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粪类圆线虫感染增加了恰加斯病患者外周血中检测到克氏锥虫DNA的可能性。

Strongyloides stercoralis infection increases the likelihood to detect Trypanosoma cruzi DNA in peripheral blood in Chagas disease patients.

作者信息

Salvador Fernando, Sulleiro Elena, Piron Maria, Sánchez-Montalvá Adrián, Sauleda Silvia, Molina-Morant Daniel, Moure Zaira, Molina Israel

机构信息

Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain.

Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.

出版信息

Trop Med Int Health. 2017 Nov;22(11):1436-1441. doi: 10.1111/tmi.12970. Epub 2017 Sep 20.

Abstract

OBJECTIVES

In a previous study performed by our group, Strongyloides stercoralis infection in patients with Chagas disease was associated with higher proportion of Trypanosoma cruzi DNA detection in peripheral blood. The aim of the study was to confirm this association in a larger cohort of patients.

METHODS

Cross-sectional study of all patients with Chagas disease diagnosed from 2005 to 2015 during blood donation at the Catalan Blood Bank. Demographic data and T. cruzi RT-PCR were collected. S. stercoralis infection diagnosis was based on a serological test.

RESULTS

Two hundred and two blood donors were included. T. cruzi RT-PCR was positive in 72 (35.6%) patients, and S. stercoralis serology was positive in 22 (10.9%) patients. Patients with positive S. stercoralis serology had higher proportion of positive T. cruzi RT-PCR than those with negative serology (54.5% vs. 33.3%, P = 0.050), and the difference increased when taking a serological index cut-off of 2.5, which increases the specificity of the test to detect a confirmed strongyloidiasis (60% vs. 33%, P = 0.017).

CONCLUSIONS

Patients with Chagas disease with positive S. stercoralis serology had higher proportion of positive T. cruzi RT-PCR in peripheral blood than those with negative serology, which reflects the potential immunomodulatory effects of S. stercoralis in T. cruzi co-infected patients.

摘要

目的

在我们团队之前进行的一项研究中,查加斯病患者的粪类圆线虫感染与外周血中克氏锥虫DNA检测比例较高有关。本研究的目的是在更大的患者队列中证实这种关联。

方法

对2005年至2015年期间在加泰罗尼亚血库献血时被诊断为查加斯病的所有患者进行横断面研究。收集人口统计学数据和克氏锥虫逆转录聚合酶链反应(RT-PCR)结果。粪类圆线虫感染诊断基于血清学检测。

结果

纳入了202名献血者。72名(35.6%)患者的克氏锥虫RT-PCR呈阳性,22名(10.9%)患者的粪类圆线虫血清学检测呈阳性。粪类圆线虫血清学检测呈阳性的患者中克氏锥虫RT-PCR阳性的比例高于血清学检测呈阴性的患者(54.5%对33.3%,P = 0.050),当采用血清学指数截断值2.5时,差异增大,这提高了检测确诊类圆线虫病的试验特异性(60%对33%,P = 0.017)。

结论

粪类圆线虫血清学检测呈阳性的查加斯病患者外周血中克氏锥虫RT-PCR阳性的比例高于血清学检测呈阴性的患者,这反映了粪类圆线虫在克氏锥虫合并感染患者中的潜在免疫调节作用。

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