University of Venda, Thohoyandou, South Africa.
Department of Medicine/Division of Infectious Diseases, University of Virginia, Charlottesville.
J Infect Dis. 2017 Dec 19;216(12):1592-1600. doi: 10.1093/infdis/jix535.
Diarrhea is frequent in communities without clean water, which include low-income South African populations in Giyani and Pretoria. In these populations, the amount of diarrhea caused by Entamoeba histolytica, inclusive of all ages, sexes, and human immunodeficiency virus status, is uncertain. Infection with E. histolytica can modulate the host microbiota, and a key species indicative of this is the Prevotella copri pathobiont.
A cross-sectional study of patients attending gastroenterology clinics was conducted to determine the frequency and burden of 4 Entamoeba species and P. copri.
Entamoeba species were present in 27% of patients (129/484), with E. histolytica detected in 8.5% (41), E. dispar in 8% (38), E. bangladeshi in 4.75% (23), and E. moshkovskii in 0%. This is the first description of E. bangladeshi outside Bangladesh. In E. histolytica-positive samples, the levels of both the parasite and P. copri were lower in nondiarrheal samples, validating the results of a study in Bangladesh (P = .0034). By contrast, in E. histolytica-negative samples positive for either of the nonpathogenic species E. dispar or E. bangladeshi, neither P. copri nor Entamoeba levels were linked to gastrointestinal status.
Nonmorphologic identification of this parasite is essential. In South Africa, 3 morphologically identical Entamoeba were common, but only E. histolytica was linked to both disease and changes in the microbiota.
在没有清洁水的社区中，腹泻很常见，包括南非低收入人群聚居的 Giyani 和比勒陀利亚。在这些人群中，由溶组织内阿米巴引起的腹泻的数量（包括所有年龄、性别和人类免疫缺陷病毒状态）尚不确定。溶组织内阿米巴感染可以调节宿主微生物群，指示这一点的关键物种是Prevotella copri 条件致病菌。
对在胃肠病学诊所就诊的患者进行了横断面研究，以确定 4 种内阿米巴物种和 P. copri 的频率和负担。
在 27%的患者（484 例中有 129 例）中存在内阿米巴物种，其中 8.5%（41 例）检测到溶组织内阿米巴，8%（38 例）为迪斯帕内阿米巴，4.75%（23 例）为孟加拉内阿米巴，0%为莫氏内阿米巴。这是首次在孟加拉国以外的地方描述孟加拉内阿米巴。在溶组织内阿米巴阳性样本中，非腹泻样本中寄生虫和 P. copri 的水平均较低，验证了在孟加拉国进行的一项研究的结果（P=0.0034）。相比之下，在溶组织内阿米巴阴性但存在非致病性种迪斯帕内阿米巴或孟加拉内阿米巴的样本中，无论是 P. copri 还是内阿米巴水平都与胃肠道状况无关。
必须进行这种寄生虫的非形态学鉴定。在南非，3 种形态相同的内阿米巴很常见，但只有溶组织内阿米巴与疾病和微生物群的变化有关。
