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Parasitology Apr 2021This epidemiological study assesses the occurrence of enteric parasites in 4303 patients attended at two public hospitals in Ankara (Turkey) during 2018-2019. Microscopy...
This epidemiological study assesses the occurrence of enteric parasites in 4303 patients attended at two public hospitals in Ankara (Turkey) during 2018-2019. Microscopy was used as a screening test. Giardia duodenalis was also identified using a commercial ELISA for the detection of parasite-specific coproantigens. Giardia-positive samples by microscopy/ELISA were confirmed by real-time PCR and characterized using a multilocus genotyping scheme. Blastocystis sp. was genotyped in a sample subset. Blastocystis sp. (11.1%, 95% CI 11.4‒14.8%) and G. duodenalis (1.56%, 95% CI 1.22‒1.96) were the most prevalent pathogens found. Cryptosporidium spp., Entamoeba histolytica and intestinal helminths were only sporadically (<0.5%) found. For G. duodenalis, sequence (n = 30) analyses revealed the presence of sub-assemblages AII (23.3%), discordant AII/AIII (23.3%) and mixed AII + AIII (6.7%) within assemblage A, and BIII (10.0%), BIV (3.3%) and discordant BIII/BIV (23.3%) within assemblage B. Two additional sequences (6.7%) were assigned to the latter assemblage but sub-assemblage information was unknown. No associations between G. duodenalis assemblages/sub-assemblages and sociodemographic and clinical variables could be demonstrated. For Blastocystis sp., sequence (n = 6) analyses identified subtypes ST1, ST2 and ST3 at equal proportions. This is the first molecular characterization of G. duodenalis based on MLG conducted in Turkey to date.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Blastocystis; Blastocystis Infections; Child; Child, Preschool; Feces; Female; Giardia lamblia; Giardiasis; Humans; Infant; Male; Middle Aged; Phylogeny; Turkey; Young Adult
PubMed: 32981546
DOI: 10.1017/S0031182020001821 -
World Journal of Gastroenterology Jul 2020() and () are two protozoan parasites of human bowel that are found throughout the world. There is still debate about the pathogenicity of these protozoans, despite...
BACKGROUND
() and () are two protozoan parasites of human bowel that are found throughout the world. There is still debate about the pathogenicity of these protozoans, despite them being commonly associated with gastrointestinal symptoms and can cause health issue in both children and adults. These parasites are usually transmitted through faecal-oral contact particularly under poor hygiene conditions or food/water contamination. Once a person is infected, the parasites live in the large intestine and are passed in the faeces.
AIM
To investigate the effect of triple antibiotic therapy using enema infusion in the treatment of and infections.
METHODS
This retrospective longitudinal study was conducted in a single medical centre, which included fifty-four patients (≥ 18 years) who were positive for , or both between 2017 and 2018. The treatment consisted of triple antibiotics that were infused over two consecutive days through rectal enema. Faecal samples were collected from participants pre- and post-treatment and were tested for parasites using microscopy and polymerase chain reaction. Patients' symptoms were recorded prior and after the treatment as well as patient demographic data.
RESULTS
Patients ( = 54), were either positive for (37%), (35%) or both (28%). All patients completed the two-day treatment and no serious adverse effect was reported. The most common side effect experienced by the patients during the treatment was urine discolouration which was cleared by six weeks of follow-up. Common symptoms reported prior to treatment were diarrhoea, abdominal pain, constipation and fatigue. Other symptoms included abdominal discomfort, dizziness and blood in the stool. Eighty-nine percent of patients completed a final stool test post-treatment. At six weeks post-treatment, 79% of patients cleared the parasites from their faeces. Symptoms such as abdominal discomfort, dizziness and blood in the stool decreased significantly at both seven days and six weeks post-treatment ( < 0.040). The enema retention time, bowel preparation, previous antibiotic treatment or previous gastrointestinal problems had no significant effect on parasite eradication.
CONCLUSION
Overall, eradication of parasites and improvement of clinical outcomes were observed in treated patients, showing the efficacy of this combination to eradicate the parasites and provide positive clinical outcome.
Topics: Adult; Animals; Anti-Bacterial Agents; Child; Enema; Feces; Female; Humans; Longitudinal Studies; Male; Parasites; Parasitic Diseases; Retrospective Studies
PubMed: 32774058
DOI: 10.3748/wjg.v26.i26.3792 -
Parasitology Research Aug 2020Shotgun metagenomics with high-throughput sequencing (HTS) techniques is increasingly used for pathogen identification and characterization. While many studies apply...
Shotgun metagenomics with high-throughput sequencing (HTS) techniques is increasingly used for pathogen identification and characterization. While many studies apply targeted amplicon sequencing, here we used untargeted metagenomics to simultaneously identify protists and helminths in pre-diagnosed faecal and tissue samples. The approach starts from RNA and operates without an amplification step, therefore allowing the detection of all eukaryotes, including pathogens, since it circumvents the bias typically observed in amplicon-based HTS approaches. The generated metagenomics datasets were analysed using the RIEMS tool for initial taxonomic read assignment. Mapping analyses against ribosomal reference sequences were subsequently applied to extract 18S rRNA sequences abundantly present in the sequence datasets. The original diagnosis, which was based on microscopy and/or PCR, could be confirmed in nearly all cases using ribosomal RNA metagenomics. In addition to the pre-diagnosed taxa, we detected other intestinal eukaryotic parasites of uncertain pathogenicity (of the genera Dientamoeba, Entamoeba, Endolimax, Hymenolepis) that are often excluded from routine diagnostic protocols. The study clearly demonstrates the applicability of untargeted RNA metagenomics for the parallel detection of parasites.
Topics: Animals; Feces; High-Throughput Nucleotide Sequencing; Humans; Intestinal Diseases, Parasitic; Metagenomics; Molecular Diagnostic Techniques; Parasites; RNA, Ribosomal, 18S; Sequence Analysis, DNA
PubMed: 32591865
DOI: 10.1007/s00436-020-06754-9 -
Gut Pathogens 2020Intestinal parasitic diseases occur worldwide, and their diagnosis poses considerable challenges. spp., (and, arguably, and spp.) are among the most important and...
BACKGROUND
Intestinal parasitic diseases occur worldwide, and their diagnosis poses considerable challenges. spp., (and, arguably, and spp.) are among the most important and common parasitic protozoans causing diarrhea. Several multiplex real-time PCR assays have been developed for the synchronous detection of these parasites. However, most assays include the use of hydrolysis probes, increasing the cost of stool examination. In this study, we designed and evaluated a real-time PCR protocol, based on high-resolution melting (HRM) curve analysis, to simultaneously detect and differentiate five gastrointestinal parasites.
RESULTS
Using a blinded panel of 143 clinical samples with laboratory diagnostic data to evaluate the method, we obtained a 95.8% concordance with conventional methods. Moreover, 4.2% of the samples were positive for and 2.8% additional infections were found with our multiplex assay. Our method is sensitive and specific for the selected parasites with the additional possibility of being run in single-plex as a backup control for mixed infections.
CONCLUSIONS
The assay is a convenient and cost-effective method that could contribute to a quicker and accurate diagnosis as well as to more targeted therapies of parasite-derived diarrhea. Finally, this new multiplex PCR assay could also be instrumental in epidemiology studies on these parasites.
PubMed: 32514315
DOI: 10.1186/s13099-020-00365-6 -
The Korean Journal of Parasitology Apr 2020In most developing countries, Dientamoeba fragilis infection is an obscure protozoan infection. We aimed to determine a frequency and clinical importance of D. fragilis...
In most developing countries, Dientamoeba fragilis infection is an obscure protozoan infection. We aimed to determine a frequency and clinical importance of D. fragilis infection in Taif, Saudi Arabia. A 1-year case control study included patients with gastrointestinal (cases, n=114) or non-gastrointestinal symptoms (controls, n=90). The fecal samples were examined with the classical parasitological methods for intestinal protozoa, and by real time PCR for D. fragilis. The infection by D. fragilis was detected in 5.8% by PCR and in 4.4% patients by microscopy. The infection was identified more in control group (n=9) than in cases (n=3); a sole infection in 11 patients and mixed with Giardia in 1 patient. The other enteric parasites detected were Blastocystis sp. (8.3%), Giardia sp. (5.3%), Cryptosporidium sp. (2.9%), Entamoeba histolytica (1.4%), Entamoeba coli (0.9%) and Hymenolepis nana (0.4%). Our results tend to reinforce the need to increase awareness of D. fragilis infection in Saudi Arabia.
Topics: Asymptomatic Diseases; Case-Control Studies; Dientamoeba; Dientamoebiasis; Digestive System Diseases; Humans; Polymerase Chain Reaction; Saudi Arabia
PubMed: 32418381
DOI: 10.3347/kjp.2020.58.2.129 -
BMC Infectious Diseases May 2020Pediatric diarrhea caused by a range of pathogens, including intestinal parasites, is one of main causes of death among children under 5 years of age. The distribution...
BACKGROUND
Pediatric diarrhea caused by a range of pathogens, including intestinal parasites, is one of main causes of death among children under 5 years of age. The distribution of these parasitic infections overlaps in many environmental, socioeconomic and epidemiological settings. Their distribution and prevalence varies from region to region. In the current study, we assess the prevalence of intestinal parasites among pediatric patients with syndromic diarrheal disease living in Franceville, Gabon.
METHODS
A cross-sectional study conducted in the Amissa Bongo Regional Hospital and Chinese-Gabonese Friendship Hospital in Franceville, between November 2016 and August 2017, enrolled a total of 100 diarrheic children between 0 and 180 months of age. Parasite detection in stool samples was performed using molecular diagnostic by PCR. Difference in means were tested by Student's t test and ANOVA while principal component analysis was used to determine the correlation between parasite distributions and age groups.
RESULTS
The overall prevalence of intestinal parasite infection was 61% (61/100). Hymenolepis sp and Cryptosporidium hominis/parvum were the most common parasites (31 and 19%, respectively), followed by Encephalitozoon intestinalis (15%), Trichuris trichiura (4%), Dientamoeba fragilis (4%), and Enterocytozoon bieneusi (2%). The polyparasitism rate was 19.7%, with 83.3% double and 16.7% triple infections. Protozoan infections (66.7%) were more prevalent than helminths infections (33.3%). Seasonal association of the circulation of intestinal parasite was statistically significant (p = 0.03). Correlations between different parasites was also observed.
CONCLUSION
The prevalence of intestinal parasitic infections is highest in diarrheic pediatric children. The prevalence of parasitic infections indicates that protozoa and helminths are the most common parasites in the Franceville environment. This study reinforces the importance of routine examination of diarrheic stool samples for the diagnostic of intestinal parasites. Further analyses are required to better understand the local epidemiology and risk factors associated with the transmission of intestinal parasites in Franceville, Gabon. KEYSWORDS: diarrhea, children, intestinal parasitic infections, molecular diagnostic, Franceville, Gabon.
Topics: Animals; Child, Preschool; Cross-Sectional Studies; Cryptosporidiosis; Cryptosporidium; Diarrhea; Feces; Female; Gabon; Helminthiasis; Humans; Infant; Intestinal Diseases, Parasitic; Male; Polymerase Chain Reaction; Prevalence; Protozoan Infections; Risk Factors
PubMed: 32414337
DOI: 10.1186/s12879-020-05071-x -
Microorganisms Apr 2020This study aims at evaluating the performances of the multiplex PCR Allplex Gastrointestinal Panel-Parasite Assay (GIPPA), which detects , spp., , , , and , by...
This study aims at evaluating the performances of the multiplex PCR Allplex Gastrointestinal Panel-Parasite Assay (GIPPA), which detects , spp., , , , and , by comparison to microscopy. A retrospective evaluation was conducted on a series of positive clinical samples ( = 99) stored at -80 °C or at +4 °C. A five-month prospective study was then conducted on all samples sent to our lab for parasite detection ( = 586). In the retrospective cohort, sensitivity was 81% for both (26/32) and (21/26) and 100% for spp. (26/26, including 6 different species), (26/26), and (4/4). During the prospective study, 95 samples were positive by microscopy and 207 by multiplex PCR assay. The molecular assay showed a significantly higher sensitivity of PCR, especially for (100% vs. 60.7%, < 0.01), (97.2% vs. 14.1%, < 0.001), and (99.4% vs. 44.2%, < 0.001) but also for (100% vs. 50.0%). The sensitivity of the Allplex GIPPA on the first stool sample was equivalent to the sensitivity of microscopy on multiple stool samples but inferior to multiplex PCR on multiple stool samples. Taken together, the Allplex GIPPA is suitable for the routine detection of protozoa in fecal samples.
PubMed: 32326453
DOI: 10.3390/microorganisms8040569 -
Journal of Infection in Developing... Oct 2019Chronic spontaneous urticaria (CSU) which develops without a known stimulation is defined as the occurrence of spontaneous wheals, angioedema or both for longer than six...
INTRODUCTION
Chronic spontaneous urticaria (CSU) which develops without a known stimulation is defined as the occurrence of spontaneous wheals, angioedema or both for longer than six weeks. Infections, autoimmunity, food intolerance and internal parasitic infections are supposed to be underlying causes of CSU. The aim of this study was to evaluate the intestinal parasites in children and adult patients diagnosed as CSU, to determine the frequency of parasites in chronic urticaria, and to compare these patients with healthy demographic control groups.
METHODOLOGY
Seventy six children and 38 adult patients with CSU were examined in terms of parasitic infections. The patients whom parasites were detected received anti-parasitic therapy and the improvements in CSU symptoms were evaluated. Stool samples were examined with direct microscopic examination (native-lugol), stool concentration and trichrome staining methods.
RESULTS
In pediatric patient group, 18.4% (n = 14) of the stool samples were positive for Blastocystis sp., 2.6% (n = 2), Dientamoeba fragilis and 1.3% (n = 1), Giardia duodenalis. In adult patient group, Blastocystis sp. was detected in 18.4% (n = 7) of the stool samples. Anti-parasitic therapy yielded substantial improvement in urticaria symptoms in 57.1% of pediatric and 60.0% of adult patients.
CONCLUSIONS
Blastocystis sp. and D. fragilis may play a role in chronic urticaria which seriously disrupts the patient's quality of life. Parasitic infections should not be neglected in patients with cutaneous manifestations.
Topics: Adolescent; Adult; Aged; Antiparasitic Agents; Blastocystis; Child; Child, Preschool; Chronic Urticaria; Dientamoeba; Eosinophils; Female; Giardia lamblia; Humans; Immunoglobulin E; Infant; Intestinal Diseases, Parasitic; Male; Metronidazole; Middle Aged; Turkey; Young Adult
PubMed: 32084024
DOI: 10.3855/jidc.11552 -
Avicenna Journal of Medicine 2019The intestinal parasites are still endemic among children, women, and men in Gaza Strip.
BACKGROUND
The intestinal parasites are still endemic among children, women, and men in Gaza Strip.
OBJECTIVES
To the best of our knowledge, this is the first study of intestinal parasites among young female students of Islamic University of Gaza to report the existence and prevalence of intestinal parasites.
METHODS
A total of 305 stool samples were collected from female students in all faculties and were examined by wet mount and formal ether sedimentation technique.
RESULTS
This study showed that the overall prevalence of intestinal parasites was 20.6%. The detected intestinal parasites were as follows: (7.5%), (4.9%), (0.3%), (2.6%), (1.0%), and (3.9%). Science students showed the highest prevalence for parasitic infections (35.3%), and married students (16.7%) had higher prevalence than single students (6.5%).
CONCLUSION
It was concluded that female students also are under risk of gaining parasitic infection in spite of their education. It is recommended that university students should be subjected to regular medical examinations for parasitic infections.
PubMed: 31903389
DOI: 10.4103/ajm.AJM_8_19 -
International Journal For Parasitology.... Dec 2019Dientamoeba fragilis is a trichomonad parasite of the human intestine that is found worldwide. However, the biological cycle and transmission of this parasite have yet...
Dientamoeba fragilis is a trichomonad parasite of the human intestine that is found worldwide. However, the biological cycle and transmission of this parasite have yet to be elucidated. Although its pathogenic capacity has been questioned, there is increasing evidence that clinical manifestations vary greatly. Different therapeutic options with antiparasitic drugs are currently available; however, very few studies have compared the effectiveness of these drugs. In the present longitudinal study, we evaluate 13,983 copro-parasitological studies using light microscopy of stools, during 2013-2015, in Terrassa, Barcelona (Spain). A total of 1150 (8.2%) presented D. fragilis. Of these, 739 episodes were finally analyzed: those that involved a follow-up parasitology test up to 3 months later, corresponding to 586 patients with gastrointestinal symptoms (53% under 15 years of age). Coinfection by Blastocystis hominis was present in 33.6% of the subjects. Our aim was to compare therapeutic responses to different antiparasitic drugs and the factors associated with the persistence of D. fragilis post-treatment. Gender, age, and other intestinal parasitic coinfections were not associated with parasite persistence following treatment. Metronidazole was the therapeutic option in most cases, followed by paromomycin: 65.4% and 17.5% respectively. Paromomycin was found to be more effective at eradicating parasitic infection than metronidazole (81.8% vs. 65.4%; p = 0.007), except in children under six years of age (p = 0.538). Although Dientamoeba fragilis mainly produces mild clinical manifestations, the high burden of infection means we require better understanding of its epidemiological cycle and pathogenicity, as well as adequate therapeutic guidelines in order to adapt medical care and policies to respond to this health problem.
Topics: Adolescent; Adult; Antiprotozoal Agents; Child; Dientamoeba; Dientamoebiasis; Feces; Female; Humans; Longitudinal Studies; Male; Metronidazole; Middle Aged; Paromomycin; Spain; Treatment Outcome; Young Adult
PubMed: 31759244
DOI: 10.1016/j.ijpddr.2019.10.005