out of 54 urticarial (group I) patients were Blastocystis positive by stool culture and PCR. Out of these 33 patients, 21 were symptomatic and 12 were asymptomatic. The amoeboid form was found in 20 (95.2%) out of 21 symptomatic Blastocystis urticarial patients assuring their pathogenic potential. Of 50 normal control group (group II), four (8%) Blastocystis isolates were found with no amoeboid form. B. hominis subtype 3 was the only detected genotype in both groups. Of 20 symptomatic Blastocystis urticarial patients, 12 (60%) patients recovered symptomatically and parasitologically after one course of metronidazole. Recovery reached 100% on repeating the treatment for a second course with disappearance of the amoeboid form. It was concluded that acute urticaria of unknown etiology and chronic idiopathic urticaria patients who are resistant to the ordinary regimen of urticaria treatment might be examined for infection with B. hominis, in order to prescribe the proper specific anti-protozoan treatment.
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Boeke CE, Mora-Plazas M, Forero Y, Villamor E. Intestinal protozoan infections in relation to nutritional status and gastrointestinal morbidity in Colombian school children. J Trop Pediatr 2010; 56:299-306. [PMID: 20061400 DOI: 10.1093/tropej/fmp136] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
While Giardia duodenalis infection has been consistently associated with nutrient malabsorption and stunting in children, the effects of other protozoans on nutritional status or gastrointestinal morbidity are less clear. We sought to determine whether infection with common intestinal protozoans including Giardia duodenalis, Entamoeba coli and Blastocystis hominis was associated with anthropometric and micronutrient status, gastrointestinal symptoms, visits to the doctor or school absenteeism in children 5-12 years of age from Bogotá, Colombia. We obtained stool samples from 442 children enrolled in primary schools in 2006 and examined the presence of intestinal protozoans in relation to height, body mass index, plasma concentrations of vitamins A and B12, ferritin and zinc and erythrocyte folate. In addition, we examined the associations between protozoan infections and the incidence of common gastrointestinal symptoms, which were registered prospectively in morbidity diaries. The prevalence rates of G. duodenalis, E. coli and B. hominis infection were 6.3, 23.1 and 22.4%, respectively. Giardia infection was associated with lower height-for-age z-score (p = 0.04), whereas E. coli infection was associated with low erythrocyte folate (p = 0.04), and B. hominis infection was related to higher vitamin A levels (p = 0.05). Infection with E. coli was also associated with a significantly higher incidence of fever but fewer visits to the doctor, while B. hominis infection was associated with significantly less diarrhea, diarrhea with vomiting, doctor visits and school absenteeism. In conclusion, G. duodenalis and E. coli infections were associated with indicators of poor nutritional status in this population, while B. hominis was related to apparently decreased morbidity.
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Affiliation(s)
- Caroline E Boeke
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA
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Eroglu F, Koltas IS. Evaluation of the transmission mode of B. hominis by using PCR method. Parasitol Res 2010; 107:841-5. [PMID: 20544220 DOI: 10.1007/s00436-010-1937-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2010] [Accepted: 05/26/2010] [Indexed: 11/26/2022]
Abstract
Blastocystis hominis is a common intestinal parasite observed in fecal examination. On the other hand, the transmission of this parasite is certainly unknown. The transmission of B. hominis can be realized by animal contact and the contamination by water and food with excreted cysts from the reservoir hosts. B. hominis isolated from 25 humans, their pets, and tap water was identified by polymerase chain reaction using sequenced tag site primers in this study. B. hominis isolates obtained from humans and pets were identified as subtype1, subtype2, and subtype3 while B. hominis isolates obtained from tap water were also identified as subtype1. The B. hominis isolates obtained from humans in this study were defined as the same as the subtypes of the B. hominis isolates obtained from the pets, of which these people keep at their homes, and the tap water. These findings reveal that the source of B. hominis infection could be pets and tap water.
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Affiliation(s)
- Fadime Eroglu
- Parasitology Department, Medical Faculty, Cukurova University, Adana, Turkey.
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Yakoob J, Jafri W, Beg MA, Abbas Z, Naz S, Islam M, Khan R. Irritable bowel syndrome: is it associated with genotypes of Blastocystis hominis. Parasitol Res 2010; 106:1033-8. [PMID: 20177906 DOI: 10.1007/s00436-010-1761-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Accepted: 01/13/2010] [Indexed: 10/19/2022]
Abstract
Blastocystis hominis is the most common intestinal parasite in humans. An extensive genetic variability has been described recently in B. hominis isolates. The aim of this study was to analyze genotypes of B. hominis isolates obtained from the healthy individuals and patients with irritable bowel syndrome-diarrhea (IBS-D). The patients with IBS-D were enrolled from gastroenterology outpatient department at the Aga Khan University Hospital. History and physical examination was done. Stool microscopy, culture, and polymerase chain reaction for B. hominis genotyping were carried out. The study included 158 patients with IBS-D, mean age 41 +/- 15, age range 16-83 years, and male/female ratio of 109:49. One hundred fifty-seven (49.8%) were taken as healthy control. The dominant B. hominis genotypes were genotype 1 in 87 (65%) and type 3 in 49 (37%). In IBS-D, genotype 1 was present in 75 (86%; P < 0.001) compared to 12 (14%) in controls while type 3 was present in 23 (47%) compared to 26 (53%) in controls (P < 0.001), respectively. Infection with single genotype of B. hominis was present in 70 (73%) with IBS-D and in 26 (27%) in control group while with multiple genotypes in 25 (64%) in IBS-D and 14 (36%) in control group (P = 0.30), respectively. Majority of our patients had typeable B. hominis infection. The genotype of B. hominis in IBS-D was type 1 while in control genotype 3 was predominant.
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Affiliation(s)
- Javed Yakoob
- Department of Medicine, The Aga Khan University, Karachi, Pakistan.
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Souppart L, Moussa H, Cian A, Sanciu G, Poirier P, El Alaoui H, Delbac F, Boorom K, Delhaes L, Dei-Cas E, Viscogliosi E. Subtype analysis of Blastocystis isolates from symptomatic patients in Egypt. Parasitol Res 2009; 106:505-11. [PMID: 19953268 DOI: 10.1007/s00436-009-1693-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Accepted: 11/16/2009] [Indexed: 11/28/2022]
Abstract
Blastocystis sp. has been described as the most common intestinal parasite in humans and has an increased impact in public health. To improve our understanding of the molecular epidemiology of this human-emerging parasite, we determined the Blastocystis subtypes (STs) and their relative frequency in Egyptian patients living in or in the vicinity of Cairo and presenting gastrointestinal symptoms. We obtained a total of 20 stool samples identified as positive for Blastocystis by microscopic examination of smears. Genotyping using partial small subunit ribosomal RNA gene analysis identified a total of 21 Blastocystis isolates corresponding to 19 single infections and one mixed infection (ST1 and ST3). Three STs were identified: ST3 was the most common ST in the present Egyptian population (61.90%) followed by ST1 (19.05%) and ST2 (19.05%). Together with previous studies carried out in different areas in Egypt, a total of five STs (ST1, ST2, ST3, ST4, and ST6) have been found in symptomatic patients. These data were compared to those available in the literature, and we underlined variations observed in the number and relative proportions of STs between and within countries. On the whole, it seemed that Blastocystis infection is likely not associated with specific STs even if some STs are predominant in the epidemiologic studies, but rather with a conjunction of factors in the course of infection including environmental risk and parasite and host factors.
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Affiliation(s)
- Laetitia Souppart
- Inserm U547, Institut Pasteur de Lille, Université Lille Nord de France, 1 Rue du Professeur Calmette, BP 245, 59019 Lille Cedex, France
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PCR-based subtyping of Blastocystis isolates from symptomatic and asymptomatic individuals in a major hospital in Ankara, Turkey. Parasitol Res 2009; 106:263-8. [PMID: 19847459 DOI: 10.1007/s00436-009-1658-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Accepted: 10/08/2009] [Indexed: 10/20/2022]
Abstract
The stool samples obtained from 94 patients with gastrointestinal symptoms and 109 asymptomatic individuals, who checked in due to other reasons, admitted at a major hospital in Ankara, Turkey were examined with native Lugol's iodine, trichrome, and Kinyoun's acid-fast stainings for parasitology examinations and with in vitro culture method for detection of Blastocystis. In a total of 203 stool samples tested, native Lugol's iodine and trichrome stainings could detect 12 (5.9%) and 20 (9.9%) positive samples for Blastocystis, respectively. Conversely, culture method could detect 66 (32.5%) positive samples, and this method was more sensitive compared to the both microscopic examinations (p < 0.001). Among 66 positive samples for Blastocystis, 27 were from symptomatic patients and 39 were from asymptomatic group. Subtypes (STs) were determined by PCR using seven different sequence-tagged site primers. ST3 was the most dominant in both symptomatic and asymptomatic groups and followed by ST1 or ST2. There were mixed infections with STs 1 and 2 or STs 1 and 3 in nine isolates. There was no statistical significance of the distribution of Blastocystis sp. subtypes between symptomatic and asymptomatic individuals (p > 0.05).
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