V Fallah Omrani1,2, Sh Fallahi3, A Rostami4, A Siyadatpanah5, Gh Barzgarpour6, S Mehravar7, F Memari8, F Hajialiani9, Z Joneidi9. 1. Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Department of Biotechnology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Department of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran. 4. Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. alirostami1984@gmail.com. 5. Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 6. 29-Bahman Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. 7. Department of Epidemiology and Statistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran. 8. Department of Biotechnology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 9. Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
PURPOSE: Intestinal parasitic infections (IPIs) can result in high morbidity and mortality, particularly in immunocompromised patients. Infectious diseases are among the main causes of death in end-stage renal disease (ESRD) patients due to their impaired immune systems. The aim of this study was to determine the prevalence IPIs and their associated symptoms in ESRD patients. METHODS: In this case-control study, the fecal samples of 78 ESRD patients undergoing hemodialysis and 140 controls without any kidney problems were analyzed for intestinal parasites using direct-smear, formol-ether and modified Ziehl-Neelsen staining techniques. RESULTS: The difference in the prevalence of IPIs between ESRD patients (30.7 %) and the control group (10.7 %) was significant (OR = 3.7; 95 % CI = 1.8-7.61; P < 0.001). Blastocystis (14.1 %) and Cryptosporidium spp.(11.5 %) were the most common IPIs detected in ESRD patients, and the presence of Cryptosporidium spp. was significantly associated with diarrhea in ESRD patients (OR = 16; 95 % CI = 1.54-166.05; P < 0.05). Leukocytosis, diarrhea, weight loss, nausea/vomiting and bloating were also significantly higher in the hemodialysis group when compared with the control group. CONCLUSION: The current study revealed a high prevalence of intestinal parasites and related clinical symptoms in ESRD patients undergoing hemodialysis. Since hemodialysis patients are immunocompromised and intestinal parasites can cause serious clinical complications, we suggest that stool examination for intestinal parasites, with an emphasis on detection of Cryptosporidium spp. and Blastocystis, should be incorporated into the routine clinical care for these patients. Measures for preventing the acquisition of IPIs are also recommended.
PURPOSE:Intestinal parasitic infections (IPIs) can result in high morbidity and mortality, particularly in immunocompromised patients. Infectious diseases are among the main causes of death in end-stage renal disease (ESRD) patients due to their impaired immune systems. The aim of this study was to determine the prevalence IPIs and their associated symptoms in ESRDpatients. METHODS: In this case-control study, the fecal samples of 78 ESRDpatients undergoing hemodialysis and 140 controls without any kidney problems were analyzed for intestinal parasites using direct-smear, formol-ether and modified Ziehl-Neelsen staining techniques. RESULTS: The difference in the prevalence of IPIs between ESRDpatients (30.7 %) and the control group (10.7 %) was significant (OR = 3.7; 95 % CI = 1.8-7.61; P < 0.001). Blastocystis (14.1 %) and Cryptosporidium spp.(11.5 %) were the most common IPIs detected in ESRDpatients, and the presence of Cryptosporidium spp. was significantly associated with diarrhea in ESRDpatients (OR = 16; 95 % CI = 1.54-166.05; P < 0.05). Leukocytosis, diarrhea, weight loss, nausea/vomiting and bloating were also significantly higher in the hemodialysis group when compared with the control group. CONCLUSION: The current study revealed a high prevalence of intestinal parasites and related clinical symptoms in ESRDpatients undergoing hemodialysis. Since hemodialysis patients are immunocompromised and intestinal parasites can cause serious clinical complications, we suggest that stool examination for intestinal parasites, with an emphasis on detection of Cryptosporidium spp. and Blastocystis, should be incorporated into the routine clinical care for these patients. Measures for preventing the acquisition of IPIs are also recommended.
Authors: Keith W Hamilton; Peter L Abt; Misha A Rosenbach; Melissa B Bleicher; Marc S Levine; Jimish Mehta; Susan P Montgomery; Richard D Hasz; Bartholomew R Bono; Michael T Tetzlaff; Shirly Mildiner-Early; Camille E Introcaso; Emily A Blumberg Journal: Transplantation Date: 2011-05-15 Impact factor: 4.939
Authors: Grazia Malaponte; Massimo Libra; Ylenia Bevelacqua; Paola Merito; Pasquale Fatuzzo; Francesco Rapisarda; Maria Cristina; Gabriele Naselli; Franca Stivala; Maria C Mazzarino; Pietro Castellino Journal: Int J Mol Med Date: 2007-10 Impact factor: 4.101