Parasitology-Mycology Department, Toulouse University Hospital, 31059 Toulouse, France.
Parasitology-Mycology Department, Toulouse University Hospital, 31059 Toulouse, France - Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, INSERM UMR1291, Paul Sabatier University, 31024 Toulouse, France.
Parasite. 2024;31:40. doi: 10.1051/parasite/2024041. Epub 2024 Jul 24.
Dientamoeba fragilis is a ubiquitous intestinal parasite with detection in the stools that has become increasingly frequent following the advent of PCR as a routine screening tool. However, the pathogenicity of this parasite is still much debated. In order to assess the potentially pathogenic nature of this protozoan, a retrospective case-control study was carried out between January and December 2020 on patients from Toulouse University Hospital, with the aim of evaluating the potential clinical effects and changes in laboratory parameters linked to the presence and load of D. fragilis in stools. After matching age, sex and mode of care (consultation or hospitalisation), no significant difference was observed in the frequency of clinical signs between the 36 patients who tested positive for Dientamoeba fragilis PCR in their stools and the 72 control patients who were PCR negative for this protozoan. The presence of D. fragilis in the faeces was not associated with changes in laboratory parameters. Furthermore, a high digestive load of D. fragilis had no identifiable impact on clinical and laboratory parameters. Only the concomitant presence of Blastocystis sp. in stools was significantly more frequent in the D. fragilis group (uni- and multivariate analysis). Finally, this study showed no significant difference in clinical or laboratory signs between patients carrying Dientamoeba fragilis and the control group, regardless of the intestinal parasite load, suggesting that D. fragilis could be considered a commensal of the digestive tract.
脆弱双核阿米巴是一种普遍存在的肠道寄生虫，随着 PCR 作为常规筛查工具的出现，其在粪便中的检测越来越频繁。然而，这种寄生虫的致病性仍存在很大争议。为了评估这种原生动物的潜在致病性，我们对 2020 年 1 月至 12 月期间图卢兹大学医院的患者进行了一项回顾性病例对照研究，旨在评估粪便中存在和负荷的脆弱双核阿米巴与临床效果和实验室参数变化之间的潜在关系。在匹配年龄、性别和护理模式（门诊或住院）后，我们发现粪便中 PCR 检测到脆弱双核阿米巴的 36 例患者与 PCR 检测结果为阴性的 72 例对照患者之间，临床体征的频率没有显著差异。粪便中存在脆弱双核阿米巴与实验室参数的变化无关。此外，高消化负荷的脆弱双核阿米巴对临床和实验室参数没有可识别的影响。只有粪便中同时存在芽囊原虫的情况在脆弱双核阿米巴组中更为频繁（单变量和多变量分析）。最后，这项研究表明，无论肠道寄生虫负荷如何，携带脆弱双核阿米巴的患者与对照组在临床或实验室体征方面均无显著差异，这表明脆弱双核阿米巴可能被认为是消化道的共生体。
