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Figueiredo AM, Santín M, Köster PC, Dashti A, Maloney JG, Torres RT, Fonseca C, Mysterud A, Carvalho J, Hipólito D, Rossa M, Palmeira JD, González-Barrio D, Calero-Bernal R, Carmena D. Molecular detection and characterization of Blastocystis in herbivore livestock species in Portugal. Vet Parasitol 2024; 327:110147. [PMID: 38364349 DOI: 10.1016/j.vetpar.2024.110147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/18/2024]
Abstract
Blastocystis is a ubiquitous intestinal protist in humans and animals worldwide. The traditional livestock free-roaming raising system in rural communities increases the risk of infection with contact with a wider range of pathogens transmitted via the faecal-oral route associated with that wildlife-livestock-human interface. However, no studies have been conducted to determine the occurrence and subtype distribution of Blastocystis in livestock in Portugal. Here, we collected 180 faecal samples from herbivore livestock (cattle, goats, horses, and sheep) in different regions of the country to investigate Blastocystis prevalence and subtype diversity using PCR and next-generation amplicon sequencing. Blastocystis was present in 40.6% (73/180; 95% CI: 33.31-48.11) of the samples (goats, 81.0%; sheep, 60.9%; cattle, 32.2%). None of the horse samples were Blastocystis-positive. Eighteen subtypes were detected (ST1-ST3, ST5-ST7, ST10, ST13, ST14, ST21, ST23-ST26, ST30, ST42-ST44). Mixed infections were detected in 97.3% of the Blastocystis-positive samples. Potentially zoonotic subtypes were identified in 75.0%, 96.4%, and 100% of the Blastocystis-positive specimens collected from cattle, sheep, and goats, respectively. These results demonstrate that cattle, sheep, and goats harbour a high diversity of Blastocystis subtypes in the study regions. Importantly, our data provide novel molecular evidence strongly suggesting that some Blastocystis STs/ST subgroups may have differential host specificity.
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Affiliation(s)
- Ana M Figueiredo
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal; Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, University of Oslo, Blindern, Oslo, Norway
| | - Mónica Santín
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA.
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Majadahonda, 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
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Majadahonda, Spain
| | - Jenny G Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - Rita T Torres
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Carlos Fonseca
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal; ForestWISE - Collaborative Laboratory for Integrated Forest & Fire Management, Vila Real, Portugal
| | - Atle Mysterud
- Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, University of Oslo, Blindern, Oslo, Norway
| | - João Carvalho
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Dário Hipólito
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal; Veterinary Biology Unit, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Mariana Rossa
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Josman D Palmeira
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - David González-Barrio
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Majadahonda, Spain
| | - Rafael Calero-Bernal
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Madrid, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Majadahonda, Spain; CIBER Infectious Diseases (CIBERINFEC), Health Institute Carlos III, Madrid, Spain.
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Martín-Escolano R, Ng GC, Tan KSW, Stensvold CR, Gentekaki E, Tsaousis AD. Resistance of Blastocystis to chlorine and hydrogen peroxide. Parasitol Res 2023; 122:167-176. [PMID: 36378332 PMCID: PMC9816239 DOI: 10.1007/s00436-022-07713-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022]
Abstract
Blastocystis is a ubiquitous, widely distributed protist inhabiting the gastrointestinal tract of humans and other animals. The organism is genetically diverse, and so far, at least 28 subtypes (STs) have been identified with ST1-ST9 being the most common in humans. The pathogenicity of Blastocystis is controversial. Several routes of transmission have been proposed including fecal-oral (e.g., zoonotic, anthroponotic) and waterborne. Research on the latter has gained traction in the last few years with the organism having been identified in various bodies of water, tap water, and rainwater collection containers including water that has been previously filtered and/or chlorinated. Herein, we assessed the resistance of 11 strains maintained in culture, spanning ST1-ST9 to various chlorine and hydrogen peroxide concentrations for 24 h, and performed recovery assays along with re-exposure. Following the treatment with both compounds, all subtypes showed increased resistance, and viability could be visualized at the cellular level. These results are hinting at the presence of mechanism of resistance to both chlorine and hydrogen peroxide. As such, this pilot study can be the platform for developing guidelines for water treatment processes.
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Affiliation(s)
- Rubén Martín-Escolano
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury, CT2 7NJ, UK
| | - Geok Choo Ng
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore, 117545, Singapore
| | - Kevin S W Tan
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore, 117545, Singapore
| | - C Rune Stensvold
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - Eleni Gentekaki
- Gut Microbiome Research Group, Mae Fah Luang University, Chiang Rai, 57100, Thailand. .,School of Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand.
| | - Anastasios D Tsaousis
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury, CT2 7NJ, UK.
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Franklin F, Rajamanikam A, Raju CS, Gill JS, Francis B, Sy-Cherng LW, Kumar S. Higher amoebic and metronidazole resistant forms of Blastocystis sp. seen in schizophrenic patients. Parasit Vectors 2022; 15:313. [PMID: 36064639 PMCID: PMC9446727 DOI: 10.1186/s13071-022-05418-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background Blastocystis sp. is one of the most common colonisers of the intestinal tract that demonstrate strong interaction with accompanying gut bacteria. Previously, the protozoan isolated from individuals with irritable bowel syndrome (IBS) showed altered phenotypic features suggesting that it can be triggered to become pathogenic. Previous studies reported altered gut microbiota and high prevalence of Blastocystis sp. in schizophrenia patients. However, the phenotypic characteristics of Blastocystis sp. isolated from individuals with SZ have yet to be described. Methods In this study, faecal samples from 50 patients with severe schizophrenia (SZ) and 100 non-schizophrenic (NS) individuals were screened for Blastocystis sp. infection. Positive isolates were subjected to genotypic and phenotypic characterization. Results We found that 12 out of 50 (24%) SZ and 5 out of 100 (5%) NS individuals were detected Blastocystis sp. positive using both in vitro culture and PCR method with no significant association to age and gender. Out of the 15 sequenced isolates, ST3 was the most prevalent subtype (66.7%) followed by ST1 (20%) and ST6 (13.3%). The isolates from SZ individuals demonstrated significant slower growth rate (34.9 ± 15.6 h) and larger range of cell diameter (3.3–140 µm). We detected higher amoebic forms and metronidazole resistance among SZ isolates with variation in cell surface glycoprotein where 98% of cells from SZ showed consistent medium to high binding affinity (+ 2 to + 3) to Concavalin A staining compared to NS isolates that demonstrated only 76% high lectin (+ 3) binding affinity. Cysteine and serine protease levels were predominantly found among SZ isolates. We also demonstrate the presence of metalloprotease in Blastocystis sp. especially among NS isolates. Introduction of solubilised antigens from SZ isolates increased the cell proliferation of HCT116 cells by two fold when compared to NS isolates. Conclusion Our findings demonstrated Blastocystis sp. isolated from SZ individuals showed variation in phenotype specifically in morphology and drug resistance. The findings indicate that the gut environment (SZ and NS) and treatment of SZ could have influenced the phenotype of Blastocystis sp. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05418-0.
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Affiliation(s)
- Freddy Franklin
- Department of Parasitology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia.,Department of Medical Microbiology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia
| | - Arutchelvan Rajamanikam
- Department of Parasitology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia.,Department of Medical Microbiology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia
| | | | - Jesjeet Singh Gill
- Department of Phycological Medicine, Pusat Perubatan Universiti Malaya (PPUM), Kuala Lumpur, 50603, Malaysia
| | - Benedict Francis
- Department of Phycological Medicine, Pusat Perubatan Universiti Malaya (PPUM), Kuala Lumpur, 50603, Malaysia
| | - Luke Woon Sy-Cherng
- Department of Psychiatry, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, 50603, Malaysia
| | - Suresh Kumar
- Department of Parasitology, Universiti Malaya (UM), Kuala Lumpur, 50603, Malaysia.
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Blastocystis hominis undergoing programmed cell death via cytotoxic gamma irradiation. Exp Parasitol 2022; 240:108341. [DOI: 10.1016/j.exppara.2022.108341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 07/04/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022]
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Oxygen levels are key to understanding "Anaerobic" protozoan pathogens with micro-aerophilic lifestyles. Adv Microb Physiol 2021; 79:163-240. [PMID: 34836611 DOI: 10.1016/bs.ampbs.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Publications abound on the physiology, biochemistry and molecular biology of "anaerobic" protozoal parasites as usually grown under "anaerobic" culture conditions. The media routinely used are poised at low redox potentials using techniques that remove O2 to "undetectable" levels in sealed containers. However there is growing understanding that these culture conditions do not faithfully resemble the O2 environments these organisms inhabit. Here we review for protists lacking oxidative energy metabolism, the oxygen cascade from atmospheric to intracellular concentrations and relevant methods of measurements of O2, some well-studied parasitic or symbiotic protozoan lifestyles, their homeodynamic metabolic and redox balances, organism-drug-oxygen interactions, and the present and future prospects for improved drugs and treatment regimes.
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Mossallam SF, El- Mansoury SA, Tolba MM, Kohla AA, Khedr SI. In vitro susceptibility of human Blastocystis subtypes to simeprevir. Saudi J Biol Sci 2021; 28:2491-2501. [PMID: 33935570 PMCID: PMC8071969 DOI: 10.1016/j.sjbs.2021.01.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction and aim Blastocystis is a common enteric parasite, having a worldwide distribution. Many antimicrobial agents are effective against it, yet side effects and drug resistance have been reported. Thus, ongoing trials are being conducted for exploring anti-Blastocystis alternatives. Proteases are attractive anti-protozoal drug targets, having documented roles in Blastocystis. Serine proteases are present in both hepatitis C virus and Blastocystis. Since drug repositioning is quite trendy, the in vitro efficacy of simeprevir (SMV), an anti-hepatitis serine protease inhibitor, against Blastocystis was investigated in the current study. Methods Stool samples were collected from patients, Alexandria, Egypt. Concentrated stools were screened using direct smears, trichrome, and modified Ziehl-Neelsen stains to exclude parasitic co-infections. Positive stool isolates were cultivated, molecularly subtyped for assessing the efficacy of three SMV doses (100,150, and 200 μg/ml) along 72 hours (h), on the most common subtype, through monitoring parasite growth, viability, re-culture, and also via ultrastructure verification. The most efficient dose and duration were later tested on other subtypes. Results Results revealed that Blastocystis was detected in 54.17% of examined samples. Molecularly, ST3 predominated (62%), followed by ST1 (8.6%) and ST2 (3.4%). Ascending concentrations of SMV progressively inhibited growth, viability, and re-culture of treated Blastocystis, with a non-statistically significant difference when compared to the therapeutic control metronidazole (MTZ). The most efficient dose and duration against ST3 was 150 µg/ml for 72 h. This dose inhibited the growth of ST3, ST1, and ST2 with percentages of 95.19%, 94.83%, and 94.74%, successively and viability with percentages of 98.30%, 98.09%, and 97.96%, successively. This dose abolished Blastocystis upon re-culturing. Ultra-structurally, SMV induced rupture of Blastocystis cell membrane leading to necrotic death, versus the reported apoptotic death caused by MTZ. In conclusion, 150 µg/ml SMV for 72 h proved its efficacy against ST1, ST2, and ST3 Blastocystis, thus sparing the need for pre-treatment molecular subtyping in developing countries.
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Key Words
- Blastocystis subtypes
- CV, central vacuole
- DMSO, Dimethyl Sulfoxide
- IBS, irritable bowel syndrome
- In vitro
- MLO, Mitochondrion-like organelle
- MTZ, Metronidazole
- PCR, Polymerase chain reaction
- Re-culture
- SEM, Scanning electron microscopy
- SMV, Simeprevir
- ST, subtypes
- Simeprevir
- TEM, Transmission electron microscopy
- Ultrastructure
- Viability
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Affiliation(s)
- Shereen F. Mossallam
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Corresponding author at: Medical Parasitology Department, El Mowasah Medical and Educational Complex, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Salwa A.T. El- Mansoury
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mona M. Tolba
- Department of Parasitology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Asmaa A. Kohla
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Safaa I. Khedr
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Bhat Yellanthoor R. Acute gastroenteritis due to Blastocystis hominis in an adolescent boy. BMJ Case Rep 2020; 13:13/12/e237810. [PMID: 33370946 PMCID: PMC7754653 DOI: 10.1136/bcr-2020-237810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Acute gastroenteritis with persistent vomiting, high degree fever and blood streaking stools often suggests bacterial aetiology in children. Authors report a 13-year-old boy presenting with acute watery diarrhoea with persistent vomiting, fever of 103°F, abdominal cramps and blood streaking stools who failed to show any response to parenteral third-generation cephalosporin for 72 hours. The stool examination revealed numerous cystic and amoeboid forms of Blastocystis hominis Metronidazole was started and the boy promptly responded within 24 hours. There was no recurrence of symptoms then onwards. The case highlights the crucial stool examination in case of acute diarrhoeal disease for rare aetiology.
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Hashan MR, Elhusseiny KM, Huu-Hoai L, Tieu TM, Low SK, Minh LHN, Nghia TLB, Loc LQ, Y MN, Eid PS, Abed M, Elkolaly SS, Tawfik GM, Huy NT. Effect of nitazoxanide on diarrhea: A systematic review and network meta-analysis of randomized controlled trials. Acta Trop 2020; 210:105603. [PMID: 32598920 DOI: 10.1016/j.actatropica.2020.105603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 01/30/2023]
Abstract
We aimed to systematically review evidence pertaining to the safety and efficacy of nitazoxanide in treating infectious diarrhea. On September 21, 2017, we identified relevant studies using 12 databases. The estimates of the included studies were pooled as a risk ratio (RR). We conducted a network and pairwise random-effects meta-analysis for both direct and indirect comparisons of different organisms that are known to cause diarrhea. The primary and secondary analysis outcomes were clinical response until cessation of illness, parasitological response and adverse events. We included 18 studies in our analysis. In cryptosporidiosis, the overall estimate favored nitazoxanide in its clinical response in comparison with placebo RR 1.46 [95% CI 1.22-1.74; P-value <0.0001]. Network meta-analysis among patients with Giardia intestinalis showed an increase in the probability of diarrheal cessation and parasitological responses in comparison with placebo, RR 1.69 [95% CI 1.08-2.64, P-score 0.27] and RR 2.91 [95% CI 1.72-4.91, P-score 0.55] respectively. In Clostridium difficile infection, the network meta-analysis revealed a non-significantly superior clinical response effect of nitazoxanide to metronidazole 31 days after treatment RR 1.21 [95% CI 0.87-1.69, P-score 0.26]. In Entamoeba histolytica, the overall estimate significantly favored nitazoxanide in parasitological response with placebo RR 1.80 [95% CI 1.35-2.40, P-value < 0.001]. We highlighted the effectiveness of nitazoxanide in the cessation of diarrhea caused by Cryptosporidium, Giardia intestinalis and Entamoeba histolytica infection. We also found significant superiority of NTZ to metronidazole in improving the clinical response to G. intestinalis, thus it may be a suitable candidate for treating infection-induced diarrhea. To prove the superiority of NTZ during a C. difficile infection may warrant a larger-scale clinical trial since its superiority was deemed insignificant. We recommend nitazoxanide as an appropriate option for treating infectious diarrhea.
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García-Flores L, Santillán-Benítez JG, Cuevas-Yáñez E, Caballero-Vásquez P, Zamudio-Chávez S, Morales-Ávila E. Evaluation of the effect of 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol in comparison with metronidazole in an in vitro culture of Blastocystis in samples of patients with irritable bowel syndrome. J Parasit Dis 2019; 43:506-512. [PMID: 31406417 PMCID: PMC6667573 DOI: 10.1007/s12639-019-01118-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/23/2019] [Indexed: 12/17/2022] Open
Abstract
Metronidazole is the most-used pharmaceutical for the treatment of infection by Blastocystis. However, studies have reported resistance of the microorganism towards this pharmaceutical. In Mexico, studies concerning the prevalence of this parasite and its relationship to Irritable Bowel Syndrome have been carried out. To evaluate the in vitro effect of metronidazole and the compound 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol over Blastocystis, as well as the prevalence of Blastocystis in patients with Irritable Bowel Syndrome. A prospective, transversal design study (April 2016-April 2017) of 51 samples of patients with Irritable Bowel Syndrome, obtained from the ISSEMyM Medical Center in Toluca, Mexico. For the identification of Blastocystis was done in three serial stool samples through direct microscopic examination and the Ritchie technique. The in vitro susceptibility test towards metronidazole and the triazolic compound was done through a microculture in concentrations of 1 to 1000 µg/mL, each one in triplicate. A 31.3% prevalence of Blastocystis was observed in the population, with greater prevalence in women (30.2%) than in men (25%). In the susceptibility test, a CL50 of 64 µg/mL was obtained for metronidazole, in comparison to the CL50 of 250 µg/mL for 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol. This molecule in development has an effect for the treatment of infection by Blastocystis in vitro in patients with IBS and therefore, more studies should be performed.
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Affiliation(s)
- L. García-Flores
- Faculty of Chemistry, Autonomous University of the State of Mexico (UAEMex), Paseo Colón esq Paseo Tollocan, Col. Residencial Colón, Toluca, C.P. 50000 Mexico
| | - JG Santillán-Benítez
- Faculty of Chemistry, Autonomous University of the State of Mexico (UAEMex), Paseo Colón esq Paseo Tollocan, Col. Residencial Colón, Toluca, C.P. 50000 Mexico
- ISSEMyM Medical Center, Av. Baja Velocidad Km. 57.5 Carr. Méx./Tol. # 284 Col San Jerónimo Chicahualco. Municipio, Metepec, Mexico
| | - E. Cuevas-Yáñez
- Faculty of Chemistry, Autonomous University of the State of Mexico (UAEMex), Paseo Colón esq Paseo Tollocan, Col. Residencial Colón, Toluca, C.P. 50000 Mexico
| | - P. Caballero-Vásquez
- ISSEMyM Medical Center, Av. Baja Velocidad Km. 57.5 Carr. Méx./Tol. # 284 Col San Jerónimo Chicahualco. Municipio, Metepec, Mexico
| | | | - E. Morales-Ávila
- Faculty of Chemistry, Autonomous University of the State of Mexico (UAEMex), Paseo Colón esq Paseo Tollocan, Col. Residencial Colón, Toluca, C.P. 50000 Mexico
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Clinical and epidemiological characteristics of intestinal parasite infection by Blastocystis hominis. Rev Clin Esp 2018. [DOI: 10.1016/j.rceng.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Características clínicas y epidemiológicas de la parasitación intestinal por Blastocystis hominis. Rev Clin Esp 2018; 218:115-120. [DOI: 10.1016/j.rce.2018.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 01/14/2018] [Accepted: 01/15/2018] [Indexed: 12/13/2022]
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