Discrimination of Entamoeba moshkovskii in patients with gastrointestinal disorders by single-round PCR

Entamoeba moshkovskii and Entamoeba dispar are impossible to differentiate microscopically from the pathogenic species Entamoeba histolytica. There are limited data on the prevalence of these commensal parasites in Iran. We utilized a single-round PCR assay to determine the prevalence of E. moshkovskii, E. dispar, and E. histolytica in stool samples from Iranian patients infected with gastrointestinal disorders. After culturing of microscopy-positive isolates and extraction of DNA, PCR was carried out to differentiate the Entamoeba isolates. Out of 3,825 stool samples examined by microscopy, 58 specimens (1.52%) were infected with E. histolytica, E. dispar, or E. moshkovskii. By PCR, 2 E. histolytica (3.45%), 53 E. dispar (91.37%), 2 E. moshkovskii (3.45%), and one mixed E. dispar/E. moshkovskii infection (1.73%) were detected. In view of the reporting of E. moshkovskii in this study in Iran and the difficulty in discriminating this ameba from two similar Entamoeba spp. by microscopy, we recommend the single-round PCR assay as an alternative tool in routine diagnosis and in epidemiological studies of amebiasis.