Acta Parasitologica

, Volume 60, Issue 1, pp 116–123 | Cite as

The pathogenic role of Blastocystis isolated from patients with irritable bowel syndrome and colitis from Iasi, Romania

  • Doina S. MatiutEmail author
  • Lucian Hritcu


Blastocystis is a common parasite and regarded as one of the etiologic agents of irritable bowel syndrome, colitis and chronic diarrhea. Our study was undertaken in order to identify different subtypes of Blastocystis isolated in patients with irritable bowel syndrome and colitis, as well as with chronic diarrhea and to evaluate their pathogenic potential. Seventy-three subjects (10 asymptomatic infected subjects, 49 subjects harboring Blastocystis or associated with other etiologic agents like bacteria, yeasts, protozoa, helminthes and 14 subjects with unknown etiologic agents) were investigated by in vitro parasitological and bacteriological stool samples followed by PCR subtyping of Blastocystis using STS primers, immunological markers (total serum IgA and IgE antibody levels), Helicobacter pylori antigen rapid test and fecal occult blood test. Also, among 49 subjects, there were 12 subjects harboring Blastocystis as the single etiologic agent. Subtyping proved that only three subtypes of Blastocystis were identified as following: subtype II (66.66%) in single infected subjects, subtype I (16.66%) in mixed infection with subtype II and subtype IV (8.33%) in single infected subjects. Total serum IgA and IgE antibody levels were in normal range. Subtype II was the most frequent subtype followed by subtype I and subtype IV of Blastocystis isolates in patients with irritable bowel syndrome, colitis, and chronic diarrhea as well as in asymptomatic infected group. Our results suggest that the severity of clinical manifestations depend on factors involving the host and possible parasitic density and not necessarily by isolated subtype.


Blastocystis subtype host irritable bowel syndrome colitis chronic diarrhea 


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  1. Albrecht H., Stellbrink H.J., Koperski K., Greten H. 1995. Blastocystis hominis in human immunodeficiency virus-related diarrhea. Scandinavian Journal of Gastroenterology, 30, 909–914CrossRefGoogle Scholar
  2. Baldo E.T., Belizario V.Y., de Leon W.U., Kong H.H., Chung D.I. 2004. Infection status of intestinal parasites in children living in residential institutions in Metro Manila, the Philippines. The Korean Journal of Parasitology, 42, 67–70CrossRefGoogle Scholar
  3. Bohm-Gloning B., Knobloch J., Walderich B. 1997. Five subgroups of Blastocystis hominis from symptomatic and asymptomatic patients revealed by restriction site analysis of PCR-amplified 16S-like rDNA. Tropical Medicine & International Health, 2, 771–778CrossRefGoogle Scholar
  4. Boorom K., Smith H., Nimri L., Viscogliosi E., Spanakos G., Parkar U., Li L.-H., Zhou X.-N., Ok U., Leelayoova S., Jones M. 2008. Oh my aching gut: irritable bowel syndrome, Blastocystis, and asymptomatic infection. Parasites & Vectors, 1, 40CrossRefGoogle Scholar
  5. Brandt L.J., Bjorkman D., Fennerty M.B., Locke G.R., Olden K., Peterson W., Quigley E., Schoenfeld P., Schuster M., Talley N. 2002. Systematic review on the management of irritable bowel syndrome in North America. The American Journal of Gastroenterology, 97(11 Suppl), S7–26PubMedGoogle Scholar
  6. Cirioni O., Giacometti A., Drenaggi D., Ancarani F., Scalise G. 1999. Prevalence and clinical relevance of Blastocystis hominis in diverse patient cohorts. European Journal of Epidemiology, 15, 389–393CrossRefGoogle Scholar
  7. Clark C.G. 1997. Extensive genetic diversity in Blastocystis hominis. Molecular and Biochemical Parasitology, 87, 79–83CrossRefGoogle Scholar
  8. Eida A., Eida M. 2008. Identification of Blastocystis hominis in patients with Irritable Bowel Syndrome using microscopy and culture compared to PCR. Parasitologists United Journal, 1, 87–92Google Scholar
  9. Florez A.C., Garcia D.A., Moncada L., Beltran M. 2003. Prevalence of microsporidia and other intestinal parasites in patients with HIV infection, Bogota, 2001. Biomedica, 23, 274–282CrossRefGoogle Scholar
  10. Fouad S.A., Basyoni M.M.A., Fahmy R.A., Kobaisi M.H. 2011. The pathogenic role of different Blastocystis hominis genotypes isolated from patients with irritable bowel syndrome. Arab Journal of Gastroenterology, 12, 194–200CrossRefGoogle Scholar
  11. Garcia L. 2001. Macroscopic and microscopic examination of fecal specimens. In: Diagnostic Medical Parasitology. The American Society of Microbiology, Washington, D.C., 741–785Google Scholar
  12. Herwaldt B.L., de Arroyave K.R., Wahlquist S.P., de Merida A.M., Lopez A.S., Juranek D.D. 2001. Multiyear prospective study of intestinal parasitism in a cohort of Peace Corps volunteers in Guatemala. Journal of Clinical Microbiology, 39, 34–42CrossRefGoogle Scholar
  13. Junod C. 1995. Blastocystis hominis: a common commensal in the colon. Study of prevalence in different populations of Paris. La Presse Médicale, 24, 1684–1688PubMedGoogle Scholar
  14. Kaneda Y., Horiki N., Cheng X.J., Fujita Y., Maruyama M., Tachibana H. 2001. Ribodemes of Blastocystis hominis isolated in Japan. The American Journal of Tropical Medicine and Hygiene, 65, 393–396CrossRefGoogle Scholar
  15. Kukoschke K.G., Muller H.E. 1991. SDS-PAGE and immunological analysis of different axenic Blastocystis hominis strains. Journal of Medical Microbiology, 35, 35–39CrossRefGoogle Scholar
  16. Li L.-H., Zhou X.-N., Du Z.-W., Wang X.-Z., Wang L.-B., Jiang J.- Y., Yoshikawa H., Steinmann P., Utzinger J., Wu Z., Chen J.-X., Chen S.-H., Zhang L. 2007. Molecular epidemiology of human Blastocystis in a village in Yunnan province, China. Parasitology International, 56, 281–286CrossRefGoogle Scholar
  17. Mahmoud M.S., Saleh W.A. 2003. Secretory and humoral antibody responses to Blastocystis hominis in symptomatic and asymptomatic human infections. Journal of the Egyptian Society of Parasitology, 33, 13–30PubMedGoogle Scholar
  18. Markell E.K., Udkow M.P. 1986. Blastocystis hominis: pathogen or fellow traveler?. The American Journal of Tropical Medicine and Hygiene, 35, 1023–1026CrossRefGoogle Scholar
  19. Moglan I., Popescu I.E. 2009. Parazitologie animală. Editura Universităţii “Alexandru Ioan Cuza”, Iasi, 100 ppGoogle Scholar
  20. Pegelow K., Gross R., Pietrzik K., Lukito W., Richards A.L., Fryauff D.J. 1997. Parasitological and nutritional situation of school children in the Sukaraja district, West Java, Indonesia. The Southeast Asian Journal of Tropical Medicine and Public Health, 28, 173–190PubMedGoogle Scholar
  21. Poirier P., Wawrzyniak I., Vivarès C.P., Delbac F., El Alaoui H. 2012. New Insights into Blastocystis spp.: a potential link with Irritable Bowel Syndrome. PLoS Pathogens, 8, e1002545. doi:10.1371/journal.ppat.1002545CrossRefGoogle Scholar
  22. Ramirez-Miranda M., Hernandez-Castellanos R., Lopez-Escamilla E., Moncada D., Rodriguez-Magallan A., Pagaza-Melero C., Gonzalez-Angulo A., Flisser A., Kawa-Karasik S., Maravilla P. 2010. Parasites in Mexican patients with irritable bowel syndrome: a case-control study. Parasites & Vectors, 3, 96CrossRefGoogle Scholar
  23. Roberts T., Stark D., Harkness J., Ellis J. 2014. Update on the pathogenic potential and treatment options for Blastocystis sp. Gut Pathogens, 6, 17CrossRefGoogle Scholar
  24. Saito Y.A., Locke G.R., Talley N.J., Zinsmeister A.R., Fett S.L., Melton L.J. 2000. A comparison of the Rome and Manning criteria for case identification in epidemiological investigations of irritable bowel syndrome. The American Journal of Gastroenterology, 95, 2816–2824CrossRefGoogle Scholar
  25. Saksirisampant W., Nuchprayoon S., Wiwanitkit V., Yenthakam S., Ampavasiri A. 2003. Intestinal parasitic infestations among children in an orphanage in Pathum Thani province. Journal of the Medical Association of Thailand 86 (Suppl 2), S263–S270PubMedGoogle Scholar
  26. Shlim D.R., Hoge C.W., Rajah R., Rabold J.G., Echeverria P. 1995. Is Blastocystis hominis a cause of diarrhea in travelers? A prospective controlled study in Nepal. Clinical Infectious Diseases, 21, 97–101CrossRefGoogle Scholar
  27. Stanley Jr S.L. 2003. Amoebiasis. The Lancet, 361, 1025–1034CrossRefGoogle Scholar
  28. Stark D., van Hal S., Marriott D., Ellis J., Harkness J. 2007. Irritable bowel syndrome: A review on the role of intestinal protozoa and the importance of their detection and diagnosis. International Journal for Parasitology, 37, 11–20CrossRefGoogle Scholar
  29. Stensvold C.R., Suresh G.K., Tan K.S.W., Thompson R.C.A., Traub R.J., Viscogliosi E., Yoshikawa H., Clark C.G. 2007. Terminology for Blastocystis subtypes — a consensus. Trends in Parasitology, 23, 93–96. DOI:10.1016/ Scholar
  30. Stenzel D.J., Boreham P.F. 1996. Blastocystis hominis revisited. Clinical Microbiology Reviews, 9, 563–84CrossRefGoogle Scholar
  31. Taamasri P., Mungthin M., Rangsin R., Tongupprakarn B., Areekul W., Leelayoova S. 2000. Transmission of intestinal blastocystosis related to the quality of drinking water. The Southeast Asian Journal of Tropical Medicine and Public Health, 31, 112–117PubMedGoogle Scholar
  32. Tan K. 2004. Blastocystis in humans and animals: new insights using modern methodologies. Veterinary Parasitology, 126, 121–144CrossRefGoogle Scholar
  33. Tan K., Singh M., Yap E. 2002. Recent advances in Blastocystis hominis research: hot spots in terra incognita. International Journal for Parasitology 32, 789–804CrossRefGoogle Scholar
  34. Wang L.C. 2004. Changing patterns in intestinal parasitic infections among Southeast Asian laborers in Taiwan. Parasitology Research, 92, 18–21CrossRefGoogle Scholar
  35. Windsor J.J., Macfarlane L., Hughes-Thapa G., Jones S.K., Whiteside T.M. 2002. Incidence of Blastocystis hominis in faecal samples submitted for routine microbiological analysis. British Journal of Biomedical Science 59, 154–157CrossRefGoogle Scholar
  36. Zaman V. 1997. Phase-contrast microscopy of cell division in Blastocystis hominis. Annals of Tropical Medicine and Parasitology 91, 223–224CrossRefGoogle Scholar
  37. Zhang X., Qiao J., Wu X., Da R., Zhao L., Wei Z. 2012. In vitro culture of Blastocystis hominis in three liquid media and its usefulness in the diagnosis of blastocystosis. International Journal of Infectious Diseases, 16, e23–e28CrossRefGoogle Scholar

Copyright information

© W. Stefański Institute of Parasitology, PAS 2015

Authors and Affiliations

  1. 1.Praxis Laboratory, Bd. Independentei, No. 33IasiRomania
  2. 2.Laboratory of Diagnosis and Investigation in Public HealthIasiRomania
  3. 3.Department of BiologyAlexandru Ioan Cuza UniversityIasiRomania

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