Molecular identification and subtypes distribution of Blastocystis sp. isolated from children and adolescent with cancer in Iran: evaluation of possible risk factors and clinical features

Abstract

Purpose

This study aimed to determine the molecular characterization and subtype distribution of Blastocystis sp. isolated from cancer children and adolescents in Shiraz, Fars province, southwestern Iran.

Methods

Overall, 200 fecal samples obtained from cancer children and adolescents under 18 years old (107 males and 93 females) and checked by microscopy, culture, and molecular methods (PCR). Possible etiological factors and clinical characteristics of Blastocystis infection were also evaluated and compared between Blastocystis infected and non-infected patients.

Results

Thirteen of 200 (6.5%) stool samples were positive for Blastocystis by microscopy. While 21 of 200 (10.5%) were positive by culture, and 24 of 200 (12%) were positive by PCR. Out of 24 positive samples tested by PCR and sequencing, ST3 was reported as the most common subtype (nine samples, 37.5%), followed by ST2 (eight samples, 33.3%), ST1 (five samples, 20.9%), and ST7 (two samples, 8.3%). The prevalence of Blastocystis infection in males was significantly higher than females (p = 0.024). Also, Blastocystis was more prevalent in patients who had received at least eight chemotherapy cycles than fewer (p = 0.002). However, no associations were found between Blastocystis-positive rate and age, residence, type of cancers, or contact with animals. Also, there was no significant difference between frequency of Blastocystis subtypes in symptomatic and asymptomatic cancer patients.

Conclusions

Various controlled epidemiologic and topographic studies need to confirm or reject these possible associations with Blastocystis infection. The data from this study are an invaluable addition to the growing body of research studies on Blastocystis infection in cancer patients.

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Acknowledgements

The authors thank the Vice Chancellor for Research of Shiraz University of Medical Sciences for the financial support of this study.

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, bioinformatics analysis, and molecular analysis were performed by MZ and AA, GH and AA, SS and AA and FG, and MM. The first draft of the manuscript was written by AA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mohammad Motazedian.

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The authors declare that they have no conflict of interest.

Ethical approval

All stages of the present study were confirmed by the Ethics Committee of Shiraz University of Medical Sciences, Shiraz, Fars province, Iran (Approval no: IR.SUMS.REC.1398.266).

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Informed consent was obtained from all individual participants included in the study (parents of patients).

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Asghari, A., Zare, M., Hatam, G. et al. Molecular identification and subtypes distribution of Blastocystis sp. isolated from children and adolescent with cancer in Iran: evaluation of possible risk factors and clinical features. Acta Parasit. 65, 462–473 (2020). https://doi.org/10.2478/s11686-020-00186-2

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Keywords

  • Blastocystis sp.
  • Prevalence
  • Subtype
  • Cancer
  • Immunocompromised
  • PCR
  • Iran