Pediatrik Gastroenteritlerde Entamoeba Histolytica, Giardia Intestinalis ve Cryptosporidium Spp. Görülme Sıklığı

Amaç: Tüm dünyada parazitik gastroenterit, çocuklarda önemli bir morbidite ve mortalite nedeni olmaya devametmektedir. Bu çalışmanın amacı, çocuklardan alınan ishal örneklerinde Entamoeba histolytica, Giardia intestinalis veCryptosporidiumspp türlerinin sıklığını değerlendirmektir. Yöntemler: Ağustos 2018'den Ocak 2019 tarihleri arasında , gastroenterit şikayetli olan çocukların 400 dışkı numunesi,hem direkt bakı (Native & Lugol iyot) hem de antijen saptama testleri ile önemli bağırsak protozoa etkenleri açısından incelendi. Bulgular: Giardia intestinalis'in en sık görülen patojen olduğu (%13) tespit edildi. Bunu Cryptosporidium spp (7.75), E.histolytica(%4,00), T. hominis (%1,00) oranlarında izledi. Bu çalışmada çocuklardaki ortak şikayet ishal tablosuydu. Tartışma ve Sonuç: Erzurum'da yaygın olarak görülen önemli patojenler E. histolytica, G. intestinalis veCryptosporidium spp olarak belirlendi. Enterik patojenlerin sıklığını azaltmak için yeterli hijyenik önlemler alınmalıdır.Sonuçların daha iyi yorumlanması için immünolojik ve moleküler testler yapılmalıdır.

In Pediatric Gastroenteritis: the Presence of Helicobacter PyloriPrevalence of Entamoeba Histolytica, Giardia Intestinalis AndCryptosporidium Spp

Objective: Parasitic gastroenteritis continues to be an important cause of morbidity and mortality in children worldwide. The purpose of this study is to evaluate the frequency of Entamoeba histolytica, Giardia intestinalis and Cryptosporidium spp species in diarrhea samples taken from children.Methods: Between August 2018 and January 2019, 400 stool samples of children suffering from gastroenteritis were examined for important intestinal protozoa agents by both direct examination (Native & Lugol iodine) and antigen detection tests.Results: It was determined that G. intestinalis was the most common pathogen (13%). This was followed by Cryptosporidium spp (7.75), E. histolytica (4.00%), T. hominis (1.00%). The common complaint in children in this study was diarrhea.Conclusion: E. histolytica, G. intestinalis and Cryptosporidium spp were identified as important pathogens commonly seen in Erzurum. Adequate hygienic measures should be taken to reduce the frequency of enteric pathogens. Immunological and molecular tests should be done for a better interpretation of the results.

PDF

___

1. Soares R, Tasca T. Giardiasis: An Update Review on Sensitivity and Specificity of Methods for Laboratorial Diagnosis. J Microbiol Methods. 2016; 129:98-102.
2. Bayram Y, Parlak M, Çıkman A. In Van Regional Training and Research Hospital Giardia intestinalis ve Entamoeba histolytica/dispar prevalence: Fouryear follow-up. Dicle Med J 2013; 40: 40-4.
3. Köksal F, Başlantı İ, Samast M.A. Retrospective evaluation of the prevalance of intestinal parazites in İstanbul Turkey. Turkiye Parazitol Derg. 2010; 34:166-71.
4. Cacciò SM, Chalmers RM. Human cryptosporidiosis in Europe. Clin Microbiol Infect. 2016; 22: 471-80.
5. Fletcher S.M., Stark D., Harkness J. et al Enteric protozoa in the developed world: a public health perspective. Clin. Microbiol. Rev. 2012; 25: 420–49.
6. Coelho CH, Durigan M, Leal DAG, et al. Giardiasis as a Neglected Disease in Brazil: Systematic Review of 20 Years of Publications. PLoS Negl Trop Dis. 2017; 11: e0006005
7. Samuel L, Stanley Jr. Amoebiasis. Second cause of death. Lancet. 2003; 361: 1025-34.
8. Adeyemo FE, Singh G, Reddy P, et al. Stenström TA. Efficiency of Chlorine and UV in the Inactivation of Cryptosporidium and Giardia in Wastewater. PLoS One. 2019; 14: e0216040.
9. Cacciò SM, Thompson RC, McLauchlin J, et al. Unravelling Cryptosporidium and Giardia Epidemiology. Trends Parasitol. 2005; 9: 430-7.
10. Petri WA Jr, Singh U. Diagnosis and management of amebiasis. Clin Infect Dis. 1999; 29:1117–25.
11. Wegayehu T, Adamu H, Petros B. Prevalence of Giardia Duodenalis and Cryptosporidium Species Infections Among Children and Cattle in North Shewa Zone, Ethiopia.BMC Infect Dis. 2013; 13-419.
12. Stark, D., J. L. Barratt, S. van Hal, D. et al. Clinical significance of enteric protozoa in the immunosuppressed human population. Clin. Microbiol. Rev.2009; 22: 634-50.
13. Korich DG, Mead JR, Madore MS, et al. Effects of ozone, chlorine dioxide, chlorine, and monochloramine on Cryptosporidium parvum oocyst viability" Applied and Environmental Microbiology. 1990; 56: 1423–8.
14. Dillingham RA, Lima AA, Guerrant RL. Cryptosporidiosis: epidemiology and impact. Microbes Infect 2002; 4: 1059-66.
15. Black RE, Cousens S, Johnson HL, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010; 375: 1969-87.
16. Tüzemen NK, Doğan N. Comparison of Direct Microscopy, Culture, ELISA and Molecular Methods for the Diagnosis of Entamoeba histolytica. Mikrobiyol Bul 2014; 48: 114-22.
17. Tanyuksel M, Petri WA Jr. Laboratory diagnosis of amebiasis. Clin Microbiol Rev 2003; 16: 713-29.
18. Tuvan Zk, Altun S, Bulut C, et al. Protozoal antigen positivity in diarrheal patients admitted to emergency service: A point prevalence study. Mikrobiyol Bul 2011; 45: 765-7.
19. Gunduz T, Cumen S, Ari A, et al. Microbiological investigation of stool in patients with acute diarrhea. Afr J Microbio Res 2011; 5: 456-58.
20. Beyhan Ye and Yılmaz H. Dışkı Örneklerinde Cryptosporidium spp. Antijen Varlığının ELISA Yöntemi ile Araştırılması: Dokuz Yıllık Değerlendirme. Turkiye Parazitol Magazine 2020; 44: 68-71.
21. Tanyuksel M, Gun H, Doganci L. Prevalence of Cryptosporidium sp. in patients with neoplasia and diarrhea. Scand J Infect Dis 1995; 27: 69-70.
22. Sarı C, Sarı K, Ertuğ S. Investigation of the frequency of Cryptosporidium spp. and Blastocystis hominis in patients with chronic renal failure. Türkiye Parazitol Magazine 2003; 27: 187-90.
23. Stark D., Al-Qassab SE, Barratt JLN, et al. Evaluation of Multiplex Tandem Real-Time PCR for Detection of Cryptosporidium spp., Dientamoeba fragilis, Entamoeba histolytica, and Giardia intestinalis in Clinical Stool Samples. J Clin Microbiol 2011; 49: 257-62.
24. Ghenghesh KS, Ghanghish K, BenDarif ET, et al. Prevalence of Entamoeba histolytica, Giardia lamblia, and Cryptosporidium spp. in Libya. Libyan J Med 2016; 11: 1-6.
25. Ahmed T, Khanum H, Uddin MS, et al. Entamoeba histolytica, Giardia lamblia and 0Cryptosporidium spp. infection in children in an urban slum area of Bangladesh. Bioresearch Communication. 2016; 2: 175-81.