BACKGROUND Blastocystis hominis(B.hominis),an anaerobic unicellular protist parasite,is known for its diverse clinical manifestations upon infecting the human gastrointestinal tract.Although globally distributed,it is...BACKGROUND Blastocystis hominis(B.hominis),an anaerobic unicellular protist parasite,is known for its diverse clinical manifestations upon infecting the human gastrointestinal tract.Although globally distributed,it is particularly prevalent in developing nations.Examining the symptoms and treatment outcomes of B.hominis infection in low-resource settings holds immense significance,providing healthcare practi-tioners with valuable insights to enhance patient care.AIM To synthesize existing evidence on the symptomatology and treatment outcomes of B.hominis infection in low-resource settings.METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines,a systematic review was conducted.The search spanned electronic databases including PubMed,Scopus,and Google Scholar.After a comprehensive screening process,a thorough examination of the papers,adhering to inclusion and exclusion criteria,and data extraction from eligible studies was conducted.The findings underwent summarization through simple descriptive analysis.RESULTS The search yielded 1200 papers,with 17 meeting inclusion criteria.Chronic diarrhea due to B.hominis infection was reported in only two studies,while abdominal pain,diarrhea,flatulence,constipation,and nausea/vomiting emerged as the most commonly documented symptoms.Recovery rates after one week of treatment ranged from 71.8%to 100%,and after two weeks,from 60%to 100%.CONCLUSION In low-resource settings,chronic diarrhea resulting from B.hominis infection is infrequent.Common symptoms include abdominal pain,diarrhea,flatulence,constipation,and nausea/vomiting.Post-treatment,clinical outcomes are notably favorable,supporting the recommendation for treatment.Metronidazole is advocated as the first-line agent,with consideration for switching to a second-line option in cases of treatment failure or poor response.展开更多
Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected...Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected from a community in San Isidro,Rodriguez,Rizal,Philippines.These samples were subjected to direct fecal smear microscopy,culture and polymerase chain reaction to detect the presence of Blastocystis sp.Results:Of the 110 stool samples collected,28(25%)were detected positive for the presence of Blastocystis sp.by two or more tests.Culture method detected the highest number of Blastocystis-positive stool samples(n=36),followed by PCR of DNA extracted from culture(n=26),PCR of DNA extracted from stool(n=10),and direct fecal smear(n=9).Compared to culture,the sensitivity of the other detection methods were 66.7%for PCR from culture and 19.4%for both PCR from stool and direct fecal smear.Specificity of the methods was high,with PCR from culture and direct fecal smear having97.3%,while PCR from stool at 95.9%.Conclusions:In this study,in vitro culture is the best method for detecting Blastocystis sp.in human stool samples.展开更多
Objective:To determine Blastocystis frequency and subtypes(ST) in ulcerative colitis(UC) patients and analyse some laboratory findings between Blastocystis positive and negative cases.Methods:Faecal samples from 150 U...Objective:To determine Blastocystis frequency and subtypes(ST) in ulcerative colitis(UC) patients and analyse some laboratory findings between Blastocystis positive and negative cases.Methods:Faecal samples from 150 UC patients in Adnan Menderes University,Training and Research Hospital were examined by direct microscopy and cultivated in Jones medium.Blastocystis positive cultures were subjected to DNA isolation and subtypes were identified by sequencing of barcode region.A retrospective analysis was conducted on C reactive protein(CRP),leukocyte counts(WBC),neutrophil counts,and sedimentation rates.Results:The overall positive rate of Blastocystis was 8%(12 patients) and the most abundant subtype was ST3(eight isolates,66.7%),followed by ST1,ST2 and ST7.Laboratory findings between Blastocystis infected and non-infected UC patients were not significantly different.Blastocystisfrequency was 3.8% among the patients in active stage,while it was 11.8% among the patients in remission stage.Conclusions:The present study confirms previous findings that have indicated the predominance of Blastocystis ST3 in humans and contributes additional evidence that suggests the low colonization of Blastocystis infection in ulcerative colitis patients during active stage.展开更多
BACKGROUND Recently,there have been several findings that showed intestinal colonisation of Blastocystis hominis(Blastocystis)as a risk factor to the worsening of colorectal cancer(CRC).However,studies have shown cont...BACKGROUND Recently,there have been several findings that showed intestinal colonisation of Blastocystis hominis(Blastocystis)as a risk factor to the worsening of colorectal cancer(CRC).However,studies have shown controversial results in the pathogenicity of Blastocystis.AIM To review systematically the evidence available on the association between CRC and Blastocystis and the prevalence of Blastocystis in CRC patients and to investigate cytopathic and immunological effects of Blastocystis in in vitro and in vivo studies.METHODS PRISMA guidelines were utilised in conducting this systematic review.Original articles published before February 2,2020 were included.PubMed,Science Direct,Scopus and Google scholar databases were searched.Manual searching was carried out to find articles missed during the online search.RESULTS Out of 12 studies selected for this systematic review,seven studies confirmed the prevalence of Blastocystis and found it to be between 2%-28%in CRC patients,whereby subtype 1 and subtype 3 were predominantly seen.A total of four studies employing in vitro human colorectal carcinoma cell line study models showed significant cytopathic and immunological effects of Blastocystis.In addition,one in vivo experimental animal model study showed that there was a significant effect of infection with Blastocystis on exacerbation of colorectal carcinogenesis.CONCLUSION Blastocystis is a commonly identified microorganism in CRC patients.These studies have provided supportive data that Blastocystis could exacerbate existing CRC via alteration in host immune response and increased oxidative damage.Future studies of CRC and Blastocystis should attempt to determine the various stages of CRC that are most likely to be associated with Blastocystis and its relationship with other intestinal bacteria.展开更多
Objective: To investigate the incidence, spontaneous clearance, persistence and risk factors of Blastocystis infection in a rural community in Thailand.Methods: In February 2016, a cohort study was conducted in a rura...Objective: To investigate the incidence, spontaneous clearance, persistence and risk factors of Blastocystis infection in a rural community in Thailand.Methods: In February 2016, a cohort study was conducted in a rural community of Thailand. Baseline information of intestinal parasitic infections and follow-up visits were conducted. Blastocystis infection was detected in stool samples examined with short-term in vitro cultivation using Jones’ medium supplemented with 10% horse serum. Participants were tested for Blastocystis infection at every study visit. Cox proportional hazard regression analysis was used to evaluate co-variates to determine the incidence of Blastocystis infection. Results: Of 733 enrolled participants, 57(7.78%) were positive and 676(92.22%) were negative for Blastocystis infection. All 676 participants were followed-up for Blastocystis infection between December 2016 and January 2018. In all, 52 of 482 cases(10.79%) comprised individual Blastocystis infection. The incidence density rates of Blastocystis infection, of spontaneous clearance of the disease and of persistent infection were 8.13, 63.14 and 38.70 per 1 000 person-months of follow-up, respectively. Our multivariate analysis revealed that opened defecation in fields or bushes(HR=4.8;95% CI=2.1-10.4, P<0.001), raising cows(HR=2.8;95% CI=1.1-7.1, P=0.032), not washing hands after animal contact(HR=2.1;95% CI=1.0-4.2, P=0.044) and presenting symptoms of nausea or vomiting(HR=2.3;95% CI=1.0-5.3, P=0.047) were predictive associated risks for the incidence of Blastocystis infection. Conclusions: Our study indicates that the best way to prevent Blastocystis infection can be by maintaining good personal hygiene, hand washing after animal contact and improving sanitary facilities.展开更多
Objective:To investigate Blastocystis’etiologic role and association with gastrointestinal symptomatology in acute and chronic urticaria patients and to identify Blastocystis subtypes responsible for urticaria.Method...Objective:To investigate Blastocystis’etiologic role and association with gastrointestinal symptomatology in acute and chronic urticaria patients and to identify Blastocystis subtypes responsible for urticaria.Methods:The study included urticaria patients and healthy individuals that presented to our polyclinic between June 2015 and May 2017.The participants were assigned into Group栺(137 patients),subdivided into acute(72)and chronic urticaria patients(65),and Group栻(129 control individuals).Blastocystis presence was investigated by native-Lugol examination,trichrome staining,PCR using sequence tagged site primers,and DNA sequencing analysis.The phylogenetic tree was constructed.Results:The native-Lugol and trichrome staining methods revealed that 16 patients(16/133,12.0%)had Blastocystis-positive stool samples,of which seven samples(7/133,5.3%)belonged acute and nine(9/133,6.8%)to chronic urticaria patients.Concerning Blastocystis subtypes,of the acute urticaria patients,three had subtype 1(ST1),one had ST2,and three had ST3.Of the chronic urticaria patients,one had ST1 and eight had ST3.Blastocystis positivity was detected in two control individuals(2/123,1.6%),both being ST3.All subtypes identified by PCR were confirmed by the sequencing analysis.The acute and chronic urticaria groups showed no statistically significant differences for Blastocystis positivity(P=0.60)and subtype distribution(P=0.15).A statistically significant difference was found between the urticaria patients and the controls for Blastocystis positivity(P<0.01),but not for subtype distribution(P=0.67)or for Blastocystis presence and gastrointestinal complaints.Conclusions:This study on Blastocystis subtype distribution among Turkish urticaria patients showed results consistent with the literature.It was concluded that Blastocystis should be kept in mind in patients with urticaria.展开更多
The patient is a 37-year-old male with a right anterior tibial mass for more than one year and a left anterior tibial mass for more than one month.There was a history of hyperthyroidism.Histopathology of the lesions s...The patient is a 37-year-old male with a right anterior tibial mass for more than one year and a left anterior tibial mass for more than one month.There was a history of hyperthyroidism.Histopathology of the lesions showed epidermal hyperkeratosis of the skin tissue,thickening of the spinous layer,extensive collagen fibrillation in the superficial dermis and reticular layer,and numerous linear and granular mucoprotein deposits in the lower and middle dermis.Blastocystis hominis was routinely detected in the stool.Diagnosis:1.Pretibial myxedema 2.intestinal parasitosis(Blastocystis hominis infection).展开更多
Objective:To determine the prevalence and risk factors of Blastocystis among underprivileged communities living in rural Malaysia. Methods:This cross-sectional study was conducted among 253 participants aged between 1...Objective:To determine the prevalence and risk factors of Blastocystis among underprivileged communities living in rural Malaysia. Methods:This cross-sectional study was conducted among 253 participants aged between 1 and 85 years. Stool samples were examined using Wheatley's trichrome stain after in-vitro cultivation in Jones' medium to detect the presence of Blastocystis. Information pertaining to the demography,socioeconomic and environment were collected using pre-validated questionnaires. Results:The total prevalence of Blastocystis infection was 40.7%. The multiple logistic regression analysis revealed that age ≥15 years(OR = 2.72; 95%CI = 1.47-5.04) and presence of infected family members(OR = 8.56; 95%CI = 4.47-16.38) were the significant risk factors associated with blastocystosis in these communities. Conclusions:Blastocystosis is revealed through this study to be still prevalent among Orang Asli communities in rural Malaysia. The two main approaches that should be implemented by the public health authority in battling this infection would be the screening of other family members and giving treatment to the infected individuals. Moreover,it is imperative for health education on good personal and food hygiene practices are provided in order to reduce the morbidity and transmission of Blastocystis infection among the Orang Asli in their communities meaningfully.展开更多
In a recent study published in Cel^(l),Piperni and colleagues revealed that Blastocystis prevalence varies significantly across geographic regions and lifestyles,with higher carriage linked to healthier plant-based di...In a recent study published in Cel^(l),Piperni and colleagues revealed that Blastocystis prevalence varies significantly across geographic regions and lifestyles,with higher carriage linked to healthier plant-based diets and favorable cardiometabolic profiles.These findings position Blastocystis as a potential biomarker for gut health and metabolic well-being,challenging its traditional perception as a pathogen(Fig.1).展开更多
The protozoan parasites Entamoeba histolytica and Blastocystis hominis are responsible for causing human amebiasis and hominis infections,respectively.These infections are highly prevalent and are often linked to wate...The protozoan parasites Entamoeba histolytica and Blastocystis hominis are responsible for causing human amebiasis and hominis infections,respectively.These infections are highly prevalent and are often linked to waterborne diseases.Due to the absence of regulations for monitoring these protozoa at the discharge points of wastewater treatment plants(WWTPs),the effluents reaching surface waters contribute to waterborne transmission.This underscores the significance of the removal capacities of WWTPs in reducing the spread of these infectious parasites.Therefore,this study examined five different types of WWTPs in Ankara,Turkey,over a year to assess their capacities to remove E.histolytica and B.hominis.The seasonal abundances of genes specific to these protozoa in both the influents and effluents of each WWTP were measured using a quantitative polymerase chain reaction.The reduction in the number of protozoan rDNA copies between the influent and effluent samples was evaluated as the removal capacity,expressed in log10 reduction(LRV)values.The results elucidated that the removal of E.histolytica and B.hominis was highly affected by the process used.Membrane bioreactor systems displayed the highest removal capacity with LRV>3.Therefore,discharges of WWTPs with other processes could need further monitoring to minimize the potential risk for public health.展开更多
Background:Blastocystis is a widespread zoonotic protozoan of mammalian species,especially in HIV/AIDS individuals.The aim of this study was to analyze the prevalence and risk factors related with Blastocystis infecti...Background:Blastocystis is a widespread zoonotic protozoan of mammalian species,especially in HIV/AIDS individuals.The aim of this study was to analyze the prevalence and risk factors related with Blastocystis infection among HIV/AIDS patients in Southwest China.Methods:The cross-sectional study was performed in 311 HIV/AIDS cases in Tengchong City,Yunnan Province from July 2016 to March 2017.For each subject,stool specimen was collected to detect the Blastocystis,and the blood sample was used to detect HIV virus load and CD4+T cell count,in addition,structured questionnaire was used to collect the basic information and risk factors.Findings:The result showed that the detection rate of Blastocystis was 3.86%(95%CI:2.22-6.62)among HIV/AIDS patients.Both raising animal(OR=12.93,95%CI:1,54-108.36)and drinking un-boiled water(OR=8A7,95%CI:1.76-37.90)were risk factors for Blastocystis infection in HIV/AIDS individuals.In addition,the interaction of CD4^+T cell count and HIV virus load was also contribution to Blastocystis infection(P=0.007).Conclusions:A high prevalence of Blastocystis infection was found in HIV/AIDS patients in Tengchong.Poor hygienic habits,the interaction of HIV virus load and CD4^+T cell count were identified as main risk factors for infection.These results will help us to develop efficient control strategies to intervene with and prevent the occurrence of Blastocystis among HIV-infected individuals.展开更多
Background Blastocystis hominis(Bh)is zoonotic parasitic pathogen with a high prevalent globally,causing opportunistic infections and diarrhea disease.Human immunodeficiency virus(HIV)infection disrupts the immune sys...Background Blastocystis hominis(Bh)is zoonotic parasitic pathogen with a high prevalent globally,causing opportunistic infections and diarrhea disease.Human immunodeficiency virus(HIV)infection disrupts the immune system by depleting CD4^(+)T lymphocyte(CD4^(+)T)cell counts,thereby increasing Bh infection risk among persons living with HIV(PLWH).However,the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood.Hence,the purpose of the study was to explore the association between Bh infection risk and CD4^(+)T cell counts,HIV viral load(VL),and duration of interruption in antiviral therapy among PLWH.Methods A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022.The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction,the CD4^(+)T cell counts in venous blood was measured using flowcytometry,and the HIV VL in serum was quantified using fluorescence-based instruments.Restricted cubic spline(RCS)was applied to assess the non-linear association between Bh infection risk and CD4^(+)T cell counts,HIV VL,and duration of interruption in highly active antiretroviral therapy(HARRT).Results A total of 1245 PLWH were enrolled in the study,the average age of PLWH was 43 years[interquartile range(IQR):33,52],with 452(36.3%)being female,50.4%(n=628)had no immunosuppression(CD4^(+)T cell counts>500 cells/μl),and 78.1%(n=972)achieved full virological suppression(HIV VL<50 copies/ml).Approximately 10.5%(n=131)of PLWH had interruption.The prevalence of Bh was found to be 4.9%[95%confidence interval(CI):3.8-6.4%]among PLWH.Significant nonlinear associations were observed between the Bh infection risk and CD4^(+)T cell counts(Pfor nonlinearity<0.001,L-shaped),HIV VL(Pfor nonlinearity<0.001,inverted U-shaped),and duration of interruption in HARRT(Pfor nonlinearity<0.001,inverted U-shaped).Conclusions The study revealed that VL was a better predictor of Bh infection than CD4^(+)T cell counts.It is crucial to consider the simultaneous surveillance of HIV VL and CD4^(+)T cell counts in PLWH in the regions with high level of socioeconomic development.The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections,the efficacy of therapeutic drugs,and the assessment of preventive and control strategies.展开更多
Background: Blastocystis is ubiquitous presence in animals and humans worldwide and has a high level genetic diversity.The aim of this study was to conduct a summary of Blastocystis prevalence,subtypes(STs)in humans a...Background: Blastocystis is ubiquitous presence in animals and humans worldwide and has a high level genetic diversity.The aim of this study was to conduct a summary of Blastocystis prevalence,subtypes(STs)in humans and animals in China and depict their distribution.Methods:: We searched for the articles related to epidemiology of Blastocystis in humans and animals throughout China which published from January 1,1990,to July 31,2019 in the following databases:PubMed,China National Knowledge Infrastructure(CNKI)and Wanfang database.The keywords were Blastocystis and one of the following ones:STs,subtypes,distribution,epidemiology,prevalence,infection,molecular,geographic,intestinal parasites,genetic diversity and characterization.Results: In recent years,various molecular epidemiological studies have been carried out in some provinces/regions of China to identify subtypes of Blastocystis.Infants and young children,school students,hospitalized diarrhea patients,HIV/AIDS patients,tuberculosis patients,and cancer patients as respondents had been included.ST1–ST7 and ST12 were the main subtypes in Chinese population.Moreover,surveys of Blastocystis infection in animal were also conducted in some provinces of China.A variety of animals were investigated including pigs,cattle,sheep,yak,giant panda,and crested ibis(Nipponia nippon)with the main subtypes of ST1–ST8,ST10,ST12–ST14.Conclusions: In recent years,some provinces/regions in China have conducted various molecular epidemiological studies to identify the Blastocystis subtypes.It is important to focus on new subtypes and mixed subtypes of infection,while increasing data on ribosomal alleles.We encourage the scientific community to start research on humans and surrounding animals(including domestic and wild animals)to better understand the possibility of Blastocystis transmission between humans and animals.We call for action among researchers studying intestinal parasitic diseases(Blastocystis),start drawing the subtype of Blastocystis and increase the subtype related to its clinical symptoms.展开更多
AIM To investigate the putative role of protozoan parasites in the development of irritable bowel syndrome(IBS).METHODS The study included 109 IBS consecutive adult patients fulfilling the RomeⅢcriteria and 100 healt...AIM To investigate the putative role of protozoan parasites in the development of irritable bowel syndrome(IBS).METHODS The study included 109 IBS consecutive adult patients fulfilling the RomeⅢcriteria and 100 healthy control subjects.All study subjects filled a structured questionnaire,which covered demographic information and clinical data.Fresh stool samples were collected from patients and control subjects and processed within less than 2 h of collection.Iodine wet mounts and Trichrome stained smears prepared from fresh stool and sediment concentrate were microscopically examined for parasites.Blastocystis DNA was detected by polymerase chain reaction,and Cryptosporidium antigens were detected by ELISA.RESULTS A total of 109 IBS patients(31 males,78 females)with a mean age±SD of 27.25±11.58 years(range:16-60 years)were enrolled in the study.The main IBS subtype based on the symptoms of these patients was constipation-predominant(88.7%of patients).A hundred healthy subjects(30 males,70 females)with a mean±SD age of 25.0±9.13 years(range 18-66 years)were recruited as controls.In the IBS patients,Blastocystis DNA was detected in 25.7%,Cryptosporidium oocysts were observed in 9.2%,and Giardia cysts were observed in 11%.In the control subjects,Blastocystis,Cryptosporidium and Giardia were detected in 9%,0%,and 1%,respectively.The difference in the presence of Blastocystis(P=0.0034),Cryptosporidium(P=0.0003),and Giardia(P=0.0029)between IBS patients and controls was statistically significant by all methods used in this study.CONCLUSION Prevalence of Blastocystis,Cryptosporidium and Giardia is higher in IBS patients than in controls.These parasites are likely to have a role in the pathogenesis of IBS.展开更多
BACKGROUND Blastocystis hominis(B.hominis)and Dientamoeba fragilis(D.fragilis)are two protozoan parasites of human bowel that are found throughout the world.There is still debate about the pathogenicity of these proto...BACKGROUND Blastocystis hominis(B.hominis)and Dientamoeba fragilis(D.fragilis)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 B.hominis and D.fragilis infections.METHODS This retrospective longitudinal study was conducted in a single medical centre,which included fifty-four patients(≥18 years)who were positive for D.fragilis,B.hominis 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(n=54),were either positive for B.hominis(37%),D.fragilis(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 followup.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(P<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.展开更多
文摘BACKGROUND Blastocystis hominis(B.hominis),an anaerobic unicellular protist parasite,is known for its diverse clinical manifestations upon infecting the human gastrointestinal tract.Although globally distributed,it is particularly prevalent in developing nations.Examining the symptoms and treatment outcomes of B.hominis infection in low-resource settings holds immense significance,providing healthcare practi-tioners with valuable insights to enhance patient care.AIM To synthesize existing evidence on the symptomatology and treatment outcomes of B.hominis infection in low-resource settings.METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines,a systematic review was conducted.The search spanned electronic databases including PubMed,Scopus,and Google Scholar.After a comprehensive screening process,a thorough examination of the papers,adhering to inclusion and exclusion criteria,and data extraction from eligible studies was conducted.The findings underwent summarization through simple descriptive analysis.RESULTS The search yielded 1200 papers,with 17 meeting inclusion criteria.Chronic diarrhea due to B.hominis infection was reported in only two studies,while abdominal pain,diarrhea,flatulence,constipation,and nausea/vomiting emerged as the most commonly documented symptoms.Recovery rates after one week of treatment ranged from 71.8%to 100%,and after two weeks,from 60%to 100%.CONCLUSION In low-resource settings,chronic diarrhea resulting from B.hominis infection is infrequent.Common symptoms include abdominal pain,diarrhea,flatulence,constipation,and nausea/vomiting.Post-treatment,clinical outcomes are notably favorable,supporting the recommendation for treatment.Metronidazole is advocated as the first-line agent,with consideration for switching to a second-line option in cases of treatment failure or poor response.
基金supported by a research grant from the Office of the Vice-Chancellor for Research and Development,University of the Philippines-Diliman(Grant No.101007 PNSE)to W.L.R.and H.J.S
文摘Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected from a community in San Isidro,Rodriguez,Rizal,Philippines.These samples were subjected to direct fecal smear microscopy,culture and polymerase chain reaction to detect the presence of Blastocystis sp.Results:Of the 110 stool samples collected,28(25%)were detected positive for the presence of Blastocystis sp.by two or more tests.Culture method detected the highest number of Blastocystis-positive stool samples(n=36),followed by PCR of DNA extracted from culture(n=26),PCR of DNA extracted from stool(n=10),and direct fecal smear(n=9).Compared to culture,the sensitivity of the other detection methods were 66.7%for PCR from culture and 19.4%for both PCR from stool and direct fecal smear.Specificity of the methods was high,with PCR from culture and direct fecal smear having97.3%,while PCR from stool at 95.9%.Conclusions:In this study,in vitro culture is the best method for detecting Blastocystis sp.in human stool samples.
文摘Objective:To determine Blastocystis frequency and subtypes(ST) in ulcerative colitis(UC) patients and analyse some laboratory findings between Blastocystis positive and negative cases.Methods:Faecal samples from 150 UC patients in Adnan Menderes University,Training and Research Hospital were examined by direct microscopy and cultivated in Jones medium.Blastocystis positive cultures were subjected to DNA isolation and subtypes were identified by sequencing of barcode region.A retrospective analysis was conducted on C reactive protein(CRP),leukocyte counts(WBC),neutrophil counts,and sedimentation rates.Results:The overall positive rate of Blastocystis was 8%(12 patients) and the most abundant subtype was ST3(eight isolates,66.7%),followed by ST1,ST2 and ST7.Laboratory findings between Blastocystis infected and non-infected UC patients were not significantly different.Blastocystisfrequency was 3.8% among the patients in active stage,while it was 11.8% among the patients in remission stage.Conclusions:The present study confirms previous findings that have indicated the predominance of Blastocystis ST3 in humans and contributes additional evidence that suggests the low colonization of Blastocystis infection in ulcerative colitis patients during active stage.
文摘BACKGROUND Recently,there have been several findings that showed intestinal colonisation of Blastocystis hominis(Blastocystis)as a risk factor to the worsening of colorectal cancer(CRC).However,studies have shown controversial results in the pathogenicity of Blastocystis.AIM To review systematically the evidence available on the association between CRC and Blastocystis and the prevalence of Blastocystis in CRC patients and to investigate cytopathic and immunological effects of Blastocystis in in vitro and in vivo studies.METHODS PRISMA guidelines were utilised in conducting this systematic review.Original articles published before February 2,2020 were included.PubMed,Science Direct,Scopus and Google scholar databases were searched.Manual searching was carried out to find articles missed during the online search.RESULTS Out of 12 studies selected for this systematic review,seven studies confirmed the prevalence of Blastocystis and found it to be between 2%-28%in CRC patients,whereby subtype 1 and subtype 3 were predominantly seen.A total of four studies employing in vitro human colorectal carcinoma cell line study models showed significant cytopathic and immunological effects of Blastocystis.In addition,one in vivo experimental animal model study showed that there was a significant effect of infection with Blastocystis on exacerbation of colorectal carcinogenesis.CONCLUSION Blastocystis is a commonly identified microorganism in CRC patients.These studies have provided supportive data that Blastocystis could exacerbate existing CRC via alteration in host immune response and increased oxidative damage.Future studies of CRC and Blastocystis should attempt to determine the various stages of CRC that are most likely to be associated with Blastocystis and its relationship with other intestinal bacteria.
基金supported by the Phramongkutklao Research Fund(Grant number 172/2559).
文摘Objective: To investigate the incidence, spontaneous clearance, persistence and risk factors of Blastocystis infection in a rural community in Thailand.Methods: In February 2016, a cohort study was conducted in a rural community of Thailand. Baseline information of intestinal parasitic infections and follow-up visits were conducted. Blastocystis infection was detected in stool samples examined with short-term in vitro cultivation using Jones’ medium supplemented with 10% horse serum. Participants were tested for Blastocystis infection at every study visit. Cox proportional hazard regression analysis was used to evaluate co-variates to determine the incidence of Blastocystis infection. Results: Of 733 enrolled participants, 57(7.78%) were positive and 676(92.22%) were negative for Blastocystis infection. All 676 participants were followed-up for Blastocystis infection between December 2016 and January 2018. In all, 52 of 482 cases(10.79%) comprised individual Blastocystis infection. The incidence density rates of Blastocystis infection, of spontaneous clearance of the disease and of persistent infection were 8.13, 63.14 and 38.70 per 1 000 person-months of follow-up, respectively. Our multivariate analysis revealed that opened defecation in fields or bushes(HR=4.8;95% CI=2.1-10.4, P<0.001), raising cows(HR=2.8;95% CI=1.1-7.1, P=0.032), not washing hands after animal contact(HR=2.1;95% CI=1.0-4.2, P=0.044) and presenting symptoms of nausea or vomiting(HR=2.3;95% CI=1.0-5.3, P=0.047) were predictive associated risks for the incidence of Blastocystis infection. Conclusions: Our study indicates that the best way to prevent Blastocystis infection can be by maintaining good personal hygiene, hand washing after animal contact and improving sanitary facilities.
基金financially supported by the Scientific Project Unit of Erzincan University(Project No:SAG-A-240215-0128).
文摘Objective:To investigate Blastocystis’etiologic role and association with gastrointestinal symptomatology in acute and chronic urticaria patients and to identify Blastocystis subtypes responsible for urticaria.Methods:The study included urticaria patients and healthy individuals that presented to our polyclinic between June 2015 and May 2017.The participants were assigned into Group栺(137 patients),subdivided into acute(72)and chronic urticaria patients(65),and Group栻(129 control individuals).Blastocystis presence was investigated by native-Lugol examination,trichrome staining,PCR using sequence tagged site primers,and DNA sequencing analysis.The phylogenetic tree was constructed.Results:The native-Lugol and trichrome staining methods revealed that 16 patients(16/133,12.0%)had Blastocystis-positive stool samples,of which seven samples(7/133,5.3%)belonged acute and nine(9/133,6.8%)to chronic urticaria patients.Concerning Blastocystis subtypes,of the acute urticaria patients,three had subtype 1(ST1),one had ST2,and three had ST3.Of the chronic urticaria patients,one had ST1 and eight had ST3.Blastocystis positivity was detected in two control individuals(2/123,1.6%),both being ST3.All subtypes identified by PCR were confirmed by the sequencing analysis.The acute and chronic urticaria groups showed no statistically significant differences for Blastocystis positivity(P=0.60)and subtype distribution(P=0.15).A statistically significant difference was found between the urticaria patients and the controls for Blastocystis positivity(P<0.01),but not for subtype distribution(P=0.67)or for Blastocystis presence and gastrointestinal complaints.Conclusions:This study on Blastocystis subtype distribution among Turkish urticaria patients showed results consistent with the literature.It was concluded that Blastocystis should be kept in mind in patients with urticaria.
文摘The patient is a 37-year-old male with a right anterior tibial mass for more than one year and a left anterior tibial mass for more than one month.There was a history of hyperthyroidism.Histopathology of the lesions showed epidermal hyperkeratosis of the skin tissue,thickening of the spinous layer,extensive collagen fibrillation in the superficial dermis and reticular layer,and numerous linear and granular mucoprotein deposits in the lower and middle dermis.Blastocystis hominis was routinely detected in the stool.Diagnosis:1.Pretibial myxedema 2.intestinal parasitosis(Blastocystis hominis infection).
基金funded by the Research Acculturation Grant Scheme(600-RMI/RAGS 5/3[52/2014])from the Universiti Teknologi MARA and Ministry of Education,Malaysia
文摘Objective:To determine the prevalence and risk factors of Blastocystis among underprivileged communities living in rural Malaysia. Methods:This cross-sectional study was conducted among 253 participants aged between 1 and 85 years. Stool samples were examined using Wheatley's trichrome stain after in-vitro cultivation in Jones' medium to detect the presence of Blastocystis. Information pertaining to the demography,socioeconomic and environment were collected using pre-validated questionnaires. Results:The total prevalence of Blastocystis infection was 40.7%. The multiple logistic regression analysis revealed that age ≥15 years(OR = 2.72; 95%CI = 1.47-5.04) and presence of infected family members(OR = 8.56; 95%CI = 4.47-16.38) were the significant risk factors associated with blastocystosis in these communities. Conclusions:Blastocystosis is revealed through this study to be still prevalent among Orang Asli communities in rural Malaysia. The two main approaches that should be implemented by the public health authority in battling this infection would be the screening of other family members and giving treatment to the infected individuals. Moreover,it is imperative for health education on good personal and food hygiene practices are provided in order to reduce the morbidity and transmission of Blastocystis infection among the Orang Asli in their communities meaningfully.
基金supported by European Cooperation in Science&Technology(EUCOST)grant(OC-2021-1-25116)awarded for Blastocystis under One Health'from the European Union(2022-2026)as well as by the Yong Loo Lin School of Medicine,National University of Singapore,through grant numbers A-8000685-00-00 and A-8000629-00-00 awarded to L.D.and K.S.-W.T.
文摘In a recent study published in Cel^(l),Piperni and colleagues revealed that Blastocystis prevalence varies significantly across geographic regions and lifestyles,with higher carriage linked to healthier plant-based diets and favorable cardiometabolic profiles.These findings position Blastocystis as a potential biomarker for gut health and metabolic well-being,challenging its traditional perception as a pathogen(Fig.1).
文摘The protozoan parasites Entamoeba histolytica and Blastocystis hominis are responsible for causing human amebiasis and hominis infections,respectively.These infections are highly prevalent and are often linked to waterborne diseases.Due to the absence of regulations for monitoring these protozoa at the discharge points of wastewater treatment plants(WWTPs),the effluents reaching surface waters contribute to waterborne transmission.This underscores the significance of the removal capacities of WWTPs in reducing the spread of these infectious parasites.Therefore,this study examined five different types of WWTPs in Ankara,Turkey,over a year to assess their capacities to remove E.histolytica and B.hominis.The seasonal abundances of genes specific to these protozoa in both the influents and effluents of each WWTP were measured using a quantitative polymerase chain reaction.The reduction in the number of protozoan rDNA copies between the influent and effluent samples was evaluated as the removal capacity,expressed in log10 reduction(LRV)values.The results elucidated that the removal of E.histolytica and B.hominis was highly affected by the process used.Membrane bioreactor systems displayed the highest removal capacity with LRV>3.Therefore,discharges of WWTPs with other processes could need further monitoring to minimize the potential risk for public health.
基金The data analysis of this study was supported by China Postdoctoral Science Foundation Grant(No.2018 M64303043)the postdoctoral research funding from Guangzhou Women and Children's Medical Center(No.5001-3001075)+1 种基金the field epidemiological investigation and Blastocystis detection were supported by the National Natural Science Foundation of China(No.81473022)in addition,and the English edit was supported by the 13th Five-Year National Science and Technology Major Project for Infectious Diseases(No.2017ZX1030550-002).
文摘Background:Blastocystis is a widespread zoonotic protozoan of mammalian species,especially in HIV/AIDS individuals.The aim of this study was to analyze the prevalence and risk factors related with Blastocystis infection among HIV/AIDS patients in Southwest China.Methods:The cross-sectional study was performed in 311 HIV/AIDS cases in Tengchong City,Yunnan Province from July 2016 to March 2017.For each subject,stool specimen was collected to detect the Blastocystis,and the blood sample was used to detect HIV virus load and CD4+T cell count,in addition,structured questionnaire was used to collect the basic information and risk factors.Findings:The result showed that the detection rate of Blastocystis was 3.86%(95%CI:2.22-6.62)among HIV/AIDS patients.Both raising animal(OR=12.93,95%CI:1,54-108.36)and drinking un-boiled water(OR=8A7,95%CI:1.76-37.90)were risk factors for Blastocystis infection in HIV/AIDS individuals.In addition,the interaction of CD4^+T cell count and HIV virus load was also contribution to Blastocystis infection(P=0.007).Conclusions:A high prevalence of Blastocystis infection was found in HIV/AIDS patients in Tengchong.Poor hygienic habits,the interaction of HIV virus load and CD4^+T cell count were identified as main risk factors for infection.These results will help us to develop efficient control strategies to intervene with and prevent the occurrence of Blastocystis among HIV-infected individuals.
文摘Background Blastocystis hominis(Bh)is zoonotic parasitic pathogen with a high prevalent globally,causing opportunistic infections and diarrhea disease.Human immunodeficiency virus(HIV)infection disrupts the immune system by depleting CD4^(+)T lymphocyte(CD4^(+)T)cell counts,thereby increasing Bh infection risk among persons living with HIV(PLWH).However,the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood.Hence,the purpose of the study was to explore the association between Bh infection risk and CD4^(+)T cell counts,HIV viral load(VL),and duration of interruption in antiviral therapy among PLWH.Methods A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022.The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction,the CD4^(+)T cell counts in venous blood was measured using flowcytometry,and the HIV VL in serum was quantified using fluorescence-based instruments.Restricted cubic spline(RCS)was applied to assess the non-linear association between Bh infection risk and CD4^(+)T cell counts,HIV VL,and duration of interruption in highly active antiretroviral therapy(HARRT).Results A total of 1245 PLWH were enrolled in the study,the average age of PLWH was 43 years[interquartile range(IQR):33,52],with 452(36.3%)being female,50.4%(n=628)had no immunosuppression(CD4^(+)T cell counts>500 cells/μl),and 78.1%(n=972)achieved full virological suppression(HIV VL<50 copies/ml).Approximately 10.5%(n=131)of PLWH had interruption.The prevalence of Bh was found to be 4.9%[95%confidence interval(CI):3.8-6.4%]among PLWH.Significant nonlinear associations were observed between the Bh infection risk and CD4^(+)T cell counts(Pfor nonlinearity<0.001,L-shaped),HIV VL(Pfor nonlinearity<0.001,inverted U-shaped),and duration of interruption in HARRT(Pfor nonlinearity<0.001,inverted U-shaped).Conclusions The study revealed that VL was a better predictor of Bh infection than CD4^(+)T cell counts.It is crucial to consider the simultaneous surveillance of HIV VL and CD4^(+)T cell counts in PLWH in the regions with high level of socioeconomic development.The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections,the efficacy of therapeutic drugs,and the assessment of preventive and control strategies.
文摘Background: Blastocystis is ubiquitous presence in animals and humans worldwide and has a high level genetic diversity.The aim of this study was to conduct a summary of Blastocystis prevalence,subtypes(STs)in humans and animals in China and depict their distribution.Methods:: We searched for the articles related to epidemiology of Blastocystis in humans and animals throughout China which published from January 1,1990,to July 31,2019 in the following databases:PubMed,China National Knowledge Infrastructure(CNKI)and Wanfang database.The keywords were Blastocystis and one of the following ones:STs,subtypes,distribution,epidemiology,prevalence,infection,molecular,geographic,intestinal parasites,genetic diversity and characterization.Results: In recent years,various molecular epidemiological studies have been carried out in some provinces/regions of China to identify subtypes of Blastocystis.Infants and young children,school students,hospitalized diarrhea patients,HIV/AIDS patients,tuberculosis patients,and cancer patients as respondents had been included.ST1–ST7 and ST12 were the main subtypes in Chinese population.Moreover,surveys of Blastocystis infection in animal were also conducted in some provinces of China.A variety of animals were investigated including pigs,cattle,sheep,yak,giant panda,and crested ibis(Nipponia nippon)with the main subtypes of ST1–ST8,ST10,ST12–ST14.Conclusions: In recent years,some provinces/regions in China have conducted various molecular epidemiological studies to identify the Blastocystis subtypes.It is important to focus on new subtypes and mixed subtypes of infection,while increasing data on ribosomal alleles.We encourage the scientific community to start research on humans and surrounding animals(including domestic and wild animals)to better understand the possibility of Blastocystis transmission between humans and animals.We call for action among researchers studying intestinal parasitic diseases(Blastocystis),start drawing the subtype of Blastocystis and increase the subtype related to its clinical symptoms.
基金Supported by Deanship of Research,Jordan University of Science and Technology,No.214/2013
文摘AIM To investigate the putative role of protozoan parasites in the development of irritable bowel syndrome(IBS).METHODS The study included 109 IBS consecutive adult patients fulfilling the RomeⅢcriteria and 100 healthy control subjects.All study subjects filled a structured questionnaire,which covered demographic information and clinical data.Fresh stool samples were collected from patients and control subjects and processed within less than 2 h of collection.Iodine wet mounts and Trichrome stained smears prepared from fresh stool and sediment concentrate were microscopically examined for parasites.Blastocystis DNA was detected by polymerase chain reaction,and Cryptosporidium antigens were detected by ELISA.RESULTS A total of 109 IBS patients(31 males,78 females)with a mean age±SD of 27.25±11.58 years(range:16-60 years)were enrolled in the study.The main IBS subtype based on the symptoms of these patients was constipation-predominant(88.7%of patients).A hundred healthy subjects(30 males,70 females)with a mean±SD age of 25.0±9.13 years(range 18-66 years)were recruited as controls.In the IBS patients,Blastocystis DNA was detected in 25.7%,Cryptosporidium oocysts were observed in 9.2%,and Giardia cysts were observed in 11%.In the control subjects,Blastocystis,Cryptosporidium and Giardia were detected in 9%,0%,and 1%,respectively.The difference in the presence of Blastocystis(P=0.0034),Cryptosporidium(P=0.0003),and Giardia(P=0.0029)between IBS patients and controls was statistically significant by all methods used in this study.CONCLUSION Prevalence of Blastocystis,Cryptosporidium and Giardia is higher in IBS patients than in controls.These parasites are likely to have a role in the pathogenesis of IBS.
基金This study was approved by the institutional ethics committee(CDD19/C02).
文摘BACKGROUND Blastocystis hominis(B.hominis)and Dientamoeba fragilis(D.fragilis)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 B.hominis and D.fragilis infections.METHODS This retrospective longitudinal study was conducted in a single medical centre,which included fifty-four patients(≥18 years)who were positive for D.fragilis,B.hominis 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(n=54),were either positive for B.hominis(37%),D.fragilis(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 followup.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(P<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.
