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Detection of Dientamoeba fragilis in Portuguese children with acute gastroenteritis between 2011 and 2013
C Júlio1, C Furtado2, R Rocha1
1Department of Infectious Diseases,National Reference Laboratory for Gastrointestinal Infections,National Institute of Health Dr Ricardo Jorge I.P.,Lisbon,Portugal.
Abstract:
Dientamoeba fragilis is an inhabitant of human gastrointestinal tract with a worldwide distribution. The first description considered this protozoan a rare and harmless commensal, since then it has struggled to gain recognition as a pathogen. Commercial multiplex real-time PCR was used to detect D. fragilis in fecal samples from hospitalized children (⩽18 years) with acute gastrointestinal disease, admitted to two hospitals of Lisbon area, with different demographic characteristics. A total of 176 children were studied, 103 (58·5%) male, 144 (81·8%) children between 0 and 5 years and 32 (18·2%) above 6 years old. The overall protozoa frequency considering the four tested microorganisms were 8·5% (15/176), and the most frequently found protozoan was D. fragilis, 6·3% (11/176). Dientamoeba fragilis frequency was higher among older children (21·9%), than younger children (2·8%), and greater in boys (6·8%) than in girls (5·5%). All positive children presented with diarrhoea associated with vomiting, fever and abdominal pain. Infection was associated with the age of children (P < 0·001), school attendance (P = 0·002) and consumption of certain foods (P = 0·014), e.g. cakes with crème and ham. The frequency of diantamoebiasis found in a cohort of hospitalized Portuguese children, with acute gastrointestinal disease, could be considered a very high value when compared with the protozoan frequency normally associated with this pathology.
Insights
Dientamoeba fragilis, a gastrointestinal protozoan, was frequently detected in hospitalized children with acute gastrointestinal disease in Lisbon. This finding highlights diantamoebiasis as a significant pathogen in this population.
Area of Science:
- Medical Parasitology
- Pediatric Gastroenterology
- Infectious Diseases
Background:
- Dientamoeba fragilis, a protozoan found in the human gut, has historically been underestimated as a pathogen.
- Recent studies suggest Dientamoeba fragilis may play a role in gastrointestinal illness.
Purpose of the Study:
- To determine the frequency of Dientamoeba fragilis in hospitalized children with acute gastrointestinal disease in the Lisbon area.
- To investigate potential associations between Dientamoeba fragilis infection and demographic or dietary factors.
Main Methods:
- Commercial multiplex real-time PCR was used to analyze fecal samples from 176 hospitalized children (≤18 years) with acute gastrointestinal disease.
- Data on patient demographics, symptoms, and food consumption were collected.
Main Results:
- Dientamoeba fragilis was detected in 6.3% (11/176) of the children, making it the most frequent protozoan identified.
- Infection prevalence was significantly higher in older children (21.9%) compared to younger children (2.8%) and slightly higher in boys (6.8%) than girls (5.5%).
- Symptoms in positive cases included diarrhea, vomiting, fever, and abdominal pain, with infection linked to age, school attendance, and consumption of specific foods like cream cakes and ham.
Conclusions:
- The study identified a high frequency of Dientamoeba fragilis in Portuguese children hospitalized with acute gastrointestinal illness, suggesting it is an important pathogen.
- Age, school attendance, and diet were associated with Dientamoeba fragilis infection in this cohort.
- These findings underscore the need for increased recognition and diagnosis of diantamoebiasis in pediatric gastrointestinal disease.
