Infectious Diseases Unit, Meyer Children's University Hospital, Florence, Italy.
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Travel Med Infect Dis. 2021 Sep-Oct;43:102107. doi: 10.1016/j.tmaid.2021.102107. Epub 2021 Jun 9.
Enteric parasite infections are underestimated due to the limited sensitivity and specificity of microscopy, which remains the diagnostic gold standard in routine clinical practice. This could be a major problem in high-income countries, where the burden of parasitic diseases is low. In recent years, Multiplex Real-Time polymerase chain reaction (RT-PCR) based methods have been implemented. Therefore, the aim of this study was to evaluate the prevalence of four enteric protozoan species detected by RT-PCR in non-native children in Italy, and to describe their clinical characteristics.
Adopted and immigrant children, evaluated for migration health assessment between 2017 and 2020 in a tertiary care children's hospital in Italy, were enrolled. Molecular analysis for Giardia lamblia, Dientamoeba fragilis, Blastocystis hominis, and Entamoeba histolytica, was conducted by in-house RT-PCR.
Overall, 209 children were enrolled and 70% of them resulted positive by RT-PCR for at least one enteric parasite. B. hominis (47.8%) was the most commonly identified protozoa, followed by D. fragilis (44.5%). Co-infections with multiple pathogens were detected in 35.4% of the samples. Almost 80% of parasite-positive children were asymptomatic and the most common symptom was flatulence (60.7% of symptomatic children). Eosinophils were significantly increased in RT-PCR positive children compared to the negative ones and children with D. fragilis presented the highest eosinophils count.
The In-house Multiplex RT-PCR assay provides a valid molecular detection system for selected enteric parasites. This novel and accurate diagnostic method can help in increasing the detection rate of parasite infection, especially in high-risk population.
由于显微镜检查的敏感性和特异性有限，肠道寄生虫感染的情况被低估了，而显微镜检查仍然是常规临床实践中的诊断金标准。这在高收入国家可能是一个主要问题，因为这些国家寄生虫病的负担较低。近年来，已经实施了基于多重实时聚合酶链反应（RT-PCR）的方法。因此，本研究的目的是评估 RT-PCR 检测到的四种肠道原生动物在意大利非本地儿童中的流行情况，并描述其临床特征。
在意大利一家三级儿童保健医院，对 2017 年至 2020 年期间进行移民健康评估的收养和移民儿童进行了研究。采用内部 RT-PCR 对蓝氏贾第鞭毛虫、脆弱双核阿米巴、人芽囊原虫和溶组织内阿米巴进行分子分析。
共有 209 名儿童入组，其中 70%的儿童通过 RT-PCR 至少检测到一种肠道寄生虫呈阳性。人芽囊原虫（47.8%）是最常见的原生动物，其次是脆弱双核阿米巴（44.5%）。在 35.4%的样本中检测到多种病原体的混合感染。几乎 80%的寄生虫阳性儿童无症状，最常见的症状是胀气（60.7%的有症状儿童）。与 RT-PCR 阴性儿童相比，RT-PCR 阳性儿童的嗜酸性粒细胞明显增加，且携带脆弱双核阿米巴的儿童嗜酸性粒细胞计数最高。
内部多重 RT-PCR 检测法为选定的肠道寄生虫提供了有效的分子检测系统。这种新颖且准确的诊断方法有助于提高寄生虫感染的检测率，特别是在高危人群中。
