Detection of Blastocystis Spp. İnfection Using Different İnvestigation Techniques in Children with or Without Acute Diarrhea
Abstract
Blastocystis species are the most common gastrointestinal system
parasites. Microscopic methods such as native-lugol and trichrome staining are
mostly used for diagnosis and culture and molecular methods are preferred for
research purposes. In this study, we aim
to evaluate the prevalence of Blastocystis spp. In 0-12 age’s children in
Eskisehir, Turkey, with or without acute diarrhoea, using direct microscopy,
trichrome stain and real-time polymerase chain reaction (PCR) technique.
Children were admitted to the emergency unit with acute diarrhoea and school
children without diarrhoea from seven different socioeconomic backgrounds have
been enrolled. Stool specimens were investigated by routine faecal examinations
in the Parasitology laboratory of Eskisehir Osmangazi University Education and
Research Hospital. The study was approved by the Local Ethical Committee of the
Eskisehir Osmangazi University and has been founded by Eskisehir Osmangazi
University Research Project.The children were included after informed consent
was given by their parents. Totally, 303 samples have been evaluated with these
three methods, and 84 out of these samples have been obtained from children had
acute watery diarrhoea. Blastocystis spp. cysts was seen in 38% of samples with
direct microscopic examination while cysts were seen in 35% of samples by the
trichrome stain and were 38% by PCR method. In the acute diarrhoea group,
Blastocystis spp. cysts have been with these three methods respectively: 13%,
18% and 18%. When methods are compared with reference to PCR method in acute
diarrhoea group; for direct microscopic evaluation the sensitivity was 65% and
the specificity was 78%, while for trichrome staining 55% and 77%, the specify
of PCR was 80.5% and sensitivity 83.8 the respectively. As a result, molecular
methods can be preferred for more specific results in diarrheic cases, but
there is a need for multicenter and also extensive clinical trials.
References
- KAYNAKLAR1. Cabrıne-Santos M, Nascimento Cıntra E, Carmo RA, Nascentes GAN, Pedrosa AL, Correıa D, Olıveıra-Sılva MB. Occurrence Of Blastocystis sp. In Uberaba, Mınas Geraıs, Brazıl Rev. Inst. Med. Trop. Sao Paulo; 2015: 57(3):211-215.2. Ertug S, Malatyalı E, Ertabaklar H, Çalışkan SÖ, Bozdoğan B. Subtype Distribution of Blastocystis Isolates and Evaluation of Clinical Symptoms Detected in Aydin Province, Turkey. Mikrobiyol Bul 2015; 49(1): 98-104.3. Elghareeb A, Younis MS, Fakahany AFE, Nagaty IM, Nagib MM. Laboratory diagnosis of Blastocystis sp. in diarrheic patients Trop Parasitol. 2015 Jan-Jun; 5(1): 36–41. 4. Santos HJ , Rivera WL. Comparison of direct fecal smear microscopy, culture, and polymerase chain reaction for the detection of Blastocystis sp. in human stool samples. Asian Pac J Trop Med, 2013. 6(10): p. 780-4.5. Vassalos CM, Spanakos G, Vassalou E, Papadopoulou C, Vakalis N. Differences in clinical significance and morphologic features of Blastocystis sp subtype 3. Am J Clin Pathol, 2010. 133(2): p. 251-8.6. Dagcı H, Kurt Ö, Demırel M, Mandıracıoglu A, Aydemır S, Saz U, Bart A, Van Gool T. Epidemiological And Diagnostic Features Of Blastocystis Infection İn Symptomatic Patients İn Izmir Province, Turkey. Iranian J Parasitol: Vol. 9, No. 4, Oct –Dec 2014, p.519-529. 7. Belleza MLB, Cadacio JLC, Borja MP, Solon JAA, Padilla MA, Tongol-Rivera PN, Rivera AL. Epidemiologic Study of Blastocystis Infection in an Urban Community in the Philippines. Journal of Environmental and Public Health. Volume 2015, Article ID 894297.8. Ozcakir O, Güreser S, Ergüven S, Yılmaz YA, Topaloğlu R, Hascelik G. Characteristics of Blastocystis hominis. Acta Parasitologica Turcica. 2007; 31:277-82.9. Amany M Eida, Mohamed M Eida. Identification of Blastocystis hominis in Patients with Irritable Bowel Syndrome using Microscopy and Culture Compared to PCR. Parasitologists United Journal.2008. 1(2): p. 87-92.10. Seguí R, Klisiowicz D, Oishi CY, Toledo R, Esteban JG, Muñoz-Antoli C. Intestinal symptoms and Blastocystis load in schoolchildren of Paranaguá Bay, Paraná, Brazil.Rev Inst Med Trop Sao Paulo. 2017 Dec 21;59:e86. doi: 10.1590/S1678-9946201759086.11. Poirier P, Wawrzyniak I, Albert A, El Alaoui H, Delbac F, Livrelli V. Development and evaluation of a real-time PCR assay for detection and quantification of blastocystis parasites in human stool samples: prospective study of patients with hematological malignancies. J Clin Microbiol, 2011. 49(3): p. 975-83.12. Dogruman-Al F, Yoshikawa H, Kustimur S, Balaban N. PCR-based subtyping of Blastocystis isolates from symptomatic and asymptomatic individuals in a major hospital in Ankara, Turkey. Parasitol Res, 2009. 106(1): p. 263-8.13. Sari IP, Benung MR, Wahdini , Kurniawan A. Diagnosis and Identification of Blastocystis Subtypes in Primary School Children in Jakarta. J Trop Pediatr. 2017: 31.
Abstract
Blastocystis
türleri, günümüzde gelişmekte olan ülkelerde en yaygın görülen gastrointestinal
sistem parazitlerindendir. Tanısında çoğunlukla nativ-lugol ve trikrom boyama
gibi mikroskobik yöntemler kullanılmakta olup, kültür ve moleküler yöntemler
daha ziyade araştırma amacıyla tercih edilmektedir. Bu çalışmada; Eskişehir
ilinde 0-12 yaş arası akut ishali olan ve olmayan çocuklarda Blastocystis spp.
varlığı ve tanıda kullanılan yöntemlerin başarısı karşılaştırılmıştır. Akut
ishal şikayeti ile iki farklı hastanenin acil servisine başvuran çocuklar ile
ishal şikayeti olmayan yedi farklı sosyoekonomik düzeydeki ilköğretim okuluna
giden çocuklardan alınan dışkı örnekleri çalışmaya dahil edilmiştir. Örnekler
Eskişehir Osmangazi Üniversitesi Tıp Fakültesi ve Araştırma Hastanesi
parazitoloji laboratuvarında rutin dışkı inceleme yöntemlerinin yanısıra,
trikrom boyama ve Real time PCR yöntemiyle Blastocystis varlığı
araştırılmıştır. Çalışma Eskişehir Osmangazi Üniversitesi etik kurulunca
onaylanmış olup, Eskişehir Osmangazi Üniversitesi Araştırma Projeleri
tarafından desteklenmiştir. Toplamda 303 dışkı örneği çalışmaya dahil edilmiş
olup, bunlardan 84’ü akut ishali olan çocuklardan alınmıştır. Blastocystis spp.
görülme oranları kullanılan testlere gore sırasıyla; direkt mikroskobi
yöntemiyle %38, Trikrom boyama yöntemiyle %35 ve moleküler yöntemle %38 olarak
saptanmıştır. Akut ishal şikayeti ile başvuran 84 olguda bu oranlar sırasıyla;
%13, %18 ve %18 olarak saptanmıştır. Akut ishalli grupta PCR yöntemi referans
alınarak yöntemler karşılaştırıldığında; direkt mikroskobi yönteminin
duyarlılığı %65, özgüllüğü %78, trikrom yönteminin duyarlılığı %55, özgüllüğü
%77, PCR yönteminin duyarlılığı %80, özgüllüğü %84 olarak saptanmıştır. Sonuç
olarak moleküler yöntemlerin duyarlılığı ve özgüllüğü ishalli olgularda daha
güvenilir sonuçlar için tercih edilebilir, ancak çok merkezli ve geniş kapsamlı
klinik çalışmalara gereksinim vardır.
Keywords
References
- KAYNAKLAR1. Cabrıne-Santos M, Nascimento Cıntra E, Carmo RA, Nascentes GAN, Pedrosa AL, Correıa D, Olıveıra-Sılva MB. Occurrence Of Blastocystis sp. In Uberaba, Mınas Geraıs, Brazıl Rev. Inst. Med. Trop. Sao Paulo; 2015: 57(3):211-215.2. Ertug S, Malatyalı E, Ertabaklar H, Çalışkan SÖ, Bozdoğan B. Subtype Distribution of Blastocystis Isolates and Evaluation of Clinical Symptoms Detected in Aydin Province, Turkey. Mikrobiyol Bul 2015; 49(1): 98-104.3. Elghareeb A, Younis MS, Fakahany AFE, Nagaty IM, Nagib MM. Laboratory diagnosis of Blastocystis sp. in diarrheic patients Trop Parasitol. 2015 Jan-Jun; 5(1): 36–41. 4. Santos HJ , Rivera WL. Comparison of direct fecal smear microscopy, culture, and polymerase chain reaction for the detection of Blastocystis sp. in human stool samples. Asian Pac J Trop Med, 2013. 6(10): p. 780-4.5. Vassalos CM, Spanakos G, Vassalou E, Papadopoulou C, Vakalis N. Differences in clinical significance and morphologic features of Blastocystis sp subtype 3. Am J Clin Pathol, 2010. 133(2): p. 251-8.6. Dagcı H, Kurt Ö, Demırel M, Mandıracıoglu A, Aydemır S, Saz U, Bart A, Van Gool T. Epidemiological And Diagnostic Features Of Blastocystis Infection İn Symptomatic Patients İn Izmir Province, Turkey. Iranian J Parasitol: Vol. 9, No. 4, Oct –Dec 2014, p.519-529. 7. Belleza MLB, Cadacio JLC, Borja MP, Solon JAA, Padilla MA, Tongol-Rivera PN, Rivera AL. Epidemiologic Study of Blastocystis Infection in an Urban Community in the Philippines. Journal of Environmental and Public Health. Volume 2015, Article ID 894297.8. Ozcakir O, Güreser S, Ergüven S, Yılmaz YA, Topaloğlu R, Hascelik G. Characteristics of Blastocystis hominis. Acta Parasitologica Turcica. 2007; 31:277-82.9. Amany M Eida, Mohamed M Eida. Identification of Blastocystis hominis in Patients with Irritable Bowel Syndrome using Microscopy and Culture Compared to PCR. Parasitologists United Journal.2008. 1(2): p. 87-92.10. Seguí R, Klisiowicz D, Oishi CY, Toledo R, Esteban JG, Muñoz-Antoli C. Intestinal symptoms and Blastocystis load in schoolchildren of Paranaguá Bay, Paraná, Brazil.Rev Inst Med Trop Sao Paulo. 2017 Dec 21;59:e86. doi: 10.1590/S1678-9946201759086.11. Poirier P, Wawrzyniak I, Albert A, El Alaoui H, Delbac F, Livrelli V. Development and evaluation of a real-time PCR assay for detection and quantification of blastocystis parasites in human stool samples: prospective study of patients with hematological malignancies. J Clin Microbiol, 2011. 49(3): p. 975-83.12. Dogruman-Al F, Yoshikawa H, Kustimur S, Balaban N. PCR-based subtyping of Blastocystis isolates from symptomatic and asymptomatic individuals in a major hospital in Ankara, Turkey. Parasitol Res, 2009. 106(1): p. 263-8.13. Sari IP, Benung MR, Wahdini , Kurniawan A. Diagnosis and Identification of Blastocystis Subtypes in Primary School Children in Jakarta. J Trop Pediatr. 2017: 31.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | ORİJİNAL MAKALE |
| Authors | |
| Publication Date | April 12, 2018 |
| Published in Issue | Year 2018 Volume: 40 Issue: 2 |