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Siti Farah Norasyikeen SO, Ngui R, Syaza Zafirah AR, Md Zoqratt MZH, Eng WWH, Ayub Q, Amin Nordin S, Narcisse Mary Sither Joseph V, Musa S, Lim YAL. Study on intestinal parasitic infections and gut microbiota in cancer patients at a tertiary teaching hospital in Malaysia. Sci Rep 2024; 14:13650. [PMID: 38871760 DOI: 10.1038/s41598-024-59969-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/17/2024] [Indexed: 06/15/2024] Open
Abstract
Intestinal parasitic infections (IPIs) can lead to significant morbidity and mortality in cancer patients. While they are unlikely to cause severe disease and are self-limiting in healthy individuals, cancer patients are especially susceptible to opportunistic parasitic infections. The gut microbiota plays a crucial role in various aspects of health, including immune regulation and metabolic processes. Parasites occupy the same environment as bacteria in the gut. Recent research suggests intestinal parasites can disrupt the normal balance of the gut microbiota. However, there is limited understanding of this co-infection dynamic among cancer patients in Malaysia. A study was conducted to determine the prevalence and relationship between intestinal parasites and gut microbiota composition in cancer patients. Stool samples from 134 cancer patients undergoing active treatment or newly diagnosed were collected and examined for the presence of intestinal parasites and gut microbiota composition. The study also involved 17 healthy individuals for comparison and control. Sequencing with 16S RNA at the V3-V4 region was used to determine the gut microbial composition between infected and non-infected cancer patients and healthy control subjects. The overall prevalence of IPIs among cancer patients was found to be 32.8%. Microsporidia spp. Accounted for the highest percentage at 20.1%, followed by Entamoeba spp. (3.7%), Cryptosporidium spp. (3.0%), Cyclospora spp. (2.2%), and Ascaris lumbricoides (0.8%). None of the health control subjects tested positive for intestinal parasites. The sequencing data analysis revealed that the gut microbiota diversity and composition were significantly different in cancer patients than in healthy controls (p < 0.001). A significant dissimilarity was observed in the bacterial composition between parasite-infected and non-infected patients based on Bray-Curtis (p = 0.041) and Jaccard (p = 0.021) measurements. Bacteria from the genus Enterococcus were enriched in the parasite-infected groups, while Faecalibacterium prausnitzii reduced compared to non-infected and control groups. Further analysis between different IPIs and non-infected individuals demonstrated a noteworthy variation in Entamoeba-infected (unweighted UniFrac: p = 0.008), Cryptosporidium-infected (Bray-Curtis: p = 0.034) and microsporidia-infected (unweighted: p = 0.026; weighted: p = 0.019; Jaccard: p = 0.031) samples. No significant dissimilarity was observed between Cyclospora-infected groups and non-infected groups. Specifically, patients infected with Cryptosporidium and Entamoeba showed increased obligate anaerobic bacteria. Clostridiales were enriched with Entamoeba infections, whereas those from Coriobacteriales decreased. Bacteroidales and Clostridium were found in higher abundance in the gut microbiota with Cryptosporidium infection, while Bacillales decreased. Additionally, bacteria from the genus Enterococcus were enriched in microsporidia-infected patients. In contrast, bacteria from the Clostridiales order, Faecalibacterium, Parabacteroides, Collinsella, Ruminococcus, and Sporosarcina decreased compared to the non-infected groups. These findings underscore the importance of understanding and managing the interactions between intestinal parasites and gut microbiota for improved outcomes in cancer patients.
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Affiliation(s)
- Sidi Omar Siti Farah Norasyikeen
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Paraclinical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Malaysia
| | - Romano Ngui
- Department of Paraclinical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Malaysia.
| | - Ab Rahman Syaza Zafirah
- Department of Paediatrics, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | | | - Wilhelm Wei Han Eng
- Monash University Malaysia Genomics Facility, Monash University Malaysia, 47500, Subang Jaya, Malaysia
| | - Qasim Ayub
- Monash University Malaysia Genomics Facility, Monash University Malaysia, 47500, Subang Jaya, Malaysia
| | - Syafinaz Amin Nordin
- Department of Microbiology, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | | | - Sabri Musa
- Department of Children's Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
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Osman E, Amin NA, Noon TPM, Lahat SNH, Rosli MS, Sham SF, Periyasamy PR, Ghazali N, Manap SNAA, Noordin R. Comparison of Two Serological Assays in Detecting Strongyloides Infection in Immunocompromised Patients. Am J Trop Med Hyg 2022; 107:tpmd220076. [PMID: 35895335 PMCID: PMC9490643 DOI: 10.4269/ajtmh.22-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/02/2022] [Indexed: 11/07/2022] Open
Abstract
Strongyloides infection may develop into fatal hyperinfection and dissemination syndrome in immunocompromised hosts. Despite suboptimal specificity issues, the detection of IgG antibodies by ELISA has been central in the serodiagnosis of Strongyloides infection. Recently, an IgG4-based lateral-flow test (SsRapid) using recombinant NIE (rNIE) protein with good diagnostic performance has been reported. This study assessed the result concordance between a commercial IgG-ELISA and the SsRapid. Additionally, we determined the Strongyloides seroprevalence and its association with clinical manifestations. Immunocompromised patients (N = 200) were from Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia, and were diagnosed with HIV/AIDS, hematological malignancy, and solid organ cancers. Their plasma samples were tested using a commercial IgG-ELISA and SsRapid. A fair concordance (κ = 0.27-0.33; P < 0.05) among the tests was demonstrated. The SsRapid exhibited a significantly higher (P < 0.05) seroprevalence (10.5% [21/200]) compared with IgG-ELISA (7.5% [15/200]). After adsorption with rNIE, all SsRapid-positive samples tested negative with the rapid test, thus showing binding specificity. There was no significant association with clinical manifestations. This study revealed that SsRapid is a useful diagnostic tool for Strongyloides infection, and there is a notable seroprevalence among the immunocompromised patients.
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Affiliation(s)
- Emelia Osman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Azma Amin
- Universiti Kuala Lumpur Institute of Medical Science Technology Selangor, Malaysia
| | - Thieeraporn Phraseart Ma Noon
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Nuratiqah Hanani Lahat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohamad Syairazi Rosli
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shazia Farhana Sham
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Nuraffini Ghazali
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Nor Azreen Abd Manap
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia (USM), Penang, Malaysia
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Costa IN, Bosqui LR, Corral MA, Costa-Cruz JM, Gryschek RCB, de Paula FM. Diagnosis of human strongyloidiasis: Application in clinical practice. Acta Trop 2021; 223:106081. [PMID: 34364894 DOI: 10.1016/j.actatropica.2021.106081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/08/2021] [Accepted: 07/26/2021] [Indexed: 12/28/2022]
Abstract
This review considers the advantages and disadvantages of parasitological techniques, methods of detecting antibodies and antigens, as well as molecular biology techniques in the diagnosis of human strongyloidiasis. In addition, it elucidates the potential of different techniques for rapid and effective detection of clinical cases, thus enabling early treatment and preventing fatal consequences of this helminthiasis.
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Eslahi AV, Olfatifar M, Houshmand E, Johkool MG, Zibaei M, Foroutan M, Hosseini H, Badri M. Prevalence of Strongyloides stercoralis in the immunocompetent and immunocompromised individuals in Iran: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2021; 116:87-99. [PMID: 34302179 DOI: 10.1093/trstmh/trab104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/27/2021] [Accepted: 07/01/2021] [Indexed: 01/25/2023] Open
Abstract
Strongyloidiasis is a neglected tropical disease mostly distributed in tropical and subtropical regions. The current study evaluated the prevalence of Strongyloides stercoralis in immunocompetent and immunodeficient patients in Iran. The available online literature published from June 1994 to October 2020 was obtained from multiple English databases (PubMed, Science Direct, Scopus, Web of Science and Google Scholar) and four Persian databases (Magiran, Iran Medex, Iran Doc and SID). All statistical analyses were performed using R software (version 3.6) meta-package and p-values <0.05 were considered significant. From 1051 articles, 74 studies (248 656 individuals) met the inclusion criteria. The pooled prevalence of S. stercoralis was 2% (95% confidence interval [CI] 1 to 3) and 4% (95% CI 1 to 8) in immunocompetent and immunodeficient patients, respectively. In immunodeficient cases, the pooled prevalence of studies utilizing serology, culture and microscopic methods was 10% (95% CI 2 to 23), 1% (95% CI 0 to 6) and 1% (95% CI 0 to 1), respectively. In immunocompetent cases, the pooled prevalence of studies utilizing microscopic, culture and molecular methods was 2% (95% CI 1 to 3), 2% (95% CI 1 to 4) and 2% (95% CI 0 to 6), respectively. We propose an appropriate screening and control program along with comprehensive research regarding the frequency of strongyloidiasis in the country.
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Affiliation(s)
- Aida Vafae Eslahi
- Clinical Research Development Unit, Velayat Hospital, Qazvin University of Medical Sciences, Shahid Bahonar Boulevard, Qazvin, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran Province, Tehran, Velenjak, 7th Floor, Bldg No.2 SBUMS, Arabi Ave, Tehran, Iran
| | - Elham Houshmand
- Department of Parasitology, Faculty of Veterinary Medicine, Islamic Azad University, Rasht Branch, Guilan, Iran
| | - Morteza Ghanbari Johkool
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Shahid Bahonar Boulevard, Qazvin, Iran
| | - Mohammad Zibaei
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Taleghani Boulevard, Taleghani square, Karaj, Iran
| | - Masoud Foroutan
- Department of Medical Parasitology, Faculty of Medicine, Abadan University of Medical Sciences, Zolfaghari 30m st, Abadan, Iran
| | - Hamid Hosseini
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Taleghani Boulevard, Taleghani square, Karaj, Iran
| | - Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Shahid Bahonar Boulevard, Qazvin, Iran
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Effectiveness and Safety of a Single-Dose Ivermectin Treatment for Uncomplicated Strongyloidiasis in Immunosuppressed Patients (ImmunoStrong Study): The Study Protocol. Pathogens 2021; 10:pathogens10070812. [PMID: 34199000 PMCID: PMC8308528 DOI: 10.3390/pathogens10070812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 12/15/2022] Open
Abstract
Strongyloidiasis affects an estimated 600 million people worldwide, especially in tropical and subtropical areas. Single-dose ivermectin treatment has shown to be effective among immunocompetent patients with uncomplicated strongyloidiasis. Here, we present the protocol of the ImmunoStrong study, a prospective observational study aiming to evaluate the effectiveness and safety of a single-dose ivermectin for treatment of uncomplicated strongyloidiasis in immunosuppressed patients. The secondary objectives are to assess accuracy of molecular techniques for the follow-up of these patients and to determine the population pharmacokinetics of ivermectin. The information retrieved by this study will cover relevant information gaps in the strongyloidiasis management among immunosuppressed patients.
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Kalantari N, Chehrazi M, Ghaffari S, Gorgani-Firouzjaee T. Serological assays for the diagnosis of Strongyloides stercoralis infection: a systematic review and meta-analysis of diagnostic test accuracy. Trans R Soc Trop Med Hyg 2021; 114:459-469. [PMID: 32052848 DOI: 10.1093/trstmh/trz135] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/04/2019] [Accepted: 12/03/2019] [Indexed: 12/18/2022] Open
Abstract
The standard method for the diagnosis of Strongyloides stercoralis, stool examinations, is inconvenient and, therefore, serological methods have been proposed. This study aimed to evaluate the accuracy of serological assays for the diagnosis of strongyloidiasis using a systematic review and meta-analysis model. Four electronic databases were reviewed. We used a random effects model and 95% CIs to determine the overall sensitivity, specificity and diagnostic odds ratio (DOR). Heterogeneity was intended with Cochran Q χ2 test and I2 statistic. The accuracy of serological assays resulted in a sensitivity of 71.7% (95% CI: 56.07 to 83.4%), a specificity of 89.9% (95% CI: 80.8 to 94.9%) and a DOR of 22.5 (95% CI: 10.8 to 46.9). The forest plot showed high heterogeneity regarding sensitivity (I2=90.4%, 95% CI: 87.4 to 93.3%; Q=228.1, p=0.000) and specificity (I2=98.9%, 95% CI: 98.8 to 99.1%; Q=2066.4, p=0.000). Fagan's nomogram showed that the probability of someone having the infection and with a positive test result was 49%. Deeks' funnel plots showed no evidence of potential publication bias for the studies (p=0.26). The current review suggests that serological techniques have acceptable sensitivity and specificity and therefore can be recommended for the screening of S. stercoralis infection.
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Affiliation(s)
- Narges Kalantari
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Ganj Afrooz Ave., Babol 47176-47745, I. R. Iran
- Department of Laboratory Sciences, Faculty of Paramedical Sciences, Babol University of Medical Sciences, Ganj Afrooz Ave., Babol 47176-47745, I.R. Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Medicine, Babol University of Medical Sciences, Ganj Afrooz Ave., Babol 47176-47745, I. R. Iran
| | - Salman Ghaffari
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Ganj Afrooz Ave., Babol 47176-47745, I.R. Iran
| | - Tahmineh Gorgani-Firouzjaee
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Ganj Afrooz Ave., Babol 47176-47745, I.R. Iran
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Ganj Afrooz Ave., Babol 47176-47745, I.R. Iran
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Ashiri A, Rafiei A, Beiromvand M, Khanzadeh A, Alghasi A. Screening of Strongyloides stercoralis infection in high-risk patients in Khuzestan Province, Southwestern Iran. Parasit Vectors 2021; 14:37. [PMID: 33422116 PMCID: PMC7796600 DOI: 10.1186/s13071-020-04549-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Strongyloidiasis, one of the neglected tropical diseases (NTDs), can be fatal in immunocompromised patients. Available data on Strongyloides stercoralis infection in high-risk patients in Iran are limited. The aim of the present study was to determine the prevalence of S. stercoralis infection and associated risk factors among high-risk patients as well as to evaluate the sensitivity of the diagnostic tests used in the diagnose of S. stercoralis infection. METHODS This cross-sectional study was performed from 2019 to 2020 among 300 high-risk patients in Khuzestan Province, southwestern Iran. Patients with autoimmune diseases, uncontrolled diabetes, HIV/AIDS, cancer, organ transplant, hematological malignancy, asthma and chronic obstructive pulmonary disease (COPD) were examined using direct smear examination, formalin-ether concentration, Baermann funnel technique, agar plate culture, and ELISA test. Since agar plate culture was considered the reference diagnostic test, culture-positive samples were confirmed by PCR amplification and the sequencing of the nuclear 18S rDNA (SSU) hypervariable region (HVRIV) of the parasite. RESULTS The prevalence of S. stercoralis infection was 1%, 1.3%, 2%, 2.7%, and 8.7% using direct smear examination, formalin-ether concentration, Baermann funnel technique, agar plate culture, and ELISA test, respectively. All culture-positive samples were confirmed by SSU-PCR. According to the results, the most sensitive test was ELISA, with 100% sensitivity, followed by the Baermann funnel technique with the sensitivity of 75%. Direct smear examination, formalin-ether concentration technique, and Baermann funnel technique had the highest PPV (100%) while the ELISA test had the highest NPV (100%). Significant eosinophilia was observed in the patients whose culture test was positive (7/8; P < 0.05). In the present study, the majority of the positive cases by the agar plate culture had a history of prolonged exposure to soil and of asthma and COPD and were > 60 years old. CONCLUSIONS Given that the ELISA test had the highest NPV, the screening of all high-risk patients for S. stercoralis infection in endemic areas is recommended prior to starting corticosteroid therapy with the ELISA test. The results indicate the importance of paying attention to patients with unknown eosinophilia in endemic areas. Ivermectin should be available to strongyloidiasis patients in the endemic areas.
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Affiliation(s)
- Alireza Ashiri
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.,Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
| | - Abdollah Rafiei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.,Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
| | - Molouk Beiromvand
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran. .,Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran.
| | | | - Arash Alghasi
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
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Mishra S, Patnayak R, Panda SS, Jena A. Strongyloides stercoralis hyperinfection in a patient with acute lymphoblastic leukemia. J Postgrad Med 2021; 67:113-114. [PMID: 33835056 PMCID: PMC8253323 DOI: 10.4103/jpgm.jpgm_1073_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- S Mishra
- Department of Medical Oncology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
| | - R Patnayak
- Department of Pathology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
| | - S S Panda
- Department of Medical Oncology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
| | - A Jena
- Department of Surgical Oncology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
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Balachandra D, Ahmad H, Arifin N, Noordin R. Direct detection of Strongyloides infection via molecular and antigen detection methods. Eur J Clin Microbiol Infect Dis 2020; 40:27-37. [DOI: 10.1007/s10096-020-03949-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
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Sahu KK, Mahagaokar K, Patel B, Winokur D, Suzuki S, Daly JS, Ramanathan M, Cerny J. Strongyloides stercoralis hyperinfection syndrome in mantle cell lymphoma in post-transplant setting. Ann Hematol 2020; 100:1089-1091. [PMID: 32372147 DOI: 10.1007/s00277-020-04049-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Kamal Kant Sahu
- Division of Hematology and Oncology, Department of Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, Massachusetts, 01608, United States.
| | - Kedar Mahagaokar
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, United States
| | - Bhavin Patel
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, United States
| | - Daniel Winokur
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, United States
| | - Sakiko Suzuki
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, United States
| | - Jennifer S Daly
- Division of Infectious disease, UMass Memorial Health Care, University of Massachusetts Medical School,, 55 Lake Avenue North, Worcester, Massachusetts, 01655, United States
| | - Muthalagu Ramanathan
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, United States
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, United States
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Banerjee S, Alwine JC, Wei Z, Tian T, Shih N, Sperling C, Guzzo T, Feldman MD, Robertson ES. Microbiome signatures in prostate cancer. Carcinogenesis 2020; 40:749-764. [PMID: 30794288 DOI: 10.1093/carcin/bgz008] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 11/21/2018] [Accepted: 02/01/2019] [Indexed: 12/20/2022] Open
Abstract
We have established a microbiome signature for prostate cancer using an array-based metagenomic and capture-sequencing approach. A diverse microbiome signature (viral, bacterial, fungal and parasitic) was observed in the prostate cancer samples compared with benign prostate hyperplasia controls. Hierarchical clustering analysis identified three distinct prostate cancer-specific microbiome signatures. The three signatures correlated with different grades, stages and scores of the cancer. Thus, microbiome signature analysis potentially provides clinical diagnosis and outcome predictions. The array data were validated by PCR and targeted next-generation sequencing (NGS). Specific NGS data suggested that certain viral genomic sequences were inserted into the host somatic chromosomes of the prostate cancer samples. A randomly selected group of these was validated by direct PCR and sequencing. In addition, PCR validation of Helicobacter showed that Helicobacter cagA sequences integrated within specific chromosomes of prostate tumor cells. The viral and Helicobacter integrations are predicted to affect the expression of several cellular genes associated with oncogenic processes.
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Affiliation(s)
- Sagarika Banerjee
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - James C Alwine
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhi Wei
- Department of Computer Science, New Jersey Institute of Technology, Newark, NJ, USA
| | - Tian Tian
- Department of Computer Science, New Jersey Institute of Technology, Newark, NJ, USA
| | - Natalie Shih
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Colin Sperling
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas Guzzo
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael D Feldman
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erle S Robertson
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
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Ortiz-Martínez S, Ramos-Rincón JM, Vásquez-Chasnamote ME, Alarcón-Baldeón JJ, Parraguez-de-la-Cruz J, Gamboa-Paredes ON, Schillyk-Guerra P, Espinoza-Venegas LA, Pinedo-Cancino VV, Perez-Tanoira R, Górgolas-Hernández-Mora M, Casapía-Morales M. A Cross-Sectional Study of Seroprevalence of Strongyloidiasis in Pregnant Women (Peruvian Amazon Basin). Pathogens 2020; 9:pathogens9050348. [PMID: 32375325 PMCID: PMC7281748 DOI: 10.3390/pathogens9050348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 01/01/2023] Open
Abstract
Strongyloidiasis is a soil-transmitted helminthiasis with a high global prevalence. Objectives: We aimed to evaluate the prevalence of Strongyloides stercoralis infection and assess strongyloidiasis serology as a screening technique in the Peruvian Amazon. Material and Methods: We performed a cross-sectional study of strongyloidiasis in 300 pregnant women in Iquitos (Peru) from 1 May 2019 to 15 June 2019. Women were tested using serology (Strongyloides IgG IVD-ELISA kit) as an index test and the modified Baermann technique and/or charcoal fecal culture as the parasitological reference standard. Results: The reference tests showed S. stercoralis in the stool of 30 women (prevalence: 10%; 95% confidence interval [CI] 7.1% to 13.9%), while 101 women tested positive on the blood test (prevalence: 33.7%; 95% CI 28.6% to 39.4%). Fourteen of the 15 women (93.3%) with positive results according to the modified Baermann technique, and 14 of the 23 women (56.5%) with positive charcoal cultures also had positive serological results. Serology showed a sensitivity of 63.3% and a negative predictive value of 94.4%. Conclusion: In Iquitos, pregnant women have a high prevalence of S stercoralis. S. stercoralis ELISA could be an excellent tool for population-based screening, as it has a high negative predictive value that can help to rule out the presence of active infection.
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Affiliation(s)
- Sonia Ortiz-Martínez
- Consultorio El Ballestero, Servicio de Salud Castellano Manchego, 2614 Albacete, Spain;
| | - José-Manuel Ramos-Rincón
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, 03550 Alicante, Spain
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, 03010 Alicante, Spain
- Correspondence:
| | | | - Jhonatan J. Alarcón-Baldeón
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | - Jorge Parraguez-de-la-Cruz
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | | | - Patricia Schillyk-Guerra
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | | | - Viviana-Vanessa Pinedo-Cancino
- Laboratorio de Biología Molecular e Inmunología, Unidad Especializada del LIPNAA-CIRNA, Universidad Nacional de la Amazonia Peruana, 16001 Iquitos, Peru;
| | - Ramón Perez-Tanoira
- Servicio de Microbiologia, Hospital Universitario Príncipe de Asturias, 28802 Alcalá de Henares, Spain;
| | - Miguel Górgolas-Hernández-Mora
- División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain;
- Departamento de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Martin Casapía-Morales
- Servicio de Enfermedades Infecciosas y Medicina Tropical, Hospital Regional de Loreto, 16001 Iquitos, Peru;
- Departamento Médico, Asociación Cívica Selva Amazónica, 16001 Iquitos, Peru;
- Facultad de Medicina, Universidad Nacional de la Amazonia Peruana, 496 Iquitos, Peru
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Bosqui LR, Marques PD, de Melo GB, Gonçalves-Pires MDRF, Malta FM, Pavanelli WR, Conchon-Costa I, Costa-Cruz JM, Paula FM, Costa IN. Molecular and Immnune Diagnosis: Further Testing for Human Strongyloidiasis. Mol Diagn Ther 2019; 22:485-491. [PMID: 29934882 DOI: 10.1007/s40291-018-0340-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Detection of Strongyloides stercoralis larvae is particularly challenging because only a small number of larvae are released into the feces, regardless of infection stage. OBJECTIVE Our objective was to apply conventional polymerase chain reaction (PCR) to the detection of S. stercoralis DNA in feces samples to evaluate its performance in samples of patients with strongyloidiasis and compare results with those of immunodiagnosis. METHODS Stool, serum, and saliva samples were collected from each individual (n = 48) at the clinic hospital of the State University of Londrina, Brazil, for parasitological, immunological, and molecular tests. Stool samples were processed via parasitological methods. Serum samples were used for immunoglobulin G (IgG) detection and saliva samples for IgA detection by ELISA. RESULTS For amplification by conventional PCR, two different primers were used: species specific (101 bp) and genus specific (392 bp). The results showed that 34 (97.1%) of the 35 copro-positive individuals for S. stercoralis were positive for serum IgG and 19 (54.3%) were positive for salivary IgA. Regarding molecular analysis, both primers (species and genus specific) demonstrated positivity in 100% of the samples, which was confirmed by sequencing the positive samples. CONCLUSION Complementary examinations of the parasitological method demonstrated excellent results in the context of the diagnosis of strongyloidiasis, especially in asymptomatic patients with irregular larval release in the feces.
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Affiliation(s)
- Larissa R Bosqui
- Departamento de Ciências Patológicas, CCB, Laboratório de Parasitologia Experimental, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid Campus Universitário, Londrina, PR, CEP 86051-990, Brazil.
| | - Priscilla D Marques
- Departamento de Moléstias Infecciosas e Parasitárias - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246903, Brazil
| | - Gessica B de Melo
- Departamento de Moléstias Infecciosas e Parasitárias - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246903, Brazil
| | - Maria do Rosário F Gonçalves-Pires
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Av. Pará 1720, Uberlândia, MG, CEP 38400-902, Brazil
| | - Fernanda M Malta
- Departamento de Moléstias Infecciosas e Parasitárias - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246903, Brazil
| | - Wander R Pavanelli
- Departamento de Ciências Patológicas, CCB, Laboratório de Parasitologia Experimental, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid Campus Universitário, Londrina, PR, CEP 86051-990, Brazil
| | - Ivete Conchon-Costa
- Departamento de Ciências Patológicas, CCB, Laboratório de Parasitologia Experimental, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid Campus Universitário, Londrina, PR, CEP 86051-990, Brazil
| | - Julia M Costa-Cruz
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Av. Pará 1720, Uberlândia, MG, CEP 38400-902, Brazil
| | - Fabiana M Paula
- Departamento de Moléstias Infecciosas e Parasitárias - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246903, Brazil
| | - Idessania N Costa
- Departamento de Ciências Patológicas, CCB, Laboratório de Parasitologia Experimental, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid Campus Universitário, Londrina, PR, CEP 86051-990, Brazil
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14
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Zhou N, Fu H, Wang Z, Shi H, Yu Y, Qu T, Wang L, Zhang X, Wang L. Seroprevalence and risk factors of Toxoplasma gondii infection in children with leukemia in Shandong Province, Eastern China: a case-control prospective study. PeerJ 2019; 7:e6604. [PMID: 30886781 PMCID: PMC6420808 DOI: 10.7717/peerj.6604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/12/2019] [Indexed: 12/20/2022] Open
Abstract
Limited information is available concerning the epidemiology of Toxoplasma gondii infection in children with leukemia in Eastern China. Therefore, a case-control study was conducted to estimate the seroprevalence of toxoplasmosis in this patient group and to identify risk factors and possible routes of infection. Serum samples were collected from 339 children with leukemia and 339 age matched health control subjects in Qingdao from September 2014 to March 2018. Enzyme linked immunoassays were used to screen anti- T. gondii IgG and anti- T. gondii IgM antibodies. Forty-eight (14.2%) children with leukemia and 31 (9.1%) control subjects were positive for anti-T. gondii IgG antibodies (P < 0.05), while 13 (3.8%) patients and 14 (4.1%) controls were positive for anti-T. gondii IgM antibodies (P = 0.84). Multivariate analysis showed exposure to soil and a history of blood transfusion were risk factors for T. gondii infection. Compared with IgG, patients with a history of blood transfusion were more likely to present anti- T. gondii IgM (P = 0.003). Moreover, patients with chronic lymphocytic leukemia and acute lymphocytic leukemia had higher T. gondii seroprevalence in comparison to control subjects (P = 0.002 and P = 0.016, respectively). The results indicated that the seroprevalence of T. gondii infection in children with leukemia is higher than that of healthy children in Eastern China. This information may be used to guide future research and clinical management, and further studies are necessary to elucidate the role of T. gondii in children with leukemia.
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Affiliation(s)
- Na Zhou
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Haiyang Fu
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhongjun Wang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hailei Shi
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yang Yu
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tingting Qu
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Longlong Wang
- Department of Urinary Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiangyan Zhang
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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15
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KAYA F, İNKAYA AÇ, ERTENLİ Aİ, ABBASOĞLU O, AKSOY S, AKYÖN YILMAZ Y, ERGÜVEN S. The investigation of Strongyloides stercoralis seroprevalence in immunosupressed patients in Turkey. Turk J Med Sci 2019; 49:16-19. [PMID: 30761833 PMCID: PMC7350872 DOI: 10.3906/sag-1804-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim In immunosuppressed patients, strongyloidiasis can be lifethreatening because of hyperinfection or dissemination. Therefore, diagnosis of S. stercoralis is important in immunosuppressed patients with chronic strongyloidiasis. In this study, our objective was to investigate the presence of S. stercoralis antibodies by an ELISA method in immunosuppressed patients. Materials and methods A total of 100 immunosuppressed patients’ sera were included in the study. Forty-two of the patients were receiving immunosuppressive therapies for cancer or being treated for hematopoietic malignancies, 38 of the patients were receiving immunosuppressive drugs for rheumatic diseases, 14 were receiving immunosuppressive therapies for liver transplantation. Two of the patients were being treated for HIV infection and 4 were being treated for hypogammaglobulinemia. As control group, 50 individuals without a known disease were included in the study. The presence of IgG antibodies against S. stercoralis was investigated with a commercial ELISA kit. Results S. stercoralis antibody test was positive in 4 of 100 (4%) sera from immunosuppressed patients. All control patients were negative for S. stercoralis. Conclusions Strongyloidiasis can be a lifelong chronic infection if not treated. In patients who are going to receive immunosuppressive therapy, it should be tested before treatment, as it can become a disseminated and life-threatening infectious disease.
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Affiliation(s)
- Filiz KAYA
- Department of Medical Microbiology, Ankara Training and Research Hospital, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Ahmet Çağkan İNKAYA
- Department of Infectious Diseases, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Ali İhsan ERTENLİ
- Department of Internal Diseases Rheumatology Subdivision, Faculty of Medicine,Hacettepe University, AnkaraTurkey
| | - Osman ABBASOĞLU
- Department of General Surgery, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Sercan AKSOY
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Yakut AKYÖN YILMAZ
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Sibel ERGÜVEN
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
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Cervone M, Gavazza A, Zbriger A, Mancianti F, Perrucci S. Intestinal parasite infections in dogs affected by multicentric lymphoma and undergoing chemotherapy. Comp Immunol Microbiol Infect Dis 2019; 63:81-86. [PMID: 30961822 DOI: 10.1016/j.cimid.2019.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/12/2019] [Accepted: 01/14/2019] [Indexed: 01/13/2023]
Abstract
Prevalence and species composition of intestinal parasites were evaluated in dogs affected by high-grade multicentric lymphoma and undergoing chemotherapy and in control healthy dogs. Obtained data were statistically analyzed. The overall prevalence of intestinal parasite infections was 33.3%. In lymphoma dogs, the prevalence of protozoa infections (46.7%) was significantly higher (p < 0.05) than that of helminth infections (6.7%) and Giardia duodenalis, Cryptosporidium spp., Neospora caninum, Cystoisospora ohioensis-complex, Entamoeba sp. and Spirocerca lupi were identified. In the control group, only 3/15 dogs (20%) were found positive and no statistically significant differences emerged regarding helminth (hookworms and Toxocara canis) and protozoa (G. duodenalis) infections. Results from this study may suggest a potential higher prevalence of opportunistic intestinal protozoa, including some potentially zoonotic species, in dogs affected by high-grade multicentric lymphoma, emphasizing the need to monitor lymphoma-affected dogs for these protozoa, especially those undergoing chemotherapy.
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Affiliation(s)
- Mario Cervone
- Université de Lyon, VetAgro Sup, Campus vétérinaire de Lyon, Département des animaux de compagnie de loisir et de sport, 69280, Marcy L'Etoile, France
| | - Alessandra Gavazza
- Scuola di Bioscienze e Medicina Veterinaria, Università di Camerino, Via Circonvallazione 93/95, 62024 Matelica (MC), Italy
| | - Alina Zbriger
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge 2, 56124, Pisa, Italy
| | - Francesca Mancianti
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge 2, 56124, Pisa, Italy
| | - Stefania Perrucci
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge 2, 56124, Pisa, Italy.
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Gorgani-Firouzjaee T, Kalantari N, Javanian M, Ghaffari S. Strongyloides stercoralis: detection of parasite-derived DNA in serum samples obtained from immunosuppressed patients. Parasitol Res 2018; 117:2927-2932. [PMID: 29978421 DOI: 10.1007/s00436-018-5985-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 06/21/2018] [Indexed: 01/07/2023]
Abstract
Strongyloidiasis is an important neglected disease, which is life threatening in immunocompromised patients. This study aimed to evaluate the frequency of Strongyloides stercoralis infection among immunosuppressed subjects living in endemic communities by conventional PCR of the 18S rRNA and Cox1 genes to detect cell-free DNA in the patients' serum samples. Fresh stool and serum samples were obtained from participants. The stool samples were examined using parasitological methods. Total DNA was extracted from the serum samples and S. stercoralis larvae isolated from patient fecal samples. Conventional PCR to amplify a 101 bp fragment of the 18S rRNA gene was carried out for all extracted DNA, and then positive samples were further evaluated for a 121 bp fragment of the Cox1 gene. The PCR products of selected samples were sequenced and BLAST analysis was performed. Out of 120 patients, 57 and 63 cases had autoimmune disorders and cancer, respectively. The 101 bp fragments of the 18S rRNA were successfully amplified in 36 out of 120 (30%) serum samples. The PCR products of five samples were sequenced and compared with reference sequences in GenBank, which showed 97% identity and 90% coverage. In conclusion, to the best of our knowledge, this is the first molecular study for the detection of S. stercoralis cell-free DNA in human serum samples. These results provide useful insights for future studies and show that serum is an alternative specimen and may be useful in molecular diagnosis of diseases, particularly in immunosuppressive patients.
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Affiliation(s)
- Tahmineh Gorgani-Firouzjaee
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Narges Kalantari
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Gang Afrooz Avenue, Babol, Iran. .,Department of Laboratory Sciences, Faculty of Paramedical Sciences, Babol University of Medical Sciences, Babol, Iran.
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Salman Ghaffari
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
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Buonfrate D, Requena-Mendez A, Angheben A, Cinquini M, Cruciani M, Fittipaldo A, Giorli G, Gobbi F, Piubelli C, Bisoffi Z. Accuracy of molecular biology techniques for the diagnosis of Strongyloides stercoralis infection-A systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12:e0006229. [PMID: 29425193 PMCID: PMC5823464 DOI: 10.1371/journal.pntd.0006229] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/22/2018] [Accepted: 01/10/2018] [Indexed: 12/11/2022] Open
Abstract
Background Strongyloides stercoralis infection is a neglected tropical disease which can lead to severe symptoms and even death in immunosuppressed people. Unfortunately, its diagnosis is hampered by the lack of a gold standard, as the sensitivity of traditional parasitological tests (including microscopic examination of stool samples and coproculture) is low. Hence, alternative diagnostic methods, such as molecular biology techniques (mostly polymerase chain reaction, PCR) have been implemented. However, there are discrepancies in the reported accuracy of PCR. Methodology A systematic review with meta-analysis was conducted in order to evaluate the accuracy of PCR for the diagnosis of S. stercoralis infection. The protocol was registered with PROSPERO International Prospective Register of Systematic Reviews (record: CRD42016054298). Fourteen studies, 12 of which evaluating real-time PCR, were included in the analysis. The specificity of the techniques resulted high (ranging from 93 to 95%, according to the reference test(s) used). When all molecular techniques were compared to parasitological methods, the sensitivity of PCR was assessed at 71.8% (95% CI 52.2–85.5), that decreased to 61.8% (95% CI 42.0–78.4) when serology was added among the reference tests. Similarly, sensitivity of real-time PCR resulted 64.4% (95% CI 46.2–77.7) when compared to parasitological methods only, 56.5% (95% CI 39.2–72.4) including serology. Conclusions PCR might not be suitable for screening purpose, whereas it might have a role as a confirmatory test. Strongyloides stercoralis is a worm that can potentially kill affected immunosuppressed individuals. The parasite is not easily detected with stool microscopy, hence novel tests have been implemented, such as polymerase chain reaction (PCR), that can detect the DNA of the parasite. This work aims at evaluating the performance of PCR for the diagnosis of S. stercoralis through a revision of diagnostic studies available in literature. According to the results of this work, PCR for S. stercoralis still misses a relevant proportion of infected people, while a positive result confirms the presence of the infection.
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Affiliation(s)
- Dora Buonfrate
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - Ana Requena-Mendez
- Barcelona Institute for Global Health, ISGlobal-CRESIB, Universitat de Barcelona, Spain
| | - Andrea Angheben
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - Michela Cinquini
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Mario Cruciani
- Centre of Community Medicine and Infectious Diseases Service, ULSS 9 Scaligera, Verona, Italy
| | | | - Giovanni Giorli
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - Federico Gobbi
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - Chiara Piubelli
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - Zeno Bisoffi
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
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Paradies P, Iarussi F, Sasanelli M, Capogna A, Lia RP, Zucca D, Greco B, Cantacessi C, Otranto D. Occurrence of strongyloidiasis in privately owned and sheltered dogs: clinical presentation and treatment outcome. Parasit Vectors 2017; 10:345. [PMID: 28728589 PMCID: PMC5520385 DOI: 10.1186/s13071-017-2275-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increasing number of reports of human infections by Strongyloides stercoralis from a range of European countries over the last 20 years has spurred the interest of the scientific community towards this parasite and, in particular, towards the role that infections of canine hosts may play in the epidemiology of human disease. Data on the epidemiology of canine strongyloidiasis is currently limited, most likely because of the inherent limitations of current diagnostic methods. METHODS Faecal samples were collected directly from the rectal ampulla of 272 animals of varying age and both genders living in Apulia, southern Italy. Dogs included were either privately owned (n = 210), living in an urban area but with unrestricted outdoor access (Group 1), or shelter dogs (n = 62 out of ~400) hosted in a single shelter in the province of Bari in which a history of diarrhoea, weight loss, reduced appetite and respiratory symptoms had been reported (Group 2). Strongyloides stercoralis infection was diagnosed by coproscopy on direct faecal smear and via the Baermann method. RESULTS Six of 272 dogs were positive for S. stercoralis at the Baermann examination; all but one were from the shelter (Group 2) and displayed gastrointestinal clinical signs. The only owned dog (Group 1) infected with S. stercoralis, but clinically healthy, had been adopted from a shelter 1 year prior to sampling. Five infected dogs were treated with fenbendazole (Panacur®, Intervet, Animal Health, 50 mg/kg, PO daily for 5 days), or with a combination of fenbendazole and moxidectin plus imidacloprid spot-on (Im/Mox; Advocate® spot-on, Bayer). Post-treatment clearance of infection was confirmed in three dogs by Baermann examination, whereas treatment failure was documented in two dogs by Baermann and/or post-mortem detection of adult parasites. CONCLUSIONS This study describes, for the first time, the presence of S. stercoralis infection in sheltered dogs from southern Italy. Data indicate that S. stercoralis infection may pose a concern for sheltered animals and raise questions on potential risks of infection for staff of municipal shelters in southern European countries. Given that a single course of treatment with fenbendazole, associated or not with Im/Mox spot-on, may not eliminate the infection, effective treatment protocols should be investigated and control strategies targeting the environment considered for reducing the risk of zoonotic infection.
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Affiliation(s)
- Paola Paradies
- Department of Emergency and Organ Transplantations, Veterinary Section, University of Bari, 70010, Valenzano, Bari, Italy
| | - Fabrizio Iarussi
- Department of Emergency and Organ Transplantations, Veterinary Section, University of Bari, 70010, Valenzano, Bari, Italy
| | - Mariateresa Sasanelli
- Department of Emergency and Organ Transplantations, Veterinary Section, University of Bari, 70010, Valenzano, Bari, Italy
| | - Antonio Capogna
- Department of Emergency and Organ Transplantations, Veterinary Section, University of Bari, 70010, Valenzano, Bari, Italy
| | - Riccardo Paolo Lia
- Department of Veterinary Medicine, University of Bari, 70010, Valenzano, Bari, Italy
| | - Daniele Zucca
- Institute of Animal Health, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Beatrice Greco
- Department of Emergency and Organ Transplantations, Veterinary Section, University of Bari, 70010, Valenzano, Bari, Italy
| | - Cinzia Cantacessi
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Domenico Otranto
- Department of Veterinary Medicine, University of Bari, 70010, Valenzano, Bari, Italy.
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Moraes D, Levenhagen MA, Costa-Cruz JM, Costa APD, Rodrigues RM. In vitro efficacy of latex and purified papain from Carica papaya against Strongyloides venezuelensis eggs and larvae. Rev Inst Med Trop Sao Paulo 2017; 59:e7. [PMID: 28380118 PMCID: PMC5441158 DOI: 10.1590/s1678-9946201759007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/22/2016] [Indexed: 11/22/2022] Open
Abstract
Latex from Carica papaya is rich in bioactive compounds, especially papain, which may help to control parasitic diseases. This study evaluated the efficacy of latex from C. papaya and purified papain against Strongyloides venezuelensis. The Egg Hatching Test (EHT) and the Larval Motility Test (LMT) using fresh and frozen latex (250mg/mL), lyophilized latex (34mg/mL), and purified papain (2.8 mg/mL) were performed. Albendazole (0.025 mg/mL) and ivermectin (316 ppm) were used as positive controls. EHT and LMT were carried out through the incubation of each solution with S. venezuelensis eggs or larvae (± 100 specimens), and results were analyzed after 48h (EHT) or 24, 48, and 72h (LMT). EHT showed that latex preparations at higher concentrations (1:10 to 1:100) resulted in partial or complete destruction of eggs and larvae inside the eggs. The result from the 1:1,000 dilution was similar to the positive control. LMT showed effectiveness in all the tested dilutions compared to negative controls. Purified papain showed a dose-dependent response in the EHT. Purified papain (2.8 mg/ mL) showed similar results to lyophilized latex at 1:1,000 in the EHT. Latex and purified papain from C. papaya were effective against S. venezuelensis eggs and larvae in vitro, suggesting their potential use as an alternative treatment for strongyloidiasis.
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Affiliation(s)
- Dayane Moraes
- Universidade Federal de Goiás, Laboratório de Parasitologia, Jataí, Goiás, Brazil
| | - Marcelo Arantes Levenhagen
- Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Departamento de Imunologia, Microbiologia e Parasitologia, Uberlândia, Minas Gerais, Brazil
| | - Julia Maria Costa-Cruz
- Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Departamento de Imunologia, Microbiologia e Parasitologia, Uberlândia, Minas Gerais, Brazil
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Paula FMD, Malta FM, Corral MA, Marques PD, Gottardi M, Meisel DMCL, Yamashiro J, Pinho JRR, Castilho VLP, Gonçalves EMDN, Gryschek RCB, Chieffi PP. DIAGNOSIS OF Strongyloides stercoralis INFECTION IN IMMUNOCOMPROMISED PATIENTS BY SEROLOGICAL AND MOLECULAR METHODS. Rev Inst Med Trop Sao Paulo 2016; 58:63. [PMID: 27680168 PMCID: PMC5048634 DOI: 10.1590/s1678-9946201658063] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 03/23/2016] [Indexed: 11/22/2022] Open
Abstract
Strongyloidiasis is a potentially serious infection in immunocompromised patients.
Thus, the availability of sensitive and specific diagnostic methods is desirable,
especially in the context of immunosuppressed patients in whom the diagnosis and
treatment of strongyloidiasis is of utmost importance. In this study, serological and
molecular tools were used to diagnose Strongyloides stercoralis
infections in immunosuppressed patients. Serum and stool samples were obtained from
52 patients. Stool samples were first analyzed by Lutz, Rugai, and Agar plate culture
methods, and then by a quantitative real time polymerase chain reaction (qPCR). Serum
samples were evaluated by an enzyme-linked immunosorbent assay (ELISA) using a
soluble (AS) or a membrane fractions antigen (AM) obtained from alkaline solutions of
the filariform larvae of Strongyloides venezuelensis. Of the 52
immunosuppressed patients, three (5.8%) were positive for S.
stercoralis by parasitological methods, compared to two patients (3.8%)
and one patient (1.9%) who were detected by ELISA using the AS and the AM antigens,
respectively. S. stercoralis DNA was amplified in seven (13.5%)
stool samples by qPCR. These results suggest the utility of qPCR as an alternative
diagnostic tool for the diagnosis of S. stercoralis infection in
immunocompromised patients, considering the possible severity of this helminthiasis
in this group of patients.
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Affiliation(s)
- Fabiana Martins de Paula
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Fernanda Mello Malta
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina Laboratório de Gastroenterologia e Hepatologia Tropical. São Paulo, SP, Brazil. E-mail: ;
| | - Marcelo Andreetta Corral
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Priscilla Duarte Marques
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Maiara Gottardi
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Dirce Mary Correia Lima Meisel
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Juliana Yamashiro
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - João Renato Rebello Pinho
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina Laboratório de Gastroenterologia e Hepatologia Tropical. São Paulo, SP, Brazil. E-mail: ;
| | - Vera Lucia Pagliusi Castilho
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Seção de Parasitologia, Divisão de Laboratório Central. São Paulo, SP, Brazil. E-mails: ;
| | - Elenice Messias do Nascimento Gonçalves
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Seção de Parasitologia, Divisão de Laboratório Central. São Paulo, SP, Brazil. E-mails: ;
| | - Ronaldo César Borges Gryschek
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Pedro Paulo Chieffi
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Faculdade de Ciências Médicas, Santa Casa. São Paulo, SP, Brazil. E-mail:
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22
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Rafiei R, Rafiei A, Rahdar M, Keikhaie B. Seroepidemiology of Strongyloides stercoralis amongst immunocompromised patients in Southwest Iran. Parasite Epidemiol Control 2016; 1:229-232. [PMID: 29988178 PMCID: PMC5991854 DOI: 10.1016/j.parepi.2016.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 07/28/2016] [Accepted: 08/01/2016] [Indexed: 11/06/2022] Open
Abstract
Strongyloidiasis is a life-threatening parasitic infection, especially in immunosuppressed patients, with death often occurring within several days. The disease has a worldwide distribution and is endemic in tropical and subtropical regions. Therefore, this study was conducted to investigate seroepidemiology of Strongyloides infection amongst immunocompromised patients in Southwest Iran. This cross-sectional study was conducted amongst a population of immunocompromised patients who were referred to health care or hospital referral centres in Ahvaz, Southwest Iran. Serum samples were tested by an enzyme immunoassay for anti-IgG Strongyloides antibody. Anti-Strongyloides stercoralis antibody was detected in 39 of 270 immunocommpromised cases, yielding a prevalence of 14.4%. No significant differences were indicated in terms of gender, age, or type of immunocompromised disorder with anti-Strongyloides stercoralis antibody levels. In conclusion, our results demonstrated high seroepidemiology of infection with this parasite in the region. Therefore, it appears immunocompromised patients should be tested for this infection using sensitive tests. However, current research underscores that strongyloidosis must not be neglected, and further assessments in high risk population are warranted.
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Affiliation(s)
- Reza Rafiei
- Department of Parasitology, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abdollah Rafiei
- Department of Parasitology, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Parasitology, Faculty of Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Rahdar
- Department of Parasitology, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bijan Keikhaie
- Department of Oncology, Shafa hospital, and Health Institute, Research Center of Thalassemia and Hemoglobinopathies, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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23
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Watts MR, Robertson G, Bradbury R. The laboratory diagnosis of Strongyloides stercoralis. MICROBIOLOGY AUSTRALIA 2016. [DOI: 10.1071/ma16003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
It is estimated that over 30million people worldwide are infected by the nematode, Strongyloides stercoralis1. It is endemic in sub-tropical and tropical parts of Australia, with high rates of infection documented in some indigenous communities2. Due to the potential for chronic autoinfection, that may persist for decades, migration leads to the presence of the infection in non-endemic areas1. Transmission to humans is generally through the penetration of larvae through the skin, following contact with faecally contaminated soil1. Disease severity ranges from asymptomatic chronic carriage to an overwhelming illness, where large numbers spread throughout the body, usually triggered by immunosuppression1.
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