Nagata Noriyuki, Marriott Deborah, Harkness John, Ellis John T, Stark Damien
Division of Microbiology, SydPath, St. Vincent's Hospital, Darlinghurst, Australia ; University of Technology Sydney, School of Medical and Molecular Biosciences, Broadway, Australia.
University of Technology Sydney, School of Medical and Molecular Biosciences, Broadway, Australia ; University of Technology Sydney, iThree Institute, Broadway, Australia.
Int J Parasitol Drugs Drug Resist. 2012 Sep 3;2:204-15. doi: 10.1016/j.ijpddr.2012.08.002. eCollection 2012 Dec.
Dientamoeba fragilis belongs to the trichomonad group of protozoan parasites and it has been implicated as a cause of gastrointestinal disease with world-wide prevalences ranging from 0.5% to 16%. The majority of patients with dientamoebiasis present with gastrointestinal complaints. Chronic symptoms are common with up to a third of patients exhibiting persistent diarrhoea. Numerous studies have successfully demonstrated parasite clearance, coupled with complete resolution of clinical symptoms following treatment with various antiparasitic compounds. Treatments reported to be successful for dientamoebiasis include carbarsone, diphetarsone, tetracyclines, paromomycin, erythromycin, hydroxyquinolines and the 5-nitroimidazoles, including metronidazole, secnidazole, tinidazole and ornidazole. It is of note that most current treatment data is based only on small number of case reports. No large scale double blind randomised placebo controlled trials testing the efficacy of antimicrobial agents against D. fragilis has been undertaken highlighting the need for further study. In addition there is very little in vitro susceptibility data available for the organism making some current treatment options questionable. The aim of this review is to critically discuss all treatment options currently available for dientamoebiasis.
脆弱双核阿米巴属于原生动物寄生虫的毛滴虫类，它被认为是一种胃肠道疾病的病因，在全球的患病率为0.5%至16%。大多数患双核阿米巴病的患者都有胃肠道不适症状。慢性症状很常见，多达三分之一的患者表现出持续性腹泻。许多研究已成功证明，使用各种抗寄生虫化合物治疗后，寄生虫得以清除，临床症状也完全缓解。据报道，对双核阿米巴病治疗成功的药物包括卡巴胂、双醋二胂、四环素、巴龙霉素、红霉素、羟基喹啉以及5-硝基咪唑类药物，包括甲硝唑、塞克硝唑、替硝唑和奥硝唑。值得注意的是，目前大多数治疗数据仅基于少数病例报告。尚未进行大规模双盲随机安慰剂对照试验来测试抗菌药物对脆弱双核阿米巴的疗效，这突出表明需要进一步研究。此外，关于该生物体的体外药敏数据非常少，这使得一些当前的治疗选择存在疑问。本综述的目的是批判性地讨论目前可用于双核阿米巴病的所有治疗选择。
