Prevalence of Intestinal Protozoa among Saudi Patients with Chronic Renal Failure: A Case-Control Study

Molecular, Microscopic, and Immunochromatographic Detection of Enteroparasitic Infections in Hemodialysis Patients and Related Risk Factors

Intestinal parasitic infection (IPI) is one of the important causes of morbidity and mortality in patients with chronic renal failure (CRF). Patients with CRF are more prone to infections due to acquired immunodeficiency caused by uremia. This study aims at determining the prevalence of parasitic intestinal infections in hemodialysis (HD) patients in Makkah, Saudi Arabia, and at comparing the techniques used for the detection of intestinal parasites. One hundred stool samples were collected from Saudi HD patients from two dialysis centers of two hospitals in Makkah City, and 50 samples were collected randomly from healthy individuals that served as control. The laboratory tests were carried out at King Fahd Medical Research Center, King Abdulaziz University, Jeddah. One stool sample was collected from each participant and examined with different techniques. The diagnosis was carried out using the direct wet smear with normal saline and native-Lugol's, Ritchie technique, rapid diagnostic test (ImmunoCard STAT! CGE), and molecular techniques (real-time polymerase chain reaction). The relation between age, gender, weight, and height to calculate body mass index, level of education, time of the HD, lifestyle, residence status, several gastrointestinal symptoms, blood pressure, diabetes, irritable bowel disease, and other factors was studied. Intestinal parasites were found in 38% of the HD patients and 36% of the control group. The most encountered intestinal parasites in the HD patients and control group were Blastocystis hominis (31%) and (34%), Entamoeba histolytica (3%) and (2%) respectively, Endolimax nana (4%) in the HD group, Giardia lamblia (4%) in the control group, and no positive results for Cryptosporidium or helminths in both groups. The IPIs should be suspected in all cases of immunodeficient patients, and stool samples should be ordered as routine with other tests in interval times and examined using special techniques. The physicians should be aware of the similarity between HD and intestinal parasitosis symptoms to perform diagnostic tests and determine the suitable treatment.

The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010-2021 in Asia

Blastocystis spp. are controversial unicellular protists that inhabit the gastrointestinal tract of humans and a wide range of animals worldwide. This review provides an overview of the prevalence and distribution of Blastocystis spp. and their subtypes throughout Asia. Research articles reporting on the presence of Blastocystis spp. in locations within Asia, between 1 January 2010, and 10 May 2021, were obtained from Scopus, PubMed, and Google Scholar. In 427 articles, the prevalence of Blastocystis spp. in 31 countries within the last decade was revealed. Isolates were found in humans, various mammals, birds, reptiles, insects, water sources, vegetables, and ambient air. Prevalence of Blastocystis spp. varied widely across host categories. Subtypes identified throughout Asia were STs 1-14, and ST18-22 (novel subtypes). ST1, ST2, ST3, ST4 were the most frequently isolated in humans; ST5 in pigs; ST10 and ST14 in goats, sheep, and cattle; and ST6 and ST7 in chickens. ST1 and ST3 were most common in water samples. ST1, ST2, ST3, ST4, ST5 and ST6 were shared by humans, animals, and water sources. There is a growing interest in the study of Blastocystis spp. and their subtypes in Asia. Due to the isolation of Blastocystis spp. from biotic and abiotic sources in Asia, the application of the One Health (OH) approach to the study of Blastocystis spp. is proposed for improved perception of this organism.

Cryptosporidium infection in chronic kidney disease patients undergoing hemodialysis in Egypt

Patients with chronic renal failure are more susceptible to infections due to acquired immunodeficiency caused by uremia. Parasitic infections are one of the significant causes of morbidity and mortality in those patients, So we aimed to assess the prevalence of Cryptosporidium spp. and other protozoan infections in patients undergoing hemodialysis in Qena Governorate, Upper Egypt. The present study took place in Qena University Hospitals, Egypt. Participants were 150 Chronic Kidney Disease (CKD) patients undergoing hemodialysis, and 50 healthy individuals. After questionnaire, three consecutive stool samples from each participant were examined macroscopically and microscopically by different techniques for the presence of different stages of different protozoa. 66% of CKD patients and 26% of the control group were infected with intestinal protozoa. Cryptosporidium spp. were the protozoa with the highest prevalence in cases (40%) and control (6%) with statistical significance (P < 0.05). It was detected only in watery stool samples (P value < 0.05). Residence, age and gender were not significant variables in the prevalence of infection among patients with CKD. In Egypt, few studies had reported the prevalence of Cryptosporidiosis in chronic renal patients. Cryptosporidium infection should be suspected in all cases of prolonged watery diarrhea in CKD patients and stool samples should be examined using special stains as cold modified Ziehl-Neelsen staining for proper diagnosis of Cryptosporidium infections.

Predominance and association risk of Blastocystis hominis subtype I in colorectal cancer: a case control study

Background

Blastocystis, a genetically diverse intestinal parasite with controversial pathogenic potential, has increasingly been incriminated for diarrheal illness in immunocompromised individuals including colorectal cancer (CRC) patients. The aim of the current study was to assess the possible association between Blastocystis infection and CRC condition in Makkah, Saudi Arabia (KSA).

Methods

Stool samples were collected from 80 non-cancer (NC) and 138 cancer subjects including 74 CRC patients and 64 patients with other cancers outside gastrointestinal tract (COGT). Molecularly confirmed Blastocystis isolates were genetically grouped and subtyped using multiplex polymerase chain reaction with restriction fragment length polymorphism (PCR-RFLP) and sequence-tagged site primers-based PCR (PCR-STS), respectively.

Results

Blastocystis hominis were confirmed in 29.7, 25 and 15% among CRC, COGT and NC patients, respectively. Obtained Blastocystis isolates were initially categorized into 2 groups (A and C), which were subsequently subtyped into 3 different subtypes; subtype-I (38%), subtype-II (44%) and subtype-V (22%). Interestingly, subtype-I was the most predominantly detected subtype (54.5%) among CRC patients with a significant association risk (COR 7.548; 95% CI: 1.629–34.987; P = 0.004).

Conclusion

To the best of our knowledge, the current study is the first to provide genetic insights on the prevalence of Blastocystis hominis among CRC patients in Makkah, KSA. Moreover, the study suggests for a possible association between subtype-I of Blastocystis hominis and CRC, which could indicate a potential influence of Blastocystis on CRC condition. Further studies are required to confirm this association risk and to investigate the possible underlying mechanism of postulated carcinogenic influence of Blastocystis hominis subtype-I.

Electronic supplementary material

The online version of this article (doi:10.1186/s13027-017-0131-z) contains supplementary material, which is available to authorized users.