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Alhindawi M, Rhouati A, Noordin R, Cialla-May D, Popp J, Zourob M. Selection of ssDNA aptamers and construction of aptameric electrochemical biosensor for the detection of Giardia intestinalis trophozoite protein. Int J Biol Macromol 2024; 267:131509. [PMID: 38608978 DOI: 10.1016/j.ijbiomac.2024.131509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/28/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
Giardia intestinalis is one of the most widespread intestinal parasites and is considered a major cause of epidemic or sporadic diarrhea worldwide. In this study, we aimed to develop a rapid aptameric diagnostic technique for G. intestinalis infection. First, the SELEX (Systematic Evolution of Ligands by Exponential Enrichment) process generated DNA aptamers specific to a recombinant protein of the parasite's trophozoite. Ten selection rounds were performed; each round, the DNA library was incubated with the target protein conjugated to Sepharose beads. Then, the unbound sequences were removed by washing and the specific sequences were eluted and amplified by Polymerase Chain Reaction (PCR). Two aptamers were selected, and the dissociation constants (Kd), were determined as 2.45 and 16.95 nM, showed their high affinity for the G. intestinalis trophozoite protein. Subsequently, the aptamer sequence T1, which exhibited better affinity, was employed to develop a label-free electrochemical biosensor. A thiolated aptamer was covalently immobilized onto a gold screen-printed electrode (SPGE), and the binding of the targeted protein was monitored using square wave voltammetry (SWV). The developed aptasensor enabled accurate detection of the G. intestinalis recombinant protein within the range of 0.1 pg/mL to 100 ng/mL, with an excellent sensitivity (LOD of 0.35 pg/mL). Moreover, selectivity studies showed a negligible cross-reactivity toward other proteins such as bovine serum albumin, globulin, and G. intestinalis cyst protein.
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Affiliation(s)
- Mohammed Alhindawi
- Department of Chemistry, Alfaisal University, Al Zahrawi Street, Al Maather, Al Takhassusi Rd, Riyadh 11355, Saudi Arabia
| | - Amina Rhouati
- Department of Chemistry, Alfaisal University, Al Zahrawi Street, Al Maather, Al Takhassusi Rd, Riyadh 11355, Saudi Arabia
| | - Rahmah Noordin
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia; Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Dana Cialla-May
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich Schiller University, Jena, Germany; Leibniz Institute of Photonic Technology, Member of Leibniz Health Technologies, Member of the Leibniz Centre for Photonics in Infection Research (LPI), Albert-Einstein-Straße 9, 07745 Jena, Germany
| | - Jürgen Popp
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich Schiller University, Jena, Germany; Leibniz Institute of Photonic Technology, Member of Leibniz Health Technologies, Member of the Leibniz Centre for Photonics in Infection Research (LPI), Albert-Einstein-Straße 9, 07745 Jena, Germany
| | - Mohammed Zourob
- Department of Chemistry, Alfaisal University, Al Zahrawi Street, Al Maather, Al Takhassusi Rd, Riyadh 11355, Saudi Arabia.
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Zhao Z, Cao S, Sun M, Yang Q, Huang T, Yang X, Li J, Zhang X, Li X, Wang X, Jiang W, Gong P. Rapid visual detection of Giardia duodenalis in faecal samples using an RPA-CRISPR/Cas12a system. Parasitol Res 2024; 123:176. [PMID: 38573530 DOI: 10.1007/s00436-024-08197-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/24/2024] [Indexed: 04/05/2024]
Abstract
Giardiasis is a common intestinal infection caused by Giardia duodenalis, which is a major economic and health burden for humans and livestock. Currently, a convenient and effective detection method is urgently needed. CRISPR/Cas12a-based diagnostic methods have been widely used for nucleic acid-based detection of pathogens due to their high efficiency and sensitivity. In this study, a technique combining CRISPR/Cas12a and RPA was established that allows the detection of G. duodenalis in faecal samples by the naked eye with high sensitivity (10-1 copies/μL) and specificity (no cross-reactivity with nine common pathogens). In clinical evaluations, the RPA-CRISPR/Cas12a-based detection assay detected Giardia positivity in 2% (1/50) of human faecal samples and 47% (33/70) of cattle faecal samples, respectively, which was consistent with the results of nested PCR. Our study demonstrated that the RPA-CRISPR/Cas12a technique for G. duodenalis is stable, efficient, sensitive, specific and has low equipment requirements. This technique offers new opportunities for on-site detection in remote and poor areas.
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Affiliation(s)
- Zhiteng Zhao
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Songgao Cao
- Pingdu People's Hospital, Qingdao, 266700, People's Republic of China
| | - Min Sun
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Qiankun Yang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Taojun Huang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Xing Yang
- Integrated Laboratory of Pathogenic Biology, College of Preclinical Medicine, Dali University, Dali, Yunnan, 671003, People's Republic of China
| | - Jianhua Li
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Xichen Zhang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Xin Li
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Xiaocen Wang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Weina Jiang
- Department of Pathology, Qingdao Municipal Hospital, Qingdao, Shandong Province, 266071, People's Republic of China.
| | - Pengtao Gong
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China.
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Ktenas S, Roeber F, Meggiolaro MN, Ktenas A, Ward MP, Šlapeta J. Comparison of Giardia duodenalis point-of-care antigen faecal tests to reference laboratory assays in non-symptomatic dogs. Vet Parasitol 2024; 327:110139. [PMID: 38295676 DOI: 10.1016/j.vetpar.2024.110139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 03/13/2024]
Abstract
Giardia duodenalis is one of the most prevalent enteric parasites of dogs. Point-of-care antigen tests (POC) are rapid and do not require additional equipment, or a specialised diagnostic laboratory. The aim of this study was to compare diagnostic tests available in veterinary practices and in a diagnostic laboratory for the detection of G. duodenalis on a cohort of group-housed dogs from New South Wales, Australia. Two different POC tests were used for the detection of G. duodenalis. Laboratory tests used were the multiplexed-tandem PCR panel (MT-PCR) that includes detection of G. duodenalis DNA, and two reference tests (an in-house TaqMan real-time PCR and a direct immunofluorescence assay, DFA). Canine faecal samples (n = 40) were tested simultaneously for the detection of G. duodenalis. Using either DFA or TaqMan real-time PCR as reference tests, 77.5% (31/40) and 82.5% (33/40) of dogs tested positive, respectively. Agreement (Kappa) between the DFA and TaqMan real-time PCR was 0.84 (95% CI 0.64 to 1.00). There was substantial G. duodenalis test outcome agreement between the two POC tests, Kappa = 0.75. Combining the two POC tests yielded 77% sensitivity and 100% specificity with DFA as reference, and for TaqMan real-time PCR it was 73% sensitivity and 100% specificity. The MT-PCR was in excellent agreement with each reference test, DFA or TaqMan real-time PCR. Due to the high specificity of both POC tests, they can be confidently used as rule-in diagnostics. Confirmatory testing that detects different biological parameters such as DNA, e.g. PCR (inc. MT-PCR), should be implemented before concluding that a dog is negative for the presence of G. duodenalis.
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Affiliation(s)
- Stella Ktenas
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, New South Wales 2006, Australia
| | - Florian Roeber
- Wongaburra Research Centre, Invetus Pty Ltd., NSW 2470, Australia
| | - Maira N Meggiolaro
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, University of Sydney, NSW 2006, Australia
| | - Athena Ktenas
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, New South Wales 2006, Australia
| | - Michael P Ward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, New South Wales 2006, Australia
| | - Jan Šlapeta
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, New South Wales 2006, Australia; The University of Sydney Institute for Infectious Diseases, New South Wales 2006, Australia.
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Santos SA, de Souza JN, Pacheco FTF, Santos MC, Dos Santos Novais D, Suzart VN, Dos Santos Guedes I, Neves MH, Gomes MA, Soares NM, Teixeira MCA. Detection of IgG Anti-Giardia duodenalis Antibodies in Sera by Indirect Immunofluorescence and Western Blotting Assays. Acta Parasitol 2024; 69:351-357. [PMID: 38095798 DOI: 10.1007/s11686-023-00753-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/14/2023] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Serological assays are alternative laboratory tools for the diagnosis of parasitic infections. The aim of this work was to evaluate the performance of the indirect fluorescent antibody test (IFAT) and Western blotting (WB) for the detection of IgG anti-Giardia antibodies in human sera. METHODOLOGY Sera from individuals infected with Giardia duodenalis, other parasites or non-parasitized were selected for serological assays. Ninety-seven sera were tested by IFAT at 1:20 and 1:40 dilutions and of these, 40 samples were also analyzed by WB. RESULTS The sensitivity and specificity of the IFAT was 97% and 46.9% at 1:20 sera dilution, and 39.4% and 59.4% at 1:40 sera dilution. The low molecular weight polypeptides fractions of 25 kDa, 27-31 kDa and 45-55 kDa were the most frequently identified by the sera of individuals infected with G. duodenalis, along with low cross-reactivity, presenting an individual sensitivity of 42.8%, 50.0% and 57.1%, and specificity of 83.3%, 83.3% and 91.7%, respectively. The highest overall sensitivity of WB (85.7%) was based on the immunoreactivity of sera with at least one of those proteins. The concordance between the detection of G. duodenalis in feces by microscopy and the WB results was considered substantial (Kappa = 0.61). CONCLUSION Constant exposure to Giardia infection throughout a lifetime can maintain high levels of specific antibodies in serum, even without active infection. Moreover, proteins found in intestinal amoebas may hinder the serological diagnosis of giardiasis in endemic areas due to cross-reactivity, which can be partially solved using Giardia low molecular weight proteins.
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Affiliation(s)
- Samara Alves Santos
- Programa de Pós-Graduação em Farmácia, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Joelma Nascimento de Souza
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | | | - Mariana Conceição Santos
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Darleide Dos Santos Novais
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Victoria Nascimento Suzart
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Isabela Dos Santos Guedes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Maena Honda Neves
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Maria Aparecida Gomes
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Neci Matos Soares
- Programa de Pós-Graduação em Farmácia, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil
| | - Márcia Cristina Aquino Teixeira
- Programa de Pós-Graduação em Farmácia, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, 40170-115, Brazil.
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Kuzi S, Zgairy S, Byrne BA, Suchodolski J, Turjeman SC, Park SY, Aroch I, Hong M, Koren O, Lavy E. Giardiasis and diarrhea in dogs: Does the microbiome matter? J Vet Intern Med 2024; 38:152-160. [PMID: 37890857 PMCID: PMC10800182 DOI: 10.1111/jvim.16894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Giardia duodenalis (Gd) causes intestinal parasitosis. The involvement of the intestinal microbiome in determining the infection's clinical phenotype is unknown. OBJECTIVE Investigate the fecal microbiome features in dogs with giardiasis. ANIMALS AND METHODS Cross-sectional study, including fecal samples of kenneled dogs with Gd diagnosed by fecal Giardia antigen dot ELISA. The fecal microbial compositional characteristics and dysbiosis index (DI) were compared between diarrheic and nondiarrheic dogs. RESULTS Fecal samples of 38 Gd-infected dogs (diarrheic, 21; nondiarrheic, 17) were included. No differences were found in Faith's phylogenic diversity and beta diversity (weighted UniFrac distances) and in specific taxa abundances at the phylum, genus, and species levels, as well as in alpha and beta diversities between diarrheic and nondiarrheic dogs, and also when divided by sex or age. Among diarrheic dogs, alpha diversity was higher in males than in females (pairwise Kruskal-Wallis, q = 0.01). Among males, fecal abundances of the genus Clostridium (W = 19) and Clostridium spiroforme species (W = 33) were higher in diarrheic compared to nondiarrheic dogs. In diarrheic dog fecal samples, Proteobacteria were more prevalent (W = 1), whereas Verrucomicrobia were less prevalent in dogs <1 year of age than in older dogs. The fecal sample DI of 19 diarrheic and 19 nondiarrheic dogs was similar (median, -0.2; range, -4.3 to 4.5 and median, -1.0; range, -4.3 to 5.8, respectively). CONCLUSIONS The fecal microbial composition of symptomatic and asymptomatic dogs with giardiasis is similar. Based on fecal DI, giardiasis is not characterized by prominent dysbiosis. Other host and parasite characteristics might determine the severity of giardiasis in dogs.
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Affiliation(s)
- Sharon Kuzi
- Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Robert H. Smith Faculty of AgricultureFood and Environment Hebrew University of JerusalemRehovotIsrael
| | - Soha Zgairy
- Azrieli Faculty of MedicineBar‐Ilan UniversitySafedIsrael
| | - Barbara A. Byrne
- Department of Pathology, Microbiology, and ImmunologyUniversity of California—DavisDavisCaliforniaUSA
| | - Jan Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical SciencesTexas A&M UniversityCollege StationTexasUSA
| | | | - So Young Park
- Gastrointestinal Laboratory, Department of Small Animal Clinical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Itamar Aroch
- Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Robert H. Smith Faculty of AgricultureFood and Environment Hebrew University of JerusalemRehovotIsrael
| | - Mike Hong
- Gastrointestinal Laboratory, Department of Small Animal Clinical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Omry Koren
- Azrieli Faculty of MedicineBar‐Ilan UniversitySafedIsrael
| | - Eran Lavy
- Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Robert H. Smith Faculty of AgricultureFood and Environment Hebrew University of JerusalemRehovotIsrael
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Xu L, Li J, Hu Z. Giardiasis Combined with Sepsis and DIC in a Chinese Child from Ganzi Tibetan Autonomous Prefecture. Clin Lab 2024; 70. [PMID: 38213213 DOI: 10.7754/clin.lab.2023.230658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND We reported a rare case of combined Giardiasis, sepsis, and DIC in a Tibetan Chinese male in this study. METHODS Multiple fecal routine examinations, blood routine examination, blood culture, coagulation screening, and biochemical tests were done after August 1st, 2022. RESULTS The child had intermittent diarrhea. Giardia cysts were found in his stool mounts. Sepsis, disseminated intravascular coagulation, fever with blood routine decreasing, low proteinemia, hyperlactemia and hypocalcemia were also found in this case. CONCLUSIONS It is suggested that improving the resistance, immunity, and personal hygiene is particularly important for children from remote ethnic minority areas of China.
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Kanski S, Weber K, Busch K. [Feline and canine giardiosis: An Update]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2023; 51:411-421. [PMID: 38056479 DOI: 10.1055/a-2191-1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Giardia duodenalis is a facultative pathogenic intestinal parasite. Giardiosis in dogs and cats may appear with or without clinical signs. Typical signs include diarrhea with or without vomiting. The prevalence in young animals is high and may amount to up to 50%. There are 8 different genotypes (A - H), which are called assemblages. Assemblages C and D are most common in dogs and assemblage F most frequent in cats. However, animals may also be infected with the zoonotically effective assemblages A and B or exhibit mixed infections. The immunofluorescence test (IFA), the enzyme-linked immunosorbent assay (ELISA) and fecal centrifugation using zinc sulphate solution are currently recommended as diagnostic methods. Polymerase chain reaction (PCR) may be used to determine the corresponding assemblage. Approved treatments for giardiosis include fenbendazole and metronidazole. In addition, undertaking specific hygiene measures is warranted. Only animals showing clinical signs or those living in the same household with high-risk patients (e. g. immunosuppressed humans) are recommended to receive medication. The aim of treatment is clinical improvement of the diseased dogs and cats. Frequently, complete elimination of Giardia is not attained.
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Affiliation(s)
- Sabrina Kanski
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Karin Weber
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Kathrin Busch
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
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Brožová K, Jirků M, Lhotská Z, Květoňová D, Kadlecová O, Stensvold CR, Samaš P, Petrželková KJ, Jirků K. The opportunistic protist, Giardia intestinalis, occurs in gut-healthy humans in a high-income country. Emerg Microbes Infect 2023; 12:2270077. [PMID: 37815802 PMCID: PMC10614719 DOI: 10.1080/22221751.2023.2270077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/05/2023] [Indexed: 10/11/2023]
Abstract
Giardia intestinalis, a cosmopolitan gastrointestinal protist, is detected mainly in patients with clinical giardiasis in high-income countries. In contrast, there is very little information on the presence of Giardia in asymptomatic individuals. Therefore, the aim of this study was to determine the presence and prevalence of Giardia in gut-healthy volunteers in the Czech Republic and to perform a comparative evaluation of different diagnostic methods, since Giardia diagnostics is complicated. Our results confirmed that the qPCR method is the most sensitive method for detecting Giardia and revealed a prevalence of 7% (22/296) in asymptomatic individuals. In most cases, the colonization intensity ranged from 10-1-101. A conventional PCR protocol targeting the TPI gene was used to identify the assemblages. However, this protocol had limited sensitivity for Giardia amplification, effectively detecting colonization above an intensity of 104. In addition, Giardia was detected in 19% of the animals, which were closely associated with the study participants. However, due to methodological limitations, zoonotic transmission could not be clearly confirmed. Notably, contact with animals proved to be the only factor that had a significant impact on the incidence of Giardia in gut-healthy humans.
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Affiliation(s)
- Kristýna Brožová
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
- Department of Medical Biology, Faculty of Science, University of South Bohemia, České Budějovice, Czech Republic
| | - Milan Jirků
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Zuzana Lhotská
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
- Department of Medical Biology, Faculty of Science, University of South Bohemia, České Budějovice, Czech Republic
| | - Dana Květoňová
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Oldřiška Kadlecová
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | | | - Peter Samaš
- Institute of Vertebrate Biology, Czech Academy of Sciences, Brno, Czech Republic
| | - Klára J. Petrželková
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
- Institute of Vertebrate Biology, Czech Academy of Sciences, Brno, Czech Republic
| | - Kateřina Jirků
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
- Department of Medical Biology, Faculty of Science, University of South Bohemia, České Budějovice, Czech Republic
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dos Reis LL, de Souza LSS, Braga FCDO, Lima DCDS, Lima NADS, Padinha JDS, Nava AFD, Vicente ACP. Zoonotic Giardia duodenalis assemblage A in northern sloth from Brazilian Amazon. Mem Inst Oswaldo Cruz 2023; 118:e230088. [PMID: 37971095 PMCID: PMC10644951 DOI: 10.1590/0074-02760230088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The parasite Giardia duodenalis infects a wide range of vertebrate hosts, including domestic and wild animals as well as humans. Giardia is genotyped into eight assemblages (A-H). Zoonotic assemblages A and B have already been identified in humans and wild and domestic animals (non-human primates and cats) from Brazilian Amazon and in the world. Due to its zoonotic/zooanthroponotic nature, surveillance initiatives and the definition of Giardia assemblages are important in order to characterise the epidemiological scenario and to implement further control measures. OBJECTIVES Determine assemblages of G. duodenalis in sloths from the Brazilian Amazon Region. METHODS Faecal parasitological examination of sloths from Amazonas State. Polymerase chain reaction (PCR) targeting the beta giardin (BG), and genes from multilocus sequence typing (MLST) scheme, amplicon sequencing and phylogenetic analysis. FINDINGS Here, we identified, by microscopy, Giardia in two northern sloths (Bradypus tridactylus). These two samples were submitted to molecular assays and it was revealed that both were infected by G. duodenalis assemblage A. Phylogenetic analysis showed that they belong to assemblage A within sequences from humans and wild and domestic animals. CONCLUSION Therefore, besides showing, by the first time, the current presence of this parasite in sloths, our findings reveals that this wild animal species would be part of the zoonotic/zooanthroponotic scenario of this parasite in the Brazilian Amazon.
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Affiliation(s)
- Lisiane Lappe dos Reis
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas & Maria Deane, Laboratório de Diversidade Microbiana da Amazônia de Importância para a Saúde, Manaus, AM, Brasil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Biologia Parasitária, Rio de Janeiro, RJ, Brasil
| | - Lirna Salvioni Silva de Souza
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas & Maria Deane, Laboratório de Diversidade Microbiana da Amazônia de Importância para a Saúde, Manaus, AM, Brasil
| | - Francisco Carlos de Oliveira Braga
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas & Maria Deane, Laboratório de Diversidade Microbiana da Amazônia de Importância para a Saúde, Manaus, AM, Brasil
| | - Dayane Costa de Souza Lima
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas & Maria Deane, Laboratório de Diversidade Microbiana da Amazônia de Importância para a Saúde, Manaus, AM, Brasil
| | | | - Jessica da Silva Padinha
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas & Maria Deane, Laboratório de Diversidade Microbiana da Amazônia de Importância para a Saúde, Manaus, AM, Brasil
| | - Alessandra Ferreira Dales Nava
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas & Maria Deane, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, AM, Brasil
| | - Ana Carolina Paulo Vicente
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Genética Molecular de Microrganismos, Rio de Janeiro, RJ, Brasil
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Pyzocha N, Cuda A. Common Intestinal Parasites. Am Fam Physician 2023; 108:487-493. [PMID: 37983700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Parasites are a source of significant illness worldwide. In the United States, giardiasis, cryptosporidiosis, cyclosporiasis, and trichinellosis are nationally notifiable conditions. Pinworm, the most common intestinal parasite in children, is not a locally notifiable infection. Intestinal parasites have a wide range of acute and chronic symptoms but should be suspected in those who present with diarrhea lasting more than seven days. Infections most often occur through a fecal-oral route. Symptoms tend to be worse for children, older adults, or immunocompromised individuals. To diagnose Giardia infection, stool microscopy with direct fluorescent antibody testing is recommended; metronidazole, nitazoxanide, or tinidazole is used for treatment. Microscopy with immunofluorescence is sensitive and specific for diagnosing Cryptosporidium infection. This infection is often self-resolving, but treatment with nitazoxanide is effective for symptoms lasting more than two weeks. Microscopy or polymerase chain reaction assays are recommended to diagnose Cyclospora infections, and sulfamethoxazole/trimethoprim may be used to treat patients with persistent diarrhea. Trichinella infection is diagnosed by serum antibody testing, and severe symptoms are treated with albendazole in patients older than one year. Pinworm infections are diagnosed visually or by a tape test or paddle test; albendazole and pyrantel pamoate are both effective treatments.
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Affiliation(s)
- Natasha Pyzocha
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Amanda Cuda
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
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11
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Archer J, Cunningham LJ, Juhàsz A, Jones S, Doull F, LaCourse JE, Mainga B, Makaula P, Kayuni SA, Musaya J, Stothard JR. Molecular Epidemiology and Assemblage Typing of Giardia duodenalis in School-Age Children Situated along the Southern Shoreline of Lake Malawi, Malawi. Am J Trop Med Hyg 2023; 109:626-639. [PMID: 37549892 PMCID: PMC10484258 DOI: 10.4269/ajtmh.23-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/16/2023] [Indexed: 08/09/2023] Open
Abstract
Almost all human giardiasis infections are caused by Giardia duodenalis assemblages A and B. Differentiation between human infections with these assemblages, as well as between single-assemblage (A or B) and mixed-assemblage (A and B) infections, is therefore needed to better understand the pathological impact of infection with either, or both, assemblages. We assessed the prevalence of G. duodenalis assemblages A and B using 305 fecal samples provided by school-age children situated along the southern shoreline of Lake Malawi. Concurrently, intestinal pathology data were also collected to test for association(s) between assemblage infection status and intestinal health. Prevalence of G. duodenalis infection was 39.3% by real-time polymerase chain reaction. Of all identified infections, 32% were single G. duodenalis assemblage A and 32% were single G. duodenalis assemblage B, whereas 33% were mixed-assemblage infections. Fifteen unique G. duodenalis assemblage A and 13 unique G. duodenalis assemblage B β-giardin haplotypes were identified. There was a positive association between single infection with G. duodenalis assemblage B and both self-reporting of abdominal pain (odds ratio [OR]: 3.05, P = 0.004) and self-reporting of diarrhea (OR: 3.1, P = 0.003). No association between single infection with assemblage A and any form of intestinal pathology was found. Additionally, there was a positive association between mixed-assemblage infections and self-reporting of abdominal pain (OR: 3.1, P = 0.002). Our study highlights the importance G. duodenalis assemblage typing and reaffirms the need for improved access to water, sanitation and hygiene infrastructure in rural areas of low- and middle-income countries.
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Affiliation(s)
- John Archer
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Lucas J. Cunningham
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Alexandra Juhàsz
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary
| | - Sam Jones
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ffion Doull
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - James E. LaCourse
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Bright Mainga
- Laboratory Department, Mangochi District Hospital, Mangochi, Malawi
- Malawi Liverpool Wellcome Trust Programme of Clinical Tropical Research, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Peter Makaula
- Malawi Liverpool Wellcome Trust Programme of Clinical Tropical Research, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Sekeleghe A. Kayuni
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Malawi Liverpool Wellcome Trust Programme of Clinical Tropical Research, Queen Elizabeth Central Hospital, Blantyre, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre, Malawi
- MASM Medi Clinics Limited, Medical Aid Society of Malawi, Area 12 Medi Clinic and Head Office, Lilongwe, Malawi
| | - Janelisa Musaya
- Malawi Liverpool Wellcome Trust Programme of Clinical Tropical Research, Queen Elizabeth Central Hospital, Blantyre, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - J. Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Michielan A, Sartori C, Casadei C, de Pretis G, Mussetto A. Unrecognized chronic giardiasis detected by motorized spiral enteroscopy: Seeing is believing! Gastrointest Endosc 2023; 98:458-460. [PMID: 37142154 DOI: 10.1016/j.gie.2023.04.2088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/27/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Andrea Michielan
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento, Italy
| | - Chiara Sartori
- Surgical Pathology Unit, Department of Laboratory Medicine, Santa Chiara Hospital, Trento, Italy
| | - Cesare Casadei
- Gastroenterology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Department of Surgery, Santa Chiara Hospital, Trento, Italy
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13
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Chang Y, Li J, Zhang L. Genetic diversity and molecular diagnosis of Giardia. Infect Genet Evol 2023; 113:105482. [PMID: 37451417 DOI: 10.1016/j.meegid.2023.105482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
Giardia is a genus of flagellated protozoan parasites that infect the small intestine of humans and animals, causing the diarrheal illness known as giardiasis. Giardia exhibits significant genetic diversity among its isolates, which can have important implications for disease transmission and clinical presentation. This diversity is influenced by the coevolution of Giardia with its host, resulting in the development of unique genetic assemblages with distinct phenotypic characteristics. Although panmixia has not been observed, some assemblages appear to have a broader host range and exhibit higher transmission rates. Molecular diagnostic methods enable researchers to examine the genetic diversity of Giardia populations, enhancing our understanding of the genetic diversity, population structure, and transmission patterns of this pathogen and providing insights into clinical presentations of giardiasis.
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Affiliation(s)
- Yankai Chang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan 450046, China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, Henan 450046, China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou, Henan 450046, China
| | - Junqiang Li
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan 450046, China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, Henan 450046, China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou, Henan 450046, China
| | - Longxian Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan 450046, China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, Henan 450046, China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou, Henan 450046, China.
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Tawana M, Onyiche TE, Ramatla T, Thekisoe O. A 'One Health' perspective of Africa-wide distribution and prevalence of Giardia species in humans, animals and waterbodies: a systematic review and meta-analysis. Parasitology 2023; 150:769-780. [PMID: 37246558 PMCID: PMC10478065 DOI: 10.1017/s0031182023000513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 05/30/2023]
Abstract
Giardiasis, caused by Giardia duodenalis, is a leading cause of diarrhoea in resource-poor countries. To gain a better insight into the epidemiology of Giardia in Africa, we undertook a robust study to comprehend the distribution and prevalence of Giardia infection in humans, animals and their dispersal in the environment. Our protocol was registered with PROSPERO (registration number CRD42022317653). Deep literature search from 5 electronic databases, namely, AJOL, Google scholar, PubMed, ScienceDirect and Springer Link was performed using relevant keywords. Meta-analysis was performed using a random-effects model and heterogeneity among studies was evaluated using Cochran's Q and the I2-statistic. More than 500 eligible studies published from 1 January 1980 until 22 March 2022 were retrieved. In humans, exactly 48 124 Giardia spp. infection cases were registered from the 494 014 stool samples examined resulting in a pooled prevalence estimate (PPE) of 8.8% using microscopy. Whereas copro-antigen tests and molecular diagnostic methods generated PPE of 14.3 and 19.5%, respectively, with HIV+ subjects and those with diarrhoeatic stool having infection rates of 5.0 and 12.3%, respectively. The PPE of Giardia spp. infection in animals using molecular methods was 15.6%, which was most prevalent in pigs (25.2%) with Nigeria registering the highest prevalence at 20.1%. The PPE of Giardia spp. contamination from waterbodies was 11.9% from a total of 7950 samples which were detected using microscopy, with Tunisia documenting the highest infection rate of 37.3%. This meta-analysis highlights the necessity of ‘One Health’ approach for consolidated epidemiological studies and control of giardiasis in the African continent.
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Affiliation(s)
- Mpho Tawana
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
| | - ThankGod E. Onyiche
- Department of Veterinary Parasitology and Entomology, University of Maiduguri, Maiduguri, Nigeria
| | - Tsepo Ramatla
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
| | - Oriel Thekisoe
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
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15
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Mitchell PD, Wang T, Billig Y, Gadot Y, Warnock P, Langgut D. Giardia duodenalis and dysentery in Iron Age Jerusalem (7th-6th century BCE). Parasitology 2023; 150:693-699. [PMID: 37231841 PMCID: PMC10410378 DOI: 10.1017/s0031182023000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/16/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023]
Abstract
The aim of this study was to determine if the protozoa that cause dysentery might have been present in Jerusalem, the capital of the Kingdom of Judah, during the Iron Age. Sediments from 2 latrines pertaining to this time period were obtained, 1 dating from the 7th century BCE and another from the 7th to early 6th century BCE. Microscopic investigations have previously shown that the users were infected by whipworm (Trichuris trichiura), roundworm (Ascaris lumbricoides), Taenia sp. tapeworm and pinworm (Enterobius vermicularis). However, the protozoa that cause dysentery are fragile and do not survive well in ancient samples in a form recognizable using light microscopy. Enzyme-linked immunosorbent assay kits designed to detect the antigens of Entamoeba histolytica, Cryptosporidium sp. and Giardia duodenalis were used. Results for Entamoeba and Cryptosporidium were negative, while Giardia was positive for both latrine sediments when the analysis was repeated three times. This provides our first microbiological evidence for infective diarrhoeal illnesses that would have affected the populations of the ancient near east. When we integrate descriptions from 2nd and 1st millennium BCE Mesopotamian medical texts, it seems likely that outbreaks of dysentery due to giardiasis may have caused ill health throughout early towns across the region.
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Affiliation(s)
| | - Tianyi Wang
- Department of Archaeology, University of Cambridge, Cambridge, UK
| | | | - Yuval Gadot
- Department of Archaeology and Ancient Near Eastern Cultures, Tel Aviv University, Tel Aviv, Israel
| | - Peter Warnock
- Social Sciences Division, Muskegon Community College, Muskegon, MI, USA
| | - Dafna Langgut
- Laboratory of Archaeobotany and Ancient Environments, Institute of Archaeology & The Steinhardt Museum of Natural History, Tel Aviv University, Tel Aviv, Israel
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16
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Taylor LA, Saleh MN, Kneese EC, Vemulapalli TH, Verocai GG. Comparison of 3 Diagnostic Tests for the Detection of Giardia and Cryptosporidium spp. in Asymptomatic Dogs ( Canis lupis familiaris). J Am Assoc Lab Anim Sci 2023; 62:139-146. [PMID: 36878482 PMCID: PMC10078926 DOI: 10.30802/aalas-jaalas-22-000108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/13/2022] [Accepted: 01/17/2023] [Indexed: 03/08/2023]
Abstract
After detecting Giardia and Cryptosporidium infections and coinfections in 2 litters of puppies in our vivarium, our team realized that we needed a simple, quick, and economical point-of-care test for concurrent screening of asymptomatic dogs for both organisms. Periodic screening of colony dogs and of all dogs introduced into a colony can prevent the spread of Giardia and Cryptosporidium to immunologically naïve animals and help keep staff safe from these zoonotic organisms. To compare methods for diagnosing Giardia and Cryptosporidium spp. in dogs, we used a convenience sampling of feces from 2 popula- tions of dogs; samples were tested with a lateral-flow assay (QC), a commercially-available direct fluorescent assay (DFA), and an inhouse PCR test using established primers. QC results were analyzed in 2 ways: 1) relative to a reference standard that permitted comparative interpretation of DFA and PCR results; and 2) using Bayesian analysis for comparison independent of a reference standard. The QC test showed good specificity for the detection of Giardia according to both the reference standard (95%) and the Bayesian analysis (98%). Similarly, specificity of the QC for the detection of Cryptosporidium was 95% according to the reference standard and 97% according to Bayesian analysis. However, the sensitivity of the QC test was much lower for both Giardia (reference standard, 38%; Bayesian analysis, 48%) and Cryptosporidium (25% and 40%, respectively). This study demonstrates that the QC test can be used to detect both Giardia and Cryptosporidium in dogs and that positive results can be accepted with confidence, whereas negative tests should be confirmed through secondary testing methods.
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Affiliation(s)
- Loni A Taylor
- Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas; Comparative Medicine Program, Texas A&M University, College Station, Texas;,
| | - Meriam N Saleh
- Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas
| | - Eric C Kneese
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Tracy H Vemulapalli
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Guilherme G Verocai
- Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas
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17
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Shrimali T, Srivastava S, Mohammad N, John N, Tak V, Saxena R. Giardiasis in an Infant With Fibrosarcoma: A Case Report. Infect Disord Drug Targets 2023; 23:82-85. [PMID: 37448372 DOI: 10.2174/1871526523666230713141153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Giardia lamblia is a neglected parasitic infection that typically affects the developing nations of the world. It is a microscopic intestinal parasite that is known to cause stomach cramps, bloating, nausea and bouts of diarrhoea. CASE PRESENTATION Here, we are presenting the case of a 1.5 years-old-baby with an immunocompromised condition who got infected by Giardia lamblia. The baby with fibrosarcoma was receiving treatment in our tertiary care centre, and later developed abdominal and minor systemic complaints. Stool samples were collected, which showed trophozoites and cysts of Giardia. DISCUSSION To the best of our knowledge, this is the first case of Giardia lamblia infection in a paediatric patient with fibrosarcoma. The patient improved after taking metronidazole for ten days. CONCLUSION It is critical to keep a watch out for this neglected parasite, and suggested samples, particularly stool samples, must be sent for investigation in order to diagnose and manage these cases properly.
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Affiliation(s)
- Twishi Shrimali
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Naila Mohammad
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Nikhil John
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
| | - Rahul Saxena
- Department of Paediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan 342005, India
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Eppler ME, Hanzlicek G, Londoño-Renteria B, Jesudoss Chelladurai JRJ. Survey of U.S. based veterinarians' knowledge, perceptions and practices about canine giardiasis. Vet Parasitol Reg Stud Reports 2022; 34:100768. [PMID: 36041803 DOI: 10.1016/j.vprsr.2022.100768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 07/20/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
Giardia spp. is a protozoal parasite capable of causing diarrhea in mammals. Certain Giardia assemblages are potentially zoonotic. As part of a public health study, a questionnaire-based cross-sectional web survey was distributed among U.S. small and mixed animal veterinarians to assess the perceived prevalence, the preferred testing and treatment methods, the recommended control measures, and the information communicated about the zoonotic potential of canine giardiasis. Between February and June 2021, over 123 veterinarians from 31 U.S. states participated in the survey. 77% of surveyed veterinarians indicated that they are aware of the prevalence of canine giardiasis in their areas of practice. 52% of veterinarians reported that they test all symptomatic dogs for Giardia, while 42.4% test dogs only some of the time. The preferred confirmatory tests were in the following order: commercial diagnostic lab > in-clinic SNAP® Test > in-clinic Direct Smear > in-clinic Fecal Flotation > state/university diagnostic lab. Several combinations of tests are frequently used to confirm diagnosis. Although there are no labelled products available for treating canine giardiasis in the U.S., 54% of respondents preferred using both fenbendazole and metronidazole simultaneously, 15% reported using fenbendazole only, and 20% reported using metronidazole only. 77.0% of respondents indicated they have dealt with treatment refractory cases often or rarely. 92.6% of veterinarians reported mentioning environmental control to pet owners sometimes or always, which included bathing the infected pet, cleaning toys/bowls/bedding, cleaning floors, and bathing other pets. 73.6% of veterinarians communicated to their clients that Giardia was potentially zoonotic. There are conflicting opinions on the importance of zoonotic transmission between humans and canines available to the general veterinary practitioner. Given that children are at a higher risk of developing Giardia infections, it is important for veterinarians to preserve the health of canine companions to protect their human owners. Thus, the contributions of veterinarians in managing canine giardiasis within the framework of One Health initiatives should not be overlooked.
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Affiliation(s)
- Megan E Eppler
- MPH Program, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave., Manhattan, KS 66506, United States of America
| | - Gregg Hanzlicek
- Kansas State Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave., Manhattan, KS 66506, United States of America; Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave., Manhattan, KS 66506, United States of America
| | - Berlin Londoño-Renteria
- Vector Biology Laboratory, Department of Entomology, Kansas State University, 1603 Old Claflin Place, Manhattan, KS 66506, United States of America
| | - Jeba R J Jesudoss Chelladurai
- Kansas State Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave., Manhattan, KS 66506, United States of America; Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave., Manhattan, KS 66506, United States of America.
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Hadi WS, Salman RS, Al-Fahham AA, Faryad Khan MU, Kadir S, Laft MH, Saeed BQ, Kadhum WR, Jalil AT, Kadhim MM. Evaluation of IL-17 and IL-35 in patients with giardiasis in Thi-Qar province, Iraq. J Med Life 2022; 15:1096-1099. [PMID: 36415524 PMCID: PMC9635227 DOI: 10.25122/jml-2021-0328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/07/2022] [Indexed: 11/21/2022] Open
Abstract
Giardia lamblia, Entamoeba histolytica, Cryptosporidium, and Blastocystis are some parasites primarily responsible for human infections. Giardia lamblia, also known as Giardia intestinalis or Giardia duodenalis, is a common pathogenic protozoan found in the human duodenum and jejunum that causes giardiasis. This study collected stool and blood samples from patients with diarrhea aged less than 1 month to 15 years, from September 2020 to December 2020, in Thi-Qar province. Our study aimed to reveal the diagnosis of Giardia lamblia using direct microscopy examination and detect some immunological parameters such as IL-17 and IL-35 in patients infected with giardiasis.
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Affiliation(s)
- Wed Shakir Hadi
- Directorate of Dhi Qar Education, Ministry of Education, Dhi Qar, Iraq
| | - Rabab Shaker Salman
- Department of Physiology, Pharmacology and Chemistry, College of Veterinary Medicine, Thi Qar University, Dhi Qar, Iraq
| | | | | | - Sunarto Kadir
- Faculty of Sports and Health Sciences, Universitas Negeri Gorontalo, Gorontalo, Indonesia
| | | | - Balsam Qubais Saeed
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah,United Arab Emirates
| | | | - Abduladheem Turki Jalil
- Medical Laboratories Techniques Department, Al-Mustaqbal University College, Babylon, Iraq
- Corresponding Author: Abduladheem Turki Jalil, Medical Laboratories Techniques Department, Al-Mustaqbal University College, Babylon, Iraq. E-mail: Mustafa Mohammed Kadhim, Department of Dentistry, Kut College University, Kut, Iraq. College of Technical Engineering, The Islamic University, Najaf, Iraq. E-mail:
| | - Mustafa Mohammed Kadhim
- Department of Dentistry, Kut College University, Kut, Iraq
- College of Technical Engineering, The Islamic University, Najaf, Iraq
- Corresponding Author: Abduladheem Turki Jalil, Medical Laboratories Techniques Department, Al-Mustaqbal University College, Babylon, Iraq. E-mail: Mustafa Mohammed Kadhim, Department of Dentistry, Kut College University, Kut, Iraq. College of Technical Engineering, The Islamic University, Najaf, Iraq. E-mail:
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20
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Dashti A, Alonso H, Escolar-Miñana C, Köster PC, Bailo B, Carmena D, González-Barrio D. Evaluation of a Novel Commercial Real-Time PCR Assay for the Simultaneous Detection of Cryptosporidium spp., Giardia duodenalis, and Entamoeba histolytica. Microbiol Spectr 2022; 10:e0053122. [PMID: 35502919 PMCID: PMC9241732 DOI: 10.1128/spectrum.00531-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/11/2022] [Indexed: 11/20/2022] Open
Abstract
Cryptosporidium spp., Giardia duodenalis, and Entamoeba histolytica are the most common diarrhea-causing protozoan species globally. Misdiagnosis is a concern for asymptomatic and chronic infections. Multiplexing, i.e., the detection of more than one parasite in a single test by real-time PCR, allows high diagnostic performance with favorable cost-effectiveness. We conducted a clinical evaluation of the VIASURE Cryptosporidium, Giardia, & E. histolytica real-time PCR assay (CerTest Biotec, San Mateo de Gállego, Spain) against a large panel (n = 358) of well-characterized DNA samples positive for Cryptosporidium spp. (n = 96), G. duodenalis (n = 115), E. histolytica (n = 25), and other parasitic species of the phyla Amoebozoa (n = 11), Apicomplexa (n = 14), Euglenozoa (n = 8), Heterokonta (n = 42), Metamonada (n = 37), Microsporidia (n = 4), and Nematoda (n = 6). DNA samples were obtained from clinical stool specimens or cultured isolates in a national reference center. Estimated sensitivity and specificity were 0.96 and 0.99 for Cryptosporidium spp., 0.94 and 1 for G. duodenalis, and 0.96 and 1 for E. histolytica, respectively. Positive and negative predictive values were calculated as 1 and 0.98 for Cryptosporidium spp., 0.99 and 0.98 for G. duodenalis, and 1 and 0.99 for E. histolytica, respectively. The assay identified six Cryptosporidium species (Cryptosporidium hominis, Cryptosporidium parvum, Cryptosporidium canis, Cryptosporidium felis, Cryptosporidium scrofarum, and Cryptosporidium ryanae) and four G. duodenalis assemblages (A, B, C, and F). The VIASURE assay provides rapid and accurate simultaneous detection and identification of the most commonly occurring species and genetic variants of diarrhea-causing parasitic protozoa in humans. IMPORTANCE Thorough independent assessment of the diagnostic performance of novel diagnostic assays is essential to ascertain their true usefulness and applicability in routine clinical practice. This is particularly true for commercially available kits based on multiplex real-time PCR aimed to detect and differentiate multiple pathogens in a single biological sample. In this study, we conducted a clinical evaluation of the VIASURE Cryptosporidium, Giardia, & E. histolytica real-time PCR assay (CerTest Biotec) for the detection and identification of the diarrhea-causing enteric protozoan parasites Cryptosporidium spp., G. duodenalis, and E. histolytica. A large panel of well-characterized DNA samples from clinical stool specimens or cultured isolates from a reference center was used for this purpose. The VIASURE assay demonstrated good performance for the routine testing of these pathogens in clinical microbiological laboratories.
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Affiliation(s)
- Alejandro Dashti
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Carlos III Health Institute, Madrid, Spain
| | - Henar Alonso
- Department of Microbiology, Paediatrics, Radiology, and Public Health, Faculty of Medicine, University of Zaragoza, Saragossa, Spain
| | - Cristina Escolar-Miñana
- Department of Animal Production and Food Science, Faculty of Veterinary, University of Zaragoza, Saragossa, Spain
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Carlos III Health Institute, Madrid, Spain
| | - Begoña Bailo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Carlos III Health Institute, Madrid, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Carlos III Health Institute, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - David González-Barrio
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Carlos III Health Institute, Madrid, Spain
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21
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Ara-Montojo MF, Bustamante J, Sainz T, Pérez S, Jiménez-Moreno B, Ruiz-Carrascoso G, Rodríguez-Molino P, Villota J, García-López-Hortenano M, Mellado-Peña MJ. Intestinal giardiasis in children: Five years' experience in a reference unit. Travel Med Infect Dis 2021; 42:102082. [PMID: 34020030 DOI: 10.1016/j.tmaid.2021.102082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Giardiasis is highly prevalent in children and is often mildly symptomatic. First-line treatment is metronidazole, but treatment failure is not uncommon. We describe a paediatric series, to identify risk factors for treatment failure and to analyse the safety and effectiveness of other treatment strategies. METHODS Retrospective observational study, including children diagnosed with giardiasis from 2014 to 2019. Diagnosis was based on direct visualisation by microscopy after concentration using an alcohol-based fixative, antigen detection and/or DNA detection by polymerase chain reaction in stool. Treatment failure was considered when GI was detected 4 weeks after treatment. RESULTS A total of 120 patients were included, 71.6% internationally adopted, median age 4.2 (2.3-7.3) years. Only 50% presented with symptoms, mainly diarrhoea (35%) and abdominal pain (14.1%); co-parasitism was frequent (45%). First-line treatment failure after a standard dose of metronidazole was 20%, lowering to 8.3% when a higher dose was administered (p < 0.001). Quinacrine was administered in 10 patients, with 100% effectiveness. Children <2 years were at higher risk of treatment failure (OR 3.49; 95% CI 1.06-11.53; p = 0.040). CONCLUSIONS In children with giardiasis, treatment failure is frequent, especially before 2 years of age. Quinacrine can be considered as a second-line treatment. After treatment, eradication should be confirmed.
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Affiliation(s)
- M F Ara-Montojo
- Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain
| | - J Bustamante
- Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain
| | - T Sainz
- Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain; Translational Research Network in Paediatric Infectious Diseases (RITIP, Red de Investigación Translacional en Infectología Pediátrica), Spain.
| | - S Pérez
- Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain
| | | | - G Ruiz-Carrascoso
- Department of Microbiology, La Paz University Hospital, Madrid, Spain
| | - P Rodríguez-Molino
- Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain
| | - J Villota
- Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain
| | - M García-López-Hortenano
- Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain; Translational Research Network in Paediatric Infectious Diseases (RITIP, Red de Investigación Translacional en Infectología Pediátrica), Spain
| | - M J Mellado-Peña
- Paediatric Tropical and Infectious Diseases, Department of Paediatrics, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (IdiPAZ), Madrid, Spain; Translational Research Network in Paediatric Infectious Diseases (RITIP, Red de Investigación Translacional en Infectología Pediátrica), Spain
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Pophali P, Veyseh M, Fraij O, Hapangama S. Chronic giardiasis: a rare cause of exocrine pancreatic insufficiency. BMJ Case Rep 2021; 14:e242129. [PMID: 33962931 PMCID: PMC8108677 DOI: 10.1136/bcr-2021-242129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/04/2022] Open
Abstract
Exocrine pancreatic insufficiency (EPI) is a major cause of maldigestion/malabsorption syndromes. It is routinely diagnosed in clinical practice with the use of faecal elastase 1 levels, and pancreatic enzyme replacement therapy continues to be the mainstay of treatment. Numerous primary pancreatic and extrapancreatic causes for EPI have been established. Chronic giardiasis is a common condition with symptoms similar to EPI; however, it has also been described as an infrequent cause of EPI. Much remains to be understood about the pathobiology of this association. Here, we present our experience of an intriguing case of severe pancreatic insufficiency in the setting of chronic giardiasis. The patient showed improvement in symptoms over weeks after completion of treatment for chronic giardiasis.
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Affiliation(s)
- Prateek Pophali
- Medicine, Jacobi Medical Center, Bronx, New York, USA
- Medicine, Jack D Weiler Hospital of the Albert Einstein College of Medicine, Bronx, New York, USA
| | - Maedeh Veyseh
- Medicine, Jacobi Medical Center, Bronx, New York, USA
| | - Omar Fraij
- Medicine, Jack D Weiler Hospital of the Albert Einstein College of Medicine, Bronx, New York, USA
| | - Sahan Hapangama
- Medicine, Jack D Weiler Hospital of the Albert Einstein College of Medicine, Bronx, New York, USA
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24
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Symeonidou I, Gelasakis AΙ, Miliotou AN, Angelou A, Arsenopoulos KV, Loukeri S, Papadopoulos E. Rapid on-site diagnosis of canine giardiosis: time versus performance. Parasit Vectors 2020; 13:544. [PMID: 33138850 PMCID: PMC7607699 DOI: 10.1186/s13071-020-04422-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infections by protozoans of the genus Giardia are a common cause of diarrhea in dogs. Canine giardiosis constitutes a disease with a zoonotic potential; however, it is often underestimated due to its challenging diagnosis. The objective of the study was to assess the diagnostic performance of an immunochromatographic strip test (SpeedTM Giardia, Virbac, France) comparing it with microscopy (zinc sulfate flotation) by utilizing the combination of an enzyme immunoassay (ProSpecTTM Giardia EZ Microplate Assay, Oxoid Ltd., UK) and the PCR as the gold standard. A positive result in both ELISA and PCR was set as the gold standard. METHODS Initially, fecal samples from dogs with clinical signs compatible with giardiosis were tested with the SpeedTM Giardia test and separated into two groups of 50 samples each: group A (positive) and group B (negative). Thereafter, all samples were examined by zinc sulfate centrifugal flotation technique and assayed by the ProSpecTTM Giardia Microplate Assay and PCR. The performance of the SpeedTM Giardia and zinc sulfate centrifugal flotation tests were calculated estimating sensitivity, specificity, and positive and negative likelihood ratio; the chi-square and McNemar tests were used for the comparison of the two methods. RESULTS Giardia cysts were not detected by microscopy in 16 out of the 50 samples (32%) of group A and in none of group B samples. Eight out of 50 samples in group B (16%) were tested positive both with the ProSpecTTM Giardia Microplate Assay and PCR. Fecal examination with the SpeedTM Giardia test was more sensitive (86.2%) than the parasitological method (58.6%, P < 0.001) while the specificity of both methods was 100%. CONCLUSIONS The SpeedTM Giardia test is an easy-to-perform diagnostic method for the detection of Giardia spp., which can increase laboratory efficiency by reducing time and cost and decrease underdiagnosis of Giardia spp. infections. This immunochromatographic strip test may be routinely exploited when a rapid and reliable diagnosis is required, other diagnostic techniques are unavailable and microscopy expertise is inefficient. In negative dogs with compatible clinical signs of giardiosis, it is recommended either to repeat the exam or proceed with further ELISA and PCR testing.
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Affiliation(s)
- Isaia Symeonidou
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GR Greece
| | - Athanasios Ι. Gelasakis
- Laboratory of Anatomy and Physiology of Farm Animals, Department of Animal Science, School of Animal Biosciences, Iera Odos str. 75, 11855 Athens, GR Greece
| | - Androulla N. Miliotou
- Laboratory of Pharmacology, School of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, GR Greece
| | - Athanasios Angelou
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GR Greece
| | - Konstantinos V. Arsenopoulos
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GR Greece
| | - Sofia Loukeri
- Medical Department Virbac, 13ème Rue, 06511 Carros, France
| | - Elias Papadopoulos
- Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GR Greece
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25
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Ahmad AA, El-Kady AM, Hassan TM. Genotyping of Giardia duodenalis in children in upper Egypt using assemblage- specific PCR technique. PLoS One 2020; 15:e0240119. [PMID: 33002078 PMCID: PMC7529291 DOI: 10.1371/journal.pone.0240119] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/18/2020] [Indexed: 01/25/2023] Open
Abstract
Giardia duodenalis is a common gastrointestinal protozoan parasite, causing diarrheal illness in humans worldwide. Yet, the distribution of G. duodenalis genotypes among human patients and their clinical relevance remains controversial. This study aimed to detect G. duodenalis in children in Upper Egypt and identify causative genotypes and elucidate a possible correlation between genotype and clinical presentation. One hundred sixty-five children, regardless of symptoms, were tested for giardiasis. Giardia positive stool samples (40/165) were subjected to PCR amplification targeting the tpi gene with positive PCR results in only 35 cases (87.5%). Assemblage-specific amplification of genotypes (A, B, and the zoonotic E strains) revealed predominantly G. duodenalis Assemblage A (45.7%). Assemblage B and mixed A and B infections were detected in 31.4% and 22.8% of children, respectively. Assemblage E was not detected. G. duodenalis assemblage A was dominant in children who complained of diarrhea and abdominal cramps. In contrast, asymptomatic children with positive stool samples display a higher frequency of assemblage B and mixed infections. The study highlights the predominance of Giardia Assemblage A in our study locality. This study is the first for this endemic area to use the copro-PCR technique for diagnosis and genotyping of giardiasis. Study results show the value of simple species-specific primers for genotyping in communities with little access to laboratory resources. Further genetic studies are needed to clarify the association between parasite genetic diversity and patient symptomatology.
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Affiliation(s)
| | - Asmaa M. El-Kady
- Department of Medical Parasitology, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Tasneem M. Hassan
- Department of Medical Parasitology, Faculty of Medicine, Assiut University, Assiut, Egypt
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26
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Maasch JRMA, Arzika AM, Cook C, Lebas E, Pilotte N, Grant JR, Williams SA, Keenan JD, Lietman TM, Aiemjoy K. Rectal Swabs as an Alternative Sample Collection Method to Bulk Stool for the Real-Time PCR Detection of Giardia duodenalis. Am J Trop Med Hyg 2020; 103:1276-1282. [PMID: 32524959 PMCID: PMC7470573 DOI: 10.4269/ajtmh.19-0909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/02/2020] [Indexed: 12/19/2022] Open
Abstract
Though bulk stool remains the gold standard specimen type for enteropathogen diagnosis, rectal swabs may offer comparable sensitivity with greater ease of collection for select pathogens. This study sought to evaluate the validity and reproducibility of rectal swabs as a sample collection method for the molecular diagnosis of Giardia duodenalis. Paired rectal swab and bulk stool samples were collected from 86 children ages 0-4 years living in southwest Niger, with duplicate samples collected among a subset of 50 children. Infection was detected using a previously validated real-time PCR diagnostic targeting the small subunit ribosomal RNA gene. Giardia duodenalis was detected in 65.5% (55/84) of bulk stool samples and 44.0% (37/84) of swab samples. The kappa evaluating test agreement was 0.81 (95% CI: 0.54-1.00) among duplicate stool samples (N = 49) and 0.75 (95% CI: 0.47-1.00) among duplicate rectal swabs (N = 48). Diagnostic sensitivity was 93% (95% CI: 84-98) by bulk stool and 63% (95% CI: 49-75) by rectal swabs. When restricting to the lowest three quartiles of bulk stool quantitation cycle values (an indication of relatively high parasite load), sensitivity by rectal swabs increased to 78.0% (95% CI: 64-89, P < 0.0001). These findings suggest that rectal swabs provide less sensitive and reproducible results than bulk stool for the real-time PCR diagnosis of G. duodenalis. However, their fair sensitivity for higher parasite loads suggests that swabs may be a useful tool for detecting higher burden infections when stool collection is excessively expensive or logistically challenging.
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Affiliation(s)
| | | | - Catherine Cook
- Proctor Foundation, University of California San Francisco, San Francisco, California
| | - Elodie Lebas
- Proctor Foundation, University of California San Francisco, San Francisco, California
| | - Nils Pilotte
- Department of Biological Sciences, Smith College, Northampton, Massachusetts
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts
| | - Jessica R. Grant
- Department of Biological Sciences, Smith College, Northampton, Massachusetts
| | - Steven A. Williams
- Department of Biological Sciences, Smith College, Northampton, Massachusetts
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts
| | - Jeremy D. Keenan
- Proctor Foundation, University of California San Francisco, San Francisco, California
| | - Thomas M. Lietman
- Proctor Foundation, University of California San Francisco, San Francisco, California
| | - Kristen Aiemjoy
- Proctor Foundation, University of California San Francisco, San Francisco, California
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
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27
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Ma S, Yan H, Shi W, You Y, Zhong ZD, Hu Y. Giardia lamblia mimicking acute graft versus host disease after allogeneic hematopoietic stem cell transplantation: A case report. Medicine (Baltimore) 2020; 99:e21752. [PMID: 32872067 PMCID: PMC7437731 DOI: 10.1097/md.0000000000021752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE As the major complications post allogeneic hematopoietic stem cell transplantation (allo-HSCT), gastrointestinal disorders were most commonly ascribed to acute graft-versus-host disease (aGVHD) and opportunistic infections. Though Giardia lamblia (G lamblia) is the most common waterborne parasite of intestinal infection worldwide, seldom has it been reported in a patient with acute severe aplastic anemia after allo-HSCT. PATIENT CONCERNS A 23-year-old male with severe aplastic anemia developed diarrhea, abdominal cramps, bloating, nausea, vomiting, fever, weight loss, and fatigue after allo-HSCT. DIAGNOSIS Stool examinations for ova and parasites showed Giardia trophozoites and cysts. INTERVENTIONS Methylprednisolone was stopped and the patient was intravenously treated with a 7-day course of metronidazole (500 mg, tid.). Simultaneously, cyclosporine (5 mg/kg) was continually utilized for suspicious gut GVHD. OUTCOMES The Giardia lamblia in stool turned negative and his symptoms were resolved after the 7-day course. LESSONS Incorporating non-invasive monitoring of stool examination for ova and parasites in the follow-up algorithm for post-HSCT patients can expedite clinical decision-making in the differential diagnoses for aGVHD even in the non-endemic area. Metronidazole therapy can be well-tolerated in HSCT patients with giardiasis.
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28
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Amann SO, Lewis JT, Desai MA, Lewis MD. Common Variable Immunodeficiency Enteropathy With Chronic Giardiasis. Mayo Clin Proc 2020; 95:1293-1294. [PMID: 32498782 DOI: 10.1016/j.mayocp.2020.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Affiliation(s)
| | - Jason T Lewis
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL
| | - Madhura A Desai
- Division of Hospital Radiology, Mayo Clinic, Jacksonville, FL; Division of Neuroradiology, Mayo Clinic, Jacksonville, FL
| | - Michele D Lewis
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.
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Rafiei A, Baghlaninezhad R, Köster PC, Bailo B, Hernández de Mingo M, Carmena D, Panabad E, Beiromvand M. Multilocus genotyping of Giardia duodenalis in Southwestern Iran. A community survey. PLoS One 2020; 15:e0228317. [PMID: 32027684 PMCID: PMC7004373 DOI: 10.1371/journal.pone.0228317] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/13/2020] [Indexed: 02/05/2023] Open
Abstract
Giardia duodenalis is one of the main enteric pathogens associated with diarrheal disease. In developing countries, giardiasis is a major public health concern, particularly in children under five years of age. This study aimed to evaluate the occurrence and genetic diversity of G. duodenalis causing human infections in Shushtar County, Southwestern Iran. Individual faecal specimens were collected from 1,163 individuals (male/female ratio: 0.9; age range 2-75 years) with (n = 258) and without (n = 905) gastrointestinal symptoms living in rural and urban settings during the period 2017-2018. Conventional (sucrose flotation and microscopy) methods were used for the initial detection of G. duodenalis cysts in faecal specimens. Microscopy-positive samples were confirmed by PCR amplification and sequencing of the small subunit rRNA (ssu rRNA) gene of the parasite. A multilocus genotyping (MLG) scheme targeting the triose phosphate isomerase (tpi), the glutamate dehydrogenase (gdh), and the beta-giardin (bg) genes was used for genotyping purposes. Giardia duodenalis cysts were detected in 7.7% (90/1,163) of samples by microscopy, of which 82 were confirmed by ssu-PCR. Successful amplification and sequencing results were obtained for 23.2% (19/82), 9.8% (8/82), and 8.5% (7/82) of the confirmed samples at the tpi, gdh, and bg loci, respectively. MLG data for the three loci were available for two samples only. Out of the 24 samples genotyped at any loci, 50% (12/24) were identified as assemblage A and the remaining half as assemblage B. Overall, AII was the most prevalent sub-assemblage detected (41.7%, 10/24), followed by BIII (25.0%, 6/24), discordant BIII/BIV (5/24) or AII/AIII (2/24) sequences, and BIV (1/24). No significant correlation was demonstrated between a given assemblage/sub-assemblage and the occurrence of clinical symptoms. No genotypes adapted to animal hosts other than humans (e.g. assemblages C-F) were found circulating in the investigated human population, suggesting that transmission of human giardiasis in this Iranian region is primarily of anthroponotic nature. Further molecular-based studies are needed to confirm and expand these results, and to ascertain the presence and public health relevance of the parasite in environmental (e.g. drinking water) samples.
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Affiliation(s)
- Abdollah Rafiei
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
| | - Raheleh Baghlaninezhad
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - Begoña Bailo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - Marta Hernández de Mingo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - Esmat Panabad
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
| | - Molouk Beiromvand
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
- Department of Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran
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30
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La Hoz RM, Morris MI. Intestinal parasites including Cryptosporidium, Cyclospora, Giardia, and Microsporidia, Entamoeba histolytica, Strongyloides, Schistosomiasis, and Echinococcus: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13618. [PMID: 31145496 DOI: 10.1111/ctr.13618] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 01/08/2023]
Abstract
These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of intestinal parasites in the pre- and post-transplant period. Intestinal parasites are prevalent in the developing regions of the world. With increasing travel to and from endemic regions, changing immigration patterns, and the expansion of transplant medicine in developing countries, they are increasingly recognized as a source of morbidity and mortality in solid-organ transplant recipients. Parasitic infections may be acquired from the donor allograft, from reactivation, or from de novo acquisition post-transplantation. Gastrointestinal multiplex assays have been developed; some of the panels include testing for Cryptosporidium, Cyclospora, Entamoeba histolytica, and Giardia, and the performance is comparable to conventional methods. A polymerase chain reaction test, not yet widely available, has also been developed to detect Strongyloides in stool samples. New recommendations have been developed to minimize the risk of Strongyloides donor-derived events. Deceased donors with epidemiological risk factors should be screened for Strongyloides and recipients treated if positive as soon as the results are available. New therapeutic agents and studies addressing the optimal treatment regimen for solid-organ transplant recipients are unmet needs.
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Affiliation(s)
- Ricardo M La Hoz
- Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michele I Morris
- Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida
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Lichtmannsperger K, Hinney B, Joachim A, Wittek T. Molecular characterization of Giardia intestinalis and Cryptosporidium parvum from calves with diarrhoea in Austria and evaluation of point-of-care tests. Comp Immunol Microbiol Infect Dis 2019; 66:101333. [PMID: 31437689 PMCID: PMC7112675 DOI: 10.1016/j.cimid.2019.101333] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/03/2019] [Accepted: 07/10/2019] [Indexed: 02/02/2023]
Abstract
Giardia intestinalis (48/177) and Cryptosporidium parvum (98/177) occur in Austrian calves. C. parvum genotypes IIaA15G2R1, IIaA19G2R2, IIaA21G2R1 and IIaA14G1R1 were found. Giardia intestinalis assemblage E and a single sample of assemblage A were found. Cryptosporidium was detected mostly in the first two weeks of age (72/102). Point-of-care test validity varied greatly for Giardia and Cryptosporidium.
To obtain information about the occurrence and genotype distribution of G. intestinalis and C. parvum in Austrian cattle, faecal samples from diarrhoeic calves younger than 180 days of age originating from 70 farms were examined. Of the 177 faecal samples, 27.1% were positive for Giardia cysts (immunofluorescence microscopy) and 55.4% for Cryptosporidium oocysts (phase-contrast microscopy). Positive samples were characterized by nested PCR for Giardia, 83.3% (triosephosphate isomerase; tpi) and 89.6% (β-giardin; bg) were positive, while the Cryptosporidium nested PCR returned 92.5% (60-kDa glycoprotein) positive results. Sequence analysis revealed one assemblage A-positive sample and 30 (bg) respectively 29 (tpi) assemblage E-positive samples for G. intestinalis. For C. parvum four subtypes within the IIa family (IIaA15G2R1, n = 29; IIaA19G2R2, n = 3; IIaA21G2R1, n = 2; IIaA14G1R1, n = 1) could be differentiated. Validation of two immunochromatographic point-of-care tests resulted in a sensitivity of 29.2% and 77.6%; a specificity of 98.4% and 91.1% for the detection of Giardia intestinalis and Cryptosporidium parvum, respectively. Results confirm the widespread occurrence of both protozoa in diarrhoeic calves in Austria.
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Affiliation(s)
- Katharina Lichtmannsperger
- University Clinic for Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, A-1210 Wien, Austria
| | - Barbara Hinney
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, A-1210 Wien, Austria
| | - Anja Joachim
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, A-1210 Wien, Austria.
| | - Thomas Wittek
- University Clinic for Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, A-1210 Wien, Austria
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Meningher T, Boleslavsky D, Barshack I, Tabibian-Keissar H, Kohen R, Gur-Wahnon D, Ben-Dov IZ, Sidi Y, Avni D, Schwartz E. Giardia lamblia miRNAs as a new diagnostic tool for human giardiasis. PLoS Negl Trop Dis 2019; 13:e0007398. [PMID: 31206518 PMCID: PMC6597124 DOI: 10.1371/journal.pntd.0007398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 06/27/2019] [Accepted: 04/16/2019] [Indexed: 01/15/2023] Open
Abstract
Background Giardia lamblia is a very common cause of gastrointestinal symptoms worldwide. There are several methods for the diagnosis of Giardia infection, however none are ideal. We aim to find a new, microRNA-based method that will improve the currently available diagnostic methods for giardiasis. Methods Deep-sequence profiling of Giardia small-RNA revealed that miR5 and miR6 are highly expressed in Giardia. These miRNAs were tested by qRT-PCR in duodenal biopsies of patients with giardiasis who were positive by microscopic pathological evaluation. The gastric biopsies of the same patients served as negative control tissues. Additionally, these miRNAs were evaluated in stool samples of patients with proven giardiasis. Results All histologically proven duodenal biopsies of patients with Giardia infection were positive for Giardia miR5, with a mean threshold cycle (Ct) of 23.7, as well as for Giardia DNA qPCR (16S-like gene, mean Ct 26.3). Gastric biopsies which were tested as a control all were negative. Stool evaluation of miR6 in patients with giardiasis showed 90% specificity but only 66% sensitivity, and a lower accuracy rate was obtained with miR5. Conclusion Giardia miR5 testing in duodenal biopsies may be a new method for the diagnosis of giardiasis. It seems to be more sensitive when compared with testing for Giardia DNA by qPCR in duodenal biopsies. It will be important to investigate the contribution of routine Giardia miRNA testing in duodenal biopsies from patients with persistent abdominal symptoms Giardiasis is a major cause of diarrheal disease throughout the world. It is more common in areas with poor sanitation such as in many low-income countries, but it occurs in high-income countries as well. It is the most commonly identified intestinal parasite in the United States and it is endemic in other industrialized countries. The causative agent is the flagellate protozoan Giardia lamblia, and transmission is mainly by the fecal-oral route. The basic method of diagnosis is stool examination. It is usually found through stool microscopy examination which should be performed on fresh stool and repeated in 3 days. Despite some newer diagnostic methods, Giardia is still difficult to detect, often leading to misdiagnoses. In this study we show that using Giardia microRNA (miR5) as a marker for Giardia infection in duodenal biopsies may be a new method for diagnosis of giardiasis. It appears to be more sensitive than histological diagnosis and also more sensitive than Giardia DNA testing in duodenal biopsies. Interestingly, in our patients, duodenal biopsies were done for persistent abdominal symptoms and the finding of Giardia in their biopsy was unexpected. Thus, testing duodenal biopsies for Giardia miRNA in patients with persistent abdominal symptoms might contribute to diagnosis and prompt treatment for those with giardiasis.
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Affiliation(s)
- Tal Meningher
- Laboratory of Molecular Cell Biology, Sheba Medical Center, Ramat Gan, Israel
- Department of Medicine C, Sheba Medical Center, Ramat Gan, Israel
- Molecular Laboratory for the Study of Tropical Diseases, Sheba Medical Center, Ramat Gan, Israel
| | | | - Iris Barshack
- Department of Pathology, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hila Tabibian-Keissar
- Department of Pathology, Sheba Medical Center, Ramat Gan, Israel
- The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Refael Kohen
- Israel National Center for Personalized Medicine, Weizmann Institute of Science, Rehovot, Israel
| | - Devorah Gur-Wahnon
- Laboratory of Medical Transcriptomics, Nephrology and Hypertension Services, Hadassah—Hebrew University Medical Center, Jerusalem, Israel
| | - Iddo Z. Ben-Dov
- Laboratory of Medical Transcriptomics, Nephrology and Hypertension Services, Hadassah—Hebrew University Medical Center, Jerusalem, Israel
| | - Yechezkel Sidi
- Laboratory of Molecular Cell Biology, Sheba Medical Center, Ramat Gan, Israel
- Department of Medicine C, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dror Avni
- Laboratory of Molecular Cell Biology, Sheba Medical Center, Ramat Gan, Israel
- Department of Medicine C, Sheba Medical Center, Ramat Gan, Israel
- Molecular Laboratory for the Study of Tropical Diseases, Sheba Medical Center, Ramat Gan, Israel
- * E-mail: , (DA); (ES)
| | - Eli Schwartz
- Molecular Laboratory for the Study of Tropical Diseases, Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Center for Geographic Medicine, Sheba Medical Center, Ramat Gan, Israel
- * E-mail: , (DA); (ES)
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Hurník P, Žiak D, Dluhošová J, Židlík V, Šustíková J, Uvírová M, Urban O, Dvořáčková J, Nohýnková E. Another case of coincidental Giardia infection and pancreatic cancer. Parasitol Int 2019; 71:160-162. [PMID: 31002881 DOI: 10.1016/j.parint.2019.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 04/12/2019] [Accepted: 04/14/2019] [Indexed: 11/17/2022]
Abstract
Until now, few cases of coincidental giardiasis and pancreatic tumors have been described. Among these cases, three described giardiasis cases coincided with confirmed pancreatic cancer. We present another case of Giardia infection coexisting with pancreatic cancer in a 67-year-old man who suffered from stenosis of the distal ductus choledochus combined with a hypoechoic mass in the head of the pancreas. The diagnostic conclusion of suspicious adenocarcinoma was based on endoscopic ultrasound fine-needle aspiration (EUS-FNA) biopsy and confirmed by a partial duodenopancreatectomy. On bloody cytology smears prepared from the EUS-FNA specimen, trophozoites of Giardia intestinalis accompanying an inflammatory background and features that fulfilled the morphological criteria of malignancy were observed. In histological sections from the duodenopancreatectomy specimens, the parasites were observed attached to the epithelium, but individual Giardia parasites were also observed beneath the epithelial lining. According to conventional genotyping, the infecting Giardia belonged to sub-assemblage AII.
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Affiliation(s)
- P Hurník
- Department of Pathology, Faculty Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; Department of Pathology, CGB Laboratory, Ostrava, Czech Republic
| | - D Žiak
- Department of Pathology, Faculty Hospital Ostrava, Ostrava, Czech Republic; Department of Pathology, CGB Laboratory, Ostrava, Czech Republic
| | - J Dluhošová
- Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - V Židlík
- Department of Pathology, Faculty Hospital Ostrava, Ostrava, Czech Republic; Department of Pathology, CGB Laboratory, Ostrava, Czech Republic
| | - J Šustíková
- Department of Pathology, Faculty Hospital Ostrava, Ostrava, Czech Republic; Department of Pathology, CGB Laboratory, Ostrava, Czech Republic
| | - M Uvírová
- Department of Pathology, Faculty Hospital Ostrava, Ostrava, Czech Republic; Department of Pathology, CGB Laboratory, Ostrava, Czech Republic
| | - O Urban
- AGEL Research and Training Institute - Ostrava-Vitkovice Branch, Ostrava-Vitkovice Hospital, Center of Care for the Gastrointestinal Tract, Ostrava, Czech Republic
| | - J Dvořáčková
- Department of Pathology, Faculty Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; Department of Pathology, CGB Laboratory, Ostrava, Czech Republic
| | - E Nohýnková
- Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
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Kimirilova OG, Kharchenko GA. [The results of the diagnosis of giardiasis in children with the use of the method of microscopy, enzyme immunoassay, polymerase chain reaction.]. Klin Lab Diagn 2019; 64:376-379. [PMID: 31200411 DOI: 10.18821/0869-2084-2019-64-6-376-379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
Giardiasis in children remains an urgent problem, the importance of which is determined by the endemicity for many countries and regions, polymorphism of the clinic, which causes difficulties in clinical diagnosis of this pathology. The report presents the results of the diagnostic significance of methods of laboratory diagnostics giardiase: microscopy of native and stained with Lugol solution preparation fecal enzyme-linked immunoassay (ELISA) for the presence of antibodies of class IgM and IgG antibodies to the antigens of Giardia in the serum and antigen of G. Lamblia in feces, polymerase chain reaction (PCR) - detection of Giardia DNA in feces obtained during the examination of 160 patients with giardiasis children aged 3 to 14 years. The results of our study suggest that the most informative methods of diagnosis of giardiasis in children is coproscopy (specificity - 96.2%, sensitivity - 98.1%), PCR coprofiltrate. (specificity - 85%, sensitivity 82.5%), determination of antigen in feces by ELISA (specificity - 87,5%, sensitivity - 60%). With high specificity of the blood ELISA method (90%), the sensitivity of the method is only 27.5%. It should be recognized that the «gold standard» diagnosis of giardiasis remains microscopy of native and stained with a solution of Lugol preparation of feces with a three - time study at intervals of 2-3 days.
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Affiliation(s)
- O G Kimirilova
- Astrakhan State Medical University, 414000, Astrakhan, Russia
| | - G A Kharchenko
- Astrakhan State Medical University, 414000, Astrakhan, Russia
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Corleto VD, Di Marino VP, Galli G, Antonelli G, Coluccio C, Di Cerbo A, Uccini S, Annibale B. Improving basic skills in celiac-like disease diagnosis: a case report. BMC Gastroenterol 2018; 18:162. [PMID: 30390626 PMCID: PMC6215663 DOI: 10.1186/s12876-018-0894-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 10/23/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The diagnosis of Coeliac disease (CD) requires a combination of sign/symptoms, positivity of specific antibodies and duodenal histological evidence of villous atrophy. Duodenal villous atrophy, despite representing the CD landmark, is not specific since it is found in many gastrointestinal disorders. Giardiasis is one of the most common human intestinal protozoan infestations in industrialized countries whose histological duodenal mucosa damage could mimic that of CD. The present report shows how a wise clinical and laboratory assessment led us shortly to a correct diagnosis. CASE PRESENTATION A 42-year-old outpatient woman without previous significant gastrointestinal diseases, was referred with dyspeptic symptoms, fatigue and mild diarrhea from 4 months. Her first investigations including immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (anti-tTG) and stool parasitological and cultural analysis were negative. An esophagogastroduodenoscopy (EGDS) showed no mucosal alteration. But histology demonstrated a Helicobacter Pylori (HP) pan-gastritis while duodenal mucosa showed villous atrophy consistent with a diagnosis of CD Marsh type 3b. While on gluten-free diet (GFD) the patient didn't experience any improvement of symptoms. Duodenal biopsies were then reviewed showing the presence of trophozoites of Giardia on the luminal surface of the duodenal wall and at the same time, a second stool examination revealed the presence of trophozoites and cysts of Giardia. Treated with metronidazole, 500 mg twice daily for 6 days the patient reduced diarrhea after few days. After about 2 months of GFD she was invited to discontinue it. At the same time stool examination was repeated with negative results. She subsequently performed eradication for Hp with triple therapy (Pylera®). Around 6 months later, the patient did not complain any gastrointestinal symptoms. Serological tests were normal and at a follow-up EGDS, duodenal mucosa had normal histology with normal finger-like villi and absence of Giardia trophozoites. CONCLUSION This case report shows how CD diagnosis can sometimes be manifold. Intestinal villous atrophy alone may not automatically establish a diagnosis of CD. In the present case the clinical scenario could be fully explained by giardiasis. Indeed, different diagnostic tools and a multi-step approaches have been used to determine the final correct diagnosis.
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Affiliation(s)
- Vito Domenico Corleto
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
- grid.7841.aDigestive Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Vincenza Patrizia Di Marino
- grid.7841.aPaedriatic Allergology, Allergology Unit, “Policlinico Umberto I” University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Gloria Galli
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Giulio Antonelli
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Coluccio
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Arcangelo Di Cerbo
- grid.7841.aPathology Unit, Azienda Ospedaliera Sant’Andrea, “Sapienza” University of Rome, Rome, Italy
| | - Stefania Uccini
- grid.7841.aPathology Unit, Azienda Ospedaliera Sant’Andrea, “Sapienza” University of Rome, Rome, Italy
| | - Bruno Annibale
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
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Bodnya K, Marchenko O, Shevchenko L, Bodnya I. [THE ITERATIVE APPROACH TO PRICING LABORATORY SERVICES FOR THE PROVISION OF MEDICAL AID (COPROPROCYCOSOPHICAL EXAMINATION ON LYAMBLIOSIS)]. Georgian Med News 2018:136-140. [PMID: 30618406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The purpose of the study was to substantiate the theoretical and methodical principles of pricing for laboratory services in the diagnosis of giardiasis, taking into account their iterability and peculiarities of parasitic research methods. The methods of laboratory study of gum disease of native smear, treated with Lyulol solution, and ether-formalin enrichment on the criteria of their quality and effectiveness are analyzed. On the basis of the study of the effectiveness of the first and repeated analyzes, the conclusion on the iterative nature of laboratory studies of giardiasis and the effectiveness of the use of an iterative approach to the determination of prices for laboratory services is substantiated. The approaches to pricing laboratories providing diagnostic services for giardiasis in Ukraine are analyzed. The necessity of applying the price trajectory for laboratory diagnosis of giardiasis on the basis of multiplicity of researches (interactive approach) and the determination of the minimum and maximum price levels (the minimax approach) is proved. The main factors of pricing for laboratory diagnostics of giardiasis are identified and characterized: iterative research, economic efficiency, social value, value for the patient, competitiveness and reputation.
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Affiliation(s)
- K Bodnya
- Kharkiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine; Yaroslav Mudriy National Law University, Kharkiv, Ukraine
| | - O Marchenko
- Kharkiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine; Yaroslav Mudriy National Law University, Kharkiv, Ukraine
| | - L Shevchenko
- Kharkiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine; Yaroslav Mudriy National Law University, Kharkiv, Ukraine
| | - I Bodnya
- Kharkiv Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine; Yaroslav Mudriy National Law University, Kharkiv, Ukraine
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Shin JH, Lee SE, Kim TS, Ma DW, Cho SH, Chai JY, Shin EH. Development of Molecular Diagnosis Using Multiplex Real-Time PCR and T4 Phage Internal Control to Simultaneously Detect Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis from Human Stool Samples. Korean J Parasitol 2018; 56:419-427. [PMID: 30419727 PMCID: PMC6243187 DOI: 10.3347/kjp.2018.56.5.419] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 11/25/2022]
Abstract
This study aimed to develop a new multiplex real-time PCR detection method for 3 species of waterborne protozoan parasites (Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis) identified as major causes of traveler's diarrhea. Three target genes were specifically and simultaneously detected by the TaqMan probe method for multiple parasitic infection cases, including Cryptosporidium oocyst wall protein for C. parvum, glutamate dehydrogenase for G. lamblia, and internal transcribed spacer 1 for C. cayetanensis. Gene product 21 for bacteriophage T4 was used as an internal control DNA target for monitoring human stool DNA amplification. TaqMan probes were prepared using 4 fluorescent dyes, FAMTM, HEXTM, Cy5TM, and CAL Fluor Red® 610 on C. parvum, G. lamblia, C. cayetanensis, and bacteriophage T4, respectively. We developed a novel primer-probe set for each parasite, a primer-probe cocktail (a mixture of primers and probes for the parasites and the internal control) for multiplex real-time PCR analysis, and a protocol for this detection method. Multiplex real-time PCR with the primer-probe cocktail successfully and specifically detected the target genes of C. parvum, G. lamblia, and C. cayetanensis in the mixed spiked human stool sample. The limit of detection for our assay was 2×10 copies for C. parvum and for C. cayetanensis, while it was 2×103 copies for G. lamblia. We propose that the multiplex real-time PCR detection method developed here is a useful method for simultaneously diagnosing the most common causative protozoa in traveler's diarrhea.
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Affiliation(s)
- Ji-Hun Shin
- Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul 03080, Korea
| | - Sang-Eun Lee
- Division of Vectors and Parasitic Diseases, Korea Centers for Disease Control and Prevention, Cheongju 28159, Korea
| | - Tong Soo Kim
- Department of Tropical Medicine and Inha Research Institute for Medical Sciences, Inha University School of Medicine, Incheon 22212, Korea
| | - Da-Won Ma
- Division of Vectors and Parasitic Diseases, Korea Centers for Disease Control and Prevention, Cheongju 28159, Korea
| | - Shin-Hyeong Cho
- Division of Vectors and Parasitic Diseases, Korea Centers for Disease Control and Prevention, Cheongju 28159, Korea
| | - Jong-Yil Chai
- Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul 03080, Korea
| | - Eun-Hee Shin
- Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul 03080, Korea
- Seoul National University Bundang Hospital, Seongnam 13620, Korea
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Morais RJ, Nunes ACR, Gullo I, Cardoso H, Andrade AP, Peixoto A, Rios E, Macedo G. Pseudolymphomatous nodular lymphoid hyperplasia of small bowel. Clin Res Hepatol Gastroenterol 2018; 42:289-290. [PMID: 28595978 DOI: 10.1016/j.clinre.2017.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/09/2017] [Accepted: 04/28/2017] [Indexed: 02/04/2023]
Affiliation(s)
- Rui Jorge Morais
- Gastroenterology Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Amadeu C R Nunes
- Gastroenterology Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Irene Gullo
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
| | - Hélder Cardoso
- Gastroenterology Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Ana Patricia Andrade
- Gastroenterology Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Armando Peixoto
- Gastroenterology Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Elisabete Rios
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department, Centro Hospitalar de São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
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Abstract
BACKGROUND Giardiasis is one of the most prevalent intestinal protozoa infections in humans. Nowadays, nitric oxide (NO) is known to be involved in the immune system against Giardia intestinalis. Therefore, the aim of the present study was to evaluate the level of NO in individuals with giardiasis in comparison to normal subjects. METHODS This descriptive study was conducted among 49 Giadia positive and 39 age and gender matched healthy volunteers. Examination of stool samples was done by wet mount technique and formol-ether concentration method. Serum samples were obtained for laboratory examination. NO production was quantified by measuring nitrite, a stable end product of NO, using the Griess reaction based on ELISA method. By using the standard curve in Excel program, the concentration of NO2- in samples was obtained. Finally, all data were analyzed using SPSS version 17. RESULTS Values obtained from NO assays were placed into 4 groups: ≤ 10 (decline), 10.01 - 15 (normal), 15.01 - 25 (increase), and more than 25 µM (sharp increase). The mean level of NO in patients with G. intestinalis was 32.19 ± 2.15 µM and in people without G. intestinalis was 17.1 ± 1.33 µM. Eight point two percent of patients with Giardiasis were in normal range, but 2%, 20.4%, and 69.4% were in decline, increase, and sharp increase ranges, respectively. In group 2 (without infection), 17.9% were in normal range, and 20.5%, 51.3%, and 10.3% were in decline, increase, and sharp increase ranges, respectively. There was a statistical difference in nitric oxide levels between positive and negative groups with a 95% confidence interval. (p-value = 0.001). CONCLUSIONS In our study, the number of people who showed a sharp increase in NO levels was significantly higher in individuals with giardiasis as compared to the control group, and patients infected with giardiasis showed significant increase in NO levels. Therefore, we suggest that further studies are required to understand the exact function of NO in the immune system against giardiasis in humans. It will be important to offer a new therapeutic target for eliminating G. intestinalis.
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Nooshadokht M, Kalantari-Khandani B, Sharifi I, Kamyabi H, Liyanage NPM, Lagenaur LA, Kagnoff MF, Singer SM, Babaei Z, Solaymani-Mohammadi S. Stool antigen immunodetection for diagnosis of Giardia duodenalis infection in human subjects with HIV and cancer. J Microbiol Methods 2017; 141:35-41. [PMID: 28716658 DOI: 10.1016/j.mimet.2017.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 01/18/2023]
Abstract
Human infection with the protozoan parasite Giardia duodenalis is one the most common parasitic diseases worldwide. Higher incidence rates of giardiasis have been reported from human subjects with multiple debilitating chronic conditions, including hypogammaglobulinemia and common variable immunodeficiency (CVID). In the current study, stool specimens were collected from 199 individuals diagnosed with HIV or cancer and immunocompetent subjects. The sensitivity of microscopy-based detection on fresh stool preparations, trichrome staining and stool antigen immunodetection for the diagnosis of G. duodenalis were 36%, 45.5% and 100%, respectively when compared with a highly sensitive stool-based PCR method as the gold standard. Further multilocus molecular analyses using glutamate dehydrogenase (gdh) and triose phosphate isomerase (tpi) loci demonstrated that the AI genotype of G. duodenalis was the most prevalent, followed by the AII genotype and mixed (AI+B) infections. We concluded that stool antigen immunodetection-based immunoassays and stool-based PCR amplification had comparable sensitivity and specificity for the diagnosis of G. duodenalis infections in these populations. Stool antigen detection-based diagnostic modalities are rapid and accurate and may offer alternatives to conventional microscopy and PCR-based diagnostic methods for the diagnosis of G. duodenalis in human subjects living with HIV or cancer.
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Affiliation(s)
- Maryam Nooshadokht
- Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Iraj Sharifi
- Leishmaniasis Research Center, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Kamyabi
- Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Namal P M Liyanage
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH, USA
| | | | - Martin F Kagnoff
- Laboratory of Mucosal Immunology, School of Medicine, University of California, San Diego, California, USA
| | - Steven M Singer
- Department of Biology and Center for Infectious Disease, Georgetown University, Washington D.C., USA
| | - Zahra Babaei
- Leishmaniasis Research Center, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Azcona-Gutiérrez JM, de Lucio A, Hernández-de-Mingo M, García-García C, Soria-Blanco LM, Morales L, Aguilera M, Fuentes I, Carmena D. Molecular diversity and frequency of the diarrheagenic enteric protozoan Giardia duodenalis and Cryptosporidium spp. in a hospital setting in Northern Spain. PLoS One 2017; 12:e0178575. [PMID: 28617836 PMCID: PMC5472271 DOI: 10.1371/journal.pone.0178575] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/15/2017] [Indexed: 11/18/2022] Open
Abstract
Background Human giardiosis and cryptosporidiosis are caused by the enteric protozoan parasites Giardia duodenalis and Cryptosporidium spp. Both pathogens are major contributors to the global burden of diarrhoeal disease, affecting primarily children and immunodebilitated individuals in resource-poor settings. Giardiosis and cryptosporidiosis also represent an important, often underestimate, public health threat in developed countries. In Spain only limited information is currently available on the epidemiology of these infections. Molecular data on the diversity, frequency, geographical distribution, and seasonality of G. duodenalis assemblages/sub-assemblages and Cryptosporidium species/sub-genotypes are particularly scarce. Methods A longitudinal molecular epidemiological survey was conducted between July 2015 to September 2016 in patients referred to or attended at the Hospital San Pedro (La Rioja, Northern Spain) that tested positive for G. duodenalis (N = 106) or Cryptosporidium spp. (N = 103) by direct microscopy and/or a rapid lateral flow immunochromatographic assay. G. duodenalis infections were subsequently confirmed by real-time PCR and positive isolates assessed by multi-locus sequence genotyping of the glutamate dehydrogenase and β-giardin genes of the parasite. Cryptosporidium species and sub-genotypes were investigated at the 60 kDa glycoprotein or the small subunit ribosomal RNA genes of the parasite. Sociodemographic and clinical parameters of infected patients were also gathered and analysed. Principal findings Out of 90 G. duodenalis-positive isolates by real-time PCR a total of 16 isolates were successfully typed. AII (44%, 7/16) was the most prevalent sub-assemblage found, followed by BIV (31%, 5/16) and BIII (19%, 3/16). A discordant genotype result AII/AIII was identified in an additional (6%, 1/16) isolate. No mixed infections A+B were detected. Similarly, a total of 81 Cryptosporidium spp. isolates were successfully typed, revealing the presence of C. hominis (81%, 66/81) and C. parvum (19%, 15/81). Obtained GP60 sequences were assigned to sub-type families Ib (73%, 59/81) within C. hominis, and IIa (7%, 6/81) and IId (2%, 2/81) within C. parvum. A marked inter-annual variation in Cryptosporidium cases was observed. Conclusions Human giardiasis and cryptosporidiosis are commonly identified in patients seeking medical care in Northern Spain and represent a more important health concern than initially thought. Assemblage A within G. duodenalis and sub-genotype IbA10G2 within C. hominis were the genetic variants of these parasite species more frequently found circulating in the population under study. Molecular data presented here seem to suggest that G. duodenalis and Cryptosporidium infections arise through anthroponotic rather than zoonotic transmission in this Spanish region.
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Affiliation(s)
| | - Aida de Lucio
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | | | | | | | - Lucía Morales
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - María Aguilera
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - Isabel Fuentes
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - David Carmena
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
- * E-mail:
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ALEXANDER CL, CURRIE S, POLLOCK K, SMITH-PALMER A, JONES BL. An audit of Cryptosporidium and Giardia detection in Scottish National Health Service Diagnostic Microbiology Laboratories. Epidemiol Infect 2017; 145:1584-1590. [PMID: 28274291 PMCID: PMC9203310 DOI: 10.1017/s0950268817000462] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 01/04/2023] Open
Abstract
Giardia duodenalis and Cryptosporidium species are protozoan parasites capable of causing gastrointestinal disease in humans and animals through the ingestion of infective faeces. Whereas Cryptosporidium species can be acquired locally or through foreign travel, there is the mis-conception that giardiasis is considered to be largely travel-associated, which results in differences in laboratory testing algorithms. In order to determine the level of variation in testing criteria and detection methods between diagnostic laboratories for both pathogens across Scotland, an audit was performed. Twenty Scottish diagnostic microbiology laboratories were invited to participate with questions on sample acceptance criteria, testing methods, testing rates and future plans for pathogen detection. Reponses were received from 19 of the 20 laboratories representing each of the 14 territorial Health Boards. Detection methods varied between laboratories with the majority performing microscopy, one using a lateral flow immunochromatographic antigen assay, another using a manually washed plate-based enzyme immunoassay (EIA) and one laboratory trialling a plate-based EIA automated with an EIA plate washer. Whereas all laboratories except one screened every stool for Cryptosporidium species, an important finding was that significant variation in the testing algorithm for detecting Giardia was noted with only four laboratories testing all diagnostic stools. The most common criteria were 'travel history' (11 laboratories) and/or 'when requested' (14 laboratories). Despite only a small proportion of stools being examined in 15 laboratories for Giardia (2%-18% of the total number of stools submitted), of interest is the finding that a higher positivity rate was observed for Giardia than Cryptosporidium in 10 of these 15 laboratories. These findings highlight that the underreporting of Giardia in Scotland is likely based on current selection and testing algorithms.
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Affiliation(s)
- C. L. ALEXANDER
- Scottish Parasite Diagnostic and Reference Laboratory, Glasgow, Scotland, UK
| | - S. CURRIE
- Scottish Parasite Diagnostic and Reference Laboratory, Glasgow, Scotland, UK
| | - K. POLLOCK
- Health Protection Scotland, Glasgow, Scotland, UK
| | | | - B. L. JONES
- Scottish Parasite Diagnostic and Reference Laboratory, Glasgow, Scotland, UK
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Toledo RDS, Martins FDC, Ferreira FP, de Almeida JC, Ogawa L, dos Santos HLEPL, dos Santos MM, Pinheiro FA, Navarro IT, Garcia JL, Freire RL. Cryptosporidium spp. and Giardia spp. in feces and water and the associated exposure factors on dairy farms. PLoS One 2017; 12:e0175311. [PMID: 28403147 PMCID: PMC5389815 DOI: 10.1371/journal.pone.0175311] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 03/23/2017] [Indexed: 12/04/2022] Open
Abstract
The aims of this study were to verify the prevalence of Cryptosporidium spp. and Giardia spp. in animal feces and drinking water on dairy farms and to identify a possible relation between the exposure factors and the presence of these parasites. Fecal samples from cattle and humans and water samples were collected on dairy farms in Paraná, Brazil. Analysis of (oo)cysts in the feces was performed by the modified Ziehl-Neelsen staining and centrifugal flotation in zinc sulfate. Test-positive samples were subjected to nested PCR amplification of the 18SSU ribosomal RNA gene for identification of Cryptosporidium and Giardia and of the gp60 gene for subtyping of Cryptosporidium. Microbiological analysis of water was carried out by the multiple-tube method and by means of a chromogenic substrate, and parasitological analysis was performed on 31 samples by direct immunofluorescence and nested PCR of the genes mentioned above. Identification of the species of Cryptosporidium was performed by sequencing and PCR with analysis of restriction fragment length polymorphisms. The prevalence of Giardia and Cryptosporidium was higher in calves than in adults. Among the samples of cattle feces, Cryptosporidium parvum was identified in 41 (64%), C. ryanae in eight (12.5%), C. bovis in four (6.3%), C. andersoni in five (7.8%), and a mixed infection in 20 samples (31.3%). These parasites were not identified in the samples of human feces. Thermotolerant coliform bacteria were identified in 25 samples of water (45.5%). Giardia duodenalis and C. parvum were identified in three water samples. The gp60 gene analysis of C. parvum isolates revealed the presence of two strains (IIaA20G1R1 and IIaA17G2R2) in the fecal samples and one (IIaA17G2R1) in the water samples. The presence of coliforms was associated with the water source, structure and degradation of springs, rain, and turbidity. The prevalence of protozoa was higher in calves up to six months of age. C. parvum and G. duodenalis were identified in the water of dairy farms, as were thermotolerant coliforms; these findings point to the need for guidance on handling of animals, preservation of water sources, and water treatment.
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Affiliation(s)
- Roberta dos Santos Toledo
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
| | - Felippe Danyel Cardoso Martins
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
| | - Fernanda Pinto Ferreira
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
| | - Jonatas Campos de Almeida
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
| | - Liza Ogawa
- Centro de Ciências Agrárias, Universidade Estadual Norte do Paraná (UENP), Bandeirantes, Paraná, Brasil
| | | | - Maíra Moreira dos Santos
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
| | - Filipe Aguera Pinheiro
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
| | - Italmar Teodorico Navarro
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
| | - João Luis Garcia
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
| | - Roberta Lemos Freire
- Departamento de Medicina Veterinária Preventiva (DMVP), Universidade Estadual de Londrina (UEL), Londrina, Paraná, Brasil
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El-Adaway AI, Elmallawnay MA, Mahnoush RKM, Hassamom OM. SUCROSE DENSITY-GRADIENT ISOLATION METHOD INTENDED FOR IMPROVEMENT OF SAMPLE PURITY PRIOR TO AMPLIFICATION OF GIARDIA B-GIARDIN GENE. J Egypt Soc Parasitol 2017; 47:107-112. [PMID: 30157338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PCR-based methods have been widely used for detection of Giardia in stool. The sensitivity and hence degree of success of the molecular tool depends on many factors including efficiency of DNA extraction method, in addition to the degree of purity which necessitate removal of a great number of inhibitors from the stool samples. Therefore, Sucrose density gradient isolation method was assessed in this study to be applied prior to nucleic acid extraction and amplification of Giardia duodenalis in stool samples. The methods: Two different approaches were applied in this study to amplify P-giardin gene specific for Giardia duodenalis (syn. G. intestinalis, G. lamblia) using 30 microscopically Giardia positive fecal sam- ples. A) Direct nucleic acid extraction using QIAamp Mini spin columns B) Sucrose density-gradient isolation method prior to DNA extraction using the same extraction Kit. The property of the extracted samples was determined by Spectrophotometric analysis at 260 and at 280 nm. The results showed that in spite of the significant larger amount of nucleic acid obtained by method (A) versus method (B), more pure form of DNA was encountered by method (B) than method (A). Purity encountered by 'method (A) reflected protein contamination of the samples. Following nested PCR reaction, 28 samples of group (B) showed positive bands (511pb), while 8 samples from group (A) failed to be amplified.
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Affiliation(s)
- Corrado Minetti
- Vector Biology Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Rachel M Chalmers
- Cryptosporidium Reference Unit, Public Health Wales Microbiology ABM, Singleton Hospital, Swansea, UK
| | - Nick J Beeching
- Clinical Sciences Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Chris Probert
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
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Ghoshal U, Shukla R, Pant P, Ghoshal UC. Frequency, diagnostic performance of coproantigen detection and genotyping of the Giardia among patients referred to a multi-level teaching hospital in northern India. Pathog Glob Health 2016; 110:316-320. [PMID: 27852150 PMCID: PMC5189869 DOI: 10.1080/20477724.2016.1254141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Giardiasis, a common gastrointestinal parasitic infection in tropics, is diagnosed on stool microscopy (gold standard); however, its sensitivity is low due to intermittent fecal shedding. Coproantigen detection (ELISA) is useful but requires further evaluation. We aimed to study: (a) detection of Giardia by stool microscopy and/or coproantigen, (b) diagnostic performance of fecal antigen detection and microscopy, and c) genotypic characterization of G. lamblia using PCR specific for triose phosphate isomerase (tpi) gene. Stool samples from 2992 patients were examined by microscopy from March 2013 to March 2015 in a multi level teaching hospital in northern India. Giardia coproantigen detection was performed by ELISA in a subset of patients. Genetic characterization of G. lamblia was performed by PCR targeting tpi gene in a subset of microscopy positive stool samples. Of 2992 patients, 132 (4.4%) had Giardia by microscopy (cyst/trophozoite) and/or ELISA. ELISA was performed in 264 patients; of them, 127 were positive by microscopy. Sensitivity, specificity, positive and negative predictive values of ELISA were 91, 91, 94, and 91%, respectively, using microscopy as a gold standard. PCR was performed in 116 randomly selected samples having Giardia using tpi gene. Assemblages A and B were found among 44 (38%) and 72 (62%) patients, respectively. Assemblage B was more often associated with malnutrition and loss of appetite than A (48/72 [67%] vs. 21/44 [48%], P = 0.044 and 17/72 [24%] vs. 14/44 [32%], P = 0.019). We conclude that 4.4% of studied population had giardiasis. Fecal antigen is a useful method for diagnosis and assemblage B is the most common genotype.
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Affiliation(s)
- Ujjala Ghoshal
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Ratnakar Shukla
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Priyannk Pant
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Uday C. Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Madbouly NA, Farid A, El-Badry AA, El-Amir AM. IMMUNE-MOLECULAR IDENTIFICATION OF GIARDIA INTESTINALIS IN DIARRHOEAL CHILDREN: COMPARISON OF THREE DIAGNOSTIC METHODS. J Egypt Soc Parasitol 2016; 46:253-260. [PMID: 30152936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Giardiasis is a major health problem in both developed and developing world. A variety of methods for diagnosis of Giardia duodenalis cysts or trophozoites is available but still has certain limitations. 100 sample from diarrhoeal children who attending outpatient clinic in Abu El Rish hospital, .Kasr Al Ainy, Faculty of Medicine, Cairo University, Egypt. Giardiasis was diagnosed by direct wet mount, microscopy after formal- ethyl acetate concentration, Ridascreen ELISA assay and n-PCR targeting beta giardin (bg) gene. Using ELISA as reference standard, the methods' sensitivities, specificities, positive (PPV) and negative (NPV) predictive values and positive (LR+) and negative (LR-) likelihood ratios with 95% confidence interval (95% CI) were analyzed.The diagnostic methods were evaluated to determine their impact on the posttest probability using Fagan's nomogram. All the studied methods led to a LR+ higher than 10 indicating ability to ruling in giardiasis. n-PCR recorded LR- equal 0.00 and the probability of giardiasis would be 0% if the test was negative. The methods were also ranked on basis of Multiattribute utility theory and Analytical hierarchy process with ELISA ranked better than n-PCR.
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Del Pilar-Morales EA, Cardona-Rodríguez Z, Bertrán-Pasarell J, Soto-Malave R, De León-Borras R. Multiple Simultaneous Gastrointestinal Parasitic Infections in a Patient with Human Immunodeficiency Virus. P R Health Sci J 2016; 35:97-99. [PMID: 27232872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Patients with the human immunodeficiency virus (HIV) infection are at high risk for gastrointestinal infections causing diarrhea, particularly when those infections are parasitic in nature. This propensity is more pronounced in AIDS, where opportunistic parasitic infections may cause severe diarrhea, marked absorptive dysfunction, and significant risk of mortality. There are scant data regarding parasitic infections among HIV patients in the developed world; most studies and research come from povertystricken areas of South Africa, India, Iran, and the South Pacific. Although multiple infections with the same or different parasites have been reported, simultaneous infections are rare. We present the case of a 35-year-old man who developed a co-infection with Giardia, Cryptosporidium, and Strongyloides, simultaneously, the diagnosis being made after the judicious evaluation of a stool sample. Given the associated morbidity, prompt diagnosis and treatment are needed to avoid further complications in patients with HIV. To our knowledge this is the first reported case of triple parasitic infection in a patient with HIV.
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Affiliation(s)
- Esteban A Del Pilar-Morales
- Infectious Diseases Department, University Hospital, University of Puerto Rico Medical Sciences Campus, San Juan, PR
| | - Zaydalee Cardona-Rodríguez
- Infectious Diseases Department, University Hospital, University of Puerto Rico Medical Sciences Campus, San Juan, PR
| | - Jorge Bertrán-Pasarell
- Infectious Diseases Department, University Hospital, University of Puerto Rico Medical Sciences Campus, San Juan, PR
| | - Ruth Soto-Malave
- Infectious Diseases Department, University Hospital, University of Puerto Rico Medical Sciences Campus, San Juan, PR
| | - Rafeal De León-Borras
- Internal Medicine Department, University of Puerto Rico Medical Sciences Campus, San Juan, PR
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Tan L, Wu S, Abdullahi AY, Yu X, Hu W, Song M, Shi X, Li G. PCR-RFLP method to detect zoonotic and host-specific Giardia duodenalis assemblages in dog fecal samples. Parasitol Res 2016; 115:2045-50. [PMID: 26852125 DOI: 10.1007/s00436-016-4948-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 01/29/2016] [Indexed: 11/26/2022]
Abstract
Giardia duodenalis is a zoonotic protozoan that parasitizes the upper small intestine of human and many mammals including dogs. To develop a restriction fragment length polymorphism (RFLP) method for typing zoonotic (A, B) and host-specific (C, D) assemblages of G. duodenalis from dog, β-giardin gene was amplified with design primer pairs B3 and B4. The PCR products were digested with restriction enzyme Afa I and Msp I; then, PCR-RFLP method was compared with HRM genotyping and sequencing method for G. duodenalis from dog. The results showed that each of assemblages A-D had unique restriction pattern, which was consistent with the predictive results. Among 21 samples tested by PCR-RFLP, 1 human-derived and 8 dog-derived G. duodenalis were identified as assemblage A; 5 dog-derived G. duodenalis as assemblage C; 7 dog-derived G. duodenalis as assemblage D, which were coincided with the HRM genotyping and sequencing results. It is concluded that the PCR-RFLP is quick, easy, and accurate method for the sequence typing of G. duodenalis zoonotic and specific assemblages from dogs.
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Affiliation(s)
- Liping Tan
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, 510642, People's Republic of China
| | - Sheng Wu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, 510642, People's Republic of China
| | - Auwalu Yusuf Abdullahi
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, 510642, People's Republic of China
| | - Xinggang Yu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, 510642, People's Republic of China
| | - Wei Hu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, 510642, People's Republic of China
| | - Meiran Song
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, 510642, People's Republic of China
| | - Xianli Shi
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, 510642, People's Republic of China
| | - Guoqing Li
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, 510642, People's Republic of China.
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Shrainer YV, Osioenko MF, Bikbulatova EA, Zavakina NV. OVERDIAGNOSIS OF COELIAC DISEASE IN A PATIENT WITH ASCARIASIS AND GIARDIASIS. Eksp Klin Gastroenterol 2016:107-110. [PMID: 29889407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There are many errors in the diagnosis of celiac disease. The most common errors are following: underestimation of the importance of comprehensive laboratory and instrumental studies (histological study of biopsy specimens of the duodenal mucosa, molecular- genetic HLA typing and serological markers of celiac disease); the positive clinical dynamics after a strict gluten-free diet is not always confirm the diagnosis of celiac disease; insufficient or incorrect orientation of biopsy specimens of the mucous of the duodenum; illiterate description and interpretation of histopathological data; neglecting to identify possible IgA deficiency, the use of serological tests with low specificity for the diagnosis of celiac disease.
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