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Intestinal Microbiota in Children With Symptomatic Dientamoeba fragilis Infection: A Case-control Study
Michael W van Kalleveen1,2, Andries E Budding3, Marc A Benninga4
1From the Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands.
Background:
Dientamoeba fragilis in children has been associated with gastrointestinal symptoms, like abdominal pain and diarrhea. The mechanism underlying these symptoms in children with D. fragilis remains unclear. We hypothesized that concomitant microbial alterations, which have been described in other parasitic infections, may be associated with gastrointestinal symptoms in D. fragilis.
Methods:
In this case-control study performed in 2 centers, 19 children referred to a pediatrician because of gastrointestinal symptoms and with a positive fecal PCR for D. fragilis were included as cases. We included 19 healthy children as controls and matched for age and gender, selected from an existing cohort of 63 children. A PCR for D. fragilis was performed on fecal samples of the 19 controls to assess D. fragilis carriership in this asymptomatic group. Microbiota was analyzed with the IS-pro technique, and the intestinal microbiota composition and diversity were compared between the 2 groups.
Results:
Microbiota of children with D. fragilis and gastrointestinal symptoms did not significantly differ in terms of composition and diversity compared with controls, both on phylum and species level. In the asymptomatic controls, a positive fecal PCR for D. fragilis was found in 16 of 19 (84.2%).
Conclusion:
Intestinal microbiota does not seem to play a key role in the presence of clinical symptoms in children with D. fragilis. The pathogenicity of D. fragilis and pathophysiologic pathways underlying the development of gastrointestinal symptoms remains yet to be clarified.
Insights
Dientamoeba fragilis infection in children does not appear to be linked to changes in gut microbiota composition or diversity. Further research is needed to understand the causes of gastrointestinal symptoms associated with this parasite.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiome Research
Background:
- Dientamoeba fragilis is linked to gastrointestinal issues in children, but the cause is unknown.
- Microbial alterations are suspected, similar to other parasitic infections.
Purpose of the Study:
- To investigate the role of intestinal microbiota in Dientamoeba fragilis-associated gastrointestinal symptoms in children.
Main Methods:
- A case-control study compared 19 symptomatic children with D. fragilis to 19 asymptomatic controls.
- Fecal samples were analyzed for D. fragilis using PCR and for microbiota composition using the IS-pro technique.
Main Results:
- No significant differences in intestinal microbiota composition or diversity were found between symptomatic and asymptomatic children.
- D. fragilis was detected in 84.2% of asymptomatic controls, suggesting frequent asymptomatic carriage.
Conclusions:
- Intestinal microbiota composition does not appear to be a major factor in D. fragilis-related symptoms in children.
- The mechanisms behind D. fragilis pathogenicity and symptom development require further investigation.
