Abstract
BackgroundGiardia duodenalis is one of the most prevalent and highly diverse human parasites, encompassing a complex of eight genetically distinct assemblages, each further divided into sub-assemblages. While in recent years, G. duodenalis genotype distribution patterns in humans have been intensely studied, there is still very little information available on the diversity of Giardia genotypes and sub-assemblages infecting people in Romania. In the present study, we investigated the genetic diversity of Giardia duodenalis in asymptomatic patients from Romania.MethodsOver an 11-month period, human feces from 7805 healthy adults were screened by microscopic analysis for G. duodenalis cysts during their obligatory periodic check-ups. DNA extraction was performed from microscopic-positive fecal samples, followed by multilocus sequence typing of four genetic loci of the ITS region, gdh, tpi and bg genes, followed by DNA sequencing and phylogenetic analysis. Statistical analysis was performed using EpiInfo 2000 software.ResultsThe prevalence of giardiasis in the present study was 0.42% (33/7805). Twenty-three samples (76.67%) were successfully genotyped at each locus. The bg and tpi genes had the highest typing success rate (100%). The identified assemblages were assemblage A in 27 cases (subtypes A2 and A3), and B in 3 cases.ConclusionsTo our knowledge, the present study is the first report of multilocus sequence typing of G. duodenalis isolated from humans in Romania. The present results may shed light on G. duodenalis infection in humans at a regional and national level, thus increasing awareness against this parasitic infection.
Highlights
Giardia duodenalis is one of the most prevalent and highly diverse human parasites, encompassing a complex of eight genetically distinct assemblages, each further divided into sub-assemblages
Among the total number of 7805 patients included in the study, 33 (0.42%; 95% CI: 0.3–0.59%) tested positive for G. duodenalis by optical microscopy
Genotyping studies of human isolates are lacking in our country. To fill in these blanks, the main goal achieved by this study was to investigate the genotypes of G. duodenalis isolated from human fecal samples taken in Romania
Summary
Giardia duodenalis is one of the most prevalent and highly diverse human parasites, encompassing a complex of eight genetically distinct assemblages, each further divided into sub-assemblages. G. duodenalis genotype distribution patterns in humans have been intensely studied, there is still very little information available on the diversity of Giardia genotypes and sub-assemblages infecting people in Romania. Giardia has a global distribution, with human contamination occurring in both tropical and temperate areas. It remains the most frequently identified parasite from human fecal samples and the most common cause of parasitic gastroenteritis [3], registering annually around 280 million new cases worldwide [4]. Human infection most often occurs by fecal-oral route through consumption of infested foods and water, by cysts (the resistant and infectious form of the parasite), and less frequently, through sexual practices (anal-oral sex). Giardia duodenalis infection can appear as endemic (mainly in subtropical and tropical regions), water-related epidemic and travelrelated epidemic (accounting for 2–3% of traveler’s diarrhea) [7]
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