Gastrointestinal şikayeti olan hastalarda Blastocystis sp. infeksiyonu: bir Küba araştırması

Öz

Amaç: Bu çalışmada; yetişkinlerdeki gastrointestinal sistem şikayetleri ile Blastocystis varlığı arasındaki ilişkinin tanımlanması amaçlanmıştır. Yöntem: Ocak-Aralık 2011 tarihleri arasında Küba, Matanzas Şehri’nde bulunan Hijyen, Epidemiyoloji ve Mikrobiyoloji Merkezi’nde tanımlayıcı bir çalışma yürütülmüştür. Toplam 749 erişkin 20-69 yaşları arasında, ortalama yaş 38 bu çalışmaya dahil edilmiştir. Patojenik bakteri, parazit açısından pozitif dışkı sonucu olanlar ve rotavirus sonucu pozitif olanlar bu çalışma dışında bırakılmıştır. Sonuç olarak 240 erişkin çalışma koşullarını karşılamıştır: 128 %53,3 erkek, 112 %46,7 kadın ve olguların yaş ortalaması 40 idi. Karşılaştırmayı kolaylaştırmak Gastrointestinal şikayetleri olan 110 erişkinden oluşan birinci grup ve şikayetleri olmayan 130 erişkinden oluşan ikinci grup. Her iki grupta da cinsiyet dağılımı homojen olmuştur. Blastocystis sp. varlığını tanımlamak için taze dışkı örnekleri nativ yöntemiyle direkt olarak incelenmiştir. Formalin-eter Ritchie yöntemi intestinal parazitlerin yanlış tanısından kaçınmak amacıyla kullanılmıştır. Her iki yöntemde de taze dışkı örnekleri ışık mikroskobu ile incelenmiştir. Bulgular: Semptomatik grupta yer alan 49 hastada %44,5 ve asemptomatik grupta yer alan 28 %22,4 asymptomatic one. Abdominal pain 52.7% or distension 38.2% , acute diarrhea 26.4% , loss of appetite 18.2% , and dyspepsia 16.4% were the gastrointestinal complains notified by patients included on the symptomatic group. The probability to identify Blastocystis sp. in patients with gastrointestinal complains was 2.9 times higher than in asymptomatic patients. Conclusion: Current results support those authors considering Blastocystis sp. as pathogen.Key Words: Blastocystis sp.; pathogen; hastada Blastocystis sp. saptanmıştır. Karın ağrısı %52,7 veya şişkinlik %38,2 , akut ishal %26,4 , iştah kaybı %18,2 , ve dispepsi %16,4 septomatik grupta yer alan hastalarda tespit edilen gastrointestinal şikayeler olarak belirlenmiştir. Gastrointestinal şikayeti olan hastalarda Blastocystis sp. tanımlanma olasılığının, asemptomatik hastalardan 2,9 kez daha yüksek olduğu bulunmuştur. Sonuç: Mevcut çalışmamız Blastocystis sp.’yi patojen olarak tanımlayan yazarları desteklemektedir

Anahtar Kelimeler

• Blastocystis sp., patojen, gastrointestinal bulgular

Blastocystis sp. infection in patients with gastrointestinal complaints: a Cuban study

Öz

Objective: This study is aimed to determine the association between the presence of Blastocystis sp. and gastrointestinal complaints in adults. Method: A descriptive study was carried out from January to December 2011 at the Centre of Hygiene, Epidemiology and Microbiology in Matanzas City, Cuba. A total of 749 adults aged from 20 to 69 years old, mean age 38 had the opportunity to be included. Patients who had positive stool results for pathogenic bacteria, parasites and those with positive result to rotavirus were excluded from the study. A total of 240 adults were finally included, 128 53.3% male and 112 46.67% female with a mean age of 40 years old. To facilitate the comparison patients were divided into two groups: 110 adults with gastrointestinal complains and a second group of 130 adults without gastrointestinal disturbances. Sex distribution was homogenous in both groups. The fresh fecal samples were examined to determine the presence of Blastocystis sp. using the direct wet mount. Formalin-ether Ritchie technique was used to avoid the misdiagnosis of other intestinal parasites. In both techniques, the fresh samples were examined under light microscope. Results: Blastocystis sp. was detected in 49 patients 44.5% in the symptomatic group and 28 22.4% in the asymptomatic one. Abdominal pain 52.7% or distension 38.2% , acute diarrhea 26.4% , loss of appetite 18.2% , and dyspepsia 16.4% were the gastrointestinal complains notified by patients included on the symptomatic group. The probability to identify Blastocystis sp. in patients with gastrointestinal complains was 2.9 times higher than in asymptomatic patients. Conclusion: Current results support those authors considering Blastocystis sp. as pathogen

Anahtar Kelimeler

• Blastocystis sp., pathogen, gastrointestinal symptoms

Kaynakça

1. 1. Cekin AH, Cekin Y, Adakan Y, Tasdemir E, Koclar FG, Yolcular BO. Blastocystosis in patients with gastrointestinal symptoms: a case-control study. BMC Gastroenterology, 2012; 12: 122.
2. 2. Cañete Villafranca R, Rodríguez Jiménez P. Infección por Blastocystis sp.: revisión de la literatura. Rev Méd Electrón [Seriada en línea], 2012 Sep- Oct [Accessed 2013 May 12]; 34(5). Available:http://www.revmatanzas.sld.cu/ revista%20medica/ano%202012/vol5%202012/ tema05.htm.
3. 3. Jiménez-González DE, Martínez-Flores WA, Reyes-Gordillo J, Ramírez-Miranda ME, ArroyoEscalante S, Romero-Valdovinos M, et al. Blastocystis infection is associated with irritable bowel syndrome in a Mexican patient population. Parasitol Res, 2012; 110(3): 1269-75.
4. 4. Scanlan PD. Blastocystis: past pitfalls and future perspectives. Trends Parasitol, 2012; 28(8): 327-34.
5. 5. Cañete Villafranca R, López García I. Incremento en la notificación de infecciones por Blastocystis sp. en la provincia de Matanzas. Rev Méd Electrón [Seriada en línea], 2012 Sep- Oct [Accessed 2013 May 12]; 34(5). Available: http://www. revmatanzas.sld.cu/revista%20medica/ano%20 2012/vol5%202012/tema13.htm.
6. 6. Arani AS, Alaghehbandan R, Akhlaghi L, Shahi M, Lari AR. Prevalence of intestinal parasites in a population in South Tehran, Iran. Rev Inst Med Trop S Paulo, 2008; 50(3): 145-9.
7. 7. Haider SS, Baqai R, Qureshi FM, Boorom K. Blastocystis spp., Cryptosporidium spp., and Entamoeba histolytica exhibit similar symptomatic and epidemiological patterns in healthcareseeking patients in Karachi. Parasitol Res, 2012; 111(3): 1357-68.
8. 8. Soriano JM, Domènech G, Martínez MC, Mañes J, Soriano F. Intestinal parasitic infections in hosted Saharawi children. Trop Biomed, 2011; 28(3): 557-62.

9. 9. Salinas JL, Vildozola Gonzales H. Infection by Blastocystis: a review. Rev Gastroenterol Peru, 2007; 27(3): 264-74.
10. 10. Stensvold CR, Nielsen HV, Mølbak K, Smith HV. Pursuing the clinical significance of Blastocystisdiagnostic limitations. Trends Parasitol, 2009; 25(1): 23-9.
11. 11. Chen TL, Chan CC, Chen HP, Fung CP, Lin CP, Chan WL, et al. Clinical characteristics and endoscopic findings associated with Blastocystis hominis in healthy adults. Am J Trop Med Hyg, 2003; 69(2): 213-6.
12. 12. Sun T, Katz S, Tanenbaum B, Schenone C. Questionable clinical significance of Blastocystis hominis infection. Am J Gastroenterol, 1989; 84(12): 1543-7.
13. 13. Leder K, Hellard ME, Sinclair MI, Fairley CK, Wolfe R. No correlation between clinical symptoms and Blastocystis hominis in immunocompetent individuals. J Gastroenterol Hepatol, 2005; 20(9): 1390-4.
14. 14. Tikhonova DV, Fedianina LV, Pliushcheeva GL. The specific features of the clinical picture of Blastocystosis and laboratory methods for its diagnosis. Med Parazitol (Mosk), 2012; (3): 44.
15. 15. Kuo HY, Chiang DH, Wang CC, Chen TL, Fung CP, Lin CP, et al. Clinical significance of Blastocystis hominis: experience from a medical center in northern Taiwan. J Microbiol Immunol Infect, 2008; 41: 222-6.
16. 16. El Guamri Y, Belghyti D, Barkia A, Tiabi M, Aujjar N, Achicha A, et al. Parasitic infection of the digestive tract in children in a regional hospital center in Gharb (Kenitra, Morroco): some epidemiological features. East Afr J Public Health, 2011; 8(4): 250-7.
17. 17. Escobedo AA, Cañete R, Núñez FA. Intestinal protozoan and helminth infections in the Municipality San Juan y Martínez, Pinar del Río, Cuba. Trop Doct, 2007; 37(4): 236-8.
18. 18. Cañete R, Díaz MM, Avalos García R, Laúd Martinez PM, Manuel Ponce F. Intestinal parasites in children from a day care centre in Matanzas city, Cuba. PLoS One, 2012; 7(12):e51394.
19. 19. Rostami Nejad M, Nazemalhosseini Mojarad E, Dabiri H, Nochi Z, Pourhoseingholi MA, Sahebekhtiari N, et al. A case-control study of Blastocystis hominis among Iranian population. East Afr J Public Health, 2010; 7(1): 101-4.
20. 20. Ertug S, Karakas S, Okyay P, Ergin F, Oncu S. The effect of Blastocystis hominis on the growth status of children. Med Sci Monit, 2007; 13(1): CR40- CR43.
21. 21. Yamamoto-Furusho JK, Torijano-Carrera E. Intestinal protozoa infections among patients with ulcerative colitis: prevalence and impact on clinical disease course. Digestion, 2012; 82(1): 18-23.
22. 22. Fouad SA, Basyoni MM, Fahmy RA, Kobaisi MH. The pathogenic role of different Blastocystis hominis genotypes isolated from patients with irritable bowel syndrome. Arab J Gastroenterol, 2011; 12(4): 194-200.
23. 23. Tai WP, Hu PJ, Wu J, Lin XC. Six ulcerative colitis patients with refractory symptoms co-infective with Blastocystis hominis in China. Parasitol Res, 2011; 108(5): 1207-10.
24. 24. Poirier P, Wawrzyniak I, Vivarès CP, Delbac F, El Alaoui H. New Insights into Blastocystis spp.: A Potential Link with Irritable Bowel Syndrome. PLoS Pathog, 2012; 8(3): e1002545.
25. 25. Dogruman-Al F, Kustimur S, Yoshikawa H, Tuncer C, Simsek Z, Tanyuksel M, et al. Blastocystis subtypes in irritable bowel syndrome and inflammatory bowel disease in Ankara, Turkey. Mem Inst Oswaldo Cruz, 2009; 104(5): 724-7.
26. 26. Laodim P, Intapan PM, Sawanyawisuth K, Laummaunwai P, Maleewong W. A hospital-based study of epidemiological and clinical data on Blastocystis hominis infection Foodborne Pathog Dis, 2012; 9(12): 1077-82.
27. 27. Masucci L, Graffeo R, Bani S, Bugli F, Boccia S, Nicolotti N, et al. Intestinal parasites isolated in a large teaching hospital, Italy, 1 May 2006 to 31 December 2008. Euro Surveill, 2011; 16(24):pii=19891.