Detection of intestinal parasites by different methods in our type 2 diabetic patients

Yıl 2022, , 64 - 71, 27.03.2022

Müge Özsan Yılmaz

https://doi.org/10.30565/medalanya.987899

Cited By: 1

Öz

Aim: Long term persistently high blood glucose levels result in various complications and conditions in diabetic patients. One of them is gastrointestinal disorders and the other is increased risk of infectious diseases like parasitosis. The aim of the study is to demonstrate of intestinal parasites with various techniques in diabetic patients and confirm of the frequency of the parasites.

Methods: A total of 65 patients with type 2 Diabetes Mellitus were included in the study. Laboratory tests were done and gastrointestinal symptoms were recorded. Fecal specimens were evaluated with direct microscopy, Kinyoun acid-fast staining method, trichrome staining method and antigen screening test.

Results: Of the patients included in the study 31 were male and 34 were female. While 53.8% of the patients had no chronic complications of diabetes, 33.8% had multiple complications. Thirty (46.2%) patients had gastrointestinal complaints. Examination of stool samples revealed G. intestinalis in two patients (3.07%), C. parvum in three patients (4.6%), and G. intestinalis + E. histolytica in six patients (9.2%) by RAT. No association was found between the existence of parasite determined by RAT and any of the patient characteristics of age, sex, duration of diabetes, and dyspeptic complaints (p-values are 0.27; 0.14; 0.90; 0.68, respectively).

Conclusion: This is the first study to explore the prevalence rate of parasitosis detected by RAT in patients with diabetes. In this study, we also compared different parasite detection methods in this patient population and showed that RAT is a more sensitive method.

Anahtar Kelimeler

Type 2 Diabetes Mellitus, Parasitic Intestinal Diseases, Gastrointestinal Disorders, antigen, microscopy

Tip 2 diyabetik hastalarımızda farklı metotlarla intestinal parazitlerin tespiti

Öz

Amaç: Uzun süreli kalıcı yüksek kan şekeri seviyeleri diyabetik hastalarda çeşitli olumsuz sonuçlara yol açar. Bunlardan bir tanesi gastrointestinal bozukluklar ve bir diğeri de parazitozlar gibi enfeksiyöz hastalıklardaki risk artışıdır. Bu çalışmanın amacı diyabetik hastalarda bağırsak parazitlerinin çeşitli tekniklerle gösterilmesi ve sıklığının belirlenmesidir.

Yöntemler: Çalışmaya 65 tip 2 diyabet hastası dahil edildi. Rutin laboratuvar testleri yapıldı ve semptomları kaydedildi. Fekal örneklerde direkt mikroskopi, Kinyoun asit fast boyama, trikrom boyama, hızlı antijen tarama (HAT) teknikleriyle intestinal parazit arandı.

Bulgular: Çalışmaya dahil edilen hastaların 31’ i erkek, 34’ü kadın cinsiyette idi. Hastaların %53.8'inde diyabetin kronik komplikasyonu mevcut olmayıp, %33.8'inde çoklu komplikasyon mevcuttu. Otuz (%46,2) hastada gastrointestinal şikayetler tespit edildi. Dışkı örneklerinin incelenmesinde HAT ile iki hastada (%3.07) G. intestinalis, üç hastada (%4.6) C. parvum ve altı hastada (%9.2) G. intestinalis + E. histolytica tespit edildi. HAT ile belirlenen parazit varlığı ile yaş, cinsiyet, diyabet süresi ve dispeptik şikayetler gibi hasta özelliklerinden herhangi biri arasında ilişki bulunmadı (p değerleri sırasıyla 0,27; 0,14; 0,90; 0,68'dir).

Sonuç: Bu çalışma diyabetik hastalarda HAT ile parazitoz prevalansını araştıran ilk çalışmadır. Ayrıca bu çalışmada bu hasta popülasyonunda farklı parazit tespit yöntemlerini de karşılaştırdık ve HAT’ın daha sensitif bir yöntem olduğunu gösterdik.

Anahtar Kelimeler

Tip 2 Diabetes Mellitus, parazitik bağırsak hastalıkları, gastrointestinal hastalıklar, antijen, mikroskopi

Kaynakça

• 1 Koch CA, Uwaifo GI. Are gastrointestinal symptoms related to diabetes mellitus and glycemic control? Eur J Gastroenterol Hepatol. 2008;20(9):822-5. doi: 10.1097/MEG.0b013e3282f5f75e.
• 2 Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15 000 adults. Arch Intern Med. 2001;161:1989-96. doi: 10.1001/archinte.161.16.1989.
• 3 Llorente L, De La Fuente H, Richaud-Patin Y, Alvarado-De La Barrera C, Diaz-Borjón A, López-Ponce, et al. Innate immune response mechanisms in non-insulin dependent diabetes mellitus patients assessed by flow cytoenzymology. Immunol Lett. 2001;74(3):239-44. doi: 10.1016/s0165-2478(01)00220-6.
• 4 Ulçay A, Görenek L, Coşkun O, Araz E, Acar A, Eyigün CP. Diagnosis of intestinal-protozoa in patients with immune deficiency. Turkiye Parazitol Derg. 2008;32(4):328-33. PMID: 19156605.
• 5 Botero HJ, Castano A, Montoya MN, Ocampo NE, Hurtado MI, Lopera MM. A -preliminary study of the prevalence of intestinal parasites in ımmunocompromised patients with and without gastrointestinal manifestations. Rev Inst Med Trop. 2003;45(4):197-200. doi: 10.1590/s0036-46652003000400004.
• 6 Lallemand M, Villeneuve A, Belda J, Dubreuil P. Field study of the efficacy of halofuginone and decoquinate in the treatment of cryptosporidiosis in veal calves. Vet Rec. 2006;159(20):672–6. doi: 10.1136/vr.159.20.672.
• 7 Grinberg A, Markovics A, Galindez J, Lopez-Villalobos N, Kosak A, Tranquillo VM. Controlling the onset of natural cryptosporidiosis in calves with paromomycin sulphate. Vet Rec. 2002;151(20),606–8. doi: 10.1136/vr.151.20.606.
• 8 Lewthwaite P, Gill GV, Hart CA, Beeching NJ. Gastrointestinal parasites in the immunocompromised. Curr Opin Infect Dis. 2005;18:427-35. doi: 10.1097/01.qco.0000182104.40128.18.
• 9 Noureldin MS, Shaltout AA, El Hamshary EM, Ali ME. Opportunistic intestinal protozoal infections in immunocompromised children. J Egypt Soc Parasitol.1999;29(3):951-961. PMID: 12561933.
• 10 Tamer GS, Gülenç S. The investigation of the presence of antibodies for Cryptosporidium spp. in fecal samples using ELISA. Turkiye Parazitol Derg. 2008;32(3):198-201. PMID:18985570.
• 11 Doğancı T, Araz E, Ensari A, Tanyüksel M, Doğancı L. Detection of Cryptosporidium parvum infection in childhood using various techniques. Med Sci Monit. 2002;8(12):223-6. PMID: 12503046.
• 12 Uyar Y, Taylan Özkan A. Antigen detection methods in diagnosis of amibiasis, giardiosis and cryptospiridiosis. Türkiye Parazitol Derg. 2009;33(2):140-50. PMID: 19598091.
• 13 Ok ÜZ, Girginkardeşler N, Kilimcioğlu A, Limoncu E: Parazit hastalıklarında tanı. In, Özcel MA, Altıntaş N (Eds): Dışkı İnceleme Yöntemleri. Türkiye Parazitoloji Derneği Yayınları, No: 15, İzmir, 1997:1-61.
• 14 Camilleri M, Parkman H, Shafi MA, Abell TL, Gerson L. Clinical guideline: Management of gastroparesis. Am J Gastroenterol. 2013;108(1):18-37. doi: 10.1038/ajg.2012.373
• 15 Jones KL, Russo A, Stevens JE, Wıshart JM, Berry MK, Horowıtz M. Predictors of delayed gastric emptying in diabetes. Diabetes Care. 2001;24:1264-9. doi: 10.2337/diacare.24.7.1264.
• 16 Horowitz M, O’Donovan D, Jones KL, Feinle C, Rayner CK, Sampson M. Gastric emptying in diabetes: clinical significance and treatment. Diabet Med. 2002;19(3):177–94. doi: 10.1046/j.1464-5491.2002.00658.x.
• 17 Tack J, Caenepeel P, Fischler B, Piessevaux H, Janssens J. Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia. Gastroenterology. 2001;121(3): 526–35. doi: 10.1053/gast.2001.27180.
• 18 Futagami S, Shindo T, Kawagoe T, Horie A, Shimpuku M, Gudis K. Migration of eosinophils and CCR2-/CD68-double positive cells into the duodenal mucosa of patients with postinfectious dyspepsia. Am J Gastroenterol. 2010;105(8):1835–42. doi: 10.1038/ajg.2010.151.
• 19 Futagami S, Itoh T, Sakamoto C. Systematic review with meta-analysis: post-infectious functional dyspepsia. Aliment Pharmacol Ther. 2015;41(2):177-88. doi: 10.1111/apt.13006.
• 20 Elnadi NA, Hassanien HA, Ahmad AM, Abd Ellah AK. Intestinal Parasites In Diabetic Patients In Sohag University Hospitals, Egypt. J Egypt Soc Parasitol. 2015;45(2):443-9. doi: 10.12816/0017597.
• 21 Alemu G, Jemal A, Zerdo Z. Intestinal parasitosis and associated factors among diabetic patients attending Arba Minch Hospital, Southern Ethiopia. BMC Res Notes. 2018;11(1):689. doi: 10.1186/s13104-018-3791-x.
• 22 Machado ER, Matos NO, Rezende SM, Carlos D, Silva TC, Rodrigues L, et al. Host-Parasite Interactions in Individuals with Type 1 and 2 Diabetes Result in Higher Frequency of Ascaris lumbricoides and Giardia lamblia in Type 2 Diabetic Individuals. J Diabetes Res. 2018:4238435. doi: 10.1155/2018/4238435.
• 23 Hakim GD, Kızıltaş S, Ciftçi H, Göktaş S, Tuncer I. The prevalence of giardia intestinalis in dyspeptic and diabetic patients. ISRN Gastroenterol. 2011;580793. doi: 10.5402/2011/580793.
• 24 Uyar Y, Taylan Özkan A. Antigen detection methods in diagnosis of amibiasis, giardiosis and cryptospiridiosis. Türkiye Parazitol Derg. 2009;33(2):140-50. PMID: 19598091
• 25 Aziz H, Beck CE, Lux MF, Hudson MJ. A comparison study of different methods used in the detection of Giardia lamblia. Clin Lab Sci. 2001;14(3):150-4. PMID: 11517624