Additional Glance on the Role of Dientamoeba fragilis & Blastocystis hominis in Patients with Irritable Bowel Syndrome
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Abstract
Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with high population prevalence. Dientamoeba fragilis and Blastocystis hominis are reported worldwide as a cause of human gastrointestinal symptoms. This study evaluated the possible link between this syndrome and the infection with D. fragilis and B. hominis in Egypt.
Methods: Overall, 310 stool samples (160 from IBS patients and 150 from controls) were obtained from Tropical Medicine Outpatient Clinic, Faculty of Medicine, Ain Shams University, Cairo, Egypt between Mar 2015 and Feb 2016. All the stool specimens underwent direct examination and Trichrome staining. Each sample was cultivated on Jones and Robinson's media.
Results: Overall, 42 cases (28%) showed B. hominis and 2 cases (1.3%) for D. fragilis infections. After performing the culture methods for B. hominis and D. fragilis, detections increased to 50 cases (33.3%) and 3 cases (2%), respectively. While among 150 controls 18 (12%) positive samples were detected as B. hominis.
Conclusion: There may be a possible relationship between the presentation of irritable bowel syndrome and D. fragilis and B. hominis infections, which have to be excluded first.
Bercik P, Verdu EF, Collins SM. Is irritable bowel syndrome a low-grade inflammato-ry bowel disease? Gastroenterol Clin North Am. 2005;34(2):235-45.
Drossman DA. Rome III: The new criteria. Chin J Dig Dis. 2006;7(4):181-5.
Enck P, Aziz Q, Barbara G et al. Irritable bowel syndrome. Nat Rev Dis Primers. 2016; 2:16014.
Stark D, Barratt J, Chan D, Ellis JT. Dien-tamoeba fragilis, the Neglected Trichomonad of the Human Bowel. Clin Microbiol Rev. 2016;29(3):553-80.
Jepps MW, Dobell C. Dientamoeba fragilis n.g., n. sp.: a new intestinal amoeba from man. Parasitology. 1918; 10:352-67.
Gerbod D, Edgcomb VP, Noël C, Zenner L, Wintjens R, Delgado-Viscogliosi P, Holder ME, Sogin ML, Viscogliosi E. Phylogenetic position of the trichomonad parasite of turkeys, Histomonas meleagridis (Smith) Tyzzer, inferred from small subu-nit rRNA sequence. J Eukaryot Microbiol. 2001;48(4):498-504.
Barratt JL, Harkness J, Marriott D, Ellis JT, Stark D. A review of Dientamoeba fragilis car-riage in humans: Several reasons why this organism should be considered in the di-agnosis of gastrointestinal illness. Gut Mi-crobes. 2011;2(1):3-12.
Azizian M, Basati G, Abangah G, Mahmoudi MR, Mirzaei A. Contribution of Blastocystis hominis subtypes and associat-ed inflammatory factors in development of irritable bowel syndrome. Parasitol Res. 2016;115(5):2003-9.
Tan KS. New insights on classification, identification, and clinical relevance of Blas-tocystis spp. Clin Microbiol Rev. 2008;21(4):639-65.
Alfellani MA, Stensvold CR, Vidal-Lapiedra A, Onuoha ES, Fagbenro-Beyioku AF, Clark CG. Variable geograph-ic distribution of Blastocystis subtypes and its potential implications. Acta Trop. 2013; 126(1):11-8.
Aguiar JI, Gonçalves AQ, Sodré FC, Perei-ra Sdos R, Bóia MN, de Lemos ER, Daher RR. Intestinal protozoa and hel-minthes among Terena Indians in the State of Mato Grosso do Sul: high preva-lence of Blastocystis hominis. Rev Soc Bras Med Trop. 2007; 40(6):631-4.
Pegelow K, Gross R, Pietrzik K, Lukito W, Richards AL, Fryauff DJ. Parasitological and nutritional situation of school children in the Sukaraja district, West Java, Indone-sia. Southeast Asian J Trop Med Public Health. 1997;28(1):173-90.
Hirata T, Nakamura H, Kinjo N, Hokama A, Kinjo F, Yamane N, Fujita J. Prevalence of Blastocystis hominis and Strongyloides ster-coralis infection in Okinawa, Japan. Parasi-tol Res. 2007;101(6):1717-9.
Wong KH, Ng GC, Lin RT, Yoshikawa H, Taylor MB, Tan KS. Predominance of subtype 3 among Blastocystis isolates from a major hospital in Singapore. Parasitol Res. 2008; 102(4):663-70.
Nagel R, Cuttell L, Stensvold CR, Mills PC, Bielefeldt-Ohmann H, Traub RJ. Blastocystis subtypes in symptomatic and asympto-matic family members and pets and re-sponse to therapy. Intern Med J. 2012;42(11):1187-95.
Tan KS, Mirza H, Teo JD, Wu B, Macary PA. Current views on the clinical relevance of Blastocystis spp. Curr Infect Dis Rep. 2010; 12(1):28-35.
Souppart L, Sanciu G, Cian A et al. Molec-ular epidemiology of human Blastocystis iso-lates in France. Parasitol Res. 2009;105(2):413-21.
Roberts T, Stark D, Harkness J, Ellis J. Update on the pathogenic potential and treatment options for Blastocystis sp. Gut Pathog. 2014; 6:17.
Verma R, Delfanian K. Blastocystis hominis associated acute urticaria. Am J Med Sci. 2013;346(1):80-1.
El Shazly AM, Awad SE, Sultan DM, Sad-ek GS, Khalil HH, Morsy TA. Intestinal parasites in Dakahlia governorate, with dif-ferent techniques in diagnosing protozoa. J J Egypt Soc Parasitol. 2006;36(3):1023-34.
Rayan HZ, Ismail OA, El Gayar EK. Prev-alence and clinical features of Dientamoeba fragilis infections in patients suspected to have intestinal parasitic infection. J Egypt Soc Parasitol. 2007;37(2):599-608.
Elnadi NA, Hassanien HA, Ahmad AM, Abd Ellah AK. Intestinal parasites in dia-betic patients in Sohag university hospitals, Egypt. J Egypt Soc Parasitol. 2015;45(2):443-9.
Stark D, Barratt J, Roberts T, Marriott D, Harkness J, Ellis J. A review of the clinical presentation of dientamoebiasis. Am J Trop Med Hyg. 2010;82(4):614-9.
Shehata AI, Hassanein F. Intestinal parasit-ic infections among mentally handicapped individuals in Alexandria, Egypt. Ann Par-asitol. 2015;61(4):275-81.
Eassa SM, El-Wahab EW, Lotfi SE, El Masry SA, Shatat HZ, Kotkat AM. Risk Factors Associated with Parasitic Infection Among Municipality Solid-Waste Workers in an Egyptian Community. J Parasitol. 2016;102(2):214-21.
Norberg A, Nord CE, Evengård B. Dien-tamoeba fragilis a protozoal infection which may cause severe bowel distress. Clin Mi-crobiol Infect. 2003; 9(1):65-8.
Ozçakir O, Güreser S, Ergüven S, Yilmaz YA, Topaloğlu R, Hasçelik G. Characteris-tics of Blastocystis hominis infection in a Turk-ish university hospital. Turkiye Parazitol Derg . 2007;31(4):277-82.
Stensvold CR, Alfellani MA, Nørskov-Lauritsen S, Prip K, Victory EL, Maddox C, Nielsen HV, Clark CG. Subtype distri-bution of Blastocystis isolates from synan-thropic and zoo animals and identification of a new subtype. Int J Parasitol. 2009;39(4):473-9.
Yakoob J, Jafri W, Beg MA, Abbas Z, Naz S, Islam M, Khan R. Blastocystis hominis and Dientamoeba fragilis in patients fulfilling irri-table bowel syndrome criteria. Parasitol Res. 2010;107(3):679-84.
Nazeer JT, El Sayed Khalifa K, von Thien H, El-Sibaei MM, Abdel-Hamid MY, Taw-fik RA, Tannich E. Use of multiplex real-time PCR for detection of common diar-rhea causing protozoan parasites in Egypt. Parasitol Res. 2013:12(2):595-601.
Haque R, Roy S, Siddique A, Mondal U, Rahman SM, Mondal D, Houpt E, Petri WA Jr. Multiplex real-time PCR assay for detection of Entamoeba histolytica, Giardia in-testinalis, and Cryptosporidium spp. Am J Trop Med Hyg. 2007; 76(4):713-7.
WHO. Techniques of collection, prepara-tion, and examination of samples, fecal specimens. In (Basic laboratory methods in medical parasitology, Parasitology -laboratory manuals). WHO 1991 Geneva, Typest in India, Printed in England. P: 10-23; 1991a.
WHO. Reagents and solutions and their preparation in (Basic laboratory methods in medical parasitology, Parasitology labor-atory manuals” .WHO 1991 Geneva, Typest in India, Printed in England. P:100-105; 1991b.
Garcia LS. Collection, Preservation and Shipment of fecal specimens in (Diagnos-tic medical parasitology). Fifth edition. (Garcia, L. S.ed). ASM (American Society for microbiology) Press. P: 768-772; 2007.
Henriksen SA, Pohlenz JF. Staining of Cryptosporidium by a modified Ziehl- Neel-sen technique. Acta Vet Scand. 1981; 22(3-4):594-6.
Zman V, Khan KZ. A comparison of di-rect microscopy with culture for the diag-nosis of Blastocystis hominis. Southeast Asian J Trop Med Public Health. 1994;25(4):792-3.
Windsor JJ, Macfarlane L, Hughes-Thapa G, Jones SK, Whiteside TM. Detection of Dientamoeba fragilis by culture. Br J Biomed Sci. 2003; 60(2):79-83.
Mumcuoğlu I, Coşkun FA, Aksu N, Pür-nak T, Güngör C. Role of Dientamoeba fragilis and Blastocystis spp. in Irritable Bowel Syndrome. Turkiye Parazitol Derg. 2013; 37(2):73-7.
Crotti D, D'Annibale ML. Dientamoeba fra-gilis and dientamoebiasis: aspects of clinical parasitology and laboratory diagnosis. Par-assitologia. 2001; 43(3):135-8.
Stark D, Beebe N, Marriott D, Ellis J, Harkness J. Prospective study of the prevalence, genotyping and clinical rele-vance of Dientamoeba fragilis infections in an Australian population. J Clin Microbiol. 2005;43(6):2718-23.
Crotti D, D'Annibale ML. Intestinal infec-tions caused by Dientamoeba fragilis and Gi-ardia duodenalis in our experience. Recenti Prog Med. 2007:98(6):361-6.
Ragavan ND, Kumar S, Chye TT, Ma-hadeva S2, Shiaw-Hooi H. Blastocystis sp. in Irritable Bowel Syndrome (IBS)-Detection in Stool Aspirates during Colonoscopy. PLoS One. 2015; 10(9):e0121173.
Morgan DR, Benshoff M, Cáceres M, Becker-Dreps S, Cortes L, Martin CF, Schmulson M, Peña R. Irritable bowel syndrome and gastrointestinal parasite in-fection in a developing nation environ-ment. Gastroenterol Res Pract. 2012:2012:343812.
Stark D, Beebe N, Marriott D, Ellis J, Harkness J. Evaluation of three diagnostic methods, including real-time PCR, for de-tection of Dientamoeba fragilis in stool spec-imens. J Clin Microbiol. 2006;44(1):232-5.
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| Issue | Vol 13 No 1 (2018) | |
| Section | Original Article(s) | |
| Keywords | ||
| Dientamoeba fragilis Blastocystis hominis Irritable bowel syndrome | ||
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