Advertisement

Evaluation of risk factors associated to detection of Blastocystis sp. in fecal samples in population from Barcelona, Spain: a case-control study

  • Laura Hidalgo
  • Fernando SalvadorEmail author
  • Elena Sulleiro
  • Isabel López
  • Martha Balladares
  • Elena García
  • Carmen Paz
  • Adrián Sánchez-Montalvá
  • Pau Bosch-Nicolau
  • Augusto Sao-Avilés
  • Israel Molina
Original Article

Abstract

Blastocystis sp. is the most common intestinal parasite isolated in humans. The aim of the study was to describe the risk factors associated to Blastocystis sp. detection. A case-control retrospective study was carried out at Vall d’Hebron University Hospital (Barcelona, Spain), which receives all fecal samples collected in Barcelona at primary care level. Eligible patients were patients older than 18 years in whom three consecutive stool samples were examined for parasitic diagnosis from January to December 2017. Positive patients for Blastocystis sp. were assigned as cases whereas negative patients were assigned as controls. Overall, 4174 patients were eligible for the study, from whom 724 (17.3%) had Blastocystis sp. detection. From these, 170 cases (Blastocystis sp. positive) and 170 controls (Blastocystis sp. negative) were randomly selected for inclusion. One hundred and twenty-six (37.1%) of them were immigrants, and 171 (50.3%) patients had traveled out of Spain the year before. The majority of individuals had jobs with no direct contact with other people (health personnel, teachers, and caregivers) (85.6%), and 29.4% were in usual contact with animals. Regarding clinical information, 68.2% of patients presented digestive symptoms, 3.5% presented an immunosuppressant condition, and 6.5% were infected by other intestinal parasites. Variables associated to Blastocystis sp. detection were being born in Africa, having traveled abroad, and working in direct contact with other people. Having other intestinal parasitic infections had a protective value. Our study provides new insights into the epidemiology of Blastocystis sp. in industrialized countries.

Keywords

Blastocystis sp. Intestinal protozoa Risk factors Spain 

Notes

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10096_2019_3532_MOESM1_ESM.docx (14 kb)
Supplementary material : Standardized questionnaire to determine the demographic and clinical characteristics of patients. (DOCX 14 kb)

References

  1. 1.
    Barbosa CV, Barreto MM, De Jesus AR, Sodré F, D’avila Levy CM, Mauro J et al (2018) Intestinal parasite infections in a rural community of Rio de Janeiro (Brazil): prevalence and genetic diversity of Blastocystis subtypes. PLoS One 13:1–12Google Scholar
  2. 2.
    Dacal E, Saugar J, De Lucio A, De Mingo MH, Robinson E, Köster P et al (2018) Prevalence and molecular characterization of Strongyloides stercoralis, Giardia duodenalis, Cryptosporidium spp. and Blastocystis spp. isolates in school children in Cubal, Western Angola. Parasit Vectors 11:1–18CrossRefGoogle Scholar
  3. 3.
    Liao CW, Chuang TW, Huang YC, Chou CM, Chiang CL, Lee FP et al (2017) Intestinal parasitic infections: current prevalence and risk factors among schoolchildren in capital area of the Republic of Marshall Islands. Acta Trop 176:242–248CrossRefPubMedGoogle Scholar
  4. 4.
    Popruk S, Rada Pintong A, Radomyos P (2013) Diversity of Blastocystis subtypes in humans. J Trop Med Parasitol 36:88–97Google Scholar
  5. 5.
    Kazmarekk A, Gola BE, Zarnoska Prymek H, Rawska A, Janzak D, Lewicki A et al (2017) Genetic diversity of Blastocystis hominis sensu lato isolated from humans in Poland. Przegl Epidemiol 71:539–546Google Scholar
  6. 6.
    Mohamed AM, Ahmed MA, Ahmed SA, Al-Semany SA, Alghamdi SS, Zaglool DA (2017) Predominance and association risk of Blastocystis hominis subtype 1 in colorectal cancer: a case control study. Infect Agent Cancer 12:21CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    El-Safadi D, Gaayeb L, Meloni D, Cian A, Poirier P, Wawryniak et al (2014) Children on Senegal river basin show the highest prevalence of Blastocystis sp. ever observed worldwide. BMC Infect Dis 14:1–11CrossRefGoogle Scholar
  8. 8.
    Alfellani MA, Stesnvold CR, Vidal-Lapiedra A, Onuoha ES, Fagbenro-Beyjoku AF, Clark CG (2013) Variable geographic distribution of Blastocystis subtypes and its potential implications. Acta Trop 126:11–18CrossRefGoogle Scholar
  9. 9.
    Heydary-Hengami M, Hamedi Y, Najadi-Asl M, Sharifi-Sarasiabi K (2018) Prevalence of intestinal parasites in food handlers of Bandar Abbas, Southern Iran. Iran J Public Health 47:111–118Google Scholar
  10. 10.
    Belleza MLB, Cadacio JLC, Borja MP, Solon JAA, Padilla MA, Tongol-Rivera PN et al (2015) Epidemiologic study of Blastocystis infection in an urban community in the Philippines. J Environ Public Health 2015:1–7CrossRefGoogle Scholar
  11. 11.
    Javanmard E, Niyyati M, Ghasemi E, Mirjalali H, Asadzadeh-Aghdaei H, Zali MR (2018) Impacts of human development index and climate conditions on prevalence of Blastocystosis a systematic review and meta-analysis. Acta Trop 185:193–203Google Scholar
  12. 12.
    Leder K, Hellar ME, Sinclair MI, Fairley CK, Wolfe R (2005) No correlation between clinical symptoms and Blastocystis hominis in immunocompetent individuals. J Gastroenterol Hepatol 20:1390–1394CrossRefPubMedGoogle Scholar
  13. 13.
    Sohail MR, Fischer PR (2005) Blastocystis hominis and travelers. Travel Med Infect Dis 3:33–38CrossRefPubMedGoogle Scholar
  14. 14.
    Eroglu F, Koltas IS (2010) Evaluation of the transmission mode of B. hominis by using PCR method. Parasitol Res 107(84):841–845CrossRefPubMedGoogle Scholar
  15. 15.
    Salvador F, Sulleiro E, Sánchez-Montalvá A, Alonso C, Santos J, Fuentes I et al (2016) Epidemiological and clinical profile of adult patients with Blastocystis hominis infection in Barcelona, Spain. Parasit Vectors 9:1–7CrossRefGoogle Scholar
  16. 16.
    Stensvold CR, Lewis HC, Hammerum AM, Porsbo LJ, Nielsen SS, Olsen KEP et al (2009) Blastocystis: unravelling potential risk factors and clinical significance of a common but neglected parasite. Epidemiol Infect 137:1655–1663CrossRefGoogle Scholar
  17. 17.
    Wawrzyniak I, Poirier P, Viscolgliosi E, Dionigia M, Texier C, Delbac F et al (2013) Blastocystis, and unrecognized parasite: an overview of pathogenesis and diagnosis. Ther Adv Inf Dis 5:167–178Google Scholar
  18. 18.
    Paulos S, Köster P, Lucio A, Hernández-de-Mingo M, Cardona GA, Fernández-Crespo JC, Stensvold CR, Carmena D (2018) Occurrence and subtype distribution of Blastocystis sp. in humans, dogs and cats sharing household in northern Spain and assessment of zoonotic transmission risk. Zoonoses Public Health 65:993–1002CrossRefGoogle Scholar
  19. 19.
    Del Aguila C, Navajas R, Gurbindo D, Ramos JT, Mellado MJ, Fenoy S, Muóz MA, Subirats M, Ruiz J, Pleniazek NJ (1997) Microsporidiosis in HIV-positive children in Madrid (Spain). J Eukaryot Microbiol 44(6):84–85CrossRefGoogle Scholar
  20. 20.
    Bart A, Wentink-Bonnema EM, Gilis H, Verhaar N, Wassenaar CJ, Van Vugt M et al (2013) Diagnosis and subtype analysis of Blastocystis sp. in 442 patients in a hospital setting in the Netherlands. BMC Infect Dis 13:1–6CrossRefGoogle Scholar
  21. 21.
    Stensvold CR, Clark CG (2016) Current status of Blastocystis: a personal view. Parasitol Int 65:763–771CrossRefGoogle Scholar
  22. 22.
    Beghini F, Pasolli E, Truong TD, Putignani L, Caddiò SM, Segata N (2017) Large-scale comparative metagenomics of Blastocystis, a common member of the human gut microbiome. ISME J 11:2848–2863CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Krogsgaard LR, Engsbro AL, Stensvold CR, Nielsen HV, Bytzer P (2015) The prevalence of intestinal parasites is not greater among individuals with irritable bowel syndrome: a population-based case-control study. Clin Gastroenterol Hepatol 13:507–513CrossRefPubMedGoogle Scholar
  24. 24.
    González-Moreno O, Domingo L, Teixidor J, Gracenea M (2011) Prevalence and associated factors of intestinal parasitation: a cross-sectional study among outpatients with gastrointestinal symptoms in Catalonia, Spain. Parasitol Res 108:87–89CrossRefPubMedGoogle Scholar
  25. 25.
    Ocaña-Losada C, Cuenca-Gómez JA, Cabezas-Fernández MT, Vázquez-Villegas K, Soriano-Pérez MJ, Cabeza-Barrera I et al (2018) Clinical and epidemiological characteristics of intestinal parasite infection by Blastocystis hominis. Rev Clin Esp 218:115–120CrossRefPubMedGoogle Scholar
  26. 26.
    Martín-Sánchez AM, Canut-Blasco A, Hernández JR, Montes-Martínez I, Rodriguez JAG (1992) Epidemiology and clinical significance of Blastocystis hominis in different population groups in Salamanca, Spain. Eur J Epidemiol 8:553–559CrossRefPubMedGoogle Scholar
  27. 27.
    El-Safadi D, Cian A, Nourrisson C, Pereira B, Morelle C, Bastien P et al (2016) Prevalence, risk factors for infection and subtype distribution of the intestinal parasite Blastocystis sp. from a large-scale multi-center study in France. BMC Infect Dis 16:451–462CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Mohtashamipour M, Hoseini SG, Pestehchian N, Yousefi H, Fallah E, Hazratian T (2015) Intestinal parasitic infections in patients with diabetes mellitus: a case-control study. J Anal Res Clin Med 3:157–163CrossRefGoogle Scholar
  29. 29.
    Ghimire A, Bhandaria S, Tandukar S, Amatya J, Bhandari D, Sherchand JB (2016) Enteric parasitic infection among HIV-infected patients visiting Tribhuvan University Teaching Hospital. Nepal BMC Res Not 9:1–5CrossRefGoogle Scholar
  30. 30.
    Punsawad C, Phasuk N, Bunratsami S, Thongtup K, Siripakonuaong N, Nongnaul S (2017) Prevalence of intestinal parasitic infection and associated risk factors among village health volunteers in rural communities of Southern Thailand. BMC Public Health 17:1–9CrossRefGoogle Scholar
  31. 31.
    Salim HR, Kumar GS, Vellayan S, Mak JW, Anuar AK, Init I et al (1999) Blastocystis in animal handlers. Parasitol Res 85:1032–1033CrossRefGoogle Scholar
  32. 32.
    Alfellani MA, Jacob AS, Perea NO, Krecek RC, Taner-Mulla D, Verweij JJ et al (2013) Diversity and distribution of Blastocystis sp. subtypes in non-human primates. Parasitol. 140:966–971CrossRefGoogle Scholar
  33. 33.
    Marcos LA, Gotuzzo E (2013) Intestinal protozoan infections in the immunocompromised host. Curr Opinion Inf Dis 26:295–301CrossRefGoogle Scholar
  34. 34.
    Leelayoova S, Siripattanapipong S, Thathaisong U, Naaglor T, Taamasri P, Piyaraj P et al (2008) Drinking water: a possible source of Blastocystis spp. subtype 1 infection in schoolchildren of a rural community in Central Thailand. Am J Trop Med Hyg 79:401–406CrossRefGoogle Scholar
  35. 35.
    Ramírez JD, Flórez C, Olivera M, Bernal MC, Giraldo JC (2017) Blastocystis subtyping and its association with intestinal parasites in children from different geographical regions of Colombia. PLoS One 12:1–13Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Laura Hidalgo
    • 1
  • Fernando Salvador
    • 2
    Email author
  • Elena Sulleiro
    • 3
  • Isabel López
    • 3
  • Martha Balladares
    • 3
  • Elena García
    • 3
  • Carmen Paz
    • 3
  • Adrián Sánchez-Montalvá
    • 2
  • Pau Bosch-Nicolau
    • 2
  • Augusto Sao-Avilés
    • 2
  • Israel Molina
    • 2
  1. 1.Universitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Department of Infectious DiseasesVall d’Hebron University Hospital, PROSICS BarcelonaBarcelonaSpain
  3. 3.Department of MicrobiologyVall d’Hebron University Hospital, PROSICS BarcelonaBarcelonaSpain

Personalised recommendations