Rodulfo Hectorina, Ahmar Beatriz, Rodríguez María E, Mora Leonor, De Donato Marcos
Laboratorio de Genética Molecular, Instituto de Investigaciones en Biomedicina y Ciencias Aplicadas "Dra. Susan Tai", Universidad de Oriente, Núcleo de Sucre, Cumaná, Venezuela.
Invest Clin. 2012 Dec;53(4):365-77.
The aim of this study was to identify the presence of Entamoeba histolytica and E. dispar by nested PCR in children attending the "Dr. Luis Razetti" Hospital, Barcelona, Anzoátegui State. Of the 1,141 fecal samples coproparasitologically evaluated by conventional microscopy, 150 were diagnosed positive for E. histolytica in 0-10 year-old-children, of both sexes. The signs, symptoms and a full coproparasitological report were obtained from all of these and nested PCR was performed to identify E. histolytica and E. dispar. The conventional microscopy results showed a diagnostic frequency of E. histolytica in 13.2% of the cases, of which 79.3% were positive only for this pathogen. However, nested PCR showed that of these, only 28% (42/150) were actually infected by Entamoeba spp., revealing a high over-diagnosis of E. histolytica. We also identified 9.3% E. histolytica, 4% E. dispar and 4.7% mixed infections. Diarrhea was the most common symptom, followed by abdominal pain and fever. Bloody stools were statistically associated with E. histolytica, but were also found for E. dispar infections. This study demonstrates that molecular techniques complementary to conventional methods enable the correct identification of Entamoeba spp., thus contributing to an improved epidemiological assessment of these parasites and implementation of the appropriate treatment.
本研究的目的是通过巢式聚合酶链反应（nested PCR），在安索阿特吉州巴塞罗那市“路易斯·拉泽蒂医生”医院就诊的儿童中，鉴定溶组织内阿米巴（Entamoeba histolytica）和迪氏内阿米巴（E. dispar）的存在情况。在通过传统显微镜进行粪便寄生虫学评估的1141份粪便样本中，150份被诊断为0至10岁儿童（男女均有）的溶组织内阿米巴阳性。从所有这些样本中获取了体征、症状和完整的粪便寄生虫学报告，并进行巢式PCR以鉴定溶组织内阿米巴和迪氏内阿米巴。传统显微镜检查结果显示，溶组织内阿米巴的诊断频率为13.2%，其中79.3%仅对该病原体呈阳性。然而，巢式PCR显示，在这些样本中，实际上只有28%（42/150）被阿米巴属（Entamoeba spp.）感染，这表明溶组织内阿米巴存在高度过度诊断的情况。我们还鉴定出9.3%的溶组织内阿米巴、4%的迪氏内阿米巴和4.7%的混合感染。腹泻是最常见的症状，其次是腹痛和发热。血便在统计学上与溶组织内阿米巴相关，但在迪氏内阿米巴感染中也有发现。本研究表明，与传统方法互补的分子技术能够正确鉴定阿米巴属，从而有助于改进对这些寄生虫的流行病学评估并实施适当的治疗。
