Abstract
Strongyloides stercoralis infection in immunocompromised subjects, including chronic alcoholics, can lead to a severe disease. Moreover, its prevalence in alcoholic patients seems to be higher than that in the general population. The aims of this study were to evaluate the frequency of S. stercoralis infection in alcoholic patients and to investigate the influence of alcohol intake on the parasite load, as well as to evaluate the sensitivity of three different parasitological methods according to the larval output. Fecal samples of 1290 chronic alcoholic patients were examined by spontaneous sedimentation, Baermann–Moraes, and agar plate culture (APC) methods. S. stercoralis was the most frequent parasite found (14.5%; n = 187). Alcoholic individuals infected with Strongyloides stercoralis had a higher daily consumption of alcohol than those who were not infected, 528.6 and 403.0 g/day, respectively (p < 0.05). In addition, individuals with higher alcohol intake presented an increase in parasite load. The S. stercoralis diagnostic method with the highest sensitivity was APC, 97.9% (183/187). In conclusion, S. stercoralis seems to be the most frequent parasite found in alcoholic individuals from endemic areas and alcohol intake is positively associated with S. stercoralis larvae output. In addition, this study confirms that APC is the most sensitive parasitological method used for Strongyloides diagnosis.
Highlights
IntroductionS. stercoralis infection as one of the most neglected and emerging worldwide infectious diseases [2,4]
A difference was observed when comparing the percentage of individuals infected and noninfected with S. stercoralis who drank for up to 10 years, 22.9% (25/109) and 7.8% (55/710), respectively (p < 0.05) (Table 2)
S. stercoralis infection in immunocompromised patients can lead to a severe clinical condition, which has a high mortality rate
Summary
S. stercoralis infection as one of the most neglected and emerging worldwide infectious diseases [2,4]. Unique among nematodes that infect humans, along with Capillaria subspecies, rhabditiform larvae of S. stercoralis can transform into invasive filariform larvae while inside the host, before being excreted. This leads to a reinfection by the larvae invasion of the intestinal wall [5] and is called autoinfection. When it occurs in low, well-regulated levels, it leads to chronic infection in Pathogens 2020, 9, 422; doi:10.3390/pathogens9060422 www.mdpi.com/journal/pathogens
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