Ibrahim Shimaa S, El-Matarawy Olfat M, Ghieth Marwa A, Abu Sarea Enas Y, El-Badry Ayman A
Department of Medical Parasitology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
World J Microbiol Biotechnol. 2015 Feb;31(2):385-90. doi: 10.1007/s11274-014-1791-0. Epub 2014 Dec 27.
Amoebiasis diagnosis is usually based on microscopy that cannot differentiate pathogenic E. histolytica from morphologically identical non-pathogenic species. 194 fecal samples were collected from diarrheic &/or dysenteric patients and examined for Entamoeba complex microscopically, E. histolytica/E. dispar coproantigen using ICT and E. histolytica coproantigen using Tech lab E. histolytica II ELISA test. Entamoeba complex trophozoites/cysts, E. histolytica/E. dispar coproantigen and E. histolytica coproantigen were detected in 22.2, 14.4 and 3.6 % of samples, respectively. Microscopy and ICT method had limited sensitivity with poor PPV (9.3 and 7.1 %, respectively) and both slightly agree with ELISA test. The prevalence of E. histolytica was low (3.6 %) in studied individuals and was 14 times lower than non-pathogenic amoebae. E. histolytica detection studied individuals was positively associated with mucoid and bloody stool, which makes them disease predictors. E. histolytica fecal ELISA assay for E. histolytica detection surpassed microscopy and E. histolytica/E. dispar ICT assay. This has highlighted the need for practical non-microscopic detection methods that can differentiate between amoeba infections to avoid unnecessary and possibly harmful therapies and to determine the true prevalence and epidemiology of E. histolytica.
阿米巴病的诊断通常基于显微镜检查,但这种方法无法区分致病性溶组织内阿米巴与形态相同的非致病性物种。从腹泻和/或痢疾患者中收集了194份粪便样本,通过显微镜检查检测内阿米巴复合体,使用免疫层析法检测溶组织内阿米巴/迪斯帕内阿米巴粪便抗原,使用Tech lab溶组织内阿米巴II ELISA检测法检测溶组织内阿米巴粪便抗原。分别在22.2%、14.4%和3.6%的样本中检测到内阿米巴复合体滋养体/包囊、溶组织内阿米巴/迪斯帕内阿米巴粪便抗原和溶组织内阿米巴粪便抗原。显微镜检查和免疫层析法的敏感性有限,阳性预测值较低(分别为9.3%和7.1%),两者与ELISA检测法的一致性都稍差。在研究对象中,溶组织内阿米巴的患病率较低(3.6%),比非致病性阿米巴低14倍。在研究对象中,溶组织内阿米巴的检测与黏液样和血性粪便呈正相关,这使其成为疾病预测指标。用于溶组织内阿米巴检测的粪便ELISA检测法优于显微镜检查和溶组织内阿米巴/迪斯帕内阿米巴免疫层析检测法。这突出表明需要实用的非显微镜检测方法,以区分阿米巴感染,避免不必要的、可能有害的治疗,并确定溶组织内阿米巴的真实患病率和流行病学情况。