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Detection of Dientamoeba fragilis in Portuguese children with acute gastroenteritis between 2011 and 2013

Published online by Cambridge University Press:  21 July 2015

C. JÚLIO ,
C. FURTADO ,
R. ROCHA ,
C. ESCOBAR ,
M. J. BRITO  and
M. OLEASTRO
C. JÚLIO*
Affiliation:
Department of Infectious Diseases, National Reference Laboratory for Gastrointestinal Infections, National Institute of Health Dr Ricardo Jorge I.P., Lisbon, Portugal
C. FURTADO
Affiliation:
Department of Infectious Diseases, Reference and Surveillance Unit, National Institute of Health Dr Ricardo Jorge I.P., Lisbon, Portugal
R. ROCHA
Affiliation:
Department of Infectious Diseases, National Reference Laboratory for Gastrointestinal Infections, National Institute of Health Dr Ricardo Jorge I.P., Lisbon, Portugal
C. ESCOBAR
Affiliation:
Hospital Professor Doutor Fernando Fonseca, Paediatric Service, Amadora, Portugal
M. J. BRITO
Affiliation:
Hospital D. Estefânia, Paediatric Service, Lisbon, Portugal
M. OLEASTRO
Affiliation:
Department of Infectious Diseases, National Reference Laboratory for Gastrointestinal Infections, National Institute of Health Dr Ricardo Jorge I.P., Lisbon, Portugal
*
* Corresponding author. Department of Infectious Diseases, National Reference Laboratory for Gastrointestinal Infections, National Institute of Health Dr Ricardo Jorge I.P., Av. Padre Cruz, 1649-016 Lisboa, Portugal. E-mail: [email protected]
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Summary

Dientamoeba fragilis is an inhabitant of human gastrointestinal tract with a worldwide distribution. The first description considered this protozoan a rare and harmless commensal, since then it has struggled to gain recognition as a pathogen. Commercial multiplex real-time PCR was used to detect D. fragilis in fecal samples from hospitalized children (⩽18 years) with acute gastrointestinal disease, admitted to two hospitals of Lisbon area, with different demographic characteristics. A total of 176 children were studied, 103 (58·5%) male, 144 (81·8%) children between 0 and 5 years and 32 (18·2%) above 6 years old. The overall protozoa frequency considering the four tested microorganisms were 8·5% (15/176), and the most frequently found protozoan was D. fragilis, 6·3% (11/176). Dientamoeba fragilis frequency was higher among older children (21·9%), than younger children (2·8%), and greater in boys (6·8%) than in girls (5·5%). All positive children presented with diarrhoea associated with vomiting, fever and abdominal pain. Infection was associated with the age of children (P < 0·001), school attendance (P = 0·002) and consumption of certain foods (P = 0·014), e.g. cakes with crème and ham. The frequency of diantamoebiasis found in a cohort of hospitalized Portuguese children, with acute gastrointestinal disease, could be considered a very high value when compared with the protozoan frequency normally associated with this pathology.

Keywords

Dientamoeba fragilisfrequencyacute gastroenteritishospitalized childrenPortugal
Type
Research Article
Information
Parasitology , Volume 142 , Issue 11 , September 2015 , pp. 1398 - 1403
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Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

Ayadi, A. and Bahri, I. (1999). Dientamoeba fragilis: pathogenic flagellate? Bulletin of the Exotic Pathology Society 92, 299–301.Google ScholarPubMed
Barratt, J. L., Harkness, J., Marriott, D., Ellis, J. T. and Stark, D. (2011). A review of Dientamoeba fragilis carriage in humans: several reasons why this organism should be considered in the diagnosis of gastrointestinal illness. Gut Microbes 2, 3–12.Google Scholar
Bøås, H., Tapia, G., Sødahl, J. A., Rasmussen, T. and Rønningen, K. S. (2012). Enterobius vermicularis and risk factors in healthy Norwegian children. The Pediatric Infectious Diseases Journal 31, 927–930.Google Scholar
de Wit, M. A., Koopmans, M. P., Kortbeek, L. M., Wannet, W. J., Vinjé, J., van Leusden, F., Bartelds, A. I. and van Duynhoven, Y. T. (2001). Sensor, a population-based cohort study on gastroenteritis in the Netherlands: incidence and etiology. American Journal of Epidemiology 154, 666–674.Google Scholar
ECDC (2013). Annual epidemiological report Reporting on 2011 surveillance data and 2012 epidemic intelligence data. http://www.ecdc.europa.eu/ Google Scholar
Fujioka, M., Otomo, Y. and Ahsan, C. R. (2013). A novel single-step multiplex polymerase chain reaction assay for the detection of diarrheagenic Escherichia coli . Journal of Microbiological Methods 92, 289–292.Google Scholar
Girginkardeşler, N., Coskun, S., Cuneyt Balcioglu, I., Ertan, P. and Ok, U. Z. (2003). Dientamoeba fragilis, a neglected cause of diarrhea, successfully treated with secnidazole. Clinical Microbiology Infections 9, 110–113.Google Scholar
Johnson, E. H., Windsor, J. J. and Clark, C. G. (2004). Emerging from obscurity: biological, clinical, and diagnostic aspects of Dientamoeba fragilis . Clinical Microbiology Review 17, 553–570.Google Scholar
Lacasella, V., Brandonisio, O., Capolongo, C., Marangi, M. and Giangaspero, A. (2013). The importance of being Dientamoeba fragilis . Le Infezioni in Medicina 21, 1–9.Google Scholar
Lagacé-Wiens, P. R., VanCaeseele, P. G. and Koschik, C. (2006). Dientamoeba fragilis: an emerging role in intestinal disease. Canadian Medical Association Journal 175, 468–469.Google Scholar
Lima, R. and Dias, J. (2010). Gastroenterite aguda. Nascer e Crescer 2, 85–90.Google Scholar
Maas, L., Dorigo-Zetsma, J. W., de Groot, C. J., Bouter, S., Plötz, F. B. and van Ewijk, B. E. (2014). Detection of intestinal protozoa in paediatric patients with gastrointestinal symptoms by multiplex real-time PCR. Clinical Microbiology Infections 20, 545–550.Google Scholar
Norberg, A., Nord, C. E. and Evengård, B. (2003). Dientamoeba fragilis – a protozoal infection which may cause severe bowel distress. Clinical Microbiology Infections 9, 65–68.Google Scholar
Ramani, S. and Kang, G. (2009). Viruses causing childhood diarrhoea in the developing world. Current Opinion of Infectious Diseases 22, 477–482.CrossRefGoogle ScholarPubMed
Röser, D., Simonsen, J., Nielsen, H. V., Stensvold, C. R. and Mølbak, K. (2013). Dientamoeba fragilis in Denmark: epidemiological experience derived from four years of routine real-time PCR. European Journal of Clinical Microbiology Infectious Diseases 32, 1303–1310.Google Scholar
Sargeaunt, P. G., Williams, J. E., Kumate, J. and Jimenez, E. (1980). The epidemiology of Entamoeba histolytica in Mexico City. A pilot survey I. Transactions of the Royal Society Tropical Medicine Hygiene 74, 653–656.CrossRefGoogle ScholarPubMed
Schuurman, T., Lankamp, P., van Belkum, A., Kooistra-Smid, M. and van Zwet, A. (2007). Comparison of microscopy, real-time PCR and a rapid immunoassay for the detection of Giardia lamblia in human stool specimens. Clinical Microbiology Infection 13, 1186–1191.Google Scholar
Stark, D., Barratt, J., Robert, T., Marriott, D., Harkness, J. and Ellis, J. (2010). A review of clinical presentation of Dientamoebiasis. American Journal of Tropical Medicine and Hygiene 82, 614–619.Google Scholar
Stark, D., Al-Qassab, S. E., Barratt, J. L. N., Stanley, K., Roberts, T., Marriott, D., Harkness, J. and Ellis, J. T. (2011). Evaluation of multiplex tandem real-time PCR for detection of Cryptosporidium spp. Dientamoeba fragilis, Entamoeba histolytica, and Giardia intestinalis in clinical stool samples. Journal of Clinical Microbiology 49, 257–262.CrossRefGoogle ScholarPubMed
Stark, D., Roberts, T., Ellis, J. T., Marriott, D. and Harkness, J. (2014). Evaluation of the EasyScreenTM Enteric Parasite Detection Kit for the detection of Blastocystis spp., Cryptosporidium spp., Dientamoeba fragilis, Entamoeba complex, and Giardia intestinalis from clinical stool samples. Diagnostic Microbiology and Infectious Disease 78, 149–152.Google Scholar
Steinitz, H., Talis, B. and Stein, B. (1970). Entamoeba histolytica and Dientamoeba fragilis and the syndrome of chronic recurrent intestinal amoebiasis in Israel. Digestion 3, 146–153.Google Scholar
Stensvold, C. R., Arendrup, M. C., Mølbak, K. and Nielsen, H. V. (2007). The prevalence of Dientamoeba fragilis in patients with suspected enteroparasitic disease in a metropolitan area in Denmark. Clinical Microbiology Infections 13, 839–842.CrossRefGoogle Scholar
Vandenberg, O., Peek, R., Souayah, H., Dediste, A., Buset, M., Scheen, R., Retore, P., Zissis, G. and van Gool, T. (2006). Clinical and microbiological features of dientamoebiasis in patients suspected of suffering from a parasitic gastrointestinal illness: a comparison of Dientamoeba fragilis and Giardia lamblia infections. International Journal of Infectious Diseases 10, 255–261.Google Scholar
Vandenberg, O., Souayah, H., Mouchet, F., Dediste, A. and van Gool, T. (2007). Treatment of Dientamoeba fragilis infection with paromomycin. Paediatric Infectious Diseases Journal 26, 88–90.CrossRefGoogle ScholarPubMed
Verdu, E. F. and Riddle, M. S. (2012). Chronic gastrointestinal consequences of acute infectious diarrhea: evolving concepts in epidemiology and pathogenesis. American Journal of Gastroenterology 107, 981–989.Google Scholar
Yakoob, J., Jafri, W., Beg, M. A., Abbas, Z., Naz, S., Islam, M. and Khan, R. (2010). Blastocystis hominis and Dientamoeba fragilis in patients fulfilling irritable bowel syndrome criteria. Parasitology Research 107, 679–684.Google Scholar