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Comparison of Giardia lamblia Infection Status in Asymptomatic and Symptomatic Pediatric Heart Transplant Patients: A
M Mozaffari1, Sh Sayyahfar1,2, M Mahdavi3
1Department of Pediatric, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.
Insights
Giardiasis is a significant opportunistic infection in pediatric heart transplant patients. Early detection and management of Giardia lamblia are crucial for this vulnerable population.
Area of Science:
- Infectious Diseases
- Transplantation Medicine
- Pediatric Cardiology
Background:
- Giardiasis is an opportunistic infection common in immunocompromised individuals, particularly organ transplant recipients.
- Pediatric heart transplant recipients are at increased risk due to their altered immune status.
Purpose of the Study:
- To determine the prevalence of Giardia lamblia infection in children who have undergone heart transplantation.
- To identify risk factors and clinical manifestations associated with Giardia lamblia in this population.
Main Methods:
- A prospective cross-sectional study involving 53 pediatric heart transplant recipients (ages 1-17).
- Stool samples were analyzed using both phenotypic assays and polymerase chain reaction (PCR) for Giardia lamblia detection.
- Patients were on Trimethoprim/Sulfamethoxazole (TMP-SMX) prophylaxis.
Main Results:
- The overall prevalence of Giardia lamblia infection was 5.7% (3 out of 53 patients).
- Infection was more frequent in symptomatic patients (27.27%) compared to asymptomatic ones (0%).
- All positive cases presented with chronic diarrhea and anorexia; genotypes A and B were identified.
Conclusions:
- The incidence of Giardia lamblia in pediatric heart transplant patients is notable.
- Guidelines for Giardia lamblia screening before and after transplantation are recommended.
Background:
Giardiasis is one of the opportunistic infections in immunocompromised patients, especially among organ transplant recipients.
Objective:
This study aimed to investigate the prevalence of Giardia lamblia infection in children with heart transplantation.
Methods:
A prospective cross-sectional study was conducted on 53 heart transplant recipients (aged 1-17 years). Transplant patients were on oral Trimethoprim/Sulfamethoxazole (TMP-SMX) from the first day of transplantation as a prophylaxis regimen. The prevalence of Giardia lamblia was evaluated on stool samples by phenotypic assay and polymerase chain reaction (PCR) method.
Results:
Out of 53 patients studied, 11 (20.75%) had gastrointestinal symptoms, and 42 (79.25%) were asymptomatic cases. No significant difference was observed between patients with and without gastrointestinal symptoms regarding type of heart disorders (p=0.13). The overall prevalence of Giardia lamblia infection among heart transplant patients was 5.7% (n=3). Moreover, the frequency was different between gastrointestinal symptomatic and asymptomatic recipients (27.27% and 0%, respectively). All three patients whose stool exams were phenotypically positive for Giardia lamblia were confirmed with PCR. Out of three, two Giardia lamblia isolates were found to have genotype B, while one isolate had genotype A. All of the Giardia positive patients suffered from chronic diarrhea and anorexia. Cryptosporidium spp., Isospora belli and Blastocysts spp. were not found in these cases.
Conclusion:
The incidence of Giardia lamblia infection in pediatric heart transplant patients is considerable and should be noted. A comprehensive guideline for the assessment of Giardia lamblia before and after transplantation is suggested.
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