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Boutahar M, Belaouni M, Ibrahimi A, Eljaoudi R, Aanniz T, Er-Rami M, Köster PC, Dashti A, Carmena D. Unveiling Blastocystis epidemiology in Morocco: subtype diversity among clinical patients with and without gastrointestinal manifestations in the Meknes region. Parasitol Res 2024; 123:273. [PMID: 39017986 DOI: 10.1007/s00436-024-08288-w] [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: 05/05/2024] [Accepted: 07/06/2024] [Indexed: 07/18/2024]
Abstract
Blastocystis is an intestinal protist frequently identified in humans and other animals, though its clinical significance remains controversial. This study aimed to determine the prevalence and genetic diversity of Blastocystis in faecal samples from symptomatic (n = 55) and asymptomatic (n = 50) individuals seeking medical care in Meknes, Morocco. Detection of the protist was accomplished through coproparasitological examination and culture in Jones medium. Culture-positive samples were subjected to molecular analyses (PCR and Sanger sequencing) based on sequences of the small subunit ribosomal RNA gene. Epidemiological questionnaires on demographics and potential risk factors were collected from participating patients. The overall Blastocystis infection rate was 51.4% (54/105), with no differences between symptomatic (52.7%, 29/55) and asymptomatic (50.0%, 25/50) individuals. Sequence analyses identified three Blastocystis subtypes, with ST3 being the most prevalent (42.0%), followed by ST1 (34.0%), and ST2 (12.0%). Regarding intra-subtype diversity, allele 4 was found within ST1; alleles 11/12 and alleles 34/36 (alone or in combination) were identified within ST2 and ST3 respectively. Allele 34 in ST3 (40.8%) and allele 4 in ST1 (34.7%) were the most common genetic variants circulating in the surveyed clinical population. A statistically significant association between ST2 and the presence of flatulence was observed. This is the first study assessing the epidemiology and genetic diversity of Blastocystis sp. in the Meknes region, Morocco.
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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, Morocco
| | - Azeddine Ibrahimi
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, 10100, Rabat, Morocco
- Mohammed VI Center for Research & Innovation (CM6), 10000, Rabat, Morocco
- Mohammed VI University of Health Sciences, 20000, Casablanca, Morocco
| | - Rachid Eljaoudi
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, 10100, Rabat, Morocco
- Mohammed VI Center for Research & Innovation (CM6), 10000, Rabat, Morocco
- Emergency Department, Military Hospital Mohammed V, 10000, Rabat, Morocco
| | - Tarik Aanniz
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, 10100, Rabat, Morocco
| | - Mohammed Er-Rami
- Parasitology-Mycology Laboratory, Moulay Ismaïl Military Hospital, Meknes, Morocco
- Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine and Pharmacy, Fez, Morocco
| | - Pamela C Köster
- Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
- Faculty of Health Sciences, Alfonso X El Sabio University (UAX), Villanueva de La Cañada, Madrid, Spain
- Faculty of Medicine, Alfonso X El Sabio University (UAX), Villanueva de La Cañada, Madrid, Spain
| | - Alejandro Dashti
- Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - David Carmena
- Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
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Molaei S, Asfaram S, Mashhadi Z, Mohammadi-Ghalehbin B, Iranpour S. Insights into parasites and COVID-19 co-infections in Iran: a systematic review. Trans R Soc Trop Med Hyg 2024; 118:350-358. [PMID: 38288655 DOI: 10.1093/trstmh/trae001] [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: 05/27/2023] [Revised: 11/28/2023] [Accepted: 01/23/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND It is well-documented that using immunosuppressive drugs such as corticosteroids or cytokine blockers in treating coronavirus disease 2019 (COVID-19) increases the risk of co-infections. Here we systematically summarized the cases of COVID-19-associated parasitic infections (CAPIs) in Iran. METHODS From 19 February 2020 to 10 May 2023, all studies on Iranian patients suffering from CAPIs were collected from several databases using a systematic search strategy. RESULTS Of 540 records, 11 studies remained for data extraction. In this research, most of the studies were related to Lophomonas and Toxoplasma. Of 411 cases of CAPIs, toxoplasmosis (385 [93.7%]) had the highest rate of infection among Iranian patients, followed by blastocystosis (15 [3.6%]), fascioliasis (4 [0.97%]), leishmaniasis (3 [0.7%]), lophomoniasis (3 [0.7%]) and strongyloidiasis (1 [0.2%]). In general, Blastocystis enhanced diarrhoea in patients with COVID-19. Lophomonas, Toxoplasma and Strongyloides increased the severity of COVID-19, but Fasciola decreased its intensity. Patients with a history of cutaneous leishmaniasis showed mild symptoms of COVID-19. Also, patients with a prior history of hydatid cysts were not affected by COVID-19. CONCLUSIONS Due to the similar symptoms of some parasitic diseases and COVID-19 and immunosuppressive treatment regimens in these patients that may cause the reactivation or recurrence of parasitic infections, early diagnosis and treatment are required.
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Affiliation(s)
- Soheila Molaei
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Shabnam Asfaram
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Zahra Mashhadi
- School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Behnam Mohammadi-Ghalehbin
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
- Department of Microbiology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Sohrab Iranpour
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
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Adao DEV, Rivera WL. Subtype-host patterns and genetic differentiation of Blastocystis sp. in the Philippines. Heliyon 2024; 10:e29019. [PMID: 38601700 PMCID: PMC11004820 DOI: 10.1016/j.heliyon.2024.e29019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024] Open
Abstract
Blastocystis sp. is a gastrointestinal protozoan commonly encountered in humans and animals. Specificity to certain hosts may be associated with 38 known subtypes (STs) and 8 nonmammalian and avian STs (NMASTs). This can be determined by analyzing ST-host associations, ST-allele data, genetic variability analyses, and fixation index (FST) with sufficient data present. Thus, newly acquired and previously published data on Blastocystis sp. STs and NMASTs from the Philippines were compiled to determine the following: (1) ST-host associations, (2) ST-allele diversity per ST in certain hosts/sources, (3) intrasubtype diversity of certain STs found in different hosts using genetic variability analysis, and (4) comparison of similarities between specific ST populations to determine if these are the same circulating populations using FST. A total of 448 samples subtyped using both sequence-tagged site primers and the 600-bp barcoding region of the Blastocystis sp. SSU rRNA gene were analyzed in this study. Patterns of association for the Philippine samples were similar to those from neighboring Southeast Asian countries and around the world: ST1-ST4 were found in humans but ST3 was the most common, ST5 were found in pigs, and ST6 and ST7 were found in poultry. Blastocystis sp. from humans are mostly the same ST alleles (ST3 allele 34 and ST1 allele 4) while 3-5 ST alleles were found in the most common STs in pigs, macaques, and poultry. Also, ST1, ST3, ST5, and NMAST I are undergoing population expansion according to genetic variability analyses through possible addition of new alleles based on ST-allele diversity. Moreover, FST shows the same circulating population of ST1 in humans, pigs, and water indicating a possible waterborne route of cross-transmission. In contrast, ST3 found in humans possibly come from the same circulating population and is genetically distinct from those in nonhuman sources.
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Affiliation(s)
- Davin Edric V. Adao
- Pathogen–Host–Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City, 1101, Philippines
| | - Windell L. Rivera
- Pathogen–Host–Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City, 1101, Philippines
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Marangi M, Boughattas S, De Nittis R, Pisanelli D, Delli Carri V, Lipsi MR, La Bella G, Serviddio G, Niglio M, Lo Caputo S, Margaglione M, Arena F. Prevalence and genetic diversity of Blastocystis sp. among autochthonous and immigrant patients in Italy. Microb Pathog 2023; 185:106377. [PMID: 37839760 DOI: 10.1016/j.micpath.2023.106377] [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: 07/27/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
The prevalence of Blastocystis sp., its genetic diversity and the distribution of circulating subtypes (STs) were molecularly investigated in a cohort of autochthonous and immigrant patients with gastrointestinal symptoms hospitalized over the period February 2022-June 2023 at the Policlinico Ospedaliero-Universitario "Riuniti", Foggia, in Southern Italy. The population variables, including patient geographical origin, gender and age classes were reported. Out of the 927 investigated patients, 36 (3.9%) were positive for Blastocystis sp. A statistically significant association with African origin and age classes >18 years old was found. ST1 (allele 4), ST2 (alleles 9, 13), ST3 (alleles 34, 36) and ST4 (allele 92) were the subtypes detected with a different distribution between autochthonous and immigrant patients. Co-infections with enteric protozoa such as Giardia duodenalis and Dientamoeba fragilis, pathogenic bacteria as Clostridioides difficile, Campylobacter jejuni and Aeromonas sp. and viral infections such as Norovirus were found in 33% of cases. This is the first study of Blastocystis sp., its circulating subtypes and allele variability among patients with different geographical origin in an area of Southern Italy, in the Central Mediterranean, characterized by high immigrant pressure. These results provide baseline data to better investigate a potential interaction between Blastocystis sp. and other risk factors in patients with gastrointestinal symptoms.
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Affiliation(s)
- Marianna Marangi
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | | | - Rosella De Nittis
- Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Daniela Pisanelli
- Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Valeria Delli Carri
- Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Maria Rosaria Lipsi
- Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Gianfranco La Bella
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy; Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, Foggia, Italy.
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Mariangela Niglio
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Sergio Lo Caputo
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Maurizio Margaglione
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Fabio Arena
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy; Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
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Hernández-Castro C, Maloney JG, Agudelo-López SP, Toro-Londoño MA, Botero-Garcés JH, Orozco MC, Quintero-Quinchia YC, Correa-Cote JC, Múnera-Duque A, Ricaurte-Ciro JC, Londoño-Álvarez LI, Escobar RM, Köster PC, Sánchez S, Carmena D, Santín M. Identification and validation of novel Blastocystis subtype ST41 in a Colombian patient undergoing colorectal cancer screening. J Eukaryot Microbiol 2023; 70:e12978. [PMID: 37195413 DOI: 10.1111/jeu.12978] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/18/2023]
Abstract
Blastocystis sp. is among the most frequent intestinal protists identified in humans globally. However, characterization of Blastocystis subtype diversity in humans is ongoing. We report here the identification of novel Blastocystis subtype ST41 in a Colombian patient undergoing colorectal cancer screening involving colonoscopy and fecal testing (microscopy, culture, PCR). The full-length ssu rRNA gene sequence of the protist was generated using MinION long-read sequencing technology. The validity of the novel subtype was confirmed via phylogenetic and pairwise distance analyses of the full-length ST41 sequence and all other valid subtypes. The study provides reference material essential for conducting subsequent experimental studies.
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Affiliation(s)
- Carolina Hernández-Castro
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Madrid, Spain
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín, Colombia
| | - Jenny G Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Maryland, USA
| | - Sonia P Agudelo-López
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín, Colombia
| | - Miguel A Toro-Londoño
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín, Colombia
| | - Jorge H Botero-Garcés
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín, Colombia
| | - María C Orozco
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín, Colombia
| | - Yulieth C Quintero-Quinchia
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín, Colombia
| | | | | | | | | | | | - Pamela C Köster
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Madrid, Spain
| | - Sergio Sánchez
- Food and Waterborne Bacterial Infections Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Madrid, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Madrid, Spain
- Center for Biomedical Research Network (CIBER) in Infectious Diseases, Health Institute Carlos III, Madrid, Spain
| | - Mónica Santín
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Maryland, USA
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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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Hussein EM, Muhammad MAA, Hussein AM, Elzagawy SM, Zaki WM, Temsah AG, Badr MS, Alabbassy MM. Levels of Genetic Variants Among Symptomatic Blastocystis Subtypes and their Relationship to Mucosal Immune Surveillance in the Precancerous Colons of Experimentally Infected Rats. Acta Parasitol 2023; 68:70-83. [PMID: 36380160 PMCID: PMC10011339 DOI: 10.1007/s11686-022-00628-z] [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: 03/25/2022] [Accepted: 10/03/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The relationship between the genetic diversity of Blastocystis and immune surveillance in precancerous colons with blastocystosis is still under investigation. This study aimed to identify the genetic Blastocystis variants among 54 symptomatic human isolates and their relationship to mucosal immune surveillance in the precancerous polyps of experimentally infected rats. METHODS Polymerase chain reaction and high-resolution melting (PCR/HRM) curves discriminated human symptomatic Blastocystis isolates into subtypes (STs)/intrasubtypes, which were orally administered to rats to induce experimental infection. Then, the mucosal immune responses of the infected colons were evaluated in relation to polyp formation through immunostaining to identify mucus MUC2 and determine mucosal immune cell (goblet, lymphocyte and mast) counts, secretory IgA levels and parasitic intestinal invasion. RESULTS ST1, ST3, and ST4 were found in 18.5% (10/54), 54.7% (29/54), and 27.8% (15/54) of the samples, respectively. Then, the HRM curve discriminated ST3 into the wild, mutant, and heterozygous [17/54 (31.5%), 5/54 (9.3%), and 7/54 (12.9%)] intrasubtypes. ST1 and ST4 had no genetic variations. Precancerous polyps were detected in the colons of 40.5% of the infected rats. ST1 constituted 14.7% of these cases, while the wild, mutant, and heterozygous intrasubtypes of ST3 showed polyps in 12.9%, 5.5%, and 5.5% of cases, respectively. Only 1.9% of the polyps were related to ST4. MUC2 showed weak immunostaining in 44.5% of the infected colons, and 38.9% were polyp inducers. Low goblet cell numbers and high interepithelial lymphocyte counts were significantly associated with polyp formation, particularly with ST1 and wild ST3. Among the polyp inducers, high numbers of mast cells were detected in wild ST3 and ST4, while a low number was found with heterozygous ST3. The level of secretory IgA was low in polyp-inducing STs. Most of the results were statistically significant. CONCLUSION Immunosurveillance showed a potential relationship between ST1 and the ST3 intrasubtypes and precancerous polyps. This relationship may provide insight into the prevention and/or development of new immunotherapeutic strategies to combat colorectal cancer.
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Affiliation(s)
- Eman M Hussein
- Medical Parasitology Department, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt.
| | - Muhammad A A Muhammad
- Pathology Department, Faculty of Medicine, Suez Canal, University, Ismailia, 41522, Egypt
| | - Abdalla M Hussein
- Bio-Physics Department, Faculty of Science, Al-Azhar University, Cairo, 11652, Egypt
| | - Sherine M Elzagawy
- Medical Parasitology Department, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Wafaa M Zaki
- Medical Parasitology Department, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Ashraf G Temsah
- Medical Parasitology Department, Faculty of Medicine, Damietta Branch, AL Azhar University, Damietta, Egypt
| | - Mohamed S Badr
- Medical Genetic Centre, Molecular Biology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Maha M Alabbassy
- Medical Parasitology Department, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
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Cobuccio LG, Laurent M, Gardiol C, Wampfler R, Poppert S, Senn N, Eperon G, Genton B, Locatelli I, de Vallière S. Should we treat Blastocystis sp.? A double-blind placebo-controlled randomized pilot trial. J Travel Med 2023; 30:6849435. [PMID: 36440639 DOI: 10.1093/jtm/taac143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Blastocystis sp. is a worldwide-distributed protist colonizing the guts of humans and a great variety of animals. It is unclear whether it is just a commensal or an infectious parasite that prompts eradication.The main objective of this study was to evaluate the usefulness of metronidazole in patients with gastrointestinal symptoms harbouring only Blastocystis sp. In addition, we explored whether Blastocystis subtype or concomitant parasitic infection detected by polymerase chain reaction (PCR) may influence treatment outcome. METHODS We included adults with persistent gastrointestinal symptoms (>14 days) visiting a primary care physician and in whom stool microscopy revealed only Blastocystis sp. Eligible patients were randomized to receive 10 days of metronidazole or placebo, followed by a crossover if still symptomatic. The primary outcome was normal stool consistency. Secondary outcomes were the changes in other abdominal symptoms (bloating, flatulence, abdominal pain, number of daily bowel movements) and general wellbeing. After the clinical phase of the study, Blastocystis subtypes were determined by PCR sequencing and stool samples were tested for 11 other protozoa with an in-house PCR. RESULTS We screened 581 outpatients for inclusion, of which 50 met the eligibility criteria. There was no difference in the primary outcome, nor any of the secondary outcomes between the subjects treated with metronidazole and placebo.The most frequent Blastocystis subtypes were ST4 (11/36) and ST2 (10/36). The in-house PCR was positive for other protozoa in 25% (10/40) of the patients. We identified Dientamoeba fragilis in 5, Entamoeba dispar in 3 and Cyclospora cayetanensis in 2 patients. Stratified analysis according to Blastocystis subtype or the presence of other protozoa showed no significant difference in treatment outcome with metronidazole or placebo. CONCLUSIONS Among patients infected with Blastocystis sp., metronidazole, compared with placebo, was not better in improving gastrointestinal symptoms, irrespective of subtype or microscopically undetected coinfection with other protozoa.
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Affiliation(s)
- Ludovico Gennaro Cobuccio
- Travel Clinic, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Marie Laurent
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Celine Gardiol
- Travel Clinic, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Rahel Wampfler
- Diagnostic Center, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sven Poppert
- Diagnostic Center, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicolas Senn
- Travel Clinic, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Gilles Eperon
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Blaise Genton
- Travel Clinic, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Research and Innovation, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Isabella Locatelli
- Department of Research and Innovation, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Serge de Vallière
- Travel Clinic, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Infectious Diseases Service, University Hospital, Lausanne, Switzerland
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Frequency, subtypes distribution, and risk factors of Blastocystis spp. in COVID-19 patients in Tehran, capital of Iran: A case-control study. New Microbes New Infect 2022; 51:101063. [PMID: 36514342 PMCID: PMC9733120 DOI: 10.1016/j.nmni.2022.101063] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Background Recent theories on the possible interactions between the intestinal parasites and COVID-19 have stated that these co-infections may cause immune imbalance and further complications in the affected patients. Until now, there is no data about Blastocystis subtypes as an intestinal parasite in COVID-19 patients. Therefore, the present work was done to evaluate the molecular prevalence of Blastocystis spp. and related risk factors in Iranian patients with COVID-19. Method Stool samples were gathered from 200 COVID-19 patients and 200 control, being matched regarding age, gender and residence. Then, stool samples were surveyed by parasitological methods, including direct slide smear and formalin-ether concentration. In the following, PCR and sequencing were used to detect Blastocystis spp. and their subtypes. Results The frequency of Blastocystis spp. in patients with COVID-19 (7.5%; 15/200 by molecular method vs. 6%; 12/200 by microscopy method) was slightly higher than in individuals without COVID-19 (4.5%; 9/200 by molecular method vs. 4%; 8/200 by microscopy method), this difference was not statistically significant (P value = 0.57 for molecular method vs. P value = 0.81 for microscopy method). Regarding associated factors for Blastocystis spp., we found significant differences regarding the residence (rural), loose and watery stool with diarrhea, and duration of treatment (6 weeks <) in the COVID-19 group. Blastocystis ST3 was the most common subtype in the patients with COVID-19 and control group. Conclusions Based on this results, health education, improved sanitation and good personal hygiene are highly recommended to prevent Blastocystis in COVID-19 patients.
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10
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Subtypes and phylogenetic analysis of Blastocystis sp. isolates from West Ismailia, Egypt. Sci Rep 2022; 12:19084. [PMID: 36351984 PMCID: PMC9873628 DOI: 10.1038/s41598-022-23360-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
In Egypt, Blastocystis sp. is not yet on the diagnostic list of parasitology reports, and information about its subtypes (STs) is scarce. This study investigated its prevalence and its STs/alleles, performed phylogenetic analysis, and considered the distribution of risk factors associated with Blastocystis sp. infections in West Ismailia, Ismailia governorate. Sociodemographic data, exposure factors, and previous parasitic infection status were recorded for symptomatic and asymptomatic individuals. Microscopy, polymerase chain reaction, sequencing, and phylogenetic analysis for Blastocystis sp. isolated from fecal samples were performed. Eighty Blastocystis sp.-infected individuals (15.3%) were examined. The age of the individuals ranged between 0.60 and 85.0 (mean 17.10 ± 15.70), the male/female ratio was 33/47, and the asymptomatic/symptomatic ratio was 55/25. The findings demonstrate clear evidence of direct contact with animals, poor water quality, and previous parasitic infections. Eleven samples yielded three Blastocystis STs (ST1: allele 4, ST2: alleles 9 and 12, and ST3: allele 34), with ST3 (45.5%) representing the most common subtype. Phylogenetic analysis with a robust bootstrap revealed three distinct clades for isolates of each subtype. This study updates the epidemiological knowledge of the distribution of Blastocystis sp. STs in Egypt and expands the current understanding of the prevalence, risk factor frequencies, and genetic diversity of this protist in the studied area.
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11
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Bertozzo TV, David ÉB, Oliveira-Arbex AP, Victória C, Guimarães S. Frequency, spatial distribution, and genetic diversity of Blastocystis among referred individuals to a clinical laboratory: First report of subtype 9 in Brazil. Acta Trop 2022; 234:106608. [PMID: 35841954 DOI: 10.1016/j.actatropica.2022.106608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/13/2022] [Accepted: 07/12/2022] [Indexed: 12/17/2022]
Abstract
The enteric protist Blastocystis has a worldwide distribution, however its prevalence in the human population is still underestimated, especially in developing countries where proper diagnosis is not performed in the routine of clinical laboratories. In this study, we aimed to assess the frequency, genetic diversity, and spatial distribution of Blastocystis isolates detected in fecal samples referred to a clinical laboratory for routine examination in inner São Paulo State, Brazil. A total of 348 leftover stool samples available for disposal from female and male individuals with age ranging from 3 months to 88 years were analyzed by both microscopic examination and PCR/sequencing of the SSU rRNA gene. The overall frequency of Blastocystis sp. was 31% (108/348), including 20.1% (70/348) and 31% (108/348) by microscopic examination and PCR/sequencing, respectively. Significant association was found only between Blastocystis infection and age, since the highest rate of positive samples was detected among 5-9 years old individuals (p < 0.0001). In addition, spatial distribution revealed a wide distribution of the positive samples, however they were densely concentrated in more populated areas. Seven subtypes were identified, namely ST1 (40.7%), ST2 (9.2%), ST3 (45.3%), ST4 (0.9%), ST6 (1.8%), ST7 (0.9%) and ST9 (0.9%). The intra-subtype analysis revealed a total of 25 different alleles previously reported. Here, the findings lead us to highlight the following aspects: (1) the identification of a ST9 isolate is a relevant finding since it is considered a very rare subtype in human infections as well as this is the first report in Brazil; (2) the high frequency of Blastocystis in fecal samples submitted for examination in a clinical laboratory points to the need to consider its search in routine parasitological examinations, (3) the spatial distribution of Blastocystis infection was not homogeneous but concentrated in more populated areas where the access for population to diagnostic services in healthcare is likely to be easier and, (4) the genetic variability of Blastocystis isolates suggests exposure of inhabitants living in inner municipalities to different sources of contamination involving anthroponotic and zoonotic transmission pathways.
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Affiliation(s)
- Thainá Valente Bertozzo
- Tropical Diseases Posgraduate Program, Medical School, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Érica Boarato David
- Department of Health Sciences, Sacred Heart University Center (UNISAGRADO), Bauru, SP, Brazil
| | | | - Cassiano Victória
- Faculty of Veterinary Medicine and Animal Science, Department of Animal Production and Preventive Veterinary Medicine, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Semíramis Guimarães
- Division of Parasitology, Institute of Bioscience, São Paulo State University (UNESP), Campus de Botucatu, PO Box: 510, Botucatu, SP CEP 18618-689, Brazil.
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12
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Su C, Mei X, Wei L, Wang J, Feng X, Wang P, He B, Chang Y, Xu F, Wang M, Tian X, Zhang Z, Li X, Wang S. Prevalence and molecular subtyping of Blastocystis in domestic pigeons in Henan Province, Central China. J Eukaryot Microbiol 2022; 69:e12888. [PMID: 35007363 DOI: 10.1111/jeu.12888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022]
Abstract
Blastocystis is an anaerobic intestinal protozoan parasite found in humans and many kinds of animals that mainly causes diarrhea, abdominal pain and other clinical symptoms. At present, research on the prevalence and subtype diversity of Blastocystis in domestic pigeons is very limited. The purpose of this study was to detect the infection rate and gene subtype distribution of Blastocystis in domestic pigeons in Henan Province, Central China, to provide a foundation for preventing and controlling Blastocystis in domestic pigeons. Fecal DNA was extracted from 504 fresh fecal samples of pigeons collected from 4 areas in Henan Province, Central China. All DNA samples were investigated by polymerase chain reaction (PCR), and positive samples were sequenced to analyze the gene subtypes based on small ribosomal subunit (SSU rRNA) gene. The overall infection rate of Blastocystis in pigeons in Henan Province was 7.7% (39/504). Four subtypes (STs) of Blastocystis were identified including ST1 (2/39, 5.1%), ST3 (16/39, 41.0%), ST4 (1/39, 2.6%) and ST7 (20/39, 51.3%), all of which belonged to zoonotic subtypes, and ST7 was the dominant gene subtype. The results show that Blastocystis infection is common in domestic pigeons in Henan Province, Central China, and the pathogen were zoonotic subtypes. Particular attention should be given to reducing the risk of transmission of Blastocystis from domestic pigeons to humans.
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Affiliation(s)
- Changwei Su
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Xuefang Mei
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Lai Wei
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Jiawen Wang
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Xia Feng
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Pei Wang
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Bo He
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Yuan Chang
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Fuyang Xu
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Mingyong Wang
- Xinxiang Key Laboratory of Immunoregulation and Molecular Diagnostics, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Xiaowei Tian
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Zhenchao Zhang
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
| | - Xiangrui Li
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China.,MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095, PR China
| | - Shuai Wang
- Xinxiang Key Laboratory of Pathogenic Biology, Department of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003, PR China
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Kosik-Bogacka D, Lepczyńska M, Kot K, Szkup M, Łanocha-Arendarczyk N, Dzika E, Grochans E. Prevalence, subtypes and risk factors of Blastocystis spp. infection among pre- and perimenopausal women. BMC Infect Dis 2021; 21:1125. [PMID: 34724915 PMCID: PMC8559403 DOI: 10.1186/s12879-021-06815-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background Blastocystis spp. are considered pathogenic or commensal organisms, although the majority of researchers suggest that these are neglected pathogens. The main aim of this study was to determine the prevalence and subtype distribution of Blastocystis spp. in pre- and perimenopausal women, with respect to socio-demographic (age and place of residence), and epidemiological factors, as well as drinking tap water, contact with domestic animals, traveling abroad, health status, and presence of gastrointestinal symptoms. Additionally, the objective was to compare hematological and biochemical parameters of Blastocystis spp. infected and uninfected women. Methods The study included 425 women aged 45–60. Their stool samples were examined microscopically and analyzed by a conventional polymerase chain reaction (cPCR). Results Blastocystis spp. were detected in 6.1% of pre- and perimenopausal women. Molecular analysis of the stool samples identified seven Blastocystis subtypes (ST1–ST4, ST6, ST7, and ST9). Blastocystis subtypes 2 and 3 were the most prevalent. The presence of Blastocystis spp. was not significantly related to socio-demographic and epidemiological factors. There were also no significant associations between Blastocystis spp. and blood parameters, or gastrointestinal symptoms. Conclusion This study complements the limited available data on the prevalence of Blastocystis spp. in pre- and perimenopausal women. It is also the first report showing the presence of Blastocystis subtype 9 in Poland.
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Affiliation(s)
- Danuta Kosik-Bogacka
- Independent Laboratory of Pharmaceutical Botany, Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Małgorzata Lepczyńska
- Department of Medical Biology, School of Public Health, University of Warmia and Mazury, Żołnierska 14 C, 10-561, Olsztyn, Poland
| | - Karolina Kot
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210, Szczecin, Poland
| | - Natalia Łanocha-Arendarczyk
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Ewa Dzika
- Department of Medical Biology, School of Public Health, University of Warmia and Mazury, Żołnierska 14 C, 10-561, Olsztyn, Poland
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210, Szczecin, Poland
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Hernández PC, Morales L, Chaparro-Olaya J, de Avila J, Bautista-Molano W, Bello-Gualtero J, Beltrán-Ostos A, Romero-Sánchez C. Frequency and distribution of Blastocystis sp. subtypes in patients with spondyloarthritis in Bogotá, Colombia. Parasite Epidemiol Control 2021; 15:e00227. [PMID: 34667886 PMCID: PMC8507199 DOI: 10.1016/j.parepi.2021.e00227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/26/2021] [Accepted: 09/30/2021] [Indexed: 11/04/2022] Open
Abstract
Although Blastocystis sp. is one of the most prevalent intestinal parasites worldwide, its role as a pathogen remains unclear. The use of molecular techniques to assess the genetic heterogeneity of Blastocystis sp. has become important to understand its function in some intestinal pathologies and if it is a key component of intestinal microbiota. Spondyloarthritis is a group of immune-mediated autoinflammatory diseases in which microbial dysbiosis in the gut (including parasites, bacteria and fungi) and intestinal inflammation are common features apparently associated with the pathophysiology of these disorders. This study included 74 patients diagnosed with spondyloarthritis and 57 systemically healthy individuals (included as controls), who were screened for intestinal parasites. Blastocystis sp. was detected in 68% and 73% of the patients with spondyloarthritis and controls, respectively. In faecal samples positive for Blastocystis sp., an 18S rRNA gene fragment of Blastocystis sp. was amplified and sequenced to identify their genetic sub-types. Patients with spondyloarthritis showed similar frequencies of ST1, ST2 and ST3 subtypes of Blastocystis sp. (30% each). The same subtypes were observed in controls, wherein almost 60% of the samples showed ST3. In addition, ST6 was found only in one sample from each group. ST1 subtype showed the greatest genetic variability. Although the same subtypes were detected in both patients with spondyloarthritis and controls, subtype prevalence studies conducted in Colombia indicate an association between ST3 and individuals with irritable bowel syndrome. This opens an interesting research avenue to further study of the epidemiology of Blastocystis sp. and its possible relationship with intestinal conditions in immunocompromised patients.
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Affiliation(s)
- Paula C Hernández
- Universidad El Bosque, Vicerrectoría de Investigaciones, Laboratorio de Parasitología Molecular, Bogotá, Colombia
| | - Liliana Morales
- Universidad El Bosque, Vicerrectoría de Investigaciones, Laboratorio de Parasitología Molecular, Bogotá, Colombia
| | - Jacqueline Chaparro-Olaya
- Universidad El Bosque, Vicerrectoría de Investigaciones, Laboratorio de Parasitología Molecular, Bogotá, Colombia
| | - Juliette de Avila
- Universidad El Bosque, Facultad de Odontología, Grupo de Inmunología Celular y Molecular -INMUBO, Bogotá, Colombia
| | - Wilson Bautista-Molano
- Universidad El Bosque, Facultad de Odontología, Grupo de Inmunología Celular y Molecular -INMUBO, Bogotá, Colombia.,Hospital Militar, Servicio de Reumatología e Inmunología, Universidad Militar Nueva Granada, Facultad de Medicina, Grupo de Inmunología Clínica Aplicada, Bogotá, Colombia
| | - Juan Bello-Gualtero
- Hospital Militar, Servicio de Reumatología e Inmunología, Universidad Militar Nueva Granada, Facultad de Medicina, Grupo de Inmunología Clínica Aplicada, Bogotá, Colombia
| | - Adriana Beltrán-Ostos
- Hospital Militar, Servicio de Reumatología e Inmunología, Universidad Militar Nueva Granada, Facultad de Medicina, Grupo de Inmunología Clínica Aplicada, Bogotá, Colombia
| | - Consuelo Romero-Sánchez
- Universidad El Bosque, Facultad de Odontología, Grupo de Inmunología Celular y Molecular -INMUBO, Bogotá, Colombia.,Hospital Militar, Servicio de Reumatología e Inmunología, Universidad Militar Nueva Granada, Facultad de Medicina, Grupo de Inmunología Clínica Aplicada, Bogotá, Colombia
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15
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Sarzhanov F, Dogruman-Al F, Santin M, Maloney JG, Gureser AS, Karasartova D, Taylan-Ozkan A. Investigation of neglected protists Blastocystis sp. and Dientamoeba fragilis in immunocompetent and immunodeficient diarrheal patients using both conventional and molecular methods. PLoS Negl Trop Dis 2021; 15:e0009779. [PMID: 34613993 PMCID: PMC8494357 DOI: 10.1371/journal.pntd.0009779] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/30/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction The clinical significance of Blastocystis sp. and Dientamoeba fragilis in patients with gastrointestinal symptoms is a controversial issue. Since the pathogenicity of these protists has not been fully elucidated, testing for these organisms is not routinely pursued by most laboratories and clinicians. Thus, the prevalence of these organisms and the subtypes of Blastocystis sp. in human patients in Turkey are not well characterized. This study aimed to determine the prevalence of Blastocystis sp. and D. fragilis in the diarrheic stool samples of immunodeficient and immunocompetent patients using conventional and molecular methods and to identify Blastocystis sp. subtypes using next generation sequencing. Material and methods Individual stool specimens were collected from 245 immunodeficient and 193 immunocompetent diarrheic patients between March 2017 and December 2019 at the Gazi University Training and Research Hospital in Ankara, Turkey. Samples were screened for Blastocystis sp. and D. fragilis by conventional and molecular methods. Molecular detection of both protists was achieved by separate qPCRs targeting a partial fragment of the SSU rRNA gene. Next generation sequencing was used to identify Blastocystis sp. subtypes. Results The prevalence of Blastocystis sp. and D. fragilis was 16.7% and 11.9%, respectively as measured by qPCR. The prevalence of Blastocystis sp. and D. fragilis was lower in immunodeficient patients (12.7% and 10.6%, respectively) compared to immunocompetent patients (21.8% and 13.5%, respectively). Five Blastocystis sp. subtypes were identified and the following subtype distribution was observed: ST3 54.4% (n = 37), ST2 16.2% (n = 11), ST1 4.4% (n = 3), ST6 2.9% (n = 2), ST4 1.5% (n = 1), ST2/ST3 11.8% (n = 8) and ST1/ST3 8.8% (n = 6). There was no statistically significant difference in the distribution of Blastocystis sp. subtypes between immunocompetent and immunodeficient patients. Conclusion and recommendation Our findings demonstrated that Blastocystis sp. and D. fragilis are commonly present in immunocompetent and immunodeficient patients with diarrhea. This study is the first to use next generation sequencing to address the presence of Blastocystis sp. mixed subtypes and intra-subtype variability in clinical samples in Turkey. Blastocystis sp. and Dientamoeba fragilis are single-cell parasites of the human intestine which are common worldwide and reported in cases with gastrointestinal symptoms. However, the role of Blastocystis sp. and D. fragilis in patients with gastrointestinal symptoms is still controversial because their presence is not always associated with symptoms. As some intestinal parasitic infections can cause severe illness in immunocompromised individuals careful consideration of intestinal protist infection is warranted. However, testing for Blastocystis sp. and D. fragilis is not routinely carried out by most laboratories and clinicians. Therefore, this study aimed to determine the prevalence of Blastocystis sp. and D. fragilis in immunocompetent and immunosuppressed patients with diarrhea by conventional and molecular methods. Both Blastocystis sp. and D. fragilis were detected more frequently by quantitative polymerase chain reaction than by conventional methods. Next generation sequencing was used to characterize the diversity and frequency of Blastocystis sp. subtypes and mixed subtypes in patients in Turkey. Five Blastocystis sp. subtypes (ST1, ST2, ST3, ST4 and ST6) were detected. ST3 was the most frequent subtype in both immunocompetent and immunosuppressed patients. Mono-infections were more common than mixed subtype infections. Our findings showed that Blastocystis sp. and D. fragilis are commonly present in immunocompetent and immunodeficient patients with diarrhea.
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Affiliation(s)
- Fakhriddin Sarzhanov
- Division of Medical Parasitology, Department of Medical Microbiology, School of Medicine, Gazi University, Ankara, Turkey
- Akhmet Yassawi International Kazakh-Turkish University, Faculty of Medicine, Turkestan, Kazakhstan
| | - Funda Dogruman-Al
- Division of Medical Parasitology, Department of Medical Microbiology, School of Medicine, Gazi University, Ankara, Turkey
- * E-mail: ,
| | - Monica Santin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Maryland, United States of America
| | - Jenny G. Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Maryland, United States of America
| | - Ayse Semra Gureser
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
| | - Djursun Karasartova
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
- Department of Medical Microbiology, Faculty of Medicine, TOBB- University of Economics and Technology, Ankara, Turkey
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Kaczmarek A, Sobociński W, Wesołowska M, Gołąb E, Kołodziej-Sobocińska M, Sałamatin R. Blastocystis occurrence and subtype diversity in wild European terrestrial mammals - The case of Białowieża Primeval Forest (NE Poland). INTERNATIONAL JOURNAL FOR PARASITOLOGY-PARASITES AND WILDLIFE 2021; 16:120-125. [PMID: 34552843 PMCID: PMC8441101 DOI: 10.1016/j.ijppaw.2021.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/28/2021] [Accepted: 08/28/2021] [Indexed: 11/04/2022]
Abstract
Blastocystis cf. Blastocystis hominis is the most common unicellular parasite found in human and animal intestines. Little is known about the life cycle, transmission and mechanisms of pathogenesis for this parasite. The aim of this study was to obtain new data on the genetic diversity of Blastocystis in selected species of mammals found in the Białowieża Primeval Forest (BPF), Poland, the best preserved lowland forest in temperate Europe. 113 faecal samples were collected in the period 2018–2020 from seven species of wild mammals occurring within the Polish part of BPF and its surroundings. Blastocystis was detected by molecular amplification and sequencing the small subunit rRNA gene. The overall prevalence of Blastocystis in animals was 8.9%. A larger number of stool samples (90) were collected from European bison and only for this species was it possible to calculate the prevalence of infection (5.6%). The isolates obtained from European bison were classified as ST1, ST3, ST5, ST7. Blastocystis was also detected in the grey wolf (Canis lupus) (ST5), wild boar (Sus scrofa) (ST5) and red deer (Cervus elaphus) (ST1). In conclusion, for the first time we have demonstrated the presence of Blastocystis in wild European bison. Preliminary studies have shown that Blastocystis is present in at least 4 species of wild mammals in the BPF area and that it exhibits great genetic diversity. Blastocystis is present in wild mammals in the Białowieża Primeval Forest Blastocystis in the Białowieża Primeval Forest exhibits great genetic diversity Intra-species and interspecific transmission of Blastocystis in Białowieża Primeval Forest is highly probable.
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Affiliation(s)
- Adam Kaczmarek
- Faculty of Medicine. Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Kazimierza Wóycickiego 1/3, 01-938 Warsaw, Poland
| | - Wojciech Sobociński
- Institute of Biology, University of Białystok, Ciołkowskiego 1J, 15-245 Białystok, Poland
| | - Maria Wesołowska
- Department of Biology and Medical Parasitology, Wrocław Medical University, J. Mikulicza-Radeckiego 9, 50-345 Wrocław, Poland
| | - Elżbieta Gołąb
- Polish Parasitological Society, Twarda 51/55, 00-818 Warsaw, Poland
| | | | - Rusłan Sałamatin
- Faculty of Medicine. Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Kazimierza Wóycickiego 1/3, 01-938 Warsaw, Poland.,Department of General Biology and Parasitology, Medical University of Warsaw, Chałubińskiego 5, 02-004 Warsaw, Poland
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17
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Popruk S, Adao DEV, Rivera WL. Epidemiology and subtype distribution of Blastocystis in humans: A review. INFECTION GENETICS AND EVOLUTION 2021; 95:105085. [PMID: 34530156 DOI: 10.1016/j.meegid.2021.105085] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 12/19/2022]
Abstract
Blastocystis is a commonly encountered gastrointestinal protozoan in humans and animals with uncertain pathogenicity. Despite its potential public health impact, epidemiological data regarding the prevalence and molecular subtype (ST) distribution of Blastocystis have been rarely reported. Among Blastocystis STs, ST1-ST4 are common in humans, including healthy and immunodeficient populations. According to the Chi-squared (χ2) association based on the data compiled for this cross-sectional study, the presence of ST1 is associated with asymptomatic infection, whereas the presence of ST4 is associated with symptomatic infection. However, cross-sectional studies cannot clarify the potential pathogenicity of Blastocystis, unlike in vivo and in vitro studies. Poor hygiene, poor sanitation and zoonotic transmission are possible factors associated with high Blastocystis prevalence, although this protozoan may be part of the normal healthy human gastrointestinal microbiota. This review covers the prevalence, STs and distribution of Blastocystis infection in humans. Thus, future epidemiological and subtyping studies could reveal new STs in humans as well as possible associations of STs with disease, drug resistance and related mechanisms such as protease activity. These associations with proper ST identification may facilitate the control of potential threats to host health, including the direct pathogenic effects of Blastocystis or alterations of the gastrointestinal microbiome.
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Affiliation(s)
- Supaluk Popruk
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok 10400, Thailand
| | - Davin Edric V Adao
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines
| | - Windell L Rivera
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines.
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Cabrine-Santos M, Moura RGF, Pedrosa AL, Correia D, Oliveira-Silva MBD. Molecular characterization of Blastocystis subtypes isolated in the city of Uberaba, Minas Gerais State, Brazil. Rev Soc Bras Med Trop 2021; 54:e03052021. [PMID: 34431950 PMCID: PMC8405216 DOI: 10.1590/0037-8682-0305-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/09/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Blastocystis is an intestinal protozoan that may play a role in the pathogenicity of humans. This study aimed to (i) genetically characterize Blastocystis isolates obtained from human fecal samples and the water supply of the city of Uberaba, Minas Gerais, Brazil, and (ii) to verify the phylogenetic relationship between these isolates. METHODS Blastocystis species present in 26 fecal samples obtained from humans and animals from Uberaba were genetically characterized by polymerase chain reaction-restriction fragment length polymorphism and polymerase chain reaction-sequence-tagged sites. All amplicons were partially sequenced and/or defined according to the GenBank classification. RESULTS Polymerase chain reaction amplicons were generated from 21 human isolates and 18 water samples. The subtypes defined were ST1 (53.3%), ST3 (40.0%), and ST2 (6.7%) for human isolates; ST10 (100%) for bovine isolates; and ST5 (50.0%), ST1 (25%), and ST3 (25%) for pigs. Sequencing of polymerase chain reaction products showed a 98%-99% identity for the Blastocystis sequences deposited in GenBank, except for sequences from water samples that showed the identity of algae sequences. Phylogenetic analysis of Blastocystis sequences showed two distinct groups, one of which was principally formed by ST1, ST5, and ST10, and the other by isolates characterized as ST3 and ST7. Both clades showed human and animal sequences, reinforcing the notion that Blastocystis subtypes are not host-specific. CONCLUSIONS The data showed that Blastocystis subtypes circulating in Uberaba are ST1-ST3, ST5, and ST10, present in both humans and animals, demonstrating that the Blastocystis subtypes are not host-specific; that is, zoonotic transmission is possible.
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Affiliation(s)
- Marlene Cabrine-Santos
- Universidade Federal do Triângulo Mineiro, Instituto de Ciências da Saúde, Departamento de Biomedicina, Uberaba, MG, Brasil
| | - Renata Gregório Franco Moura
- Universidade Federal do Triângulo Mineiro, Programa de Pós-graduação em Medicina Tropical e Infectologia, Uberaba, MG, Brasil
| | - André Luiz Pedrosa
- Universidade Federal do Triângulo Mineiro, Instituto de Ciências Biológicas e Naturais, Departamento de Bioquímica, Farmacologia e Fisiologia, Uberaba, MG, Brasil
| | - Dalmo Correia
- Universidade Federal do Triângulo Mineiro, Instituto de Ciências da Saúde, Departamento de Clínica Médica, Uberaba, MG, Brasil
| | - Márcia Benedita de Oliveira-Silva
- Universidade Federal do Triângulo Mineiro, Instituto de Ciências Biológicas e Naturais, Departamento de Microbiologia, Parasitologia e Imunologia, Uberaba, MG, Brasil
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Genotypes of Blastocystis sp. among elderly health checkup people in South Korea with a questionnaire on risk factors. Parasitol Res 2021; 120:3297-3306. [PMID: 34351493 DOI: 10.1007/s00436-021-07274-w] [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: 05/02/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
Blastocystis sp. is a common zoonotic intestinal parasite of humans and animals, and has been classified into at least 17 distinct subtypes. Despite its potential impact on public health, the prevalence and subtype distribution of Blastocystis sp. have seldom been the study subject in South Korea. To determine the prevalence and subtype distribution of Blastocystis sp. and to obtain information on risk factors, we performed a cross-sectional study targeting elderly health checkup people, who visited Seoul Western Branch of the Korea Association of Health Promotion (KAHP) in October 2019. Stool samples were collected from 293 participants consisting of 128 males and 165 females with a mean age of 64.7 years (from 50 to 88 years) with a questionnaire on potential risk factors. All the samples were tested by PCR targeting the SSU rRNA gene of Blastocystis sp., and nucleotide sequences of positive samples were used to identify the subtypes. The overall prevalence of Blastocystis sp. was 9.2% (27/293). Among the positive samples, subtype 3 was predominant (59%; 16/27), followed by subtype 1 (41%; 11/27). No other subtypes were detected. In the univariable analysis, the age, sex, presence of digestive symptoms, source of drinking water, and history of drug intake were not significantly associated with Blastocystis sp. infection. Two parameters, including the Enterococcus hirae bacterial infection and the frequency of intake of cooked or boiled vegetables less than twice a week, showed statistical significance. However, the multivariable regression analysis revealed that only the latter parameter was statistically significant. The results suggested that subtypes 3 and 1 are the 2 major genotypes of Blastocystis sp. among elderly people in South Korea, and low frequency of consuming cooked or boiled vegetables is a potential risk factor.
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Molecular Subtyping of Blastocystis sp. Isolated from Farmed Animals in Southern Italy. Microorganisms 2021; 9:microorganisms9081656. [PMID: 34442735 PMCID: PMC8399531 DOI: 10.3390/microorganisms9081656] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/28/2021] [Accepted: 07/31/2021] [Indexed: 12/04/2022] Open
Abstract
Blastocystis is a common intestinal protist distributed worldwide, infecting humans and a wide range of domestic and wild animals. It exhibits an extensive genetic diversity and, so far, 25 distinct small subunit ribosomal RNA (SSU rRNA) lineages termed subtypes (STs)) have been characterized; among them, 12 have thus far been reported in humans. The aims of the present study were to detect and genetically characterize Blastocystis sp. in synantropic animals to improve our current knowledge on the distribution and zoonotic transmission of Blastocystis STs in Italy. Samples were collected from N = 193 farmed animals and submitted to DNA extraction and PCR amplification of the SSU rRNA. Blastocystis was detected in 60 samples (31.08%) and successfully subtyped. Phylogenetic analysis evidenced that the isolates from fallow deer, goats, and pigs (N = 9) clustered within the ST5; those from pheasants (N = 2) in the ST6; those from chickens (N = 8) in the ST7; those from sheep (N = 6) in the ST10; and those from water buffaloes (N = 9) in the ST14 clade. The comparison between the present isolates from animals and those previously detected in humans in Italy suggested the animal-to-human spillover for ST6 and ST7. The present study represents the widest Blastocystis survey performed thus far in farmed animals in Italy. Further epidemiological studies using molecular approaches are required to determine the occurrence and distribution of Blastocystis STs in other potential animal reservoirs in Italy and to define the pathways of zoonotic transmission.
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21
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Billy V, Lhotská Z, Jirků M, Kadlecová O, Frgelecová L, Parfrey LW, Pomajbíková KJ. Blastocystis Colonization Alters the Gut Microbiome and, in Some Cases, Promotes Faster Recovery From Induced Colitis. Front Microbiol 2021; 12:641483. [PMID: 33897648 PMCID: PMC8058373 DOI: 10.3389/fmicb.2021.641483] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/03/2021] [Indexed: 12/11/2022] Open
Abstract
Protists are a normal component of mammalian intestinal ecosystems that live alongside, and interact with, bacterial microbiota. Blastocystis, one of the most common intestinal eukaryotes, is reported as a pathogen that causes inflammation and disease, though health consequences likely vary depending on host health, the gut ecosystem, and genetic diversity. Accumulating evidence suggests that Blastocystis is by and large commensal. Blastocystis is more common in healthy individuals than those with immune mediated diseases such as Inflammatory Bowel Diseases (IBD). Blastocystis presence is also associated with altered composition and higher richness of the bacterial gut microbiota. It is not clear whether Blastocystis directly promotes a healthy gut and microbiome or is more likely to colonize and persist in a healthy gut environment. We test this hypothesis by measuring the effect of Blastocystis ST3 colonization on the health and microbiota in a rat experimental model of intestinal inflammation using the haptenizing agent dinitrobenzene sulfonic acid (DNBS). We experimentally colonized rats with Blastocystis ST3 obtained from a healthy, asymptomatic human donor and then induced colitis after 3 weeks (short term exposure experiment) or after 13 weeks (long term exposure experiment) and compared these colonized rats to a colitis-only control group. Across experiments Blastocystis ST3 colonization alters microbiome composition, but not richness, and induces only mild gut inflammation but no clinical symptoms. Our results showed no effect of short-term exposure to Blastocystis ST3 on gut inflammation following colitis induction. In contrast, long-term Blastocystis exposure appears to promote a faster recovery from colitis. There was a significant reduction in inflammatory markers, pathology 2 days after colitis induction in the colonized group, and clinical scores also improved in this group. Blastocystis colonization resulted in a significant reduction in tumor necrosis factor alpha (TNFα) and IL-1β relative gene expression, while expression of IFNγ and IL17re/17C were elevated. We obtained similar results in a previous pilot study. We further found that bacterial richness rebounded in rats colonized by Blastocystis ST3. These results suggest that Blastocystis sp. may alter the gut ecosystem in a protective manner and promote faster recovery from disturbance.
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Affiliation(s)
- Vincent Billy
- Department of Zoology, Biodiversity Research Centre, University of British Columbia, Vancouver, BC, Canada
| | - Zuzana Lhotská
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czechia.,Department of Medical Biology, Faculty of Science, University of South-Bohemia, České Budějovice, Czechia
| | - Milan Jirků
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czechia
| | - Oldřiška Kadlecová
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czechia
| | - Lucia Frgelecová
- Department of Pathology and Parasitology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czechia
| | - Laura Wegener Parfrey
- Department of Zoology, Biodiversity Research Centre, University of British Columbia, Vancouver, BC, Canada.,Department of Botany, University of British Columbia, Vancouver, BC, Canada
| | - Kateřina Jirků Pomajbíková
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czechia.,Department of Medical Biology, Faculty of Science, University of South-Bohemia, České Budějovice, Czechia
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Wild whale faecal samples as a proxy of anthropogenic impact. Sci Rep 2021; 11:5822. [PMID: 33712645 PMCID: PMC7955090 DOI: 10.1038/s41598-021-84966-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/23/2021] [Indexed: 01/04/2023] Open
Abstract
The occurrence of protozoan parasite, bacterial communities, organic pollutants and heavy metals was investigated in free-ranging species of fin (Balaenoptera physalus, n. 2) and sperm (Physeter macrocephalus, n. 2) whales from the Pelagos Sanctuary, Corsican-Ligurian Provencal Basin (Northern-Western Mediterranean Sea). Out of four faecal samples investigated, two from fin whales and one from sperm whale were found positive to Blastocystis sp. A higher number of sequences related to Synergistetes and Spirochaetae were found in sperm whales if compared with fin whales. Moreover, As, Co and Hg were found exclusively in sperm whale faecal samples, while Pb was found only in fin whale faecal samples. The concentration of both PAH and PCB was always below the limit of detection. This is the first report in which the presence of these opportunistic pathogens, bacteria and chemical pollutants have been investigated in faecal samples of free-ranging whale species and the first record of Blastocystis in fin and sperm whales. Thus, this study may provide baseline data on new anthropozoonotic parasite, bacterial records and heavy metals in free-ranging fin and sperm whales, probably as a result of an increasing anthropogenic activity. This survey calls for more integrated research to perform regular monitoring programs supported by national and/or international authorities responsible for preservation of these still vulnerable and threatened whale species in the Mediterranean Sea.
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Muadica AS, Köster PC, Dashti A, Bailo B, Hernández-de-Mingo M, Balasegaram S, Carmena D. Molecular Diversity of Giardia duodenalis, Cryptosporidium spp., and Blastocystis sp. in Symptomatic and Asymptomatic Schoolchildren in Zambézia Province (Mozambique). Pathogens 2021; 10:255. [PMID: 33668348 PMCID: PMC7996272 DOI: 10.3390/pathogens10030255] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
Infections by the protist enteroparasites Giardia duodenalis, Cryptosporidium spp., and, to a much lesser extent, Blastocystis sp. are common causes of childhood diarrhoea in low-income countries. This molecular epidemiological study assesses the frequency and molecular diversity of these pathogens in faecal samples from asymptomatic schoolchildren (n = 807) and symptomatic children seeking medical attention (n = 286) in Zambézia province, Mozambique. Detection and molecular characterisation of pathogens was conducted by polymerase chain reaction (PCR)-based methods coupled with Sanger sequencing. Giardia duodenalis was the most prevalent enteric parasite found [41.7%, 95% confidence interval (CI): 38.8‒44.7%], followed by Blastocystis sp. (14.1%, 95% CI: 12.1‒16.3%), and Cryptosporidium spp. (1.6%, 95% CI: 0.9‒2.5%). Sequence analyses revealed the presence of assemblages A (7.0%, 3/43) and B (88.4%, 38/43) within G. duodenalis-positive children. Four Cryptosporidium species were detected, including C. hominis (30.8%; 4/13), C. parvum (30.8%, 4/13), C. felis (30.8%, 4/13), and C. viatorum (7.6%, 1/13). Four Blastocystis subtypes were also identified including ST1 (22.7%; 35/154), ST2 (22.7%; 35/154), ST3 (45.5%; 70/154), and ST4 (9.1%; 14/154). Most of the genotyped samples were from asymptomatic children. This is the first report of C. viatorum and Blastocystis ST4 in Mozambique. Molecular data indicate that anthropic and zoonotic transmission (the latter at an unknown rate) are important spread pathways of diarrhoea-causing pathogens in Mozambique.
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Affiliation(s)
- Aly S. Muadica
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
- Departamento de Ciências e Tecnologia, Universidade Licungo, 106 Quelimane, Zambézia, Mozambique
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
| | - Alejandro Dashti
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
| | - Begoña Bailo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
| | - Marta Hernández-de-Mingo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
| | - Sooria Balasegaram
- Field Epidemiology Services, National Infection Service, Public Health England, London SE1 8UG, UK;
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
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24
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Pérez MR, Yáñez CM, Hernández AM, Sustaita JJD, Jiménez EG, Andrade MR, Vargas GGG, Gómez JOG. Blastocystis infection frequency and subtype distribution in university students. Heliyon 2020; 6:e05729. [PMID: 33385079 PMCID: PMC7770537 DOI: 10.1016/j.heliyon.2020.e05729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/26/2020] [Accepted: 12/11/2020] [Indexed: 12/21/2022] Open
Abstract
Blastocystis is a parasite commonly found in the gut of humans and animals; there are 22 known subtypes (STs). STs 1-9 and 12 have been found in humans. This parasite has a faecal-oral route of transmission; its high infection prevalence in developing countries is due to poor hygiene practices, exposure to infected animals, and intake of contaminated water or food. Its pathogenicity has not been established, because it has been found in symptomatic and asymptomatic patients. The goal of this study was to analyze the frequency of Blastocystis and its subtypes (1, 2, 3, 4, 5, and 7), and assess the relationship between these subtypes and abdominal pain and distension. 202 university students participated in this study. A questionnaire was applied to assess the gastrointestinal symptoms, and subsequently the students were asked to provide faecal samples. The presence of parasites was determined by optical microscopy. Blastocystis-positive samples had their DNA extracted and end-point PCR was performed to corroborate the presence of Blastocystis and determine its subtypes. Among the samples, 47.03% were positive according to PCR analysis. The most prevalent subtypes were ST3 (29.79%), ST4 (16.84%), and ST1 (14.89%). We found a relationship between ST1 and abdominal pain (OR = 0.196; CI = 0.0533-0.7318; p = 0.015), and between ST4 and abdominal distension (OR = 0.2928; CI = 0.1017-0.8429; p = 0.023). However, the presence of this parasite and the probable relationship with gastrointestinal symptoms suggest the need to determine its role within intestinal microbiota in order to confirm whether its eradication is really necessary or not.
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Affiliation(s)
- Marcela Ramírez Pérez
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
| | - Claudia Muñoz Yáñez
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
| | - Alejandra Méndez Hernández
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
| | | | - Efraín Gaytan Jiménez
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
| | - Marisela Rubio Andrade
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
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Khorshidvand Z, Khazaei S, Amiri M, Taherkhani H, Mirzaei A. Worldwide prevalence of emerging parasite Blastocystis in immunocompromised patients: A systematic review and meta-analysis. Microb Pathog 2020; 152:104615. [PMID: 33246090 DOI: 10.1016/j.micpath.2020.104615] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/15/2020] [Accepted: 11/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Blastocystis is one of the most common pathogens of the human intestine, caused by an emerging parasite, which can lead to severe symptoms and even death in immunocompromised patients. We aimed to determine the global prevalence of Blastocystosis infection in people with immunodeficiency. A systematic literature search was conducted on Web of Science, Scopus, Google scholar, Science Direct and MEDLINE databases to select all observational studies reporting the prevalence of Blastocystosis infection in Worldwide, based on different diagnostic methods in immunocompromised patients of any age and published from inception to February 2019. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using random effects models and in addition, the I2 statistic was calculated. The geographic distribution of studies was evaluated and the diagnosis of Blastocystis was compared by various techniques. Electronic databases were reviewed for Blastocystosis infection in HIV/AIDS, cancer and other immunocompromised patients, and meta-analyses were conducted to calculate the overall estimated prevalence. Total68 eligible studies were included. The estimated pooled prevalence rate of Blastocystosis infection in immunocompromised patients was overall 10% (95% CI, 7-13%; I2 96.04%) (P < 0.001), of whom 21% [18-25] were in Australia, 12% [4-24] in America, 11% [6-17] in Europe and 10% [5-15], 7% [3-13] in Asia and Africa, respectively. It was calculated that the estimated pooled prevalence rate of Blastocystosis infection in immunocompromised patients was overall 10% and the prevalence estimates ranged from 0.44 to 72.39. Also, overall the prevalence of parasites co-infection in immunocompromised patients was detected as 0.024%. Our finding showed that immunocompromised people show a high prevalence of Blastocystosis infection compared to the control population. Adequate information on the prevalence rate is still missing from many countries. However, current information underscore that Blastocystis should not be neglected.
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Affiliation(s)
- Zohreh Khorshidvand
- Department of Parasitology and Mycology, School of Medicine Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - MohamadReza Amiri
- Department of medical Library and Information Science, Faculty of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Heshmatollah Taherkhani
- Department of Parasitology and Mycology, School of Medicine Hamadan University of Medical Sciences, Hamadan, Iran
| | - Asad Mirzaei
- Department of Parasitology, School of Allied Medical Science, Ilam University of Medical Sciences, Ilam, Iran; Zoonotic Diseases ResearchCenter, Ilam University of Medical sciences, Ilam, Iran.
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Molecular Diversity of Giardia duodenalis, Cryptosporidium spp. and Blastocystis sp. in Asymptomatic School Children in Leganés, Madrid (Spain). Microorganisms 2020; 8:microorganisms8040466. [PMID: 32218318 PMCID: PMC7232429 DOI: 10.3390/microorganisms8040466] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/31/2022] Open
Abstract
Enteric parasites including Giardia duodenalis, Cryptosporidium spp., and to a lesser extent, Blastocystis sp. and Enterocytozoon bieneusi, are major worldwide contributors to diarrhoeal disease. Assessing their molecular frequency and diversity is important to ascertain the sources of infection, transmission dynamics, and zoonotic potential. Little molecular information is available on the genotypes of these pathogens circulating in apparently healthy children. Here, we show that asymptomatic carriage of G. duodenalis (17.4%, 95% CI: 15.5‒19.4%), Blastocystis sp. (13.0%, 95% CI: 11.4‒14.8%), and Cryptosporidium spp. (0.9%, 95% CI: 0.5‒1.5%) is common in children (1‒16 years; n = 1512) from Madrid, Spain. Our genotyping data indicate that; (i) the observed frequency and diversity of parasite genetic variants are very similar to those previously identified in Spanish clinical samples, so that the genotype alone does not predict the clinical outcome of the infection, (ii) anthroponotic transmission accounts for a large proportion of the detected cases, highlighting that good personal hygiene practices are important to minimizing the risk of infection, (iii) Blastocystis ST4 may represent a subtype of the parasite with higher pathogenic potential, and (iv) Enterocytozoon bieneusi does not represent a public health concern in healthy children.
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Gabrielli S, Furzi F, Fontanelli Sulekova L, Taliani G, Mattiucci S. Occurrence of Blastocystis-subtypes in patients from Italy revealed association of ST3 with a healthy gut microbiota. Parasite Epidemiol Control 2020; 9:e00134. [PMID: 32258445 PMCID: PMC7096745 DOI: 10.1016/j.parepi.2020.e00134] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 12/18/2022] Open
Abstract
An epidemiological survey on Blastocystis was carried out enrolling a total of 2524 subjects referred to the Umberto I Academic Hospital in Rome, for the routine parasitological exams, during 2017–2018. The studied population included a sample of immunocompromised individuals (N = 130) followed at the same hospital. DNA sequencing of the small subunit rRNA gene (SSU rDNA) locus was performed on samples positive to the coproparasitological analysis to molecular characterize the Blastocystis-subtypes. Microscopical analysis detected Blastocystis in 192/2524 (7.6%) of the enrolled subjects. It was the organism most frequently identified in the analysed faecal samples diagnosed in single infection (5.6%) or in co-infection with other enteric protozoa (2%). Furthermore, it was found mainly in immunocompromised patients (22.3%) compared to immunocompetent ones (6.8%). As expected, ST3 was the most occurring subtype identified in 40% of the subjects, followed by ST1 (29%), ST2 (16%), ST4 (12%), and ST7 (3%). Next-generation sequencing (NGS) of the 16S rDNA was performed on a sub-sample of Blastocystis-ST3-carriers, homogenous by age and gender, as well as on Blastocystis-free subjects, to profile and compare their gut bacterial composition. A higher bacterial diversity was found in ST3-Blastocystis-carriers, which exhibited a high abundance of Prevotella, Methanobrevibacter and Ruminococcus while, a high percentage of Bacteroides was found in Blastocystis-free subjects. This study evidenced the presence of Blastocystis in 7.6% of faecal samples in Italy and a high circulation of the protist among immunocompromised patients (22.3%). Molecular characterization of positive samples evidenced the occurrence of five different subtypes, including zoonotic ST such as the ST7, highlighting the risk of transmission from animals. Study of the gut microbiota composition confirms previous evidences according to which, the colonisation by Blastocystis would be linked with an eubiotic gut characterized by potentially beneficial species such as Prevotella and Ruminococcus, rather than with a dysbiotic state, with a high abundance of Enterobacteriaceae, and corroborated the role of the protist as “an old friend” of the human gut. Microscopical analysis detected Blastocystis in 7.6% subjects in Italy. Molecular methods allowed the identification of 5 STs (ST1, ST2, ST3, ST4, ST7). ST3 resulted the most frequent subtype. NGS of the 16S rDNA gene was performed in Blastocystis-ST3-carriers. Blastocystis-ST3 resulted correlated to an eubiotic gut characterized by potentially beneficial species.
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Affiliation(s)
- Simona Gabrielli
- Department of Public Health and Infectious Diseases, "Sapienza-University of Rome", Piazzale Aldo Moro 5, 00185 Rome, Italy
- Diagnostic Parasitology laboratory, Academic Hospital "Policlinico Umberto I", Rome, Viale del Policlinico 155, 00185 Rome, Italy
| | - Federica Furzi
- Department of Public Health and Infectious Diseases, "Sapienza-University of Rome", Piazzale Aldo Moro 5, 00185 Rome, Italy
| | | | - Gloria Taliani
- Department of Translation and Precision Medicine, "Sapienza University of Rome", 00185 Rome, Italy
| | - Simonetta Mattiucci
- Department of Public Health and Infectious Diseases, "Sapienza-University of Rome", Piazzale Aldo Moro 5, 00185 Rome, Italy
- Diagnostic Parasitology laboratory, Academic Hospital "Policlinico Umberto I", Rome, Viale del Policlinico 155, 00185 Rome, Italy
- Corresponding author at: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
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Stensvold CR, Lebbad M, Hansen A, Beser J, Belkessa S, O'Brien Andersen L, Clark CG. Differentiation of Blastocystis and parasitic archamoebids encountered in untreated wastewater samples by amplicon-based next-generation sequencing. Parasite Epidemiol Control 2019; 9:e00131. [PMID: 31909230 PMCID: PMC6940715 DOI: 10.1016/j.parepi.2019.e00131] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/06/2019] [Accepted: 12/16/2019] [Indexed: 01/08/2023] Open
Abstract
Background Application of next-generation sequencing (NGS) to genomic DNA extracted from sewage offers a unique and cost-effective opportunity to study the genetic diversity of intestinal parasites. In this study, we used amplicon-based NGS to reveal and differentiate several common luminal intestinal parasitic protists, specifically Entamoeba, Endolimax, Iodamoeba, and Blastocystis, in sewage samples from Swedish treatment plants. Materials and methods Influent sewage samples were subject to gradient centrifugation, DNA extraction and PCR-based amplification using three primer pairs designed for amplification of eukaryotic nuclear 18S ribosomal DNA. PCR products were sequenced using ILLUMINA® technology, and resulting sequences were annotated to species and subtype level using the in-house BION software, sequence clustering, and phylogenetic analysis. Results A total of 26 samples from eight treatment plants in central/southern Sweden were analysed. Blastocystis sp. and Entamoeba moshkovskii were detected in all samples, and most samples (n = 20) were positive for Entamoeba coli. Moreover, we detected Entamoeba histolytica, Entamoeba dispar, Entamoeba hartmanni, Endolimax nana, and Iodamoeba bütschlii in 1, 11, 4, 10, and 7 samples, respectively. The level of genetic divergence observed within E. nana and E. moshkovskii was 20.2% and 7.7%, respectively, across the ~400-bp region studied, and two clades of E. moshkovskii were found. As expected, Blastocystis sp. subtypes 1–4 were present in almost all samples; however, ST8 was present in 10 samples and was the only subtype not commonly found in humans that was present in multiple samples. Conclusions Entamoeba and Blastocystis were identified as universal members of the “sewage microbiome”. Blastocystis sp. ST8, which has been rarely reported in humans, was a very common finding, indicating that a hitherto unidentified but common host of ST8 contributed to the sewage influent. The study also provided substantial new insight into the intra-generic diversity of Entamoeba and Endolimax.
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Affiliation(s)
- Christen Rune Stensvold
- Laboratory of Parasitology, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Marianne Lebbad
- Department of Microbiology, Public Health Agency of Sweden, SE-171 82 Solna, Sweden
| | - Anette Hansen
- Department of Microbiology, Public Health Agency of Sweden, SE-171 82 Solna, Sweden
| | - Jessica Beser
- Department of Microbiology, Public Health Agency of Sweden, SE-171 82 Solna, Sweden
| | - Salem Belkessa
- Laboratory of Parasitology, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.,Department of Biochemistry and Microbiology, Faculty of Biological and Agronomic Sciences, Mouloud Mammeri University of Tizi Ouzou, 15000 Tizi Ouzou, Algeria.,Department of Natural and Life Sciences, Faculty of Exact Sciences and Natural and Life Sciences, Mohamed Khider University of Biskra, 07000 Biskra, Algeria
| | - Lee O'Brien Andersen
- Laboratory of Parasitology, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - C Graham Clark
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Rojas-Velázquez L, Maloney JG, Molokin A, Morán P, Serrano-Vázquez A, González E, Pérez-Juárez H, Ximénez C, Santin M. Use of next-generation amplicon sequencing to study Blastocystis genetic diversity in a rural human population from Mexico. Parasit Vectors 2019; 12:566. [PMID: 31775832 PMCID: PMC6882168 DOI: 10.1186/s13071-019-3814-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/19/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The intestinal parasite Blastocystis is found in humans and animals around the world. It is spread through the consumption of contaminated food and water and has been associated with a variety of intestinal symptoms. Blastocystis is one of the most common intestinal parasites in humans, yet its prevalence and distribution in humans in North America is not well characterized. METHODS Next-generation amplicon sequencing of a region of the Blastocystis SSU rRNA gene was applied to DNA extracted from fecal specimens obtained from 182 inhabitants of a rural population in Mexico to characterize Blastocystis prevalence, subtype distribution, and intra-host subtype diversity in humans. RESULTS Of the 182 samples tested in this study, 68.1% (124) contained one or more Blastocystis subtypes. Subtype 3 was the most common subtype observed and was found in 81.5% of the positive samples. Subtype 1, 16.9% of the positive samples, and subtype 2, 17.7% of the positive samples, were also found in this population. Mixed infections were observed in 13.7% of the positive samples. In this population, the odds of having Blastocystis increased in adulthood (> 15 years; OR: 1.72, P < 0.0001), and the odds of having subtype 1 increased in the presence of farm animals (OR: 1.51, P = 0.03). The odds of having subtype 1, subtype 2, or a mixed infection decreased in the presence of cement flooring (OR: - 1.61, P = 0.005; OR: - 1.14, P = 0.03; OR: - 1.48, P = 0.02) possibly indicating socioeconomic factors are involved in the risk of acquiring one of these subtypes. CONCLUSIONS These data contribute to our understanding of the epidemiology of Blastocystis infection in humans and can be used to shape future studies which aim to better characterize the transmission pathways and health outcomes of Blastocystis infections.
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Affiliation(s)
- Liliana Rojas-Velázquez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Unidad de Posgrado, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Jenny G Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - Aleksey Molokin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - Patricia Morán
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Angélica Serrano-Vázquez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Enrique González
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Horacio Pérez-Juárez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Unidad de Posgrado, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Cecilia Ximénez
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
| | - Monica Santin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA.
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Melo GBD, Malta FDM, Maruta CW, Criado PR, Castilho VLP, Gonçalves EMDN, Espirito-Santo MCDCD, Paula FMD, Gryschek RCB. Characterization of subtypes of Blastocystis sp. isolated from patients with urticaria, São Paulo, Brazil. Parasite Epidemiol Control 2019; 7:e00124. [PMID: 31872093 PMCID: PMC6911935 DOI: 10.1016/j.parepi.2019.e00124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/18/2019] [Accepted: 11/05/2019] [Indexed: 01/01/2023] Open
Abstract
Blastocystis sp. is described as an enteric protist prevalent in fecal samples from humans and animals; its pathogenicity and epidemiology are still controversial. Currently, it has been associated with intestinal diseases such as irritable bowel syndrome and clinical manifestations of allergic skin, such as chronic urticaria. In the context of urticaria, it is still uncertain whether this organism is directly related to the allergic manifestation or just a common component of the intestinal microbiota. This study aimed to evaluate the occurrence and molecular diversity of Blastocystis sp. in individuals with urticaria from a dermatology outpatient clinic, São Paulo, Brazil. Fecal samples of 58 patients with urticaria were examined using parasitological methods; and subsequently tested by polymerase chain reaction using Blastocystis-specific primers. The subtypes (STs) and alleles (a) were determined using BLASTn and MLST tools. ST1, ST2, ST3, ST4, ST6 and mixed infection (ST1 + ST3) were identified in the patients with urticaria; ST1 (a4), ST3 (a34 and a36) and ST4 (a42) were the most prevalent. Our molecular analyses allowed an initial description of Blastocystis subtypes in patients with urticaria from São Paulo city, Brazil.
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Affiliation(s)
- Gessica Baptista de Melo
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Corresponding author.
| | - Fernanda de Mello Malta
- Laboratório de Gastroenterologia e Hepatologia Tropical (LIM-07), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Celina Wakisaka Maruta
- Departamento de Dermatologia, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Ricardo Criado
- Departamento de Dermatologia, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Faculdade de Medicina Do ABC, São Paulo, Brazil
| | - Vera Lucia Pagliusi Castilho
- Seção de Parasitologia, Divisão Do Laboratório Central, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Fabiana Martins de Paula
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ronaldo Cesar Borges Gryschek
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Fontanelli Sulekova L, Gabrielli S, Furzi F, Milardi GL, Biliotti E, De Angelis M, Iaiani G, Fimiani C, Maiorano M, Mattiucci S, Taliani G. Molecular characterization of Blastocystis subtypes in HIV-positive patients and evaluation of risk factors for colonization. BMC Infect Dis 2019; 19:876. [PMID: 31640585 PMCID: PMC6805496 DOI: 10.1186/s12879-019-4537-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/09/2019] [Indexed: 01/11/2023] Open
Abstract
Background Blastocystis is one of the most common intestinal protozoa in human faecal samples with uncertain impact on public health. Studies on the prevalence of Blastocystis in HIV-positive patients are limited and dated. Methods A cross-sectional study was carried out involving 156 HIV-positive patients to evaluate the prevalence of Blastocystis-subtypes by molecular amplification and sequencing the small subunit rRNA gene (SSU rDNA), to identify the risk factors for its transmission, to examine the relationship between the presence of the protist and gastrointestinal disorders. Furthermore, the evaluation of the faecal calprotectin by immunoassay from a sample of subjects was performed to evaluate the gut inflammation in Blastocystis-carriers. Results Blastocystis-subtypes ST1, ST2, ST3, ST4 were identified in 39 HIV-positive patients (25%). No correlation was found between the presence of the protist and virological or epidemiological risk factors. Blastocystis was more frequently detected in homosexual subjects (p = 0.037) infected by other enteric protozoa (p = 0.0001) and with flatulence (p = 0.024). No significant differences in calprotectin level was found between Blastocystis-carriers and free ones. Conclusions Blastocystis is quite common in HIV-positive patients on ART showing in examined patients 25% prevalence. Homosexual behaviour may represent a risk factor for its transmission, while CD4 count and viremia didn’t correlate with the presence of the protist. The pathogenetic role of Blastocystis remains unclear and no gut inflammation status was detected in Blastocystis-carriers. The only symptom associated with Blastocystis was the flatulence, evidencing a link between the presence of the protist and the composition and stability of gut microbiota.
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Affiliation(s)
| | - Simona Gabrielli
- Clinical Diagnostic Parasitology laboratory, Umberto I Academic Hospital, 00185, Rome, Italy. .,Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
| | - Federica Furzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Giovanni Luigi Milardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Elisa Biliotti
- Department of Translation and Precision Medicine, Sapienza University of Rome, 00185, Rome, Italy
| | - Maurizio De Angelis
- Department of Translation and Precision Medicine, Sapienza University of Rome, 00185, Rome, Italy
| | - Giancarlo Iaiani
- Department of Translation and Precision Medicine, Sapienza University of Rome, 00185, Rome, Italy
| | - Caterina Fimiani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Myriam Maiorano
- Department of Translation and Precision Medicine, Sapienza University of Rome, 00185, Rome, Italy
| | - Simonetta Mattiucci
- Clinical Diagnostic Parasitology laboratory, Umberto I Academic Hospital, 00185, Rome, Italy.,Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Gloria Taliani
- Department of Translation and Precision Medicine, Sapienza University of Rome, 00185, Rome, Italy
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Gazzonis AL, Marangi M, Zanzani SA, Villa L, Giangaspero A, Manfredi MT. Molecular epidemiology of Blastocystis sp. in dogs housed in Italian rescue shelters. Parasitol Res 2019; 118:3011-3017. [PMID: 31418113 DOI: 10.1007/s00436-019-06424-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 08/07/2019] [Indexed: 01/06/2023]
Abstract
Blastocystis is a ubiquitous protozoan with a wide range of hosts. In humans, its presence has been associated with gastrointestinal disorders, although its role as a pathogen still needs to be elucidated. Until now, 17 Blastocystis subtypes (STs) have been identified, with ST1-ST4 the most commonly found in humans. Among domestic animals, the same STs reported in humans have been detected in dogs. An epidemiological survey on dog kennels was carried out to evaluate the prevalence of Blastocystis and the STs involved. Overall, 99 faecal samples were collected from the rescue shelters. Blastocystis detection was performed through conventional barcoding PCR targeting the 1800-bp SSU-rDNA, followed by sequencing and phylogenetic analysis. Blastocystis DNA was found in 21 faecal samples (21.2%), and all samples were successfully sequenced and identified as ST3 in a unique monophyletic group. The presence of Blastocystis was reported for the first time in dogs from Italy, with the identification of ST3, the subtype most commonly found in humans.
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Affiliation(s)
| | - Marianna Marangi
- Department of Science of Agriculture, Food and Environment, University of Foggia, Foggia, Italy
| | | | - Luca Villa
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | - Annunziata Giangaspero
- Department of Science of Agriculture, Food and Environment, University of Foggia, Foggia, Italy
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Deng L, Chai Y, Zhou Z, Liu H, Zhong Z, Hu Y, Fu H, Yue C, Peng G. Epidemiology of Blastocystis sp. infection in China: a systematic review. ACTA ACUST UNITED AC 2019; 26:41. [PMID: 31309925 PMCID: PMC6632114 DOI: 10.1051/parasite/2019042] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/24/2019] [Indexed: 11/14/2022]
Abstract
Blastocystis sp., a unicellular intestinal parasite in humans and animals worldwide, is frequently found in immunocompromized patients and people in close contact with animals. Here, we reviewed recent studies on the prevalence, subtypes, and distribution of Blastocystis infection in humans and animals in China. To date, more than 12 provinces have reported Blastocystis infection in humans, with identification of six different subtypes (ST1, ST2, ST3, ST4, ST5, and ST6). The overall infection rate reported was 3.37% (3625/107,695), with the lowest prevalence (0.80%) in Fujian province and the highest prevalence (100%) in Guangdong province. ST3 (62%, 186/300) was the most dominant subtype, identified in all tested provinces in China. A total of eight provinces have reported Blastocystis infection in various animals, with the overall prevalence being 24.66% (1202/4874). Molecular analysis revealed 14 subtypes that infected animals, including 10 known (ST1, ST2, ST3, ST4, ST5, ST6, ST7, ST10, ST13, ST14), and 4 novel (Novel1, Novel2, Novel3, Novel4) subtypes. ST5 was the dominant subtype infecting artiodactyls (44.1%, 460/1044), while ST1 commonly infected carnivores (45.5%, 5/11). These findings provide insights into the epidemiological behavior of Blastocystis sp. in China, and could help in developing effective control strategies against the parasite.
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Affiliation(s)
- Lei Deng
- The Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, PR China
| | - Yijun Chai
- The Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, PR China
| | - Ziyao Zhou
- The Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, PR China
| | - Haifeng Liu
- The Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, PR China
| | - Zhijun Zhong
- The Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, PR China
| | - Yanchun Hu
- The Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, PR China
| | - Hualin Fu
- The Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, PR China
| | - Chanjuan Yue
- Sichuan Key Laboratory of Conservation Biology for Endangered Wildlife, Chengdu, Sichuan Province 611130, PR China
| | - Guangneng Peng
- The Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan 611130, PR China
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Blastocystis subtype 1 (allele 4); Predominant subtype among tuberculosis patients in Iran. Comp Immunol Microbiol Infect Dis 2019; 65:201-206. [PMID: 31300114 DOI: 10.1016/j.cimid.2019.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/08/2019] [Accepted: 06/10/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Blastocystis and tuberculosis are two public health issues that are frequently reported in regions with low level of hygiene. Therefore, the current study aimed to investigate Blastocystis subtype and allele distribution in TB patients. METHODS Totally, 161 stool samples were taken from TB patients who were undergoing anti-MTB treatment. Stool samples were concentrated using conventional formalin-ether technique and examined using Lugol's iodine staining under light microscopy. DNA extraction was carried out and discriminative fragment was amplified and sequenced. With comparison in GenBank database, relevant subtypes and alleles were characterized and phylogenetically analyzed using MEGA v.7 and Tamura 3-parameter model. RESULTS In total, from 161 stool samples, 19 samples were suspected to be Blastocystis-positive. The expected fragment was amplified in 13 (8.07%) of samples. Accordingly, 11/13 (84.62%) of Blastocystis cases settled in urban and 2/13 (15.38%) were villagers. Close-contact with animals was also seen among 7/13 (53.84%) of samples. Subtype 1 (7/13; 53.84%) was the most prevalent followed by subtype 2 (5/13; 38.46%) and subtype 3 (1/13, 7.69%). All ST1 were allele 4, while alleles 9, 11 and 12 were seen in ST2 and allele 34 was the only allele observed in ST3. All three subtypes were clearly separated, while there was no separation between sequences from TB and non-TB patients. CONCLUSION Blastocystis ST1 was the most prevalent subtype in TB patients and there was no difference between Blastocystis isolates from TB and non-TB human subjects.
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Valença-Barbosa C, do Bomfim TCB, Teixeira BR, Gentile R, Neto SFDC, Magalhães BSN, Balthazar DDA, da Silva FA, Biot R, d’Avila Levy CM, Santos HLC. Molecular epidemiology of Blastocystis isolated from animals in the state of Rio de Janeiro, Brazil. PLoS One 2019; 14:e0210740. [PMID: 30682075 PMCID: PMC6347289 DOI: 10.1371/journal.pone.0210740] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 12/31/2018] [Indexed: 01/25/2023] Open
Abstract
The enteric protist Blastocystis is one of the most frequently reported parasites infecting both humans and many other animal hosts worldwide. A remarkable genetic diversity has been observed in the species, with 17 different subtypes (STs) on a molecular phylogeny based on small subunit RNA genes (SSU rDNA). Nonetheless, information regarding its distribution, diversity and zoonotic potential remains still scarce, especially in groups other than primates. In Brazil, only a few surveys limited to human isolates have so far been conducted on Blastocystis STs. The aim of this study is to determine the occurrence of Blastocystis subtypes in non-human vertebrate and invertebrate animal groups in different areas of the state of Rio de Janeiro, Brazil. A total of 334 stool samples were collected from animals representing 28 different genera. Blastocystis cultivated samples were subtyped using nuclear small subunit ribosomal DNA (SSU rDNA) sequencing. Phylogenetic analyses and BLAST searches revealed six subtypes: ST5 (28.8%), ST2 (21.1%), ST1 and ST8 (19.2%), ST3 (7.7%) and ST4 (3.8%). Our findings indicate a considerable overlap between STs in humans and other animals. This highlights the importance of investigating a range of hosts for Blastocystis to understand the eco-epidemiological aspects of the parasite and its host specificity.
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Affiliation(s)
- Carolina Valença-Barbosa
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Bernardo Rodrigues Teixeira
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Rosana Gentile
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Sócrates Fraga da Costa Neto
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Daniel de Almeida Balthazar
- Fundação Jardim Zoológico da cidade do Rio de Janeiro, Parque da Quinta da Boa Vista, Rio de Janeiro, Brazil
| | | | - Renata Biot
- Laboratório de Parasitologia do Departamento de Patologia do Hospital Universitário Antônio Pedro/Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Claudia Masini d’Avila Levy
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, RJ, Brazil
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Piubelli C, Soleymanpoor H, Giorli G, Formenti F, Buonfrate D, Bisoffi Z, Perandin F. Blastocystis prevalence and subtypes in autochthonous and immigrant patients in a referral centre for parasitic infections in Italy. PLoS One 2019; 14:e0210171. [PMID: 30615638 PMCID: PMC6322732 DOI: 10.1371/journal.pone.0210171] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/18/2018] [Indexed: 11/19/2022] Open
Abstract
In this study we characterized the presence and subtype (ST1-ST4) of Blastocystis in patients attended at a referral center for tropical diseases in Northern Italy. We also, evaluated the organism's association with other intestinal parasites. Parasite screening was performed on 756 patients, from different geographical origins (namely, Italians, Africans, South Americans, Asian and non-Italian Europeans) in which Italians represented the largest group. Blastocystis was seen to be the most prevalent parasite in the study. Subtype 3 and 1 were the most frequently found in the Italians and Africans. Our data confirmed previous studies performed in Italy, in which ST3 proved to be the most prevalent subtype, but we highlighted also a high frequency of mixed subtypes, which were probably underestimated in former analyses. Interestingly, the mixed subtypes group was the most prevalent in all the analysed geographical areas. About half of our cases showed other co-infecting parasites and the most frequent was Dientamoeba fragilis. Our study confirms that, in Blastocystis infection, multiple subtypes and co-infecting parasites are very frequently present, in particular Dientamoeba fragilis.
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Affiliation(s)
- Chiara Piubelli
- Department of Infectious and Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Vr), Italy
- * E-mail:
| | - Hossein Soleymanpoor
- Department of Infectious and Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Vr), Italy
- Institute of Infectious Diseases and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Giovanni Giorli
- Department of Infectious and Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Vr), Italy
| | - Fabio Formenti
- Department of Infectious and Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Vr), Italy
| | - Dora Buonfrate
- Department of Infectious and Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Vr), Italy
| | - Zeno Bisoffi
- Department of Infectious and Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Vr), Italy
| | - Francesca Perandin
- Department of Infectious and Tropical Diseases, IRCCS Sacro Cuore Don Calabria Hospital, Negrar (Vr), Italy
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Maloney JG, Lombard JE, Urie NJ, Shivley CB, Santin M. Zoonotic and genetically diverse subtypes of Blastocystis in US pre-weaned dairy heifer calves. Parasitol Res 2018; 118:575-582. [PMID: 30483890 DOI: 10.1007/s00436-018-6149-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022]
Abstract
Blastocystis is an emerging zoonotic pathogen with global distribution. However, limited data exist on the prevalence and genetic diversity of Blastocystis in the USA and in food animals. We conducted the first large-scale molecular investigation of Blastocystis in the USA by testing 2539 fecal samples from dairy heifer calves from 13 states. Blastocystis was detected in 73 (2.9%) fecal samples and in 10 of the 13 tested states. Molecular characterization showed a wide diversity of subtypes. Eleven subtypes were identified, seven previously reported (ST-3, ST-4, ST-5, ST-10, ST-14, ST-17, and ST-21) and four potentially novel subtypes (named ST-23 to ST-26). Zoonotic subtypes 3, 4, and 5 were found in 67% (49) of the positive specimens in this population. Our results suggest that cattle could serve as reservoirs of infection for humans and other domestic animals highlighting the potential risk of zoonotic transmission for Blastocystis.
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Affiliation(s)
| | | | | | | | - Monica Santin
- Agricultural Research Service, U.S. Department of Agriculture, Beltsville, MD, USA.
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Paulos S, Köster PC, de Lucio A, Hernández-de-Mingo M, Cardona GA, Fernández-Crespo JC, Stensvold CR, Carmena D. Occurrence and subtype distribution of Blastocystis
sp. in humans, dogs and cats sharing household in northern Spain and assessment of zoonotic transmission risk. Zoonoses Public Health 2018; 65:993-1002. [DOI: 10.1111/zph.12522] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Silvia Paulos
- Microbiology Service; Quirón Madrid University Hospital; Madrid Spain
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | - Aida de Lucio
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | - Marta Hernández-de-Mingo
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | | | - Juan C. Fernández-Crespo
- Sub-Direction of Public Health of Álava, Department of Health; Basque Government; Vitoria-Gasteiz Spain
| | - Christen R. Stensvold
- Department of Bacteria, Parasites and Fungi; Statens Serum Institut; Copenhagen Denmark
| | - David Carmena
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
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Seguí R, Muñoz-Antoli C, Klisiowicz DR, Oishi CY, Köster PC, de Lucio A, Hernández-de-Mingo M, Puente P, Toledo R, Esteban JG, Carmena D. Prevalence of intestinal parasites, with emphasis on the molecular epidemiology of Giardia duodenalis and Blastocystis sp., in the Paranaguá Bay, Brazil: a community survey. Parasit Vectors 2018; 11:490. [PMID: 30165880 PMCID: PMC6117969 DOI: 10.1186/s13071-018-3054-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/10/2018] [Indexed: 12/22/2022] Open
Abstract
Background Intestinal protozoan parasites are major contributors to the global burden of gastrointestinal disease causing significant socioeconomic consequences. Children living in resource-poor settings with restricted access to water and sanitary services are particularly at risk of these infections. Methods A prospective, community-based, cross-sectional survey was conducted in Paraná (southern Brazil) between May 2015 and May 2016. A total of 766 stool samples were individually collected from volunteers (male/female ratio: 0.99; age range: 0–76 years) and used for investigating the presence of intestinal helminth and protozoan species by routine microscopic procedures including the Kato-Katz and modified Ritchie concentration methods and the Ziehl-Neelsen stain technique. Quantitative real-time PCR confirmed microscopy-positive samples for Giardia duodenalis and the assemblages and sub-assemblages determined by multilocus sequence-based genotyping of the glutamate dehydrogenase (gdh) and β-giardin (bg) genes of the parasite. Identification of Blastocystis subtypes was carried out by amplification and sequencing of a partial fragment of the small-subunit ribosomal RNA gene (SSU rDNA) of this heterokont microorganism. Results Overall, 46.1% (353/766) of the participants were infected/colonised by at least one intestinal parasite/commensal species. Protozoan and helminth species were detected in 42.7% and 10.1% of the surveyed population, respectively. Blastocystis sp. (28.2%), Endolimax nana (14.9%), and Giardia duodenalis (11.0%) were the most prevalent species found among protozoans and Ascaris lumbricoides (5.0%), Trichuris trichiura (4.6%) and hookworms (1.0%) among helminths. A total of 38 G. duodenalis-positive samples were genotyped at gdh and bg markers, revealing the presence of the sub-assemblages AII (47.4%), AII/AIII (2.6%), BIII (5.3%), BIV (26.3%) and BIII/BIV (13.1%). Two samples (5.3%) were only identified as assemblage B. AII was predominantly found in females aged 5–9 years and was associated with a higher likelihood of reporting gastrointestinal symptoms. A total of 102 Blastocystis-positive samples were successfully subtyped at the SSU rRNA gene revealing the presence of ST1 (36.3%), ST2 (15.7%), ST3 (41.2%), ST4 (2.9%), ST6 (1.0%) and ST8 (2.9%). Conclusions Data presented here indicate that enteric parasites still represent a pressing health concern in Paraná, Brazil, probably due to sub-optimal water, sanitation and hygiene conditions. A mostly anthroponotic origin is suspected for G. duodenalis and Blastocystis sp. infections. Electronic supplementary material The online version of this article (10.1186/s13071-018-3054-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Raimundo Seguí
- Department of Pharmacy, Pharmaceutical Technology and Parasitology, Parasitology Area, Faculty of Pharmacy, Valencia University, Avda. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Carla Muñoz-Antoli
- Department of Pharmacy, Pharmaceutical Technology and Parasitology, Parasitology Area, Faculty of Pharmacy, Valencia University, Avda. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain.
| | - Debora R Klisiowicz
- Department of Basic Pathology, Biological Sciences Area, Paraná Federal University, Av. Cel. Francisco H. dos Santos 100, Curitiba, 19031, Brazil
| | - Camila Y Oishi
- Department of Basic Pathology, Biological Sciences Area, Paraná Federal University, Av. Cel. Francisco H. dos Santos 100, Curitiba, 19031, Brazil
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Aida de Lucio
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Marta Hernández-de-Mingo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Paula Puente
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Rafael Toledo
- Department of Pharmacy, Pharmaceutical Technology and Parasitology, Parasitology Area, Faculty of Pharmacy, Valencia University, Avda. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - José G Esteban
- Department of Pharmacy, Pharmaceutical Technology and Parasitology, Parasitology Area, Faculty of Pharmacy, Valencia University, Avda. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain.
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van Hattem JM, Arcilla MS, Schultsz C, Bootsma MC, Verhaar N, Rebers SP, Goorhuis A, Grobusch MP, Penders J, de Jong MD, van Gool T, Bart A. Carriage of Blastocystis spp. in travellers - A prospective longitudinal study. Travel Med Infect Dis 2018; 27:87-91. [PMID: 29929001 DOI: 10.1016/j.tmaid.2018.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/31/2018] [Accepted: 06/07/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION A lack of prospective and longitudinal data on pre- and post-travel carriage of Blastocystis spp. complicates interpretation of a positive test post-travel. Therefore we studied dynamics of Blastocystis carriage in a cohort of Dutch travellers. METHODS From the prospective, multicentre COMBAT study among 2001 Dutch travellers, a subset of 491 travellers was selected based on travel destination to 7 subregions (70 or 71 travellers each). Faecal samples taken directly before and after travel were screened for Blastocystis with qPCR, followed, when positive, by sequence analysis to determine subtypes. RESULTS After exclusion of 12 samples with missing samples or inhibited qPCR-reactions, stool samples of 479 travellers were analysed. Before travel, 174 of them (36.3%) carried Blastocystis and in most of these, the same subtype was persistently carried. However, in 48/174 of those travellers (27.6%; CI95 20.8-36.6%) no Blastocystis or a different subtype was detected in the post-travel sample, indicating loss of Blastocystis during travel. Only 26 (5.4%; CI95 3.7%-8.0%) of all travellers acquired Blastocystis, including two individuals that were already positive for Blastocystis before travel but acquired a different subtype during travel. DISCUSSION This study shows that Blastocystis carriage in travellers is highly dynamic. The observed acquisition and loss of Blastocystis could either be travel-related or reflect the natural course of Blastocystis carriage. We demonstrate that the majority of Blastocystis detected in post-travel samples were already carried before travel.
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Affiliation(s)
- Jarne M van Hattem
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands.
| | - Maris S Arcilla
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Constance Schultsz
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands; Department of Global Health - Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, the Netherlands
| | - Martin C Bootsma
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Mathematics, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Nienke Verhaar
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Sjoerd P Rebers
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Abraham Goorhuis
- Centre of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Martin P Grobusch
- Centre of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - John Penders
- School for Public Health and Primary Care (Caphri), Department of Medical Microbiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Menno D de Jong
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Tom van Gool
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Aldert Bart
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
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Valença Barbosa C, de Jesus Batista R, Pereira Igreja R, d'Avila Levy CM, Werneck de Macedo H, Carneiro Santos HL. Distribution of Blastocystis subtypes isolated from humans from an urban community in Rio de Janeiro, Brazil. Parasit Vectors 2017; 10:518. [PMID: 29070053 PMCID: PMC5657060 DOI: 10.1186/s13071-017-2458-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 10/06/2017] [Indexed: 12/13/2022] Open
Abstract
Background Blastocystis is a cosmopolitan protist parasite found in the human gastrointestinal tract and is highly prevalent in developing countries. Recent molecular studies have revealed extensive genetic diversity, which has been classified into different subtypes (STs) based on sequence analysis of small subunit ribosomal RNA gene. Blastocystis is one of the most common fecal parasites in Brazil, but the diversity of subtypes remains unknown in the country. This study aimed to determine the distribution of Blastocystis STs in an urban community in Duque de Caxias, Rio de Janeiro, Brazil. Methods A total of 64 stool samples positive for Blastocystis in Pavlova’s medium were subtyped by PCR and sequenced using primers targeting the small subunit rRNA gene, in addition to phylogenetic analysis and subtype-specific PCR using sequence-tagged-site (STS) primers. Results Endolimax nana (14%), Entamoeba complex (10.5%), Taenia sp. (0.6%), Trichuris trichiura (1.3%) and Enterobius vermicularis (1.3%) were detected in Blastocystis-positive samples. Of the 64 samples tested by PCR/DNA sequencing, 55 were identified as ST1 (42%), ST3 (49%), ST2 (7%) and ST4 (2%), and the presence of mixed ST (ST1 + ST3) infection was detected in nine samples (14%). Conclusions DNA sequencing and phylogenetic analysis of Brazilian Blastocystis isolates identified four different subtypes. To our knowledge, this study provided the first genetic characterization of Blastocystis subtypes in an urban area of Rio de Janeiro, Brazil. We also identified ST4 for the first time in Brazil. Further studies are necessary to determine the distribution of STs across human populations in Rio de Janeiro.
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Affiliation(s)
- Carolina Valença Barbosa
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Av. Brasil, 4365 Pavilhão Arthur Neiva, Rio de Janeiro, 21.045-900, Brazil
| | - Rosemary de Jesus Batista
- Departamento de Ginecologia e Obstetrícia, IFF/Fiocruz, Rio de Janeiro, Brasil, Av. Rui Barbosa, 716, Flamengo, Rio de Janeiro, 22250-020, Brazil
| | - Ricardo Pereira Igreja
- Departamento de Medicina Preventiva da Faculdade de Medicina da UFRJ , Av. Carlos Chagas Filho, 373, Edifício do Centro de Ciências da Saúde Bloco K, 2° andar, Sala 49 - Cidade Universitária - Ilha do Fundão, Rio de Janeiro, 21.941-902, Brazil
| | - Claudia Masini d'Avila Levy
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Av. Brasil, 4365 Pavilhão Arthur Neiva, Rio de Janeiro, 21.045-900, Brazil
| | - Heloisa Werneck de Macedo
- Laboratório de Parasitologia do Departamento de Patologia, Hospital Universitário Antônio Pedro/Universidade Federal Fluminense, Niterói, RJ, Rua Marquês do Paraná, 303. 4º andar, sala 12, Niterói, Rio de Janeiro, 24033 900, Brazil
| | - Helena Lúcia Carneiro Santos
- Laboratório de Estudos Integrados em Protozoologia, Instituto Oswaldo Cruz/FIOCRUZ, Av. Brasil, 4365 Pavilhão Arthur Neiva, Rio de Janeiro, 21.045-900, Brazil.
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Molecular epidemiology of blastocystosis in Malaysia: does seasonal variation play an important role in determining the distribution and risk factors of Blastocystis subtype infections in the Aboriginal community? Parasit Vectors 2017; 10:360. [PMID: 28760145 PMCID: PMC5537991 DOI: 10.1186/s13071-017-2294-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 07/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alternating wet and dry seasons may play an important role in the acquisition and distribution of Blastocystis subtype infection in the tropics. This cross-sectional study was therefore conducted to provide the prevalence of Blastocystis and to determine the potential risk factors associated with each subtype during the wet and dry seasons in the Aboriginal community, Pahang, Malaysia. METHODS A total of 473 faecal samples were collected: 256 (54.1%) and 217 (45.9%) samples were obtained during the wet (October-November 2014) and the dry season (June 2015), respectively. All fresh faecal samples were subjected to molecular analysis for subtype and allele identification. RESULTS Of the 473 samples, 42.6% and 37.8% were positive for Blastocystis ST1, ST2, ST3 and ST4 during wet and dry seasons, respectively. Prevalence of Blastocystis ST1 was significantly higher during the wet season compared to the dry season (Z = 2.146, P < 0.05). Analysis of the association of each Blastocystis subtype with socioeconomic characteristics showed the presence of other family members infected with Blastocystis ST3 and the use of stored river water for domestic activities were the significant risk factors for Blastocystis ST3 infections during both seasons. Untreated water supply and low monthly household income (less or equal to RM 500) were the other significant risk factors for Blastocystis ST3 infections during wet and dry season, respectively. The presence of other family members with Blastocystis ST1 and ST2 was the only significant risk factor associated with ST1 and ST2 infections during both seasons. We hypothesise that transmission of Blastocystis ST1, ST2 and ST3 occurred from person to person during both seasons. The waterborne transmission was also identified as a mode of transmission of Blastocystis ST3. CONCLUSION The significant risk factors identified in this study were important in the dynamic transmission of Blastocystis infections during both seasons. Provision of treated water supply and health education are affirmative actions to be taken to control Blastocystis infections in this community.
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Distribution and phylogenetic analysis of Blastocystis sp. subtypes isolated from IBD patients and healthy individuals in Iran. Eur J Clin Microbiol Infect Dis 2017; 36:2335-2342. [PMID: 28741097 DOI: 10.1007/s10096-017-3065-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/04/2017] [Indexed: 12/19/2022]
Abstract
Blastocystis is a single-celled intestinal parasite commonly found in humans and a broad range of animals all over the world. In humans, its role in health and disease remains unsettled. The aim of our study was to investigate the distribution of Blastocystis and Blastocystis subtypes (ST) in patients with inflammatory bowel disease (IBD) and control subjects. A total of 71 stool samples were collected from IBD patients, 69 and 2 of whom had ulcerative colitis (UC) and Crohn's Disease (CD), respectively. Moreover, 166 stool samples from healthy subjects were included as control samples. All stool samples were cultivated, and 550-bp fragments of the small subunit ribosomal RNA gene was amplified from Blastocystis-positive cultures. All PCR-positive samples were sequenced. Blastocystis was observed in 9 (12.67%) and 35 (21.1%) IBD patients and healthy controls, respectively. There was no statistically significant correlation between IBD and presence of Blastocystis (P = 0.147). There was a statistically significant correlation between age and Blastocystis colonization in the IBD group (P < 0.05), but not among healthy controls. No significant correlation between gender and colonization was observed. ST1 and ST3 were obtained from 1 (12.5%) and 7 (87.5%) IBD patients, respectively, while in the healthy control group, subtypes 1, 2, and 3 were found in 14 (40%), 12 (34.28%), and 9 (25.72%), respectively. Phylogenetic analysis showed no variation in the distribution of subtypes nor intra-subtype genetic diversity between samples acquired from IBD patients and healthy controls. This study showed a trend towards a lower prevalence of Blastocystis in IBD patients than in control subjects. ST3 sequences isolated from IBD patients and control individuals did not appear to differ genetically.
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Comparative Prevalence of Blastocystis in Patients with the Irritable Bowel Syndrome and Healthy Individuals: A Case Control Study. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.13572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Seyer A, Karasartova D, Ruh E, Güreser AS, Turgal E, Imir T, Taylan-Ozkan A. Epidemiology and Prevalence of Blastocystis spp. in North Cyprus. Am J Trop Med Hyg 2017; 96:1164-1170. [PMID: 28167596 PMCID: PMC5417212 DOI: 10.4269/ajtmh.16-0706] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/28/2016] [Indexed: 01/29/2023] Open
Abstract
AbstractThis study was conducted to investigate the prevalence of Blastocystis spp. and its subtypes (STs) in North Cyprus; and to evaluate the presence of this parasite and its STs with respect to demographic, socioeconomic, and epidemiological factors, as well as gastrointestinal symptoms. Stool samples were collected from 230 volunteers. Each participant also filled out a questionnaire. The samples were examined microscopically by native-Lugol and trichrome methods and further tested by polymerase chain reaction (PCR) and sequencing. Prevalence of Blastocystis spp. infection was found to be 10.5%, 10.5%, and 27.8%, by direct microscopy, trichrome method, and PCR, respectively. No other parasites were detected in the specimens except Giardia spp. (n = 2; 0.8%) and Entamoeba coli (n = 1; 0.4%). The most common Blastocystis STs were ST3 (20; 31.2%), ST2 (18; 28.2%), ST1 (8; 12.5%), and ST4 (7; 11%); whereas other STs were identified as ST6 (3; 4.7%), ST7 (2; 3.2%), and non-ST (6; 9.4%). Presence of Blastocystis spp. and its STs was not significantly related to any of the demographic, socioeconomic, and epidemiological factors. Furthermore, no significant association of Blastocystis spp. and its STs with gastrointestinal symptoms was found. This study is the first investigation of the epidemiology of Blastocystis spp. in North Cyprus. Distribution of Blastocystis spp. and its STs among demographic, socioeconomic, and epidemiological factors showed complete homogeneity. Presence of the parasite and its STs was not significantly related with the gastrointestinal symptoms among symptomatic and asymptomatic individuals. These findings suggest that Blastocystis spp. may be part of the intestinal flora in humans.
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Affiliation(s)
- Ayse Seyer
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
- Faculty of Health Sciences, Girne American University, Kyrenia, Cyprus
| | - Djursun Karasartova
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Emrah Ruh
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Ayse Semra Güreser
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Ebru Turgal
- Department of Biostatistics, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Turgut Imir
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
- Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
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Identification of Blastocystis subtypes in clinical stool samples from Sao Paulo City, Brazil. ACTA ACUST UNITED AC 2017. [DOI: 10.1017/pao.2017.3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
SUMMARY
Blastocystis sp. is a protozoan commonly found in human and animal stool samples. Several pathogenic and zoonotic aspects of this organism are still unknown. The aim of the present study was to investigate Blastocystis subtypes (STs) in samples from patients of the Hospital das Clínicas of the Faculdade de Medicina at the Universidade de São Paulo (HC-FMUSP), Brazil. Blastocystis sp.-positive stool samples diagnosed at the Section of Parasitology of the Central Laboratory (HC-FMUSP) were used for DNA isolation. Polymerase chain reaction (PCR) was performed using specific primers targeting the small-subunit rRNA gene. Direct DNA sequencing of the PCR products was performed and the DNA sequences were then aligned and compared with other sequences obtained from the GenBank database. Phylogenetic analysis was used to identify STs and determine the phylogenetic relationships between the sequences. Four STs were identified: ST1 (22·5%), ST2 (12·5%), ST3 (60%) and ST6 (5%). In conclusion, ST3 was the most prevalent ST among the human isolates followed by ST1. The present study is one of the few providing STs data from the human population in South America. Determining ST prevalence in human samples may contribute to the monitoring of Blastocystis sp. infection transmission in endemic regions.
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Salvador F, Sulleiro E, Sánchez-Montalvá A, Alonso C, Santos J, Fuentes I, Molina I. Epidemiological and clinical profile of adult patients with Blastocystis sp. infection in Barcelona, Spain. Parasit Vectors 2016; 9:548. [PMID: 27741951 PMCID: PMC5064914 DOI: 10.1186/s13071-016-1827-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/02/2016] [Indexed: 12/14/2022] Open
Abstract
Background Blastocystis spp. are among the most frequently observed intestinal parasites in humans. Despite the discovery of Blastocystis approximately 100 years ago, limited information is available regarding its pathogenesis, genetic diversity, and available treatment options. The aim of this study was to describe the epidemiological and clinical characteristics of patients with Blastocystis sp. infections diagnosed at Vall d’Hebron University Hospital (Barcelona, Spain). Methods A retrospective observational study was performed which included all adult patients who attended Vall d’Hebron University Hospital from February 2009 to March 2014 that had Blastocystis sp. detected in their stool. Results Four hundred eighteen patients were included, the median age was 36 (18–86) years and 236 (56.5 %) were men. Regarding patient symptoms, 234 (56 %) patients were completely asymptomatic, 92 (22 %) patients had symptoms, and 92 (22 %) patients had symptoms that could be attributed to other causes. Of the 92 patients with symptoms not attributable to other etiologies except for Blastocystis infection, the most frequent symptoms were diarrhea (61 patients, 66.3 %) and abdominal pain (34 patients, 37 %). Additionally, nine (9.8 %) patients had cutaneous manifestations. Thirty-one (7.4 %) patients received specific treatment for Blastocystis infection. The clinical response of treated patients was varied. Five patients experienced complete resolution of symptoms, 12 patients reported improvement of clinical symptoms, eight patients described no clinical improvement, and information was unavailable for six patients. Conclusions Blastocystis infection was detected in 418 patients, most of them foreign-born. Although the vast majority of patients were asymptomatic, 22 % of patients had gastrointestinal symptoms or cutaneous manifestations in the absence of other causes. Despite the scarce information available, given the safety of antiparasitic treatment, and the percentage of patients who experienced resolution or improvement of symptoms, treatment should be considered in patients with chronic symptoms.
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain.
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Carmen Alonso
- Gastroenterology Department, Vall d' Hebron Research Institute, Digestive Diseases Research Unit, Vall d'Hebron University Hospital, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain
| | - Javier Santos
- Gastroenterology Department, Vall d' Hebron Research Institute, Digestive Diseases Research Unit, Vall d'Hebron University Hospital, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain
| | - Isabel Fuentes
- Instituto de Salud Carlos III, National Centre of Microbiology, Madrid, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
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El Safadi D, Cian A, Nourrisson C, Pereira B, Morelle C, Bastien P, Bellanger AP, Botterel F, Candolfi E, Desoubeaux G, Lachaud L, Morio F, Pomares C, Rabodonirina M, Wawrzyniak I, Delbac F, Gantois N, Certad G, Delhaes L, Poirier P, Viscogliosi E. Prevalence, risk factors for infection and subtype distribution of the intestinal parasite Blastocystis sp. from a large-scale multi-center study in France. BMC Infect Dis 2016; 16:451. [PMID: 27566417 PMCID: PMC5002209 DOI: 10.1186/s12879-016-1776-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/11/2016] [Indexed: 12/21/2022] Open
Abstract
Background Blastocystis sp. is the most common intestinal parasite of humans. Despite its potential public health impact, epidemiological data regarding the prevalence and molecular subtype distribution of Blastocystis sp. in Europe are rarely reported. Therefore, the first multi-center epidemiological survey performed in Europe was conducted in France to diagnose and subtype Blastocystis sp. and to identify risk factors for infection. Methods Stool samples from 788 patients were collected either in summer or winter in 11 hospitals throughout France together with patient data. All stool samples were tested for the presence of Blastocystis sp. by quantitative PCR targeting the SSU rDNA gene. Positive samples were sequenced to determine the distribution of the subtypes in our cohort. Statistical analyses were performed to identify potential risk factors for infection. Results Using quantitative PCR, the overall prevalence of Blastocystis sp. was shown to reach 18.1 %. The prevalence was significantly higher in summer (23.2 %) than in winter (13.7 %). Travellers or subjects infected with other enteric parasites were significantly more infected by Blastocystis sp. than non-travellers or subjects free of other enteric parasites, respectively. Different age-related epidemiological patterns were also highlighted from our data. The prevalence of Blastocystis sp. was not significantly higher in patients with digestive symptoms or diagnosed with chronic bowel diseases. Among symptomatic patients, Blastocystis sp. infection was significantly associated with abdominal pain. Gender, socioeconomic status, and immune status were not identified as potential risk factors associated with infection. Among a total of 141 subtyped isolates, subtype 3 was predominant (43.3 %), followed by subtype 1 and subtype 4 (20 %), subtype 2 (12.8 %), subtype 6 and subtype 7 (2.1 %). No association between ST and clinical symptoms was statistically evidenced. Conclusions A high prevalence of Blastocystis sp. infection was found in our French patient population. Seasonal impact on the prevalence of Blastocystis sp. was highlighted and recent travels and age were identified as main risk factors for infection. Most cases were caused by subtypes 1 to 4, with a predominance of subtype 3. Large variations in both prevalence and ST distribution between hospitals were also observed, suggesting distinct reservoirs and transmission sources of the parasite. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1776-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dima El Safadi
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France
| | - Amandine Cian
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France
| | - Céline Nourrisson
- Laboratoire de Parasitologie-Mycologie, CHU Gabriel-Montpied, Clermont-Ferrand, France.,Clermont Université, Université Blaise Pascal-Université d'Auvergne - CNRS UMR 6023 Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Unité de Biostatistiques, Direction de la Recherche Clinique (DRCI), Clermont-Ferrand, France
| | - Christelle Morelle
- Laboratoire de Parasitologie-Mycologie, CHU de Montpellier, CNRS UMR 5290/IRD 224/UM1, Université de Montpellier 1, Montpellier, France
| | - Patrick Bastien
- Laboratoire de Parasitologie-Mycologie, CHU de Montpellier, CNRS UMR 5290/IRD 224/UM1, Université de Montpellier 1, Montpellier, France
| | | | - Françoise Botterel
- Laboratoire de Parasitologie-Mycologie, AP-HP Hôpital Henri Mondor, Créteil, France
| | - Ermanno Candolfi
- Institut de Parasitologie et de Pathologie Tropicale de Strasbourg, Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Guillaume Desoubeaux
- Service de Parasitologie-Mycologie-Médecine Tropicale, CHU de Tours/CEPR Inserm U1100 Equipe 3, Université François-Rabelais de Tours, Tours, France
| | - Laurence Lachaud
- Département de Parasitologie-Mycologie, Faculté de Médecine de Montpellier-Nîmes, Université de Montpellier I, CHU de Montpellier, Montpellier, France
| | - Florent Morio
- Département de Parasitologie et Mycologie Médicale, Laboratoire de Parasitologie-Mycologie, Institut de Biologie, CHU de Nantes, EA1155-IICiMed, Université de Nantes, Nantes, France
| | - Christelle Pomares
- Laboratoire de Parasitologie-Mycologie CHU de Nice, C3M INSERM U1065, Université de Nice Sophia Antipolis, Nice, France
| | | | - Ivan Wawrzyniak
- Clermont Université, Université Blaise Pascal-Université d'Auvergne - CNRS UMR 6023 Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Frédéric Delbac
- Clermont Université, Université Blaise Pascal-Université d'Auvergne - CNRS UMR 6023 Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Nausicaa Gantois
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France
| | - Gabriela Certad
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France
| | - Laurence Delhaes
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France.,Département de Parasitologie-Mycologie, CHU de Lille, Faculté de Médecine, Lille, France
| | - Philippe Poirier
- Laboratoire de Parasitologie-Mycologie, CHU Gabriel-Montpied, Clermont-Ferrand, France. .,Clermont Université, Université Blaise Pascal-Université d'Auvergne - CNRS UMR 6023 Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France.
| | - Eric Viscogliosi
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France.
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