贾第虫病概述

Giardiasis: An Overview.

作者信息

Leung Alexander K C, Leung Amy A M, Wong Alex H C, Sergi Consolato M, Kam Joseph K M

机构信息

Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.

Department of Family Medicine, The University of Alberta, Edmonton, Alberta, Canada.

出版信息

Recent Pat Inflamm Allergy Drug Discov. 2019;13(2):134-143. doi: 10.2174/1872213X13666190618124901.

DOI:10.2174/1872213X13666190618124901

PMID:31210116

Abstract

BACKGROUND

Giardiasis is an important cause of waterborne and foodborne diarrhea, daycare center outbreaks, and traveler's diarrhea.

OBJECTIVE

The study aimed to provide an update on the evaluation, diagnosis, and treatment of giardiasis.

METHODS

A PubMed search was completed in Clinical Queries using the key terms "giardiasis", "Giardia lamblia", "Giardia duodenalis" and "Giardia intestinalis". The search strategy included metaanalyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to the English literature. Patents were searched using the key term "giardiasis" from www.freepatentsonline.com.

RESULTS

Giardiasis is caused by the protozoan parasite Giardia lamblia. The parasite is transmitted by the fecal-oral route, frequently through ingestion of contaminated water and food or person-to person transmission. Risk factors for infection include children in day-care settings, child-care workers, institutionalized individuals, travelers in endemic areas, ingestion of contaminated or recreational water, immunodeficiency, cystic fibrosis, and oral-anal sex. Approximately 50 to 75% of infected children are asymptomatic. Other children present acute or chronic diarrhea. Direct fluorescent antibody tests that detect intact organisms, enzyme immunoassays that detect soluble antigens, and multiplex real-time polymerase chain reaction assays that detect specific genes of the parasite in stool samples have improved sensitivity and specificity compared with microscopic examination of stool specimens for the detection of Giardia trophozoites or cysts. Drugs used in the treatment of symptomatic giardiasis are reviewed in this study. Moreover, recent patents related to the management of giardiasis are also discussed.

CONCLUSION

Metronidazole, tinidazole, and nitazoxanide are drugs of choice. Resistance to common antigiardial drugs has increased in recent years, therefore, the search for new molecular targets for antigiardial drugs is urgently needed. In general, treatment of asymptomatic carriers is not recommended. Purification of water supply is an important preventive measure.

摘要

背景

贾第虫病是水源性和食源性腹泻、日托中心暴发以及旅行者腹泻的重要病因。

目的

本研究旨在提供贾第虫病评估、诊断和治疗的最新信息。

方法

在临床查询中使用关键词“贾第虫病”“蓝氏贾第鞭毛虫”“十二指肠贾第虫”和“肠贾第虫”在PubMed上完成检索。检索策略包括荟萃分析、随机对照试验、临床试验、观察性研究和综述。检索限于英文文献。使用关键词“贾第虫病”在www.freepatentsonline.com上检索专利。

结果

贾第虫病由原生动物寄生虫蓝氏贾第鞭毛虫引起。该寄生虫通过粪口途径传播，通常是通过摄入受污染的水和食物或人传人传播。感染的危险因素包括日托机构中的儿童、儿童保育员、机构化个体、流行地区的旅行者、摄入受污染的或用于娱乐的水、免疫缺陷、囊性纤维化以及口交。大约50%至75%受感染的儿童无症状。其他儿童则出现急性或慢性腹泻。与粪便标本显微镜检查以检测贾第虫滋养体或包囊相比，检测完整生物体的直接荧光抗体试验、检测可溶性抗原的酶免疫测定以及检测粪便样本中寄生虫特定基因的多重实时聚合酶链反应测定具有更高的敏感性和特异性。本研究综述了用于治疗有症状贾第虫病的药物。此外，还讨论了与贾第虫病管理相关的近期专利。