BLASTOCYSTIS SUBTYPES IN SYMPTOMATIC AND ASYMPTOMATIC FAMILY MEMBERS AND PETS AND RESPONSE TO THERAPY.


Nagel, R; Cuttell, L; Stensvold, CR; Mills, PC; Bielefeldt-Ohmann, H; Traub, RJ; (2011) BLASTOCYSTIS SUBTYPES IN SYMPTOMATIC AND ASYMPTOMATIC FAMILY MEMBERS AND PETS AND RESPONSE TO THERAPY. Intern Med J. ISSN 1444-0903 DOI: https://doi.org/10.1111/j.1445-5994.2011.02626.x

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Abstract

: Background: Blastocystis is a common, enteric parasite. The pathogenicity of the organism is uncertain but subtypes (ST) 1,3 have been reported more likely to cause Irritable Bowel-like symptoms. Aims: We treated symptomatic patients positive for Blastocystis (BSP) with conventional therapy and analysed 16SSU rDNA to assess clearance and carriage rates and subtype prevalence of the parasite in the asymptomatic household members. Methods: In a longitudinal, prospective case study 11 symptomatic patients positive for Blastocystis (SBPs) underwent outpatient clinical assessment to exclude other diagnoses before 14 days of either metronidazole 400 mg three times daily or trimethoprim/sulfamethoxazole 160/800 mg twice-daily therapy. Faecal specimens were collected from patients at baseline, Day 15, 28 and 56 after therapy and from 17 family members and 8 pets at Day 15. Specimens were analysed by faecal smear, culture and PCR analysis of 16SSU rDNA. Results: No patient cleared the organism following therapy. Subtypes 1 (45%), 3 (36%), 4 (36%), and 6 (9%) were found in the SBPs and subtypes identified before and after therapy were identical in each individual. All household contacts were positive for Blastocystis and 16/17 (94%) contacts showed identical Blastocystis subtypes to the symptomatic family member. All pets were positive for Blastocystis with PCR testing, 7/8 (88%) demonstrating ST concordance with the SBP. Conclusions: Conventional therapy is ineffective for symptomatic Blastocystis infection. The high prevalence of Blastocystis infection within households suggested transmission between humans and their pets. Sub-typing analysis of SSU rDNA alone in Blastocystis does not appear to predict pathogenicity.

Item Type: Article
PubMed ID: 22032439
URI: http://researchonline.lshtm.ac.uk/id/eprint/20046

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