Fotedar R, Stark D, Beebe N, Marriott D, Ellis J, Harkness J
St. Vincent's Hospital, Department of Microbiology, Sydney, Darlinghurst, NSW 2010, Australia.
Clin Microbiol Rev. 2007 Jul;20(3):511-32, table of contents. doi: 10.1128/CMR.00004-07.
The genus Entamoeba contains many species, six of which (Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, Entamoeba polecki, Entamoeba coli, and Entamoeba hartmanni) reside in the human intestinal lumen. Entamoeba histolytica is the causative agent of amebiasis and is considered a leading parasitic cause of death worldwide in humans. Although recent studies highlight the recovery of E. dispar and E. moshkovskii from patients with gastrointestinal symptoms, there is still no convincing evidence of a causal link between the presence of these two species and the symptoms of the host. New approaches to the identification of E. histolytica are based on detection of E. histolytica-specific antigen and DNA in stool and other clinical samples. Several molecular diagnostic tests, including conventional and real-time PCR, have been developed for the detection and differentiation of E. histolytica, E. dispar, and E. moshkovskii in clinical samples. The purpose of this review is to discuss different methods that exist for the identification of E. histolytica, E. dispar, and E. moshkovskii which are available to the clinical diagnostic laboratory. To address the need for a specific diagnostic test for amebiasis, a substantial amount of work has been carried out over the last decade in different parts of the world. The molecular diagnostic tests are increasingly being used for both clinical and research purposes. In order to minimize undue treatment of individuals infected with other species of Entamoeba such as E. dispar and E. moshkovskii, efforts have been made for specific diagnosis of E. histolytica infection and not to treat based simply on the microscopic examination of Entamoeba species in the stool. The incorporation of many new technologies into the diagnostic laboratory will lead to a better understanding of the public health problem and measures to control the disease.
内阿米巴属包含许多物种，其中六种（溶组织内阿米巴、迪斯帕内阿米巴、莫氏内阿米巴、波列基内阿米巴、结肠内阿米巴和哈氏内阿米巴）寄居于人类肠道腔。溶组织内阿米巴是阿米巴病的病原体，被认为是全球人类寄生虫致死的主要原因。尽管最近的研究强调了从有胃肠道症状的患者中检出迪斯帕内阿米巴和莫氏内阿米巴，但仍没有令人信服的证据表明这两个物种的存在与宿主症状之间存在因果关系。鉴定溶组织内阿米巴的新方法基于检测粪便和其他临床样本中的溶组织内阿米巴特异性抗原和DNA。已经开发了几种分子诊断测试，包括传统PCR和实时PCR，用于临床样本中溶组织内阿米巴、迪斯帕内阿米巴和莫氏内阿米巴的检测与鉴别。本综述的目的是讨论临床诊断实验室可用于鉴定溶组织内阿米巴、迪斯帕内阿米巴和莫氏内阿米巴的不同方法。为满足对阿米巴病特异性诊断测试的需求，在过去十年中世界各地开展了大量工作。分子诊断测试越来越多地用于临床和研究目的。为尽量减少对感染其他内阿米巴物种（如迪斯帕内阿米巴和莫氏内阿米巴）个体的过度治疗，已努力对溶组织内阿米巴感染进行特异性诊断，而不是仅仅基于粪便中内阿米巴物种的显微镜检查进行治疗。将许多新技术纳入诊断实验室将有助于更好地理解公共卫生问题及控制该疾病的措施。
