Katia BRİTO, Maria E. GONZALEZ, Roberto CANETE, Pablo Rodriguez JİMENEZ, Kokou M. SOUNOUVE, Ronaldo VALDES

Gastrointestinal şikayeti olan hastalarda Blastocystis sp. infeksiyonu: bir Küba araştırması

AMAÇ: Bu çalışmada; yetişkinlerdeki gastrointestinal sistem şikayetleri ile Blastocystis varlığı arasındaki ilişkinin tanımlanması amaçlanmıştır. YÖNTEMLER: Ocak-Aralık 2011 tarihleri arasında Küba, Matanzas Şehrinde bulunan Hijyen, Epidemiyoloji ve Mikrobiyoloji Merkezinde tanımlayıcı bir çalışma yürütülmüştür. Toplam 749 erişkin (20-69 yaşları arasında, ortalama yaş 38) bu çalışmaya dahil edilmiştir. Patojenik bakteri, parazit açısından pozitif dışkı sonucu olanlar ve rotavirus sonucu pozitif olanlar bu çalışma dışında bırakılmıştır. Sonuç olarak 240 erişkin çalışma koşullarını karşılamıştır: 128 (%53,3) erkek, 112 (%46,7) kadın ve olguların yaş ortalaması 40 idi. Karşılaştırmayı kolaylaştırmak için grup ikiye bölünmüştür: Gastrointestinal şikayetleri olan 110 erişkinden oluşan birinci grup ve şikayetleri olmayan 130 erişkinden oluşan ikinci grup. Her iki grupta da cinsiyet dağılımı homojen olmuştur. Blastocystis sp. varlığını tanımlamak için taze dışkı örnekleri nativ yöntemiyle direkt olarak incelenmiştir. Formalin-eter (Ritchie) yöntemi intestinal parazitlerin yanlış tanısından kaçınmak amacıyla kullanılmıştır. Her iki yöntemde de taze dışkı örnekleri ışık mikroskobu ile incelenmiştir. BULGULAR: Semptomatik grupta yer alan 49 hastada (%44,5) ve asemptomatik grupta yer alan 28 (%22,4) hastada Blastocystis sp. saptanmıştır. Karın ağrısı (%52,7) veya şişkinlik (%38,2), akut ishal (%26,4), iştah kaybı (%18,2), ve dispepsi (%16,4) septomatik grupta yer alan hastalarda tespit edilen gastrointestinal şikayeler olarak belirlenmiştir. Gastrointestinal şikayeti olan hastalarda Blastocystis sp. tanımlanma olasılığının, asemptomatik hastalardan 2,9 kez daha yüksek olduğu bulunmuştur. SONUÇ: Mevcut çalışmamız Blastocystis sp.yi patojen olarak tanımlayan yazarları desteklemektedir.

Blastocystis sp. infection in patients with gastrointestinal complaints: a Cuban study

OBJECTIVE: This study is aimed to determine the association between the presence of Blastocystis sp. and gastrointestinal complaints in adults. METHODS: A descriptive study was carried out from January to December 2011 at the Centre of Hygiene, Epidemiology and Microbiology in Matanzas City, Cuba. A total of 749 adults (aged from 20 to 69 years old, mean age 38) had the opportunity to be included. Patients who had positive stool results for pathogenic bacteria, parasites and those with positive result to rotavirus were excluded from the study. A total of 240 adults were finally included, 128 (53.3%) male and 112 (46.67%) female with a mean age of 40 years old. To facilitate the comparison patients were divided into two groups: 110 adults with gastrointestinal complains and a second group of 130 adults without gastrointestinal disturbances. Sex distribution was homogenous in both groups. The fresh fecal samples were examined to determine the presence of Blastocystis sp. using the direct wet mount. Formalin-ether (Ritchie) technique was used to avoid the misdiagnosis of other intestinal parasites. In both techniques, the fresh samples were examined under light microscope. RESULTS: Blastocystis sp. was detected in 49 patients (44.5%) in the symptomatic group and 28 (22.4%) in the asymptomatic one. Abdominal pain (52.7%) or distension (38.2%), acute diarrhea (26.4%), loss of appetite (18.2%), and dyspepsia (16.4%) were the gastrointestinal complains notified by patients included on the symptomatic group. The probability to identify Blastocystis sp. in patients with gastrointestinal complains was 2.9 times higher than in asymptomatic patients. CONCLUSION: Current results support those authors considering Blastocystis sp. as pathogen.

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