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Martins AS, Santos SA, Lisboa CADS, Barros TF, Ribeiro TCM, da Costa-Ribeiro H, de Mattos ÂP, Mendes PSDA, Mendes CMC, Souza EL, Amor ALM, Soares NM, Teixeira MCA. Infectious etiology and indicators of malabsorption or intestinal injury in childhood diarrhea. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2024; 44:80-91. [PMID: 38648349 PMCID: PMC11349067 DOI: 10.7705/biomedica.6913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 02/20/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION The multifactorial etiology of gastroenteritis emphasizes the need for different laboratory methods to identify or exclude infectious agents and evaluate the severity of diarrheal disease. OBJECTIVE To diagnose the infectious etiology in diarrheic children and to evaluate some fecal markers associated with intestinal integrity. MATERIALS AND METHODS The study group comprised 45 children with diarrheal disease, tested for enteropathogens and malabsorption markers, and 76 children whose feces were used for fat evaluation by the traditional and acid steatocrit tests. RESULTS We observed acute diarrhea in 80% of the children and persistent diarrhea in 20%. Of the diarrheic individuals analyzed, 40% were positive for enteropathogens, with rotavirus (13.3%) and Giardia duodenalis (11.1%) the most frequently diagnosed. Among the infected patients, occult blood was more evident in those carrying pathogenic bacteria (40%) and enteroviruses (40%), while steatorrhea was observed in infections by the protozoa G. duodenalis (35.7%). Children with diarrhea excreted significantly more lipids in feces than non-diarrheic children, as determined by the traditional (p<0.0003) and acid steatocrit (p<0.0001) methods. Moreover, the acid steatocrit method detected 16.7% more fecal fat than the traditional method. CONCLUSIONS Childhood diarrhea can lead to increasingly severe nutrient deficiencies. Steatorrhea is the hallmark of malabsorption, and a stool test, such as the acid steatocrit, can be routinely used as a laboratory tool for the semi-quantitative evaluation of fat malabsorption in diarrheic children.
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Affiliation(s)
- Adson Santos Martins
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaUniversidade Federal da BahiaSalvadorBrazil
| | - Samara Alves Santos
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaUniversidade Federal da BahiaSalvadorBrazil
| | - Claudia Alves da Silva Lisboa
- Laboratório de Análises Clínicas do Hospital Geral de Salvador - Hospital do Exército, Salvador, BrasilLaboratório de Análises Clínicas do Hospital Geral de SalvadorHospital do ExércitoSalvadorBrasil
| | - Tânia Fraga Barros
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaUniversidade Federal da BahiaSalvadorBrazil
- Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaFaculdade de FarmáciaUniversidade Federal da BahiaSalvadorBrazil
| | - Tereza Cristina Medrado Ribeiro
- Hospital Universitário Professor Edgard Santos - HUPES, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaHospital Universitário Professor Edgard Santos - HUPESUniversidade Federal da BahiaSalvadorBrazil
| | - Hugo da Costa-Ribeiro
- Hospital Universitário Professor Edgard Santos - HUPES, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaHospital Universitário Professor Edgard Santos - HUPESUniversidade Federal da BahiaSalvadorBrazil
| | - Ângela Peixoto de Mattos
- Hospital Universitário Professor Edgard Santos - HUPES, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaHospital Universitário Professor Edgard Santos - HUPESUniversidade Federal da BahiaSalvadorBrazil
| | - Patrícia Silva de Almeida Mendes
- Hospital Universitário Professor Edgard Santos - HUPES, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaHospital Universitário Professor Edgard Santos - HUPESUniversidade Federal da BahiaSalvadorBrazil
| | - Carlos Maurício Cardeal Mendes
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaUniversidade Federal da BahiaSalvadorBrazil
| | - Edna Lúcia Souza
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaFaculdade de Medicina da BahiaUniversidade Federal da BahiaSalvadorBrazil
| | - Ana Lúcia Moreno Amor
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, BrasilUniversidade Federal do Recôncavo da BahiaCentro de Ciências da SaúdeUniversidade Federal do Recôncavo da BahiaSanto Antônio de JesusBrazil
| | - Neci Matos Soares
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaUniversidade Federal da BahiaSalvadorBrazil
- Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaFaculdade de FarmáciaUniversidade Federal da BahiaSalvadorBrazil
| | - Márcia Cristina Aquino Teixeira
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaUniversidade Federal da BahiaSalvadorBrazil
- Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, BrasilUniversidade Federal da BahiaFaculdade de FarmáciaUniversidade Federal da BahiaSalvadorBrazil
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Santos SA, de Souza JN, Pacheco FTF, Santos MC, Dos Santos Novais D, Suzart VN, Dos Santos Guedes I, Neves MH, Gomes MA, Soares NM, Teixeira MCA. Detection of IgG Anti-Giardia duodenalis Antibodies in Sera by Indirect Immunofluorescence and Western Blotting Assays. Acta Parasitol 2024; 69:351-357. [PMID: 38095798 DOI: 10.1007/s11686-023-00753-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/14/2023] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Serological assays are alternative laboratory tools for the diagnosis of parasitic infections. The aim of this work was to evaluate the performance of the indirect fluorescent antibody test (IFAT) and Western blotting (WB) for the detection of IgG anti-Giardia antibodies in human sera. METHODOLOGY Sera from individuals infected with Giardia duodenalis, other parasites or non-parasitized were selected for serological assays. Ninety-seven sera were tested by IFAT at 1:20 and 1:40 dilutions and of these, 40 samples were also analyzed by WB. RESULTS The sensitivity and specificity of the IFAT was 97% and 46.9% at 1:20 sera dilution, and 39.4% and 59.4% at 1:40 sera dilution. The low molecular weight polypeptides fractions of 25 kDa, 27-31 kDa and 45-55 kDa were the most frequently identified by the sera of individuals infected with G. duodenalis, along with low cross-reactivity, presenting an individual sensitivity of 42.8%, 50.0% and 57.1%, and specificity of 83.3%, 83.3% and 91.7%, respectively. The highest overall sensitivity of WB (85.7%) was based on the immunoreactivity of sera with at least one of those proteins. The concordance between the detection of G. duodenalis in feces by microscopy and the WB results was considered substantial (Kappa = 0.61). CONCLUSION Constant exposure to Giardia infection throughout a lifetime can maintain high levels of specific antibodies in serum, even without active infection. Moreover, proteins found in intestinal amoebas may hinder the serological diagnosis of giardiasis in endemic areas due to cross-reactivity, which can be partially solved using Giardia low molecular weight proteins.
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Affiliation(s)
- Samara Alves Santos
- Programa de Pós-Graduação em Farmácia, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Joelma Nascimento de Souza
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | | | - Mariana Conceição Santos
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Darleide Dos Santos Novais
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Victoria Nascimento Suzart
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Isabela Dos Santos Guedes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Maena Honda Neves
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Maria Aparecida Gomes
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Neci Matos Soares
- Programa de Pós-Graduação em Farmácia, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Márcia Cristina Aquino Teixeira
- Programa de Pós-Graduação em Farmácia, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil.
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Ahmed SAA, Quattrocchi A, Elzagawy SM, Karanis P, Gad SEM. Diagnostic Performance of Toluidine Blue Stain for Direct Wet Mount Detection of Cryptosporidium Oocysts: Qualitative and Quantitative Comparison to the Modified Ziehl-Neelsen Stain. Diagnostics (Basel) 2023; 13:2557. [PMID: 37568920 PMCID: PMC10416936 DOI: 10.3390/diagnostics13152557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: The wet mount staining technique is a simple, economical, and rapid method for detecting parasitic stages. The objective of the current study was to evaluate wet mount diagnostic stains for Cryptosporidium infection in human faecal samples and to compare the sensitivity and qualitative performance of toluidine blue (TolB) and modified Ziehl-Neelsen (mZN) stain. (2) Methods: The collection, purification, and molecular amplification of Cryptosporidium oocysts were performed. TolB, malachite green, trypan blue, and crystal violet were evaluated qualitatively to diagnose Cryptosporidium oocysts. The outperforming stain was compared to mZN using a quantitative evaluation and qualitative scoring system. (3) Results: The oocysts of Cryptosporidium parvum were effectively purified and utilized for spiking. TolB was the most effective diagnostic stain among wet mount stains for detecting Cryptosporidium oocysts. TolB outperformed mZN in terms of sensitivity, with 100% versus 79% at a concentration of 104 and 49% versus 23% at a concentration of 102. TolB had the most favourable qualitative stain characteristics against mZN; however, sample freshness and being a temporary stain were crucial considerations. (4) Conclusions: This study emphasizes that TolB, as a routine wet mount technique for screening Cryptosporidium infection, will provide a more sensitive and faster method than mZN staining.
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Affiliation(s)
- Shahira Abdelaziz Ali Ahmed
- Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.M.E.); (S.E.M.G.)
| | - Annalisa Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, Nicosia CY-1700, Cyprus;
| | - Sherine M. Elzagawy
- Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.M.E.); (S.E.M.G.)
- College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Panagiotis Karanis
- Medical Faculty and University Hospital, University of Cologne, 50923 Cologne, Germany
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, Nicosia CY-1700, Cyprus
| | - Samer Eid Mohamed Gad
- Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.M.E.); (S.E.M.G.)
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Prakoeswa FRS, Rumondor BB, Prakoeswa CRS. Acid-Fast Staining Revisited, a Dated but Versatile Means of Diagnosis. Open Microbiol J 2022. [DOI: 10.2174/18742858-v16-e2206081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Acid-fast staining has been utilized in the field of medicine since the late 1800s. It was, for a while, considered the gold standard for diagnosing leprosy and tuberculosis. Principally it uses 1 primary staining agent, carbol fuchsin; and methylene blue as a counter stain. The emergence of molecular-based diagnostic tests makes some of us question the relevance of acid-fast staining in daily practice. This literature review aimed to revisit the acid-fast staining method, its uses, and the modification that occurred throughout the years.
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Pacheco FTF, Freitas HFD, Silva RKNR, Carvalho SSD, Martins AS, Menezes JF, Ribeiro TCM, Mattos ÂPD, Costa-Ribeiro Júnior HD, Pedreira JNR, Soares NM, Teixeira MCA. Cryptosporidium diagnosis in different groups of children and characterization of parasite species. Rev Soc Bras Med Trop 2022; 55:e00412022. [PMID: 35894396 PMCID: PMC9359344 DOI: 10.1590/0037-8682-0041-2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/18/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Microscopy and enzyme-linked immunosorbent assay (ELISA) are routinely used for Cryptosporidium diagnosis, without differentiating the parasite species. Methods: Children’s feces were analyzed by modified Ziehl-Neelsen (mZN) and ELISA for Cryptosporidium diagnosis and by polymerase chain reaction-restriction fragment length polymorphism for species identification. Results: Cryptosporidium frequency was 2.6%. The sensitivity and specificity of ELISA were 85.7% and 99.7%, respectively, with excellent concordance with mZN (kappa=0.854). Parasite species were characterized as Cryptosporidium hominis (78.3%), Cryptosporidium felis (17.4%), and Cryptosporidium parvum (4.3%). Conclusions: Coproantigen ELISA is as efficient as mZN for Cryptosporidium diagnosis. Cryptosporidium genotyping suggests anthroponotic and zoonotic transmission to children.
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Affiliation(s)
- Flávia Thamiris Figueiredo Pacheco
- Universidade Federal da Bahia, Programa de Pós-Graduação Stricto Sensu em Farmácia, Salvador, BA, Brasil.,Universidade Federal da Bahia, Hospital Professor Edgard Santos, Salvador, BA, Brasil
| | | | - Renata Kelly Novais Rodrigues Silva
- Universidade Federal da Bahia, Programa de Pós-Graduação Stricto Sensu em Farmácia, Salvador, BA, Brasil.,Universidade Federal da Bahia, Hospital Professor Edgard Santos, Salvador, BA, Brasil
| | - Silvia Souza de Carvalho
- Universidade Federal da Bahia, Programa de Pós-Graduação Stricto Sensu em Farmácia, Salvador, BA, Brasil
| | - Adson Santos Martins
- Universidade Federal da Bahia, Programa de Pós-Graduação Stricto Sensu em Farmácia, Salvador, BA, Brasil
| | - Joelma Figueiredo Menezes
- Universidade Federal da Bahia, Departamento de Análises Clínicas e Toxicológicas, Salvador, BA, Brasil
| | | | | | | | - Joice Neves Reis Pedreira
- Universidade Federal da Bahia, Programa de Pós-Graduação Stricto Sensu em Farmácia, Salvador, BA, Brasil.,Universidade Federal da Bahia, Departamento de Análises Clínicas e Toxicológicas, Salvador, BA, Brasil
| | - Neci Matos Soares
- Universidade Federal da Bahia, Programa de Pós-Graduação Stricto Sensu em Farmácia, Salvador, BA, Brasil.,Universidade Federal da Bahia, Departamento de Análises Clínicas e Toxicológicas, Salvador, BA, Brasil
| | - Márcia Cristina Aquino Teixeira
- Universidade Federal da Bahia, Programa de Pós-Graduação Stricto Sensu em Farmácia, Salvador, BA, Brasil.,Universidade Federal da Bahia, Departamento de Análises Clínicas e Toxicológicas, Salvador, BA, Brasil
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Cunha FDS, Jann HW, Lugon JR, Peralta JM, Peralta RHS. Molecular characterization of Cryptosporidium spp. obtained from fecal samples of immunosuppressed patients from Brazil. Rev Soc Bras Med Trop 2022; 55:e05552021. [PMID: 35416875 PMCID: PMC9009872 DOI: 10.1590/0037-8682-0555-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/30/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Cryptosporidium spp. are pathogenic protozoans that play an important role in developing diseases in the elderly, children, and immunosuppressed individuals. Methods: The objective of this study was to detect and genetically characterize Cryptosporidium spp. in kidney transplanted patients (n = 97 samples; group 1) and immunosuppressed individuals from an outpatient clinic suspected of having Cryptosporidium infection (n = 53 samples; group 2). All fecal samples were analyzed by parasitological stool examination, immunochromatographic test, and real-time polymerase chain reaction (real-time PCR). Cryptosporidium-positive samples were tested using nested PCR for the gp60 gene, followed by sequencing for subtype determination. Results: Parasitological examination was negative in all Group 1, and positive in four Group 2 samples. Real-time PCR revealed Cryptosporidium in 13 samples: four in Group 1 (three C. hominis and one C. parvum) and nine in Group 2 (seven C. hominis, one C. parvum, and one mixed C. hominis/C. parvum). The immunochromatographic test was reactive in 11 samples (four in Group 1 and seven in Group 2). All 11 C. hominis isolates were identified as subtype IbA10G2 and one C. parvum as subtype IIbA15G2R1. All C. hominis belonged to subtype IbA10G2, which is recognized as the most prevalent and pathogenic subtype. Conclusions: This study showed, for the first time, that the presence of Cryptosporidium subtypes is considered more virulent in Brazilian transplanted kidney patients.
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Affiliation(s)
- Flávia de Souza Cunha
- Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Patologia, Niterói, RJ, Brasil
| | - Higor Wilson Jann
- Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Patologia, Niterói, RJ, Brasil
| | - Jocemir Ronaldo Lugon
- Universidade Federal Fluminense, Faculdade de Medicina, Departamento de Nefrologia, Niterói, RJ, Brasil
| | - José Mauro Peralta
- Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Paulo de Góes, Departamento de Imunologia, Rio de Janeiro, RJ, Brasil
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Molecular detection of Cystoisospora belli by single-run polymerase chain reaction in stool samples. Indian J Gastroenterol 2021; 40:512-518. [PMID: 34569012 DOI: 10.1007/s12664-021-01170-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/11/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Cystoisospora belli (C. belli) is the only pathogenic species of the Cystoisospora genus responsible for severe diarrhea in immunocompromised patients. Most common microscopic method of diagnosis is less sensitive due to intermittent shedding of oocysts. We developed a new single-run polymerase chain reaction (PCR)-based diagnostic assay for C. belli. METHODS A new single-run PCR-based diagnostic assay was standardized for the detection of C. belli. Diagnostic reproducibility and repeatability of the PCR assay were evaluated. A cross-sectional analytical study was done on a total of 354 stool samples collected from 331 immunocompromised patients with diarrhea. All the stool samples were tested for the presence of oocysts of C. belli and were also tested by our new PCR assay for C. belli. Three of the representative PCR products were confirmed by sequencing. Fisher's exact test was used to compare the two proportions. RESULTS Microscopy detected C. belli in 11/354 (3.1%) of stool samples, and the new PCR-based assay detected C. belli in 16/354 (4.5%). The new single-run PCR-based assay detected C. belli in all the stool samples which were tested positive by microscopy and additionally detected C. belli in five stool samples. The developed PCR assay detected statistically significant proportion of C. belli (p < 0.001) as compared to microscopy. The 795 base pair PCR product from one microscopy positive stool sample and two microscopy negative stool samples were confirmed by sequencing. CONCLUSION Our newly developed single-run PCR-based detection assay for C. belli is robust and reproducible. It may be used for molecular diagnosis of cystoisosporiasis especially in transplant, pediatrics, and human immunodeficiency virus (HIV) positive patients.
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AL-Yasary JTO, Faraj AA. Comparison Study about Selected Human Infection of Zoonotic Cryptosporidiosis by Conventional Diagnostic Methods in Karbala Province, Iraq. THE IRAQI JOURNAL OF VETERINARY MEDICINE 2021. [DOI: 10.30539/ijvm.v45i1.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This study was carried out to detect the Cryptosporidium spp in Karbala province, Iraq from. December 2019 to September 2020. Age, sex, and months interference with parasite prevalence were studied. A total of 100 fecal samples were collected from adults and young and from both sexes of human. Fecal samples were subjected to conventional methods (Flotation Methods by Sheather's sugar solution and stained with modified Ziehl-Neelsen) for parasite diagnosis. The result recorded that the infection rate of Cryptosporidium spp was 26%. The age group of 2-6 years had the highest infection rate comparing to other age groups ranged from 12-25 years yet was marginal significant (P<0.06). Regarding sex, there was no significant differences in infection rate, although the males recorded numerically higher rate of prevalence. The rate of infection of Cryptosporidium spp were varied among months, where in February recorded 46.66% in contrast to 10% recorded in July. It can be concluded that variables studied (age, sex, and months) have no influence on Cryptosporidium prevalence in Karbala province.
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Pacheco FTF, de Carvalho SS, Santos SA, das Chagas GMT, Santos MC, Santos JGS, da Costa-Ribeiro H, Ribeiro TCM, de Mattos ÂP, Gomes MA, Soares NM, Teixeira MCA. Specific IgG and IgA Antibody Reactivities in Sera of Children by Enzyme-Linked Immunoassay and Comparison With Giardia duodenalis Diagnosis in Feces. Ann Lab Med 2021; 40:382-389. [PMID: 32311851 PMCID: PMC7169635 DOI: 10.3343/alm.2020.40.5.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 01/05/2020] [Accepted: 03/31/2020] [Indexed: 01/03/2023] Open
Abstract
Background Giardia duodenalis is conventionally diagnosed in fecal samples using parasitological methods. However, sensitivity is poor when only a single sample is analyzed, due to intermittent excretion of cysts in feces. Alternatively, the serum antibodies to G. duodenalis can be used for parasite diagnosis and epidemiological studies to determine previous exposure. We compared the rate of G. duodenalis infection between serum anti-Giardia IgG and IgA antibodies and fecal examination in Brazilian children. Methods Fecal and serum samples were tested from 287 children at a clinical laboratory and from 187 children at daycare centers. Fecal samples were processed using conventional parasitological methods and coproantigen detection for Giardia diagnosis. Serum samples were tested using an in-house ELISA for detection of anti-Giardia IgG and IgA. Results G. duodenalis was found in 8.2% (N=39) of the 474 children analyzed. The sensitivity and specificity of ELISA were 80.0% and 90.0% for IgG and 80.0% and 83.3% for IgA, respectively. The total positivity rate of anti-Giardia IgG and IgA in the sera was 13.9% (N=66) and 23.6% (N=112). The agreement between the positivity of specific antibodies and the detection of G. duodenalis in feces was moderate for ELISA-IgG, kappa index (95% CI)=0.543 (0.422–0.664), and mild for ELISA-IgA, kappa index (95% CI)=0.283 (0.162–0.404). Among the children infected with other enteroparasites, 11.6% (N=10) and 24.4% (N=21) showed reactivity to anti-Giardia IgG and to IgA, respectively. This cross-reactivity was more frequent in samples from children infected with Endolimax nana and Entamoeba coli. Conclusions The higher frequency of specific antibody reactivity compared with G. duodenalis diagnosis in feces could reflect continuous exposure of children to G. duodenalis infection, resulting in long-lasting immunological memory and/or cross-reactivity with other intestinal amoebas.
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Affiliation(s)
- Flávia Thamiris Figueiredo Pacheco
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil.,Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | - Samara Alves Santos
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil
| | | | | | | | | | | | | | - Maria Aparecida Gomes
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Neci Matos Soares
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil
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The Predominance of Giardia duodenalis AII sub-assemblage in young children from Salvador, Bahia, Brazil. ACTA ACUST UNITED AC 2020; 40:557-568. [PMID: 33030834 PMCID: PMC7666847 DOI: 10.7705/biomedica.5161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Indexed: 11/29/2022]
Abstract
Introduction. Giardia duodenalis is an intestinal protozoan with a high prevalence in children of developing countries. Molecular studies revealed a great genetic diversity of G. duodenalis, with assemblages A and B found mainly in humans. Despite its importance, the information on the molecular epidemiology of human giardiasis is still limited in Brazil. Objective. To characterize G. duodenalis molecular isolates in children from Salvador, Bahia, Brazil. Materials and methods. Giardia duodenalis positive fecal samples were obtained from 71 children from two day care centers and 39 users of a clinical analysis laboratory. Samples were analyzed by PCR-RFLP of the glutamate dehydrogenase (gdh) and beta-giardin genes and by the sequencing of beta-giardin. Results. Of the 110 G. duodenalis samples, 80 (72.7%) amplified one or both target genes. Of these, 62 (77.5 %) were identified as assemblage A and 18 (22.5%) as assemblage B. The subassemblage AII was identified in 58.8% (n=47) of isolates followed by the sub-assemblage AI (18.8%, n=15), BIV (11.2%, n=9), and BIII (5.0%, n=4). The AII sub-assemblage was the most frequent in children of both day care centers whereas AI was found only in the group attended at the clinical laboratory. Sub-assemblage AII predominated in children under two years. Conclusions. The higher frequency of AII sub-assemblage suggests that anthroponotic transmission is more common in Salvador, but that zoonotic transmission pathways are also present and a change in susceptibility to different molecular patterns of Giardia may occur during child growth.
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Gerace E, Lo Presti VDM, Biondo C. Cryptosporidium Infection: Epidemiology, Pathogenesis, and Differential Diagnosis. Eur J Microbiol Immunol (Bp) 2019; 9:119-123. [PMID: 31934363 PMCID: PMC6945992 DOI: 10.1556/1886.2019.00019] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 08/16/2019] [Indexed: 12/12/2022] Open
Abstract
Cryptosporidium is a protozoan that infects a wide variety of vertebrates, including humans, causing acute gastroenteritis. The disease manifests with abdominal pain and diarrhea similar to that of choleric infection. In the immunocompromised hosts, the parasite causes prolonged infections that can also be fatal. For this reason, cryptosporidiosis is considered one of riskiest opportunistic infections for patients with acquired immunodeficiency syndrome. The best way to control the infection in these patients is setting up sensitive and specific diagnostic tests for epidemiological surveillance and morbidity reduction. Here, we summarized the general aspects of Cryptosporidium infection focusing on available diagnostic tools used for the diagnosis of cryptosporidiosis. Molecular methods currently available for its detection and progress in the development of new diagnostics for cryptosporidiosis are also discussed.
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Affiliation(s)
| | | | - Carmelo Biondo
- Laboratory of Microbiology and Parasitology, Departments of Human Pathology, University of Messina, Messina, Italy
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Abstract
Cystoisospora belli is a coccidian parasite of humans, with a direct fecal-oral transmission cycle. It is globally distributed, but mainly found in tropical and subtropical areas. Many cases of C. belli infections have been reported in patients with HIV, and in patients undergoing immunosuppressive therapy for organ transplants or those treated for tumours worldwide. Unsporulated or partially sporulated oocysts of C. belli are excreted in feces. When sporulated oocysts in contaminated water or food are ingested, asexual and sexual stages of C. belli are confined to the epithelium of intestines, bile ducts and gallbladder. Monozoic tissue cysts are present in extra-intestinal organs (lamina propria of the small and large intestine, lymph nodes, spleen, and liver) of immunosuppressed humans. However, a paratenic host has not been demonstrated. Cystoisospora belli infections can be persistent, lasting for months, and relapses are common; the mechanism of relapse is unknown. Recently, the endogenous stages of C. belli were re-examined and attention was drawn to cases of misidentification of non-protozoal structures in the gallbladder of patients as C. belli. Here, we review all aspects of the biology of C. belli, including morphology, endogenous stages, prevalence, epidemiology, symptoms, diagnosis and control.
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Affiliation(s)
- J P Dubey
- United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Service, Animal Parasitic Disease Laboratory, Building 1001, BARC-East, Beltsville, MD 20705-2350, USA
| | - S Almeria
- Departmentof Health and Human Services, Food and Drug Administration, Center for Food Safety and Nutrition, Office of Applied Research and Safety Assessment, Division of Virulence Assessment, Laurel, MD 20708, USA
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Immune response markers in sera of children infected with Giardia duodenalis AI and AII subassemblages. Immunobiology 2019; 224:595-603. [PMID: 30962033 DOI: 10.1016/j.imbio.2019.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 12/29/2022]
Abstract
In this study, we evaluated serum markers of immune responses in children infected with G. duodenalis and compared them with the characterized parasite isolates. The reactivity indexes (RI) of IgG (1.503 ± 0.819) and IgA (2.308 ± 1.935) antibodies were significantly higher (P < 0.001) in infected children than in non-infected children. There were also statistically significantly higher serum levels (P < 0.05) of IFN-γ (393.10 ± 983.90 pg/mL) as well as serum (30.03 ± 10.92 μmol/L) and saliva nitric oxid derivatives (NOx) (192.4 ± 151.2 μmol/L) in children infected with G. duodenalis compared to the group of non-parasitized children (127.4 ± 274.30 pg/mL; 25.82 ± 7.74 μmol/L and 122.5 ± 105.90 μmol/L, respectively). Regarding the characterized genetic variants of G. duodenalis and the immune response profiles, no differences were observed in terms of antibody reactivity or levels of serum cytokine and NOx among children infected with AI or AII subassemblages. The elevated levels of IFN-γ and NOx indicate that G. duodenalis intestinal infection in humans induces a cellular immune response detectable at the systemic level. Moreover, no significant differences in the antibody reactivity profile or the cytokine and NOx production in the sera of children infected with AI or AII G. duodenalis variants were observed, suggesting that subtypes of the parasite do not influence the immune response profile.
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Joachim A, Ruttkowski B, Sperling D. Detection of Cystoisospora suis in faeces of suckling piglets - when and how? A comparison of methods. Porcine Health Manag 2018; 4:20. [PMID: 30250747 PMCID: PMC6145109 DOI: 10.1186/s40813-018-0097-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/26/2018] [Indexed: 12/30/2022] Open
Abstract
Background Cystoisospora suis is the causative agent of porcine neonatal coccidiosis, a diarrheal disease which affects suckling piglets in the first weeks of life. Detection of oocysts in the faeces of infected animals is frequently hampered by the short individual excretion period and the high fat content of faecal samples. We analysed oocyst excretion patterns of infected piglets, evaluated different detection methods for their detection limit and reproducibility, and propose a sampling scheme to improve the diagnosis of C. suis in faecal samples from the field using a protocol for reliable parasite detection. Results Based on a hypothesized model of the course of infection on a farm, three samplings (days of life 7–14-21 or 10–15-20) should be conducted including individual samples of piglets from each sampled litter. Samples can be examined by a modified McMaster method (lower detection limit: 333 oocysts per gram of faeces, OpG), by examining faecal smears under autofluorescence (lower detection limit: 10 OpG) or after carbol-fuchsin staining (lower detection limit: 100 OpG). Reproducibility and inter-test correlations were high with (R2 > 0.8). A correlation of oocyst excretion with diarrhoea could not be established so samples with different faecal consistencies should be taken. Pooled samples (by litter) should be comprised of several individual samples from different animals. Conclusions Since oocyst excretion by C. suis-infected piglets is usually short the right timing and a sufficiently sensitive detection method are important for correct diagnosis. Oocyst detection in faecal smears of samples taken repeatedly is the method of choice to determine extent and intensity of infection on a farm, and autofluorescence microscopy provides by far the lowest detection limit. Other methods for oocyst detection in faeces are less sensitive and/or more labour- and cost intensive and their usefulness is restricted to specific applications.
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Affiliation(s)
- Anja Joachim
- 1Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, A-1210 Vienna, Austria
| | - Bärbel Ruttkowski
- 1Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, A-1210 Vienna, Austria
| | - Daniel Sperling
- CEVA Santé Animale, 10 avenue de la Ballastière, 33500 Libourne, France
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Occurrence of Cryptosporidium spp. and Cystoisospora belli among adult patients with diarrhoea in Maputo, Mozambique. Heliyon 2018; 4:e00769. [PMID: 30211333 PMCID: PMC6129678 DOI: 10.1016/j.heliyon.2018.e00769] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/05/2018] [Accepted: 08/30/2018] [Indexed: 11/21/2022] Open
Abstract
Infections with Cryptosporidium spp. and Cystoisospora belli are important causes of diarrhoea in HIV patients. Nevertheless, information concerning these two parasites is scarce in many African countries, including Mozambique. In this study occurrence of Cryptosporidium spp. and C. belli was investigated by microscopy of stool specimens from 108 adult diarrhoeal patients, most with a confirmed HIV diagnosis. The Cryptosporidium isolates were further characterized by molecular methods. Cryptosporidium and C. belli oocysts were found in 8.3% (9/108), and 25.0% (27/108) of the study participants, respectively. Species identification was possible for all Cryptosporidium isolates with available DNA. The following Cryptosporidium species were detected (number of cases within parentheses): C. parvum (3), C. hominis (3), C. felis (1), and C. hominis/C. parvum (1). Subtyping targeting the gp60 gene revealed two C. hominis isolates with subtype IaA23R3, one C. parvum isolate with IIcA5G3d, and one with IIeA12G1. In summary the occurrence of C. hominis and anthroponotic subtypes of C. parvum indicates that the main route of Cryptosporidium transmission in the present study population was human to human (direct or via food and water). The high prevalence of C. belli highlights the need for early diagnosis of this parasite, for which a treatment exists.
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Mohapatra S, Singh DP, Alcid D, Pitchumoni CS. Beyond O&P Times Three. Am J Gastroenterol 2018; 113:805-818. [PMID: 29867172 DOI: 10.1038/s41395-018-0083-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 02/23/2018] [Indexed: 12/11/2022]
Abstract
Although examination of the stool for ova and parasites times three (O&P ×3) is routinely performed in the United States (US) for the evaluation of persistent and/or chronic diarrhea, the result is almost always negative. This has contributed to the perception that parasitic diseases are nearly non-existent in the country unless there is a history of travel to an endemic area. The increasing number of immigrants from third-world countries, tourists, and students who present with symptoms of parasitic diseases are often misdiagnosed as having irritable bowel syndrome or inflammatory bowel disease. The consequences of such misdiagnosis need no explanation. However, certain parasitic diseases are endemic to the US and other developed nations and affect both immunocompetent and immunocompromised patients. Testing for parasitic diseases either with O&P or with other diagnostic tests, followed by the recommended treatment, is quite rewarding when appropriate. Most parasitic diseases are easily treatable and should not be confused with other chronic gastrointestinal (GI) disorders. In this review, we critically evaluate the symptomatology of luminal parasitic diseases, their differential diagnoses, appropriate diagnostic tests, and management.
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Affiliation(s)
- Sonmoon Mohapatra
- Department of Internal Medicine, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. Department of Infectious Diseases, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. 3Department of Gastroenterology, Hepatology and Clinical Nutrition Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
| | - Dhruv Pratap Singh
- Department of Internal Medicine, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. Department of Infectious Diseases, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. 3Department of Gastroenterology, Hepatology and Clinical Nutrition Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
| | - David Alcid
- Department of Internal Medicine, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. Department of Infectious Diseases, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. 3Department of Gastroenterology, Hepatology and Clinical Nutrition Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
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Pumipuntu N, Piratae S. Cryptosporidiosis: A zoonotic disease concern. Vet World 2018; 11:681-686. [PMID: 29915508 PMCID: PMC5993756 DOI: 10.14202/vetworld.2018.681-686] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/23/2018] [Indexed: 01/12/2023] Open
Abstract
Cryptosporidiosis is considered to be a crucial zoonotic disease caused by worldwide distributing parasitic protozoa called Cryptosporidium spp. Cryptosporidiosis becomes a major public health and veterinary concern by affecting in human and various host range species of animals. Essentially, its importance of infection is increasing because of the high incidence in young children, immunocompromised persons, or immunodeficiency syndrome patients, especially in HIV/AIDS, and it is also one of the most causes of mortality in those patients who infected with Cryptosporidium spp. as well as young animals. All domestic animal, livestock, wildlife, and human can be potential reservoirs that contribute Cryptosporidium spp. to food and surface waters and transmitted to other hosts through fecal-oral route. The oocyst stage of Cryptosporidium spp. can remain infective and resistant to various environmental exposure and also resistant to many general disinfecting agents including chlorination which normally used in water treatment. Therefore, the understanding of these zoonotic pathogens is very essential in both animal and human health. This review focuses on the biology, life cycle, transmission, diagnosis, treatment, prevention, and control of this protozoan infection to emphasize and remind as the significant One Health problem.
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Affiliation(s)
- Natapol Pumipuntu
- One Health Research Unit, Faculty of Veterinary Sciences, Mahasarakham University, Maha Sarakham, Thailand
| | - Supawadee Piratae
- One Health Research Unit, Faculty of Veterinary Sciences, Mahasarakham University, Maha Sarakham, Thailand
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18
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Comparison of current methods used to detect Cryptosporidium oocysts in stools. Int J Hyg Environ Health 2018; 221:743-763. [PMID: 29776848 DOI: 10.1016/j.ijheh.2018.04.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 04/17/2018] [Accepted: 04/17/2018] [Indexed: 01/12/2023]
Abstract
In this review all of the methods that are currently in use for the investigation of Cryptosporidium in stool material are highlighted and critically discussed. It appears that more qualifications and background knowledge in this field regarding the diagnosis of the Cryptosporidium parasite is required. Furthermore, there is no standardization for the protocols that are commonly used to either detect oocysts in faeces or to diagnose the Cryptosporidium infection. It is therefore necessary to initiate further education and research that will assist in improving the accuracy of the diagnosis of Cryptosporidium oocysts in the faecal micro-cosmos. Where ambient concentrations of oocysts are low in stool material, detection becomes a formidable task. Procedures for ring tests and the standardization of multi-laboratory testing are recommended. It is also necessary to enhance the routine surveillance capacity of cryptosporidiosis and to improve the safety against it, considering the fact that this disease is under diagnosed and under reported. This review is intended to stimulate research that could lead to future improvements and further developments in monitoring the diagnostic methodologies that will assist in harmonizing Cryptosporidium oocysts in stool diagnosis.
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An overview of methods/techniques for the detection of Cryptosporidium in food samples. Parasitol Res 2018; 117:629-653. [PMID: 29350281 DOI: 10.1007/s00436-017-5735-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/26/2017] [Indexed: 11/27/2022]
Abstract
Cryptosporidium is one of the most important parasitic protozoa of concern within the food production industry, worldwide. This review describes the evolution and its development, and it monitors the methodology that has been used for Cryptosporidium in food material since 1984, when the first publication appeared regarding the detection of Cryptosporidium parvum in food materials. The methods that are currently being used for the detection of Cryptosporidium oocysts in food material (mainly vegetables) and all of the other available published methods are discussed in this review. Generating more consistent and reliable data should lead to a better understanding of the occurrence, transport and fate of the oocysts in food material. Improvements in monitoring and developing effective methodology, along with food security, offer more practical possibilities for both the developed and developing worlds.
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Garcia LS, Arrowood M, Kokoskin E, Paltridge GP, Pillai DR, Procop GW, Ryan N, Shimizu RY, Visvesvara G. Practical Guidance for Clinical Microbiology Laboratories: Laboratory Diagnosis of Parasites from the Gastrointestinal Tract. Clin Microbiol Rev 2018; 31:e00025-17. [PMID: 29142079 PMCID: PMC5740970 DOI: 10.1128/cmr.00025-17] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This Practical Guidance for Clinical Microbiology document on the laboratory diagnosis of parasites from the gastrointestinal tract provides practical information for the recovery and identification of relevant human parasites. The document is based on a comprehensive literature review and expert consensus on relevant diagnostic methods. However, it does not include didactic information on human parasite life cycles, organism morphology, clinical disease, pathogenesis, treatment, or epidemiology and prevention. As greater emphasis is placed on neglected tropical diseases, it becomes highly probable that patients with gastrointestinal parasitic infections will become more widely recognized in areas where parasites are endemic and not endemic. Generally, these methods are nonautomated and require extensive bench experience for accurate performance and interpretation.
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Affiliation(s)
| | - Michael Arrowood
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne, and Environmental Diseases, Waterborne Disease Prevention Branch, Atlanta, Georgia, USA
| | - Evelyne Kokoskin
- Public Health Ontario, Ottawa, Ontario, Canada
- Public Health Laboratories-Ottawa, Ottawa, Ontario, Canada
| | | | - Dylan R Pillai
- Calgary Laboratory Services, Diagnostic and Scientific Centre, Calgary, Alberta, Canada
| | - Gary W Procop
- Enterprise Test Utilization and Pathology Consultative Services, Cleveland, Ohio, USA
- Molecular Microbiology, Parasitology, and Mycology Laboratories, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | - Norbert Ryan
- Bacteriology and Parasitology, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute, Melbourne, Victoria, Australia
| | | | - Govinda Visvesvara
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne, and Environmental Diseases, Waterborne Disease Prevention Branch, Atlanta, Georgia, USA
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Oddó D, Méndez GP, Retamal Y, Oddó A. Intestinal isosporiasis in patients with acquired immunodeficiency syndrome (AIDS). Pathologic diagnosis in small intestinal mucosal biopsies. Ann Diagn Pathol 2017; 33:17-22. [PMID: 29566942 DOI: 10.1016/j.anndiagpath.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 10/31/2017] [Accepted: 11/04/2017] [Indexed: 11/16/2022]
Affiliation(s)
- David Oddó
- Department of Anatomic Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Chile.
| | - Gonzalo P Méndez
- Department of Anatomic Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Yasmina Retamal
- Department of Anatomic Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Aarón Oddó
- Faculty of Medicine, Universidad Mayor, Santiago de Chile, Chile
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[Concordance between the zinc sulphate flotation and centrifugal sedimentation methods for the diagnosis of intestinal parasites]. BIOMEDICA 2016; 36:519-524. [PMID: 27992978 DOI: 10.7705/biomedica.v36i4.2799] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 04/10/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The diagnosis of intestinal parasitic infections depends on the parasite load, the specific gravity density of the parasite eggs, oocysts or cysts, and the density and viscosity of flotation or sedimentation medium where faeces are processed. OBJECTIVE To evaluate the concordance between zinc sulphate flotation and centrifugal sedimentation in the recovery of parasites in faecal samples of children. MATERIALS AND METHODS Faecal samples of 330 children from day care centers were evaluated by zinc sulphate flotation and centrifugal sedimentation techniques. The frequencies of detection of parasites by each method were determined and the agreement between the diagnostic techniques was evaluated using the kappa index, with 95% confidence intervals. RESULTS The faecal flotation in zinc sulphate diagnosed significantly more cases of Trichuris trichiura infection when compared to centrifugal sedimentation (39/330; 11.8% vs. 13/330; 3.9%, p<0.001), with low diagnostic concordance between methods (kappa=0.264; 95% CI: 0.102-0.427). Moreover, all positive samples for Enterobius vermicularis eggs (n=5) and Strongyloides stercoralis larvae (n=3) were diagnosed only by zinc sulphate. No statistical differences were observed between methods for protozoa identification. CONCLUSIONS The results showed that centrifugal flotation in zinc sulphate solution was significantly more likely to detect light helminths eggs such as those of T. trichiura and E. vermicularis in faeces than the centrifugal sedimentation process.
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Performance of microscopy and ELISA for diagnosing Giardia duodenalis infection in different pediatric groups. Parasitol Int 2016; 65:635-640. [PMID: 27586394 DOI: 10.1016/j.parint.2016.08.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 07/24/2016] [Accepted: 08/29/2016] [Indexed: 11/22/2022]
Abstract
Techniques for Giardia diagnosis based on microscopy are usually applied as routine laboratory testing; however, they typically exhibit low sensitivity. This study aimed to evaluate Giardia duodenalis and other intestinal parasitic infections in different pediatric groups, with an emphasis on the comparison of Giardia diagnostic techniques. Feces from 824 children from different groups (diarrheic, malnourished, with cancer and from day care) were examined by microscopy and ELISA for Giardia, Cryptosporidium sp. and Entamoeba histolytica coproantigen detection. Giardia-positive samples from day-care children, identified by either microscopy or ELISA, were further tested by PCR targeting of the β-giardin and Gdh genes. Statistically significant differences (P<0.05) were observed when comparing the frequency of each protozoan among the groups. Giardia duodenalis was more frequent in day-care children and Cryptosporidium sp. in diarrheic and malnourished groups; infections by Entamoeba histolytica were found only in children with diarrhea. Considering positivity for Giardia by at least one method, ELISA was found to be more sensitive than microscopy (97% versus 55%). To examine discrepancies among the diagnostic methods, 71 Giardia-positive stool samples from day-care children were tested by PCR; of these, DNA was amplified from 51 samples (77.4%). Concordance of positivity between microscopy and ELISA was found for 48 samples, with 43 confirmed by PCR. Parasite DNA was amplified from eleven of the 20 Giardia samples (55%) identified only by ELISA. This study shows the higher sensitivity of ELISA over microscopy for Giardia diagnosis when a single sample is analyzed and emphasizes the need for methods based on coproantigen detection to identify this parasite in diarrheic fecal samples.
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