Abstract
BackgroundBlastocystis sp. are among the most commonly observed intestinal parasites in routine clinical parasitology. Blastocystis in humans consists of at least 9 genetic subtypes. Different subtypes of Blastocystis may be associated with differences in pathogenicity and symptomatology.MethodsAdvanced microscopy on two samples and sequence-confirmed PCR on a third sample from the same individual were used for Blastocystis diagnosis and subtype analyses on routine clinical samples in a university hospital.ResultsWith a combined gold standard of sequence-confirmed PCR and positive advanced microscopy, 107 out of 442 (24.2%) patients were diagnosed with Blastocystis. infection, which is a high frequency of detection in comparison to previous reports from industrialized countries. The sensitivity of microscopy and sequence-confirmed PCR was 99.1% (106/107) and 96.3% (103/107), respectively.Among 103 typable samples, subtype 3 was most abundant (n = 43, 42%), followed by subtypes 1 and 2 (both n = 23, 22%), subtype 4 (n = 12, 12%), and single samples with subtypes 6 (1%) and subtype 7 (1%). The prevalence of Blastocystis infection was 38% in patients from the Department of Tropical Medicine and 18% in patients from other departments.ConclusionsA high prevalence of Blastocystis infection was found with both advanced microscopy and sequence-confirmed PCR in our patient population. Most cases were caused by subtypes ST1, ST2, ST3 and ST4. A significantly higher prevalence was found among patients with a history of recent travel to tropical countries.
Highlights
Blastocystis sp. are among the most commonly observed intestinal parasites in routine clinical parasitology
Samples and parasitological examination Stool samples of 442 patients submitted for routine parasitological examination at the Department of Clinical Parasitology, Academic Medical Center (AMC) were collected and processed with the Triple Faeces Test (TFT) as described previously [35]
Study population and microscopy From October 2008 to January 2009, 442 TFT sets from 442 patients were included in the study
Summary
Blastocystis sp. are among the most commonly observed intestinal parasites in routine clinical parasitology. Blastocystis in humans consists of at least 9 genetic subtypes. Different subtypes of Blastocystis may be associated with differences in pathogenicity and symptomatology. Blastocystis is one of the most prevalent unicellular parasites in human faecal specimens. Other studies suggest Blastocystis to be a commensal parasite in humans without any pathogenic role [16,17,18]. Conflicting views about pathogenicity may be related to the number of infecting parasites present, duration of infection (acute or chronic), host genetic factors or to different subtypes or species of Blastocystis infecting humans [3,19,20,21,22,23,24,25,26,27]. 17 subtypes or species of Blastocystis have been described based on sequence analysis, of which 9 have been reported in humans [28,29,30,31]
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