Advertisement

Parasitology Research

, Volume 107, Issue 3, pp 679–684 | Cite as

Blastocystis hominis and Dientamoeba fragilis in patients fulfilling irritable bowel syndrome criteria

  • Javed Yakoob
  • Wasim Jafri
  • Mohammad Asim Beg
  • Zaigham Abbas
  • Shagufta Naz
  • Muhammad Islam
  • Rustam Khan
Original Paper

Abstract

Studies have suggested a possible role for Blastocystis hominis and Dientamoeba fragilis in the etiology of irritable bowel syndrome (IBS). We studied the prevalence of B. hominis and D. fragilis in patients with IBS-diarrhea (IBS-D). Three hundred and thirty patients were enrolled, 171 (52%) with IBS-D and 159 (48%) were controls, respectively. Stool microscopy, culture, and polymerase chain reaction (PCR) for B. hominis and D. fragilis were done. B. hominis was positive by stool microscopy in 49% (83/171) of IBS compared to 24% (27/159) in control (p < 0.001). B. hominis culture was positive in 53% (90/171) in IBS compared to 16% (25/159) in control (p < 0.001). B. hominis PCR was positive in 44% (75/171) in IBS compared to 21% (33/159) in control (p < 0.001). D. fragilis microscopy was positive in 3.5% (6/171) in IBS-D compared to 0.6% (1/159) in control (p = 0.123). D. fragilis culture was positive in 4% (7/171) in IBS compared to 1.3% (2/159) in control (p = 0.176). D. fragilis PCR was positive in 4% (6/171) in IBS-D compared to 0% (0/159) in control (p = 0.030). B. hominis is common, while D. fragilis was less prevalent in our patients with IBS-D. B. hominis and D. fragilis culture had a better yield compared to stool microscopy and PCR.

Keywords

Polymerase Chain Reaction Irritable Bowel Syndrome Irritable Bowel Syndrome Patient Stool Specimen Irritable Bowel Syndrome Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

This study was supported by the Higher Educational Commission Grant Ref: 20-774/R&D/06/267 to JY. We are thankful to Dr. C. Graham Clark (Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England) for providing us the controlled DNA of D. fragilis cultures and to Dr. JJ Windsor (NPHS Microbiology Aberystwyth, Bronglais Hospital, Ceredigion, UK) for his valuable comments.

Conflict of interest

The authors declare they have no conflict of interests.

References

  1. Brody TJ, Warren E, Wettstein A, Robertson P, Recabarren A (2002) Eradication of Dientamoeba fragilis can resolve IBS-like symptoms. J Gastroenterol Hepatol 17:A103CrossRefGoogle Scholar
  2. Dobell C (1940) Researches on the intestinal protozoa of monkeys and man. The life history of Dientamoeba fragilis: observations, experiments and speculations. Parasitology 32:417–461CrossRefGoogle Scholar
  3. Drossman DA (2006) Rome III: the new criteria. Chin J Dig Dis 7:181–185CrossRefPubMedGoogle Scholar
  4. Eroglu F, Genc A, Elgun G, Koltas IS (2009) Identification of Blastocystis hominis isolates from asymptomatic and symptomatic patients by PCR. Parasitol Res 105:1589–1592CrossRefPubMedGoogle Scholar
  5. Hussein EM, Hussein AM, Eida MM, Atwa MM (2008) Pathophysiological variability of different genotypes of human Blastocystis hominis Egyptian isolates in experimentally infected rats. Parasitol Res 102:853–860CrossRefPubMedGoogle Scholar
  6. Hussain R, Jafri W, Zuberi S, Baqai R, Abrar N, Ahmed A, Zaman V (1997) Significantly increased IgG2 subclass antibody levels to Blastocystis hominis in patients with irritable bowel syndrome. Am J Trop Med Hyg 56:301–306PubMedGoogle Scholar
  7. Johnson EH, Windsor JJ, Clark CG (2004) Emerging from obscurity: biological, clinical, and diagnostic aspects of Dientamoeba fragilis. Clin Microbiol Rev 17:553–570CrossRefPubMedGoogle Scholar
  8. Norberg A, Nord CE, Evengard B (2003) Dientamoeba fragilis—a protozoal infection which may cause severe bowel distress. Clin Microbiol Infect 9:65–68CrossRefPubMedGoogle Scholar
  9. Schuster H, Jackson RS (2009) Prevalence of Dientamoeba fragilis among patients consulting complementary medicine practitioners in the British Isles. J Clin Pathol 62:182–184CrossRefPubMedGoogle Scholar
  10. Silberman JD, Clark CG, Sogin ML (1996) Dientamoeba fragilis shares a recent common evolutionary history with the trichomonads. Mol Biochem Parasitol 76:311–314CrossRefPubMedGoogle Scholar
  11. Stark D, Beebe N, Marriott D, Ellis J, Harkness J (2005) Prospective study of the prevalence, genotyping and clinical relevance of Dientamoeba fragilis infections in an Australian population. J Clin Microbiol 43:2718–2723CrossRefPubMedGoogle Scholar
  12. Stensvold CR, Brillowska-Dabrowska A, Nielsen HV, Arendrup MC (2006) Detection of Blastocystis hominis in unpreserved stool specimens by using polymerase chain reaction. J Parasitol 92:1081–1087CrossRefPubMedGoogle Scholar
  13. Stensvold CR, Arendrup MC, Mølbak K, Nielsen HV (2007) The prevalence of Dientamoeba fragilis in patients with suspected enteroparasitic disease in a metropolitan area in Denmark. Clin Microbiol Infect 13:839–842CrossRefPubMedGoogle Scholar
  14. Tan KSW (2008) New insights on classification, identification and clinical relevance of Blastocystis spp. Clin Microbiol Rev 21:639–665CrossRefPubMedGoogle Scholar
  15. Windsor JJ, Johnson EH (1999) Dientamoeba fragilis: the unflagellated human flagellate. Br J Biomed Sci 56:293–306PubMedGoogle Scholar
  16. Windsor JJ, Macfarlane L, Hughes-Thapa G, Jones SK, Whiteside TM (2002) Incidence of Blastocystis hominis in faecal samples submitted for routine microbiological analysis. Br J of Biomed Sc 59:154–157Google Scholar
  17. Windsor JJ, Macfarlane L, Hughes-Thapa G, Jones SK, Whiteside TM (2003) Detection of Dientamoeba fragilis by culture. Br J Biomed Sci 60:79–83PubMedGoogle Scholar
  18. Yakoob J, Jafri W, Jafri N, Khan R, Islam M, Beg MA, Zaman V (2004) Irritable bowel syndrome: in search of an etiology: role of Blastocystis hominis. Am J Trop Med Hyg 70:383–385PubMedGoogle Scholar
  19. Yakoob J, Jafri W, Beg MA, Abbas Z, Naz S, Islam M, Khan R (2010) Irritable bowel syndrome: is it associated with genotypes of Blastocystis hominis. Parasitol Res 106:1033–1038CrossRefPubMedGoogle Scholar
  20. Yan Y, Su S, Ye J, Lai R, Liao H, Ye J, Li X, Luo X, Chen G (2006) Genetic variability of Blastocystis hominis isolates in China. Parasitol Res 99:597–601CrossRefPubMedGoogle Scholar
  21. Yang J, Scholten TH (1977) Dientamoeba fragilis: a review with notes on its epidemiology, pathogenicity, mode of transmission and diagnosis. Am J Trop Med Hyg 26:16–22PubMedGoogle Scholar
  22. Yoshikawa H, Abe N, Iwasawa M, Kitano S, Nagano I, Wu Z, Takahashi (2000) Genomic analysis of Blastocystis hominis strains isolated from two long-term Health care facilities. J Clin Microbiol 38:1324–1330PubMedGoogle Scholar
  23. Zaman V, Khan K (1994) A comparison of direct microscopy with culture for the diagnosis of Blastocystis hominis. Southeast Asian J Trop Med Hyg Public Health 25:792–793Google Scholar
  24. Zonta ML, Oyhenart EE, Navone GT (2010) Nutritional status, body composition, and intestinal parasitism among the Mbyá-Guaraní communities of Misiones, Argentina. Am J Hum Biol 22:193–200PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Javed Yakoob
    • 2
  • Wasim Jafri
    • 2
  • Mohammad Asim Beg
    • 1
  • Zaigham Abbas
    • 2
  • Shagufta Naz
    • 2
  • Muhammad Islam
    • 2
  • Rustam Khan
    • 2
  1. 1.Department of Microbiology and PathologyThe Aga Khan UniversityKarachiPakistan
  2. 2.Department of MedicineAga Khan University HospitalKarachiPakistan

Personalised recommendations