Evaluation of Adhesin Antigen Test Results in Samples Sent with Suspicion of Amebiasis

Year 2024, , 542 - 546, 31.08.2024

Duygu Beder , Fatma Esenkaya Taşbent

https://doi.org/10.54005/geneltip.1470640

Abstract

Objective: The study aimed to evaluate E.histolytica-specific ELISA adhesin antigen test results in stool samples sent to the medical microbiology laboratory with suspicion of amebiasis.
Materials and Methods: A total of 1120 stool samples were included in the study, which were sent to the medical microbiology laboratory with suspicion of amebiasis in the two-year period between January 2022 and December 2023. The results of ELISA adhesin antigen test studied on stool samples were evaluated retrospectively.
Results: Of the 1120 samples in the study, 578 (51.6%) were obtained from male and 542 (48.4%) from female patients. The mean age of the patients was 33.92±24.33 (0-94) years. There were 335 (30%) samples from pediatric patients, and the mean age was determined as 4.48 ±4.78. The positivity rate of E.histolytica specific ELISA adhesin antigen test was 14.3% (n=161). Of the positive patients, 77 (47.8%) were male and 84 (52.2%) were female. There were 55 (34.1%) positive samples from pediatric patients. While there was no statistically significant difference between the positivity status and age of the patients, or between the positivity status and gender (p>0.05), the seasonal difference was considered significant (p<0.05).
Conclusion: With the E.histolytica-specific ELISA adhesin antigen test, E.histolytica and non-pathogenic E.dispar can be differentiated and patients can be prevented from receiving unnecessary treatment.

Keywords

amebiasis, Entamoeba histolytica, ELISA adhesin antigen test

Amibiyazis Şüphesiyle Gönderilen Örneklerde Adezin Antijen Test Sonuçlarının Değerlendirilmesi

Abstract

Amaç: Bu çalışmada amibiyazis şüphesiyle tıbbi mikrobiyoloji laboratuvarına gönderilen dışkı örneklerinde E. histolytica’ya spesifik ELISA adezin antijen test sonuçlarının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Ocak 2022 ile Aralık 2023 tarihleri arasındaki iki yıllık dönemde amibiyazis şüphesiyle tıbbi mikrobiyoloji laboratuvarına gönderilen dışkı örneklerinde incelenen ELISA (Cellabs, Entamoeba Celisa Path, Brookvale, NSW Avustralya) adezin antijen testi sonuçları retrospektif olarak değerlendirilmiştir. Olgulara ait test sonuçları, cinsiyet, yaş, tarih ve örneğin geldiği klinik bilgileri hastanemiz laboratuvar bilgi sisteminden elde edilmiştir. İstatistiksel analizlerde Fisher kesin ki-kare testi kullanılmıştır.
Bulgular: Çalışmadaki 1120 örneğin 578 (%51.6)’i erkek, 542 (%48.4)’si kadın hastalara aittir. Hastaların yaşları 0 - 94 yaş aralığında olup, yaş ortalaması 33.92 (standart sapma: ±24.33) olarak bulunmuştur. Çalışmada çocuk hastalara ait 335 (%30) örnek bulunmaktadır ve bu hastaların yaş ortalamaları 4.48 (standart sapma: ±4.78) olarak tespit edilmiştir. E. histolytica’ ya spesifik ELISA adezin antijen testi ile 161 (%14.3) örnek pozitif bulunmuştur. Pozitif örneklerin 77 (% 47.8)’si erkek, 84 (%52.2)’ü kadın hastalara aittir. Pozitif örnekler içinde çocuk hastalara ait 55 (%34.1) örnek bulunmaktadır. Hastaların pozitiflik durumu ile yaşı arasında ve pozitiflik durumu ile cinsiyeti arasında istatistiksel olarak anlamlı bir farklılık görülmemişken (p>0.05), mevsimler arasındaki farklılık anlamlı kabul edilmiştir (p<0.05).
Sonuç: Çalışmamızda E. histolytica’ ya spesifik ELISA adezin antijen testi pozitifliği %14.3 oranında belirlenmiş ve bu oran ülke literatür verilerine yakın bulunmuştur. Amibiyazisin tropikal ve subtropikal iklim özelliklerinde daha sık görüldüğü belirlenmiştir. Ucuz, hızlı ve deneyimli personel gerektirmeyen E. histolytica’ya spesifik ELISA adezin antijen testi kullanımı ile yanlış tanı oranı düşürülerek gereksiz tedavi uygulamaları azaltılabilmektedir.

Keywords

amibiyazis, Entamoeba histolytica, ELISA adezin antijen testi

References

• Tortop, S. Evaluation of the Methods Used for the Detection of Entamoeba histolytica in Stool Samples of Patients with Diarrhea. Mikrobiyol Bul 2022; 56(4):682-691. Turkish
• Fotedar R, Stark D,Beebe N, Marriott D, Ellis J, Harkness J. Laboratory diagnostic tecniques for Entamoeba species. Clin Microbiol Rev 2007; 20(3):511-32.
• Uyar Y. Antigen detection methods in diagnosis of amebiasis, giardiasis and cryptosporidiosis. Turkiye Parazitol Derg 2009; 33(2):140-150. Turkish
• Caballero-Salcedo A, Viveros-Rogel M, Salvatierra B, Tapia-Conyer R, Sepulveda-Amor J, Gutierrez G, et al. Seroepidemiology of amebiasis in Mexico. Am J Trop Med Hyg 1994; 50(4):412-9.
• Haque R, Huston CD, Hughes M, Houpt E, Petri WA Jr. Amebiasis. New England J Med 2003; 348(16):1565.
• Demirtas, L. Cıkman, A. Alpcan, H, Timuroglu, A, Karakecili, F. Importance and seroprevalence of Entamoeba histolytica in patients presenting with abdominal pain without diarrhea. Ortadoğu Tıp Derg 2018; 10(2):157-161. Turkish
• Petri WA, Singh U. Diagnosis and management of amebiasis. Clin Infect Dis 1999; 29(5): 1117-1125.
• 8.Tanyuksel M, Petri W.A. Laboratory diagnosis of amebiasis. Clin Microbiol Rev 2003; 16(4):713-729.
• WHO. World Health Organization report of a consultation experts on amoebiasis. Wkly Epidemiol Rep 1997; 72:97–100.
• Dogruman F, Oguz I, Ozekinci T. Investigation of adhesin antigen in feces by ELISA method in the diagnosis of Entamoeba histolytica. Gazi Med J 2015; 26(1):19-21. Turkish
• Shirley DT, Farr L, Watanabe K, Moonah S. A review of the global burden, new diagnostics, and current therapeutics for amebiasis. Open Forum Infectious Diseases 20185(7):ofy161.
• Saidin S, Othman N, Noordin R. Update on laboratory diagnosis of amoebiasis. European Journal of Clinical Microbiology and Infectious Diseases. 2019; 38:15-38.
• Carrero JC, Reyes-López M, Serrano-Luna J, Shibayama M, Unzueta J, León-Sicairos N, Garza M. Intestinal amoebiasis:160 years of its first detection and still remains as a health problem in developing countries. Int J Med Microbiol 2020; 310(1):151358.
• Tuncay S, Inceboz T, Over L, Yalcin G, Usluca S, Sahin S, et al. The evaluation of the techniques used for diagnosis of Entamoeba histolytica in stool specimens. Turkiye Parazitol Derg 2007; 31(3):188-93. Turkish
• Haque R, Faruque AS, Hahn P, Lyerly DM, Petri WA Jr. Entamoeba histolytica and Entamoeba dispar infection in children in Bangladesh. J Infect Dis 1997; 175(3):734-6.
• Braga LL, Gomes ML, Silva MW, Paiva C, Sales A, Mann BJ. Entamoeba histolytica and Entamoeba dispar infections as detected by monoclonal antibody in an urban slum in Fortaleza, Northeastern Brazil. Rev Soc Bras Med Trop 2001; 34:467-71.
• Godwın YD, Ohwo UC, Omonigho O, et al. Pattern of E. histolytica infection and its correlates among patients in a general practice clinic: A four-year retrospective evaluation. Int J Life Sci 2024; 6(1):55-61.
• Agalar C, Alpay Y, Kaygusuz S, Kılıc D, Erol O, Saygun M. Prevalence of Entamoeba histolytica antibodies in donors applying to Kırıkkale University Faculty of Medicine Hospital. KU Tıp Fak Derg 2008; 10(2):5-7. Turkish
• Alver O, Ozakın C, Tore O. Distribution of intestinal parasites detected in Uludag University Faculty of Medicine Hospital in 2009-2010. Turkiye Parazitol Derg 2012; 36:17-22. Turkish
• Yuksel P, Celik DG, Gungordu Z, et al. Demonstration of Entamoeba histolytica lectin antigen in stool samples by ELISA method: Three-year data. Klimik Journal 2011; 24(3):150-53.
• Delialioglu N, Aslan G, Ozturk C, Ozturhan H, Sen S, Emekdas G. Detection of Entamoeba histolytica antigen in stool samples in Mersin, Turkey. J Parasitol 2008; 94(2):530-32.
• Dogancı L, Tanyuksel M, Gun H. Overdiagnosis of intestinal amoebosis in Turkey. Lancet 1997; 350(9078):670.
• Haji HM, Bamarni SSI. Prevalence of Entamoeba histolytica and Giardia lamblia in children in Duhok Province, Kurdistan Region, Iraq. Journal of Duhok University. 2023;26(1):274-80. https://journal.uod.ac/index.php/uodjournal/article/view/2390
• Zeyrek FY, Ozbilge H, Yuksel MF et al. Parasite fauna in Sanlıurfa and the frequency of Entamoeba histolytica/Entamoeba dispar in feces by ELISA method. Turkiye Parazitol Derg 2006; 30(2):95-8. Turkish.
• Mohanty S, Sharma N, Deb M. Microscopy versus enzyme linked immunosorbent assay test for detection of Entamoeba histolytica infectionin stool samples. Trop Parasitol 2014; 4(2):136-8.
• Pereira VV, Conceição AS, Maximiano LH, Belligoli LQG, Silva ES. Laboratory diagnosis of amebiasis in a sample of students from southeastern Brazil and a comparison of microscopy with enzyme-linked immunosorbent assay for screening of infections with Entamoeba spp. Rev Soc Bras Med Trop 2014; 47(1):52-6.
• Soares NM, Azevedo HC, Pacheco FTF, Souza JN, Del-Rei RP, Teixeira MCA, et al. A cross-sectional study of Entamoeba histolytica/dispar/moshkovskii complex in Salvador, Bahia, Brazil. BioMed Res Int 2019; 7523670.
• Espinosa-Cantellano M, Martínez-Palomo A. Pathogenesis of intestinal amebiasis: from molecules to disease. Clin Microbiol Rev 2000; 13:318-31.
• Schunk M, Jelinek T, Wetzel K, Nothdurft HD. Detection of Giardia lamblia and Entamoeba histolytica in stool samples by two enzyme immunoassays. European Journal of Clinical Microbiology and Infectious Diseases 2001; 20:389-91.
• Yıldırım D, Hasbek M, Nur N. Examination of intestinal amebiasis in patients with diarrhea by Adhesin antigen test and direct microscopy. Turkiye Parazitol Derg 2014; 38:155-8. Turkish
• Masihzade A, Izadi N, Mohsenzadeh M, et al. Prevalence of Entamoeba Histolytica in Iranian Children: A Systematic Review and Meta-analysis. Govaresh 2024; 28(4):238-246.
• Abate M, Eriso F, Kalyankar VB, et al. Prevalence of Entamoeba histolytica among schoolchildren in Dilla town, Gedeo zone, Ethiopia. Infect Dis Now 2023; 53(1):104621.
• Al-Braiken FA, Salem HS. Diagnosis of Entamoeba histolytica in symptomatic children, Jeddah City, Saudi Arabia. Egypt J Immunol 2008; 15(1):85-92.
• Sezgin FM, Demir T, Guney A.K. Evaluation of the presence of E.histolytica adhesin antigen in stool samples by ELISA method at Kırşehir Training and Research Hospital. 2nd National Clinical Microbiology Congress Book 2013; 348.