The Distribution of Blastocystis Subtypes among School-aged Children in Mugla, Turkey
AbstractBackground: Blastocystis is a common protozoon that inhabits human intestinal tract and has a worldwide distribution. This study aimed to determine subtype (ST) distribution of Blastocystis among school-aged children in a western city of Turkey between Mar and Jun 2014.Methods: This cross-sectional study was conducted among primary school children in Mugla between Mar and Jun 2014. Overall, 468 stool samples from children were examined by direct microscopy and inoculated into Jones medium. Blastocystis partial small subunit ribosomal RNA gene (SSU-rDNA) was amplified and sequenced from culture positive isolates. Subtypes were determined according to closest or exact match at GenBank and Blastocystis ST (18S) database. Results: The positive rate of Blastocystis was 7.4% (n=35) with xenic in-vitro culture (XIVC). The subtypes could be identified for 33 (94.2%) isolates; 12 (34.2%) were ST3, 11 (31.4%) were ST1, 9 (25.7%) were ST2, one was (2.8%) ST7. No relationship was found between Blastocystis infected and non-infected cases in terms of gastrointestinal symptoms. Additionally, none of the possible risk factors was related to Blastocystis infection. Conclusion: Subtypes in children was similar to those reported in most of the studies that found ST3 as the most common subtype.
Wawrzyniak I, Poirier P, Viscogliosi E et al. Blastocystis, an unrecognized parasite: an overview of pathogenesis and diagnosis. Ther Adv Infect Dis. 2013; 1(5):167-78.
El Safadi D, Meloni D, Poirier P et al. Molecular epidemiology of Blastocystis in Lebanon and correlation between subtype 1 and gastrointestinal symptoms. Am J Trop Med Hyg. 2013; 88(6):1203-6.
Coyle CM, Varughese J, Weiss LM et al. Blastocystis: to treat or not to treat. Clin Infect Dis. 2012; 54(1):105-10.
Scanlan PD, Stensvold CR. Blastocystis: getting to grips with our guileful guest. Trends Parasitol. 2013;29(11):523-9.
Jimenez-Gonzalez DE, Martinez-Flores WA, Reyes-Gordillo J et al. Blastocystis infection is associated with irritable bowel syndrome in a Mexican patient population. Parasitol Res. 2012;110(3):1269-75.
Zuel-Fakkar NM, Abdel Hameed DM, Hassanin OM. Study of Blastocystis hominis isolates in urticaria: a case-control study. Clin Exp Dermatol. 2011;36(8):908-10.
Tan TC, Ong SC, Suresh KG. Genetic variability of Blastocystis sp. isolates obtained from cancer and HIV/AIDS patients. Parasitol Res. 2009;105(5):1283-6.
Stensvold CR, Lewis HC, Hammerum AM et al. Blastocystis: unravelling potential risk factors and clinical significance of a common but neglected parasite. Epidemiol Infect. 2009; 137(11):1655-63.
Poirier P, Wawrzyniak I, Albert A et al. 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):975-83.
Alfellani MA, Taner-Mulla D, Jacob AS et al. Genetic diversity of Blastocystis in livestock and zoo animals. Protist. 2013;164(4):497-509.
Stensvold CR. Comparison of sequencing (barcode region) and sequence-tagged-site PCR for Blastocystis subtyping. J Clin Microbiol. 2013; 51(1):190-4.
Dagci H, Kurt Ö, Demirel M et al. Epidemiological and Diagnostic Features of Blastocystis Infection in Symptomatic Patients in Izmir Province, Turkey. Iran J Parasitol. 2014;9(4):519-29.
Ozyurt M, Kurt O, Mølbak K et al. Molecular epidemiology of Blastocystis infections in Turkey. Parasitol Int. 2008;57(3):300-6.
Turkish Statistical Institute. Report no. 4200. Secilmis gostergelerle Mugla 2013. TUIK: Ankara, 2014.
Scicluna SM, Tawari B, Clark CG. DNA barcoding of Blastocystis. Protist. 2006;157(1):77-85.
Altschul SF, Gish W, Miller W et al. Basic local alignment search tool. J Mol Biol. 1990;215(3):403-10.
17 Jolley KA, Maiden MC. BIGSdb: Scalable analysis of bacterial genome variation at the population level. BMC Bioinformatics. 2010;11:595.
Stensvold CR, Suresh GK, Tan KS et al. Terminology for Blastocystis subtypes-a consensus. Trends Parasitol. 2007;23(3):93-6.
Saitou N, Nei M. The neighbor-joining method: a new method for reconstructing phylogenetic trees. Mol Biol Evol. 1987;4(4):406-25.
Tamura K, Stecher G, Peterson D et al. MEGA6: Molecular Evolutionary Genetics Analysis version 6.0. Mol Biol Evol. 2013;30(12):2725-9.
Harhay MO, Horton J, Olliaro PL. Epidemiology and control of human gastrointestinal parasites in children. Expert Rev Anti Infect Ther. 2010;8(2):219-34.
Celik T, Daldal N, Karaman U et al. Incidence of intestinal parasites among primary school children in Malatya. Turkiye Parazitol Derg. 2006; 30(1):35-8.
Göz Y, Aydin A, Tuncer O. Distribution of intestinal parasites in children from the 23 Nisan Primary School in Hakkari. Turkiye Parazitol Derg. 2005;29(4):268-70.
Moosavi A, Haghighi A, Mojarad EN et al. Genetic variability of Blastocystis sp. isolated from symptomatic and asymptomatic individuals in Iran. Parasitol Res. 2012;111(6):2311-5.
Roberts T, Barratt J, Harkness J et al. Comparison of microscopy, culture, and conventional polymerase chain reaction for detection of Blastocystis sp. in clinical stool samples. Am J Trop Med Hyg. 2011;84(2):308-12.
Suresh K, Smith H. Comparison of methods for detecting Blastocystis hominis. Eur J Clin Microbiol Infect Dis. 2004;23(6):509-11.
Tan KS. New insights on classification, identification, and clinical relevance of Blastocystis spp. Clin Microbiol Rev. 2008;21(4):639-65.
Parkar U, Traub RJ, Kumar S et al. Direct characterization of Blastocystis from faeces by PCR and evidence of zoonotic potential. Parasitology. 2007;134(Pt 3):359-67.
Stensvold R, Brillowska-Dabrowska A, Nielsen HV et al. Detection of Blastocystis hominis in unpreserved stool specimens by using polymerase chain reaction. J Parasitol. 2006;92(5):1081-7.
El Safadi D, Gaayeb L, Meloni D et al. Children of Senegal River Basin show the highest prevalence of Blastocystis sp. ever observed worldwide. BMC Infect Dis. 2014;14:164.
Yoshikawa H, Wu Z, Pandey K et al. Molecular characterization of Blastocystis isolates from children and rhesus monkeys in Kathmandu, Nepal. Vet Parasitol. 2009;160(3-4):295-300.
Dogruman-Al F, Dagci H, Yoshikawa H et al. A possible link between subtype 2 and asymptomatic infections of Blastocystis hominis. Parasitol Res. 2008;103(3):685-9.
Dogruman-Al F, Yoshikawa H, Kustimur S et al. PCR-based subtyping of Blastocystis isolates from symptomatic and asymptomatic individuals in a major hospital in Ankara, Turkey. Parasitol Res. 2009;106(1):263-8.
Stensvold CR. Blastocystis: Genetic diversity and molecular methods for diagnosis and epidemiology. Trop Parasitol. 2013;3(1):26-34.
Ertuğ S, Malatyal E, Ertabaklar H et al. Subtype distribution of Blastocystis isolates and evaluation of clinical symptoms detected in Aydin province, Turkey. Mikrobiyol Bul. 2015;49(1):98-104.
Pipatsatitpong D, Rangsin R, Leelayoova S et al. Incidence and risk factors of Blastocystis infection in an orphanage in Bangkok, Thailand. Parasit Vectors. 2012;5:37.
Dinleyici EC, Eren M, Dogan N et al. Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection. Parasitol Res. 2011;108(3):541-5.