Subtype Analyses Of 50 Blastocystis spp. Isolates From Symptomatıc Patients

Abstract

Aim: Blastocystis spp. is an enteric protozoon that has grown in importance with recent knowledge of the symptoms, disorders it may cause. Its prevalence varies in different countries, but it is most frequently detected in developing countries. Nine subtypes (ST) of Blastocystis spp. have been detected in humans and it is suggested that these subtypes can be related to its varying clinical symptoms.

Methods: In this study, stool samples were examined with microscopy after performing formol-ethyl acetate sedimentation for the presence of Blastocystis spp. Fifty samples with Blastocystis spp. were cultured in 2 different media and underwent subsequent sequencing to determine the subtypes. Relations between clinical symptoms and the subtypes were examined.

Results: Fourty (80%) of the samples were positive with both culture media; 5 (10%) showed no growth in any media; 5 (10%) grew in only one. 39 (78%) samples had one subtype while 11 (22%) had mixed subtypes. ST3 was determined as the most common subtype followed by ST1, ST5, ST2, and ST4. Abdominal pain was the most common clinical symptom in 23 (46%) patients, followed by 17 (34%) with allergic symptoms. Others had gastrointestinal symptoms and joint paint. No significant relationship detected between symptoms and subtypes.

Conclusion: ST3 was the predominant subtype in patients with gastrointestinal and allergic symptoms. Also, one patient with joint paint suggests that Blastocystis spp. could also be related to arthritis, and even though few cases have been reported, this should be considered by physicians. Although we could not determine a relationship between subtypes and clinical symptoms, further investigations are needed to clarify this subject.

Keywords

• Blastocystis spp.,subtype,clinical symptoms

Blastocystis spp. Saptanan 50 Semptomatik Hastada Subtip Dağılımın Saptanması

Abstract

Amaç: Blastocystis spp. neden olduğu klinik semptomlar nedeniyle günümüzde önem kazanan enterik bir protozoondur. Prevalansı dünyanın farklı bölgelerinde değişmekle birlikte gelişmekte olan ülkelerde daha sık görüldüğü bildirilmektedir. Bugüne kadar insanlarda 9 Blastocystis spp. alt tipi saptanmıştır ve bu örneklerin farklı klinik semptomlar ile ilişkili olabileceği öne sürülmüştür.

Yöntem: Bu çalışmada formol-etil asetat yöntemi ile Blastocystis spp. varlığı saptanan 50 semptomatik hastadan elde edilen izolatlarının iki farklı besiyerinde kültürleri yapılmış, bu izolatların alt tip dağılımı sekanslama yöntemi ile belirlenmiş, alt tipler ile klinik bulgular arasındaki ilişkiler incelenmiştir.

Bulgular: Örneklerden 40 (%80)’ı her iki besiyerinde de üremiş, 5 (%10)’i iki besiyerinde de ürememiş, 5 (%10) örnek ise iki besiyerinden sadece birinde üremiştir. 39 (%78) örnekte tek bir alt tip saptanırken, 11 (%22) örnekte birden fazla alt tip varlığı saptanmıştır. Örnekler arasında en sık ST3 saptanırken bunu sırasıyla ST1, ST5, ST2 ve ST4 takip etmiştir. Karın ağrısı 23 (%46) hastada olmak üzere en sık rastlanan klinik semptom olup, allerjik semptomlar ise 17 (%34) hastada gözlenmiştir. Bunun dışında hastalarda çeşitli gastrointestinal semptomlar ve eklem ağrısı varlığı da gözlenmiştir. Klinik semptomlar ile alt tipler arasında anlamlı bir ilişki saptanamamıştır.

Sonuç: Çalışmamızda, gastrointestinal ve allerjik semptomları olan hastalarda ST3 alt tipi en sık saptanmıştır. Ayrıca her ne kadar az sayıda olgu bildirilmiş olsa da bir hastada eklem ağrısı saptanmış olması Blastocystis spp.’nin artrit ile ilişkisi olabileceğini ve klinisyenler tarafından göz önünde bulundurulması gerektiğini düşündürmektedir. Her ne kadar çalışmamızda klinik bulgular ile alt tipler arasında anlamlı bir ilişki bulunamamış olsa da Blastocystis spp. alt tiplerinin, klinik bulgularla ilişkilerinin anlaşılması için daha fazla araştırmaya ihtiyaç vardır.

Keywords

• Blastocystis spp.,alt tip,klinik belirtiler

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