Investigation of the Frequency of Cryptosporidium spp. and Giardia intestinalis in Patients with Suppressed Immune System

Year 2022, , 225 - 228, 03.10.2022

Mehmet Tevfik Bayraktar , Medine Cömert , Ali Öztürk

https://doi.org/10.30934/kusbed.1156716

Abstract

Objective: Giardia intestinalis and Cryptosporidium spp. are important agents causing diarrhea in developing and developed countries. If untreated, these agents may cause severe life-threatening diarrhea, especially in immunocompromised people and children. This study aimed to investigate the frequency of Cryptosporidium spp. and G. intestinalis in the stool samples of immunocompromised patients who applied to Harran University Research and Application Hospital.
Methods: This study was carried out with a total of 100 patients with immunosuppression and diarrhea who were admitted to our hospital between January 2017 and January 2019. Cryptosporidium spp. and G. intestinalis antigens were investigated in stool samples of the patients by immunochromatographic (IC) method and oocyst, and cyst-trophozoite were examined with Native-Lugol and Kinyoun acid-fast staining.
Results: G. intestinalis was detected in eight (8%) patients. Seven of them (14%) were pediatric patients (n=50) and one (2%) was an adult female patient (n=50). Cryptosporidium spp. was detected in 3 (3%) patients. Of these, two (4%) were children patients and one (2%) was an adult female patient. Our results also demonstrated that both Cryptosporidium and Giardia were more found in immunocompromised patients, especially in pediatric ones (4% and 14% respectively).
Conclusion: Although the cost of the IC method, which detects antigens in stool samples is high, it is easy to work with, provides early results and it also helps to overcome the difficulties in active diagnostic methods. Despite the limited number of investigated samples, our findings showed that the incidence of infections from these two parasites is higher than in other studies conducted in Turkey or European countries.

Keywords

Giardia intestinalis, Cryptosporidium spp, chromatographic method, immunosuppressed, diarrhea

Supporting Institution

This study was supported by Harran University Scientific Research Coordinatorship (HÜBAK)

Project Number

16167

Bağışıklık Sistemi Baskılanmış Hastalarda Cryptosporidium spp. ve Giardia intestinalis Sıklığının Araştırılması

Abstract

Amaç: Giardia intestinalis ve Cryptosporidium spp. türleri gelişmiş ve gelişmekte olan ülkelerde ishale neden olan bağırsak parazitleridir. Özelikle bağışıklık sistemi baskılanmış hastalarda ve çocuklarda tedavi edilemediğinde ölümcül olabilmektedir. Bu çalışmada Harran Üniversitesi Araştırma ve Uygulama Hastanesine başvuran bağışıklık sistemi baskılanmış hastaların dışkı örneklerinde Cryptosporidium spp. ve G.intestinalis sıklığının araştırılması amaçlanmıştır.
Yöntem: Bu çalışma Ocak 2017 ve Ocak 2019 yılları arasında hastanemize başvuran bağışıklık sistemi baskılanmış ve ishal şikâyeti olan toplam 100 hasta ile gerçekleştirildi. Hastaların dışkı örneklerinde immünokromatografik (İK) metot ile Cryptosporidium spp. ve G. intestinalis antijenleri arandı ve nativ-lugol ve kinyoun asit fast boyama ile ookist, kist-trofozoit açısından incelendi.
Bulgular: Toplam sekiz (%8) hastada G. intestinalis saptandı. Bunlardan yedisi (%14) çocuk hasta (n=50) ve biri (%2) yetişkin (n=50) bir kadın hasta olduğu tespit edildi. Hastaların 3 (%3)’ünde ise Cryptosporidium spp. görüldü. Bunlardan ikisi (%4) çocuk ve biri (%2) yetişkin kadın hastalar idi. Sonuçlarımız hem Cryptosporidium hem de G. intestinalis’in bağışıklık sistemi baskılanmış çocuk hastalarda (sırasıyla %4 ve %14) daha fazla saptandığını göstermiştir.
Sonuç: Dışkı örneklerinde antijen saptayan İK metodun maliyeti yüksek olmasına rağmen çalışması kolay, erken sonuç vermesi ve etkensel tanı yöntemlerindeki zorluklara yardımcı olduğu görülmektedir. Sınırlı sayıda araştırılmış örnek bulunmasına rağmen bulgularımız bu iki parazitten kaynaklı enfeksiyonların Türkiye'de veya Avrupa ülkelerinde yapılan diğer çalışmalardaki görülme sıklığından daha yüksek olduğunu gösterdi.

Keywords

Giardia intestinalis, Cryptosporidium spp., kromatografik metot, bağıklık sistemi baskılanmış, ishal

Project Number

16167

References

• Akpolat N, Çakır F, Çiçek M, Bilden A. Retrospective analysis of the distribution of intestinal parasites in patients admitted to dicle university faculty of medicine between the years 2011-2020. Turkiye Parazitol Derg. 2022;46(2):119-123. doi:10.4274/tpd.galenos.2022.88598.
• Ataş AD. The distribution of pathogenic intestinal parasites in sivas cumhuriyet university faculty of medicine research and application hospital between 2006-2018. Turkiye Parazitol Derg. 2020;44(1):25-30. doi:10.4274/tpd.galenos.2020.6619.
• Ahmed SA, Karanis P. Cryptosporidium and Cryptosporidiosis: The perspective from the gulf countries. Int J Environ Res Public Health. 2020;17(18):6824. doi:10.3390/ijerph17186824.
• Güler E, Süer K. Epidemiology of intestinal parasites in a university hospital in Northern Cyprus: A 4-year retrospective experience. Turkiye Parazitol Derg. 2021;45(2):128-132. doi:10.4274/tpd.galenos.2021.684.
• Cengiz ZT, Yılmaz H, Beyhan YE, Çiçek M. A comprehensive retrospective study: Intestinal parasites in human in van province. Türkiye Parazitol Derg. 2019;43(2):70-73. doi:10.4274/tpd.galenos.2019.5997.
• Khan NA, Morabet R, Khan R. Cryptosporidium and Giardia lamblia epidemiology in middle eastern countries: study of the proliferation problem in the aquatic environment. Ecological Questions. 2021;32(3):2-18. doi:10.12775/ EQ.2021.021.
• Pieok T, Nowak S, Kłudkowska M, Frąckowiak K, Kuszel T, Zmora P, et al. Massive Cryptosporidium infections and chronic diarrhea in HIV-negative patients. Parasitol Res. 2019;118:1937–1942. doi:10.1007/s00436-019-06302-0.
• Erismann S, Diagbouga S, Odermatt P, Knoblauch AM, Gerold J, Shrestha A, et al. Prevalence of intestinal parasitic infections and associated risk factors among schoolchildren in the Plateau Central and Centre-Ouest regions of Burkina Faso. Parasit Vectors. 2016;9:554. doi:10.1186/s13071-016-1835-4.
• Sánchez A, Munoz M, Gómez N, Tabares J, Segura L, Salazar Á, et al. Molecular epidemiology of Giardia, Blastocystis and Cryptosporidium among indigenous children from the colombian amazon basin. Front Microbiol. 2017;8:248. doi:10.3389/fmicb.2017.00248.
• Hooshyar H, Rostamkhani P, Arbabi M, Delavari M. Giardia lamblia infection: review of current diagnostic strategies. Gastroenterol Hepatol Bed Bench. 2019;12(1):3–12.
• Polat E, Özdemir S, Sirekbasan S. The distribution of ıntestinal parasites in patients presenting to a university hospital in Istanbul: A seven-year retrospective analysis. Turkiye Parazitol Derg. 2020;44(3):139-142. doi:10. 4274/tpd.galenos.2020.6653.
• Yaman K, Özkan AT, Akarsu G, Babür C, Muncan M. Investigation of Giardia intestinalis in fresh stool specimens by using microscopy and EIA. Flora. 2014;19(1):54-58.
• Bednarska M, Jankowska I, Pawelas A, Piwczyńska K, Bajer A, Wolska-Kuśnierz B, et al. Prevalence of cryptosporidium, blastocystis, and other opportunistic infections in patients with primary and acquired immunodeficiency. Parasitol Res. 2018;117(9):2869–2879. doi:110.1007/s00436-018-5976-6.
• Gerace, E, Marco Lo Presti VD, Biondo C. Cryptosporidium infection: Epidemiology, pathogenesis, and differential diagnosis. Eur J Microbiol Immunol. 2019;9(4):119–123. doi:10.1556/1886.2019.00019.
• Squire SA, Ryan U. Cryptosporidium and Giardia in Africa: current and future challenges. Parasit Vectors. 2017;10:195. doi:10.1186/s13071-017-2111-y.
• Zeyrek FY, Özbilge H, Gürses G, Tümer S. Şanlıurfa çocuk yuvası ve yetiştirme yurdunda bağırsak parazitlerinin dağılımı. Türkiye Parazitol Derg. 2003;27:133-135.
• Baiomy A, Mohamed K, Ghannam M, Al-Razek Shahat SA, Al-Saadawy ASK. Opportunistic parasitic infections among immunocompromised Egyptian patients. J Egypt Soc Parasitol. 2010;40(3):797-808.
• Uysal S, Tun AV, Öztürk EA, Ardeniz Ö, Taşbakan MI, Pullukçu H, et al. Incidence of parasitic diarrhea in patients with commonvariable immunedeficiency. Turkiye Parazitol Derg. 2016;40:67-71. doi:10.5152/tpd.2016.4687.