El-Badry Ayman A, Abd El Wahab Wegdan M, Hamdy Doaa A, Aboud Alaa
Department of Microbiology-Medical Parasitology Section, College of Medicine, Imam Abdulrahman Bin Fasial University (previously University of Dammam), P.O. Box 2114, Dammam, 31451, Saudi Arabia.
Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Parasitol Res. 2018 Jan;117(1):127-137. doi: 10.1007/s00436-017-5679-4. Epub 2017 Nov 14.
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disease presenting clinically by abdominal pain with alteration of bowel habits. Although IBS has uncertain etiology, chronic gut inflammation due to persistent exposure to an infectious agent including Blastocystis sp. was proposed. The aim of this study was to detect the prevalence of Blastocystis sp. subtype (ST) isolated from stool of IBS patients and to assess Blastocystis sp. and H. pylori co-infection in IBS patients from Beni-Suef Governorate, Egypt. Stool samples were collected from 115 IBS patients, following Rome III criteria. All stool samples were microscopically examined by wet mount and permanent trichrome stain, cultured on Jones' medium with further sequencing of positive Blastocystis isolates and screened for detection of H. pylori coproantigen. Blastocystis sp. was the predominant parasite in IBS patients; it had statistical significant association with both rural residence (OR = 10) and flatulence (OR = 8.2). There was a predominance of Blastocystis sp. ST3 (81%) followed by ST1 (19%). Blastocystis culture results (19.1%) were superior than microscopy (16.5%). The majority of Blastocystis-positive IBS patients (72.7%) were co-infected with H. pylori with statistical significance; however, H. pylori was higher in Blastocystis-negative IBS patients (47/64) than in Blastocystis-positive IBS patients (17/64). Interestingly, IBS is usually associated with gut dysbiosis, while the most prevalent parasite in our IBS patients was Blastocystis sp., which is frequently found in asymptomatic individuals. Whether Blastocystis sp. is a cause or a consequence of IBS still needs further investigation, with a particular focus on correlation of IBS with different Blastocystis sp. subtypes and gut microbiomes.
肠易激综合征（IBS）是一种慢性功能性胃肠疾病，临床上表现为腹痛伴排便习惯改变。尽管IBS的病因尚不明确，但有观点认为，持续接触包括芽囊原虫属在内的感染因子会导致慢性肠道炎症。本研究旨在检测从IBS患者粪便中分离出的芽囊原虫属亚型（ST）的流行率，并评估埃及贝尼苏韦夫省IBS患者中芽囊原虫属与幽门螺杆菌的合并感染情况。按照罗马III标准，从115例IBS患者中采集粪便样本。所有粪便样本均通过湿片法和永久性三色染色进行显微镜检查，在琼斯培养基上培养，对阳性芽囊原虫分离株进行进一步测序，并筛查幽门螺杆菌粪便抗原。芽囊原虫属是IBS患者中主要的寄生虫；它与农村居住（比值比[OR]=10）和气胀（OR=8.2）均有统计学显著关联。芽囊原虫属ST3占主导（81%），其次是ST1（19%）。芽囊原虫培养结果（19.1%）优于显微镜检查结果（16.5%）。大多数芽囊原虫阳性的IBS患者（72.7%）合并感染幽门螺杆菌，具有统计学意义；然而，幽门螺杆菌在芽囊原虫阴性的IBS患者（47/64）中比在芽囊原虫阳性的IBS患者（17/64）中更常见。有趣的是，IBS通常与肠道菌群失调有关，而在我们的IBS患者中最常见的寄生虫是芽囊原虫属，它在无症状个体中也经常被发现。芽囊原虫属是IBS的病因还是结果仍需进一步研究，尤其要关注IBS与不同芽囊原虫属亚型及肠道微生物群的相关性。
