Epidemiology and Infection

Original Papers

Parasites

Blastocystis: unravelling potential risk factors and clinical significance of a common but neglected parasite

C. R. STENSVOLDa1 c1, H. C. LEWISa2, A. M. HAMMERUMa3, L. J. PORSBOa4, S. S. NIELSENa1, K. E. P. OLSENa1, M. C. ARENDRUPa1, H. V. NIELSENa1 and K. MØLBAKa2

a1 Department of Bacteriology, Mycology and Parasitology, Statens Serum Institut, Copenhagen, Denmark

a2 Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark

a3 National Centre for Antimicrobials and Infection Control, Statens Serum Institut, Copenhagen, Denmark

a4 National Food Institute, Technical University of Denmark, Søborg, Denmark

SUMMARY

Two independent studies were conducted to describe symptoms and potential risk factors associated with Blastocystis infection. Isolates were subtyped by molecular analysis. In the NORMAT study (126 individuals randomly sampled from the general population) 24 (19%) were positive for Blastocystis. Blastocystis was associated with irritable bowel syndrome (P=0·04), contact with pigs (P<0·01) and poultry (P=0·03). In the Follow-up (FU) study (follow-up of 92 Blastocystis-positive patients), reports on bloating were associated with subtype (ST) 2 (P<0·01), and blood in stool to mixed subtype infection (P=0·06). ST1 was more common in FU individuals (32%) than in NORMAT individuals (8%), whereas single subtype infections due to ST3 or ST4 were seen in 63% of the NORMAT cases and 28% of the FU cases. Only FU individuals hosted ST7, and ST6/7 infections due to ST7 or ST9 were characterized by multiple intestinal symptoms. The data indicate subtype-dependent differences in the clinical significance of Blastocystis.

(Accepted April 03 2009)

(Online publication April 27 2009)

Correspondence:

c1 Author for correspondence: Dr C. R. Stensvold, Department of Bacteriology, Mycology and Parasitology, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark. (Email: RUN@ssi.dk)

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