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Dientamoeba fragilis, a Commensal in Children in Danish Day Care Centers
Pikka Jokelainen1,2,3, Betina Hebbelstrup Jensen4, Bente Utoft Andreassen5
1Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark PIJO@ssi.dk RUN@ssi.dk.
Insights
Dientamoeba fragilis is a common intestinal protozoan in young children, frequently found in daycare settings. This study suggests it acts as a commensal, as no link was found between D. fragilis and gastrointestinal symptoms.
Area of Science:
- Microbiology
- Pediatrics
- Parasitology
Background:
- Dientamoeba fragilis is an intestinal protozoan with unclear clinical significance.
- Daycare settings represent environments where enteric pathogens can spread among young children.
Purpose of the Study:
- To investigate the prevalence and risk factors of Dientamoeba fragilis infection in children aged 0-6 years.
- To determine the association between D. fragilis and gastrointestinal symptoms in a pediatric cohort.
Main Methods:
- A 1-year multi-day-care-center cohort study in Copenhagen, Denmark.
- Real-time PCR was used to detect D. fragilis in stool samples.
- Parental questionnaires collected data on risk factors and symptoms.
Main Results:
- D. fragilis was detected in 68.3% of children's initial stool samples.
- Risk factors for D. fragilis positivity included being older than 3 years and recent travel abroad.
- No statistical association was found between D. fragilis and reported gastrointestinal symptoms.
Conclusions:
- Dientamoeba fragilis is a common enteric commensal in young children attending daycare.
- The presence of D. fragilis does not appear to be associated with gastrointestinal illness in this population.
Abstract:
Dientamoeba fragilis is an intestinal protozoan of debated clinical significance. Here, we present cross-sectional and longitudinal observations on D. fragilis in children aged 0 to 6 years from a 1-year multi-day-care-center cohort study set in Copenhagen, Denmark. The inclusion period for the cohort was 2009 through 2012. Stool samples collected from the children were accompanied by questionnaires completed by the parents or guardians of the children. Using real-time PCR, D. fragilis was detected in the first stool sample from 97 of 142 (68.3%) children. We evaluated the associations between seven plausible risk factors (age, sex, having siblings, having domestic animals at home, having had infant colic, recent history of intake of antibiotics, and recent history of travel abroad) as well as six reported symptoms (lack of appetite, nausea, vomiting, abdominal pain, weight loss, and diarrhea) and testing positive for D. fragilis The final multivariable model identified being >3 years old and having a history of recent travel abroad as risk factors for testing positive for D. fragilis Moreover, univariable analyses indicated that having siblings was a risk factor. There was no statistical association between a recent history of gastrointestinal symptoms and testing positive for D. fragilis Among the 108 children who were represented by ≥2 samples and thus included in the longitudinal analysis, 32 tested negative on the first sample and positive later, and the last sample from each of the 108 children was positive. The results are in support of D. fragilis being a common enteric commensal in this population.
