Investigation of Blastocystis hominis Frequency in Patients with Diabetes by Microscopy and Conventional PCR Methods
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Abstract
Background: We aimed to determine the frequency and subtype of B. hominis in diabetic patients.
Methods: One hundred and fifty diabetic patients and 100 healthy people without any chronic disease were included in the study. Stool samples were analyzed by native-Lugol, condensation, trichrome staining and PCR methods.
Results: İn 150 patients with diabetes; B. hominis was detected in 38 (25.3%) by PCR, in 34 (22.7%) by native-Lugol and trichrome staining. In the control group, 14 (14%) out of 100 subjects were positive by PCR, and 10 (10%) were positive by native-Lugol and trichrome staining. In the statistical evaluation, a significant difference was found between gender (P=0.023), age (P=0.045; ≤35 and >35 comparison), duration of diabetes (P=0.04), the HbA1c value (P=0.023; <8 and ≥8 comparison), and B. hominis positivity. ST1 was determined in 76.9% of patients with diabetes, and ST2 was determined in 23.07%. Considering the 3 methods, B. hominis positivity was detected in 40 patients (26.7%) in diabetic group and in 14 participants (14%) in the control group (P=0.011).
Conclusion: B. hominis is a factor to be considered in patients with diabetes. Herein, the most common subtype detected in the patients with diabetes mellitus was ST1, but this result was not considered sufficient to reveal the importance of the subtype factor in the pathogenicity of B. hominis in patients with diabetes. In this context, there is a need for more comprehensive studies in both diabetic and other immunocompromised patient groups.
1. Mingmongkol S, Prasartpan S, Aumkha-yan S, Watthanakulpanich D. Asymp-tomatic Blastocystis infected persons as potential carriers of disease in Thailand. IJTDH. 2015;10(2):1-10.
2. Wawrzyniak I, Poirier P, Viscogliosi E, et al Blastocystis, an unrecognized para-site: an overview of pathogenesis and diagnosis. Ther Adv Infect Dis. 2013; 1(5):167-78.
3. Stenzel DJ, Boreham PF. Blastocystis hom-inis revisited. Clin Microbiol Rev. 1996; 9(4):563-84.
4. Casqueiro J, Casqueiro J, Alves C. Infec-tions in patients with diabetes mellitus: A review of pathogenesis. Indian J En-docrinol Metab. 2012; 16 (1)İ: 27-36.
5. Yakoob J, Jafri W, Beg MA, et al Irrita-ble bowel syndrome: is it associated with genotypes of Blastocystis hominis. Parasitol Res. 2010;106(5):1033-8.
6. Roberts T, Barratt J, Harkness J, Ellis J, Stark D. Comparison of microscopy, culture, and conventional polymerase chain reaction for detection of Blasto-cystis sp. in clinical stool samples. Am J Trop Med Hyg. 2011; 84(2):308-12.
7. Santos HJ, Rivera WR. 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):780-784.
8. Adıyaman Korkmaz G, Doğruman Al F, Mumcuoğlu İ. Investigation of the presence of Blastocystis spp. in stool samples with microscopic, culture and molecular methods. Mikrobiyol Bul. 2015; 49(1):85-97.
9. Mohamed AM, Ahmed MA, Ahmed SA, Al-Semany SA, Alghamdi SS, Zaglool DA. Predominance and association risk of Blastocystis hominis subtype I in colo-rectal cancer: a case control study. In-fect Agent Cancer. 2017; 12:21.
10. Barazesh A, Fouladvand M, Tahmasebi R, Heydari A, Fallahi J. The prevalence of intestinal parasites in hemodialysis patients in Bushehr, Iran. Hemodial Int. 2015; 19(3):447-51.
11. Poorkhosravani Z, Agholi M, Sharifi-Sarasiabi K, Heydari-Hengami M, Shamseddin J. Frequency of intestinal parasites in patients with diabetes melli-tus compared with healthy controls in Fasa, Fars province, Iran, 2018. Hor-mozgan Med J. (in press). 2019. DOI: 10.5812/hmj.91284
12. Tangi FB, Fokam EB, Longdoh NA, Eteneneng EJ. Intestinal parasites in di-abetes mellitus patients in the Limbe and Buea Municipalities, Cameroon. DROJ. 2016; 2:123.
13. Mohtashamipour M, Hoseini SGG, Pes-tehchian N, Yousefi H, Fallah E, Haz-ratian T. .Intestinal parasitic infections in patients with diabetes mellitus: A case-control study. J Anal Res Clin Med. 2015;3(3):157-63.
14. Aourarh S, Skali H, Abainou L, Baizri, El Mezouari E, Moutaj R. Intestinal para-sites in the diabetic patient. Int J Diabe-tes Metab Disord. 2020;5(1):7-9.
15. Bafghi AF, Afkhami-Ardekani M, Tafti AD. Frequency distribution of intestinal parasitic infections in diabetic patients-Yazd 2013. IJDO. 2015; 7(1):33-7.
16. Popruk N, Prasongwattana S, Mahit-tikorn A, Palasuwan A, Popruk S, Palasuwan D. Prevalence and subtype distribution of Blastocystis infection in patients with diabetes mellitus in Thai-land. Int J Environ Res Public Health. 2020; 17(23):8877.
17. Ibrahim SS, Ismail MAM, Shaker MA, Khalili DM, Raafat A. Blastocystıs hominis in diabetic and non-diabetic patients with irritable bowel syndrome in Beni-Suef city, Egypt. JESP. 2020; 50(3):683-8.
18. Melo GP, Mazzaro MC, Gomes-Gouvea MS, et al Blastocystis subtypes in patients with diabetes mellitus from the Midwest region of Brazil. Rev Inst Med Trop Sao Paulo. 2021; 63:e32.
19. Khoshnood S, Rafiei A, Saki J, Alizadeh K. Prevalence and genotype characteri-zation of Blastocystis hominis among the Baghmalek people in southwestern Iran in 2013-2014. Jundishapur J Microbiol. 2015; 8(10):e23930.
20. Kiani H, Haghighi A, Rostami A, et al Prevalence, risk factors and symptoms associated to intestinal parasite 3-infections among patients with gastroin-testinal disorders in Nahavand, Western Iran. Rev Inst Med Trop Sao Paulo. 2016; 58:42.
21. Seyer A, Karasartova D, Ruh E, et al Ep-idemiology and prevalence of Blastocystis spp. in North Cyprus. Am J Trop Med Hyg. 2017; 96(5):1164-70.
22. Salehi M, Mardaneh J, NiazkarHR, et al Prevalence and subtype analysis of Blas-tocystis hominis isolated from patients in the Northeast of Iran. J Parasitol Res. 2021; 8821885 .
23. Abdulsalam AM, Ithoi I, Al-Mekhlafi HM, et al Prevalence, predictors and clinical significance of Blastocystis sp. in Sebha, Libya. Parasit Vectors. 2013; 6:86.
24. Munoz-Antolia C, Pavon A, Marcilla A, Toledo R, Esteban JG. Prevalence and risk factors related to intestinal para-sites among children in Department of Rio San Juan, Nicaragua. Trans R Soc Trop Med Hyg. 2014;108(12):774-82.
25. Mohammad NA, Al-Mekhlafi HM, Moktar N, Anuar TS. Prevalence and risk factors of Blastocystis infection among underprivileged communities in rural Malaysia. Asian Pac J Trop Med. 2017; 10(5):491-7.
26. El Safadi D, Cian A, Nourrisson C, et al Prevalence, risk factors for infection and subtype distribution of the intesti-nal parasite Blastocystis sp. from a large-scale multi-center study in France. BMC Infect Dis. 2016;16(1):451.
27. Asfaram S, Daryani A, Sarvi S, et al Ge-ospatial analysis and epidemiological aspects of human infections with Blasto-cystis hominis in Mazandaran Province, Northern Iran. Epidemiol Health. 2019; 41: e2019009.
28. Akinbo FO, Olujobi SO, Omoregie R, Egbe E. Intestinal parasitic infections among diabetes mellitus patients. Bi-omark Genomic Med. 2013; 5:44-7.
29. Sisu A, Abugri J, Ephraim RKD, et al In-testinal parasite infections in diabetes mellitus patients; A cross-sectional study of the Bolgatanga municipality, Ghana. Scient Afr. 2021; 11:e00680.
30. Padukone S, Mandal J, Rajkumari N, Bhat BV, Swaminathan RP, Parija SC. Detection of Blastocystis in clinical stool specimens using three different meth-ods and morphological examination in Jones' medium. Trop Parasitol. 2018;8(1):33-40.
31. Darwish B, Aboualchamat G, Al Nahhas S. Detection of Blastocystis in stool isolates using different diagnostic methods. Res Sq. 2021:1-12.
32. Cakır F, Cicek M, Yildirim IH. Deter-mination the subtypes of Blastocystis sp. and evaluate the effect of these sub-types on pathogenicity. Acta Parasitol. 2019; 64(1):7-12.
33. Yan Y, Su S, Lai R, et al Genetic varia-bility of Blastocystis hominis isolates in China. Parasitol Res. 2006;99(5):597-601.
34. Dominguez-Marquez MV, Guna R, Munoz C, Gomez-Munoz MT, Borras R. High prevalence of subtype 4 among isolates of Blastocystis hominis from symp-tomatic patients of a health district of Valencia (Spain). Parasitol Res. 2009;105(4):949-55.
35. Kaneda Y, Horiki N, Cheng XJ, et al Ribodemes of Blastocystis hominis isolated in Japan. Am J Trop Med Hyg. 2001; 65(4):393-6.
36. Hussein EM, Hussein AM, Eida MM, Atwa MM. Pathophysiological variabil-ity of different genotypes of human Blastocystis hominis Egyptian isolates in experimentally infected rats. Parasitol Res. 2008;102(5):853-60.
37. Doğruman Al F, Dağci H, Yoshikawa H, Kurt Ö, Demirel M. A possible link be-tween subtype 2 and asymptomatic in-fections of Blastocystis hominis. Parasitol Res. 2008;103(3):685-9.
38. Stensvold CR, Clark CG. Current status of Blastocystis: A personal view. Parasitol Int. 2016; 65(6 Pt B):763-71.
2. Wawrzyniak I, Poirier P, Viscogliosi E, et al Blastocystis, an unrecognized para-site: an overview of pathogenesis and diagnosis. Ther Adv Infect Dis. 2013; 1(5):167-78.
3. Stenzel DJ, Boreham PF. Blastocystis hom-inis revisited. Clin Microbiol Rev. 1996; 9(4):563-84.
4. Casqueiro J, Casqueiro J, Alves C. Infec-tions in patients with diabetes mellitus: A review of pathogenesis. Indian J En-docrinol Metab. 2012; 16 (1)İ: 27-36.
5. Yakoob J, Jafri W, Beg MA, et al Irrita-ble bowel syndrome: is it associated with genotypes of Blastocystis hominis. Parasitol Res. 2010;106(5):1033-8.
6. Roberts T, Barratt J, Harkness J, Ellis J, Stark D. Comparison of microscopy, culture, and conventional polymerase chain reaction for detection of Blasto-cystis sp. in clinical stool samples. Am J Trop Med Hyg. 2011; 84(2):308-12.
7. Santos HJ, Rivera WR. 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):780-784.
8. Adıyaman Korkmaz G, Doğruman Al F, Mumcuoğlu İ. Investigation of the presence of Blastocystis spp. in stool samples with microscopic, culture and molecular methods. Mikrobiyol Bul. 2015; 49(1):85-97.
9. Mohamed AM, Ahmed MA, Ahmed SA, Al-Semany SA, Alghamdi SS, Zaglool DA. Predominance and association risk of Blastocystis hominis subtype I in colo-rectal cancer: a case control study. In-fect Agent Cancer. 2017; 12:21.
10. Barazesh A, Fouladvand M, Tahmasebi R, Heydari A, Fallahi J. The prevalence of intestinal parasites in hemodialysis patients in Bushehr, Iran. Hemodial Int. 2015; 19(3):447-51.
11. Poorkhosravani Z, Agholi M, Sharifi-Sarasiabi K, Heydari-Hengami M, Shamseddin J. Frequency of intestinal parasites in patients with diabetes melli-tus compared with healthy controls in Fasa, Fars province, Iran, 2018. Hor-mozgan Med J. (in press). 2019. DOI: 10.5812/hmj.91284
12. Tangi FB, Fokam EB, Longdoh NA, Eteneneng EJ. Intestinal parasites in di-abetes mellitus patients in the Limbe and Buea Municipalities, Cameroon. DROJ. 2016; 2:123.
13. Mohtashamipour M, Hoseini SGG, Pes-tehchian N, Yousefi H, Fallah E, Haz-ratian T. .Intestinal parasitic infections in patients with diabetes mellitus: A case-control study. J Anal Res Clin Med. 2015;3(3):157-63.
14. Aourarh S, Skali H, Abainou L, Baizri, El Mezouari E, Moutaj R. Intestinal para-sites in the diabetic patient. Int J Diabe-tes Metab Disord. 2020;5(1):7-9.
15. Bafghi AF, Afkhami-Ardekani M, Tafti AD. Frequency distribution of intestinal parasitic infections in diabetic patients-Yazd 2013. IJDO. 2015; 7(1):33-7.
16. Popruk N, Prasongwattana S, Mahit-tikorn A, Palasuwan A, Popruk S, Palasuwan D. Prevalence and subtype distribution of Blastocystis infection in patients with diabetes mellitus in Thai-land. Int J Environ Res Public Health. 2020; 17(23):8877.
17. Ibrahim SS, Ismail MAM, Shaker MA, Khalili DM, Raafat A. Blastocystıs hominis in diabetic and non-diabetic patients with irritable bowel syndrome in Beni-Suef city, Egypt. JESP. 2020; 50(3):683-8.
18. Melo GP, Mazzaro MC, Gomes-Gouvea MS, et al Blastocystis subtypes in patients with diabetes mellitus from the Midwest region of Brazil. Rev Inst Med Trop Sao Paulo. 2021; 63:e32.
19. Khoshnood S, Rafiei A, Saki J, Alizadeh K. Prevalence and genotype characteri-zation of Blastocystis hominis among the Baghmalek people in southwestern Iran in 2013-2014. Jundishapur J Microbiol. 2015; 8(10):e23930.
20. Kiani H, Haghighi A, Rostami A, et al Prevalence, risk factors and symptoms associated to intestinal parasite 3-infections among patients with gastroin-testinal disorders in Nahavand, Western Iran. Rev Inst Med Trop Sao Paulo. 2016; 58:42.
21. Seyer A, Karasartova D, Ruh E, et al Ep-idemiology and prevalence of Blastocystis spp. in North Cyprus. Am J Trop Med Hyg. 2017; 96(5):1164-70.
22. Salehi M, Mardaneh J, NiazkarHR, et al Prevalence and subtype analysis of Blas-tocystis hominis isolated from patients in the Northeast of Iran. J Parasitol Res. 2021; 8821885 .
23. Abdulsalam AM, Ithoi I, Al-Mekhlafi HM, et al Prevalence, predictors and clinical significance of Blastocystis sp. in Sebha, Libya. Parasit Vectors. 2013; 6:86.
24. Munoz-Antolia C, Pavon A, Marcilla A, Toledo R, Esteban JG. Prevalence and risk factors related to intestinal para-sites among children in Department of Rio San Juan, Nicaragua. Trans R Soc Trop Med Hyg. 2014;108(12):774-82.
25. Mohammad NA, Al-Mekhlafi HM, Moktar N, Anuar TS. Prevalence and risk factors of Blastocystis infection among underprivileged communities in rural Malaysia. Asian Pac J Trop Med. 2017; 10(5):491-7.
26. El Safadi D, Cian A, Nourrisson C, et al Prevalence, risk factors for infection and subtype distribution of the intesti-nal parasite Blastocystis sp. from a large-scale multi-center study in France. BMC Infect Dis. 2016;16(1):451.
27. Asfaram S, Daryani A, Sarvi S, et al Ge-ospatial analysis and epidemiological aspects of human infections with Blasto-cystis hominis in Mazandaran Province, Northern Iran. Epidemiol Health. 2019; 41: e2019009.
28. Akinbo FO, Olujobi SO, Omoregie R, Egbe E. Intestinal parasitic infections among diabetes mellitus patients. Bi-omark Genomic Med. 2013; 5:44-7.
29. Sisu A, Abugri J, Ephraim RKD, et al In-testinal parasite infections in diabetes mellitus patients; A cross-sectional study of the Bolgatanga municipality, Ghana. Scient Afr. 2021; 11:e00680.
30. Padukone S, Mandal J, Rajkumari N, Bhat BV, Swaminathan RP, Parija SC. Detection of Blastocystis in clinical stool specimens using three different meth-ods and morphological examination in Jones' medium. Trop Parasitol. 2018;8(1):33-40.
31. Darwish B, Aboualchamat G, Al Nahhas S. Detection of Blastocystis in stool isolates using different diagnostic methods. Res Sq. 2021:1-12.
32. Cakır F, Cicek M, Yildirim IH. Deter-mination the subtypes of Blastocystis sp. and evaluate the effect of these sub-types on pathogenicity. Acta Parasitol. 2019; 64(1):7-12.
33. Yan Y, Su S, Lai R, et al Genetic varia-bility of Blastocystis hominis isolates in China. Parasitol Res. 2006;99(5):597-601.
34. Dominguez-Marquez MV, Guna R, Munoz C, Gomez-Munoz MT, Borras R. High prevalence of subtype 4 among isolates of Blastocystis hominis from symp-tomatic patients of a health district of Valencia (Spain). Parasitol Res. 2009;105(4):949-55.
35. Kaneda Y, Horiki N, Cheng XJ, et al Ribodemes of Blastocystis hominis isolated in Japan. Am J Trop Med Hyg. 2001; 65(4):393-6.
36. Hussein EM, Hussein AM, Eida MM, Atwa MM. Pathophysiological variabil-ity of different genotypes of human Blastocystis hominis Egyptian isolates in experimentally infected rats. Parasitol Res. 2008;102(5):853-60.
37. Doğruman Al F, Dağci H, Yoshikawa H, Kurt Ö, Demirel M. A possible link be-tween subtype 2 and asymptomatic in-fections of Blastocystis hominis. Parasitol Res. 2008;103(3):685-9.
38. Stensvold CR, Clark CG. Current status of Blastocystis: A personal view. Parasitol Int. 2016; 65(6 Pt B):763-71.
| Files | ||
| Issue | Vol 18 No 2 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijpa.v18i2.13186 | |
| Keywords | ||
| Blastocystis hominis Diabetes Microscopy Subtype | ||
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How to Cite
1.
Şahin M, Taş Cengiz Z, Galip Halidi A, Aydemir S. Investigation of Blastocystis hominis Frequency in Patients with Diabetes by Microscopy and Conventional PCR Methods. Iran J Parasitol. 2023;18(2):202-210.
