Ahmed Shahira Abdelaziz Ali, Mokhtar Amira Bakr, Mohamed Samar Farag, El-Din Marwa Ibrahim Saad, Phanis Catherine O'Dowd, Kazamia Stefani, Schou Chad, Gładysz Paweł, Lass Anna, Quattrocchi Annalisa, Karanis Panagiotis, Gad Samer Eid Mohamed
Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt.
Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt.
Gut Pathog. 2024 Dec 13;16(1):74. doi: 10.1186/s13099-024-00668-y.
Giardia duodenalis (G. duodenalis) is an intestinal protozoan parasite of human and animal hosts. The present study investigated and compared the assemblages of G. duodenalis-infected faecal samples in patients on corticosteroid therapy (POCT) and control patients-not on corticosteroid therapy (CONT) and differentiated its assemblages and/or sub-assemblages' relationship with associated risk factors.
Utilizing multi-locus sequence typing (MLST) with three loci targeted-triosephosphate isomerase (tpi), ꞵ-giardin (bg), and glutamate dehydrogenase (gdh)-G. duodenalis isolated from POCT and CONT were analyzed. Risk factors linked with Giardia infection and its assemblages were investigated.
In total, 52 G. duodenalis-infected patients were enrolled: 21 POCT and 31 CONT. The mean age was 12.3 years, the majority were male (59.6%), and 73.1% lived in rural areas. The POCT group was 36 times more likely than the CONT group to have a concurrent parasitic infection. About 73% (38/52) of Giardia samples were genotyped and/or sub-genotyped in at least one of the three loci. MLST identified sixteen isolates (42.0%) as assemblage B, ten isolates (26.3%) as assemblage A, and twelve isolates (31.6%) as a mixed infection of A + B and B + E. Most individuals of the POCT group were infected with G. duodenalis assemblage A while most of the CONT group were infected with assemblage B. Sub-assemblage AII was identified by phylogenetic analysis in the isolates of both groups under investigation.
This research advances giardiasis epidemiology in Arab Republic of Egypt (ARE) and reflects how corticosteroid-treated patients differ from those non-treated in Giardia assemblage pattern and their susceptibility to concomitant infection. Overall, Giardia assemblage patterns in this research populations reflect anthroponotic and zoonotic transmission, emphasizing the importance of public health policy and giardiasis prevention of illness transmission, particularly among those on corticosteroid therapy in ARE.
十二指肠贾第虫是人和动物宿主的肠道原生动物寄生虫。本研究调查并比较了接受皮质类固醇治疗的患者（POCT）和未接受皮质类固醇治疗的对照患者（CONT）中十二指肠贾第虫感染粪便样本的组合，并区分了其组合和/或亚组合与相关危险因素的关系。
利用针对三个基因座——磷酸丙糖异构酶（tpi）、β-贾第素（bg）和谷氨酸脱氢酶（gdh）的多位点序列分型（MLST）对从POCT和CONT中分离出的十二指肠贾第虫进行分析。研究了与贾第虫感染及其组合相关的危险因素。
总共纳入了52例十二指肠贾第虫感染患者：21例POCT和31例CONT。平均年龄为12.3岁，大多数为男性（59.6%），73.1%生活在农村地区。POCT组并发寄生虫感染的可能性是CONT组的36倍。约73%（38/52）的贾第虫样本在三个基因座中的至少一个进行了基因分型和/或亚基因分型。MLST鉴定出16株（42.0%）为B组，10株（26.3%）为A组，12株（31.6%）为A+B和B+E的混合感染。POCT组的大多数个体感染了十二指肠贾第虫A组，而CONT组的大多数个体感染了B组。通过系统发育分析在两个研究组的分离株中鉴定出AII亚组。
本研究推动了埃及阿拉伯共和国贾第虫病的流行病学研究，并反映了接受皮质类固醇治疗的患者与未接受治疗的患者在贾第虫组合模式及其对合并感染的易感性方面的差异。总体而言，本研究人群中的贾第虫组合模式反映了人传人及人畜共患病传播，强调了公共卫生政策和预防贾第虫病传播的重要性，特别是在埃及阿拉伯共和国接受皮质类固醇治疗的人群中。
