md-medicaldata


Go to content

Main menu:

 

 

 

 

 

 

 

CIP -  Каталогизација у публикацији
Народна библиотека Србије, Београд
61
MD : Medical Data : medicinska revija = medical review / glavni i odgovorni urednik Dušan Lalošević. - Vol. 1, no. 1 (2009)- . - Zemun : Udruženje za kulturu povezivanja Most Art Jugoslavija ; Novi Sad : Pasterovo društvo, 2009- (Beograd : Scripta Internacional). - 30 cm

Dostupno i na: http://www.md-medicaldata.com. - Tri puta godišnje.

ISSN 1821-1585 = MD. Medical Data
COBISS.SR-ID 158558988


METRONIDAZOL U TERAPIJI BLASTOCISTOZE KOD DECE
METRONIDAZOLE IN THE THERAPY OF BLASTOCYSTOSIS IN CHILDREN

Authors

 

Mirjana Stojšić1,2, Jovanka Kolarović1,2

1Institut za zdravstvenu zaštitu dece i omladine Vojvodine, Novi Sad, Srbija
2Medicinski fakultet Univerziteta u Novom Sadu, Srbija

 


Rad je primljen 21.08.2017. / Prihvaćen 25.08.2017

 


Correspondence to


Mirjana Stojšić, MD, PhD,
pediatrician-gastroenterohepatologist
Chief of Cabinet for GI endoscopy
Department of gastroenterology, hepatology and nutrition
Institute of Child and Youth Health Care of Voyvodina
Hajduk Veljkova 10,
21000 Novi Sad, Serbia
mobil : +381 62 20 33 40
e-mail: drstojsic@gmail.com

 

 

Sažetak

 

Blastocistis hominis (Bh) je najrasprostranjeniji protist na našoj planeti, ali pri tome najkontraverzniji. Infekcija Bh počinje ingestijom hrane ili tečnosti koja je kontaminirana cističnom formom Bh. Nakon gutanja, iz ciste se razvijaju u debelom crevu čoveka vakuolarne forme protista.  Fekalno - oralni prenos je najčešći put širenja infekcije. Oboljenje koje Bh izaziva kod ljudi naziva se blastocistoza. Najčešće kliničke manifestacije blastocistoze su gastrointestinalne, ali mogu biti prisutni i drugi nespecifični znaci. Terapija blastocistoze je neophodna kod  imunokompromitovane dece, bez obzira da li je ona simptomatska i asimptomatska, ali i kod imunokompetentnih osoba koje imaju tegobe. Najčešće preporučeni antibiotik za lečenje blastocistoze je metronizaol u trajanju 10 dana, primenjen peroralno. U slučaju  razvoja gastroenteroloških smetnji savetuje se promena načina aplikacije metronidazola i parenteralni put davanja.  Rezistencija na antibiotike je uslovljena genetskim karakteristikama Bh, jer različiti subtipovi Bh imaju različitu osetljivost na lekove, ali i geografskim položajem, jer rezistencija na određene antibiotike različita u različitim delovima sveta, u skladu sa  proširenosti zloupotrebe tog antibiotka. Za proveru terapijske efikasnosti treba ponoviti analizu stolice na Bh najranije mesec dana nakon zavšetka lečenja. Efikasnost metronidazola u terapiji blastocistoze, čak do 100%, te se zbog visoke stope eradikacije smatra se lekom izbora u lečenju blastocistoze.

 

 

 

Ključne reči:

Blastocistis hominis, blastocistoza, metronidazol, dete, adolescent

 

 

Abstract

 

Blastocystis hominis (Bh) is the most outspread protist on our planet, but also the most controversial. Infection Bh starts by digestion of the eaten food or liquid which has been contained by a cyst form Bh. After swallowing, from the cyst they grow (progress) in the colon of the human, with a vacuolar form of a protest. Oral transmission is the most common way of spreading the infection. The disease caused by Bh on humans is called blastocystisis. The most common clinical manifestations of blastocystosis are gastrointestinal, but other non-specific signs may also be present. Blastocystosis therapy is necessary in immunocompromised children, regardless of whether it is symptomatic and asymptomatic, but also in immunocompetent individuals with a symtoms. The most commonly recommended antibiotic for the treatment of blastocystosis is metronidazole for 10 days, administered orally. In case of gastroenterological disorders, it is advised to change the way metronidazole is administered and the parenteral route of administration. Resistance to antibiotics is conditioned by genetic characteristics of Bh, since different subtypes Bh have different susceptibility to drugs, but also geographical position, because resistance to certain antibiotics is different in different parts of the world, in line with the extent of abuse of that antibiotic. To check the therapeutic efficacy, it is necessary to repeat the analysis of the stool on Bh at the earliest one month after the treatment has finished. The efficacy of metronidazole in the treatment of blastocystosis, up to 100%, and due to the high rate of eradication it is considered a medication choice in the treatment of blastocystosis.

 

 

Key words:

Blastocystis hominis, blastocystosis, metronidazole, child, adolescent

 

 

References

 

  1. Lesh FA. Massive development of amebas in the large intestine. Am J Trop Med Hyg. 1975;24(3):383–92.
  2. Alexeieff A. Sur la nature des formations dites “kystes de Trichomonas intestinalis.” C R Soc Biol. 1911;71:296–8.
  3. Brumpt E. Blastocystis hominis n. sp. et formes voisines. Bull Soc Pathol Exot Fil [Internet]. 1912;5:725–30.
  4. Roberts T, Stark D, Harkness J, Ellis J. Update on the Molecular Epidemiology and Diagnostic Tools for Blastocystis sp. J Med Microbiol Diagnosis [Internet]. 2014;3(1):1–6.
  5. Basak S, Rajurkar MN, Mallick SK. Detection of Blastocystis hominis: A controversial human pathogen. Parasitol Res. 2014;113:261–5.
  6. Maqbool A DR. Gastrointestinal parasites. In: Pediatric gastroenterology: the requisites Philadelphia: Elsevier, WB Saunders, Piccoli DA, Liacouras C. 2008. p. 170–7.
  7. Rajilic-Stojanovic M, de Vos WM. The first 1000 cultured species of the human gastrointestinal microbiota. FEMS Microbiol Rev. 2014;38(5):996–1047.
  8. Denoeud F, Roussel M, Noel B, Wawrzyniak I, Da Silva C, Diogon M, et al. Genome sequence of the stramenopile Blastocystis, a human anaerobic parasite. Genome Biol [Internet]. 2011;12(3):R29.
  9. Noël C, Dufernez F. Molecular phylogenies of Blastocystis isolates from different hosts: implications for genetic diversity, identification of species, and zoonosis. J Clin Microbiol. 2005;43(1):348–55.
  10. Yoshikawa H, Yoshida K, Nakajima A, Yamanari K, Iwatani S, Kimata I. Fecal-oral transmission of the cyst form of Blastocystis hominis in rats. Parasitol Res. 2004;94:391–6.
  11. Zierdt CH. Blastocystis hominis--past and future. Clin Microbiol Rev. 1991;4(1):61–79.
  12. Yoshikawa H, Wu Z, Kimata I, Iseki M, Ali IKMD, Hossain MB, et al. Polymerase chain reaction-based genotype classification among human Blastocystis hominis populations isolated from different countries. Parasitol Res. 2004;92(1):22–9.
  13. Petersen AM, Stensvold CR, Mirsepasi H, Engberg J, Friis-Møller A, Porsbo LJ, et al. Active ulcerative colitis associated with low prevalence of Blastocystis and Dientamoeba fragilis infection. Scand J Gastroenterol [Internet]. 2013;48(5):638–9.
  14. Scanlan PD, Stensvold CR, Rajili??-Stojanovi?? M, Heilig HGHJ, De Vos WM, O’Toole PW, et al. The microbial eukaryote Blastocystis is a prevalent and diverse member of the healthy human gut microbiota. FEMS Microbiol Ecol. 2014;90(1):326–30.
  15. Sinniah B, Hassan AKR, Sabaridah I, Soe MM, Ibrahim Z, Ali O. Prevalence of intestinal parasitic infections among communities living in different habitats and its comparison with one hundred and one studies conducted over the past 42 years (1970 to 2013) in Malaysia. Trop Biomed. 2014;31(2):190–206.
  16. El Safadi D, Gaayeb L, Meloni D, Cian A, Poirier P, Wawrzyniak I, et al. Children of Senegal River Basin show the highest prevalence of Blastocystis sp. ever observed worldwide. BMC Infect Dis [Internet]. 2014;14:164.
  17. Graczyk TK, Shiff CK, Tamang L, Munsaka F, Beitin AM, Moss WJ. The association of Blastocystis hominis and Endolimax nana with diarrheal stools in Zambian school-age children. Parasitol Res. 2005;98(1):38–43.
  18. Javaherizadeh H, Khademvatan S, Soltani S, Torabizadeh M, Yousefi E. Distribution of haematological indices among subjects with Blastocystis hominis infection compared to controls. Prz Gastroenterol. 2014;9(1):38–42.
  19. Stensvold CR, Lewis HC, Hammerum  a M, Porsbo LJ, Nielsen SS, Olsen KEP, et al. Blastocystis: unravelling potential risk factors and clinical significance of a common but neglected parasite. Epidemiol Infect. 2009;137(11):1655–63.
  20. Stojšić M, Lazić J. Transition patients with Inflammatory bowel disease: A bridge or barriers. MD-Medical Data. 2017;9(1):039–44.
  21. Idris NS, Dwipoerwantoro PG, Kurniawan A, Said M. Intestinal parasitic infection of immunocompromised children with diarrhoea: clinical profile and therapeutic response. J Infect Dev Ctries. 2010;4(5):309–17.
  22. Tan TC, Ong SC, Suresh KG. Genetic variability of Blastocystis sp. isolates obtained from cancer and HIV/AIDS patients. Parasitol Res. 2009;105:1283–6.
  23. Young CR, Yeo FE. Blastocystis and Schistosomiasis Coinfection in a Patient with Chronic Kidney Disease. Case Rep Med [Internet]. Hindawi Publishing Corporation; 2014;(Article ID 676395):1–3.
  24. Yavasoglu I, Kadikoylu G, Uysal H, Ertug S, Bolaman Z. Is Blastocystis hominis a new etiologic factor or a coincidence in iron deficiency anemia? Eur J Haematol. 2008;81:47–50.
  25. Tejera B. Reactive Arthritis Caused by Blastocistys hominis. Reumatol Clin. 2012;8(1):50–1.
  26. Biedermann T, Hartmann K, Sing A, Przybilla B. Hypersensitivity to non-steroidal anti-inflammatory drugs and chronic urticaria cured by treatment of Blastocystis hominis infection. Br J Dermatology 2002; 146 1102–1117. 2002;146(6):1113–4.
  27. Smirnova MO, Ruzhitskaia EA, Pampura AN, Prodeus T V. (Blastocystis hominis infection in a baby with food allergy). Med Parazitol (Mosk). 2010;(3):11–5.
  28. Kick G, Rueff F PB. Palmoplantar pruritus subsiding after Blastocystis hominis eradication. J Allergy Clin Immunol. 2002;82(1):140.
  29. Micheloud D, Jensen J, Fernandez-Cruz E, Carbone J. Angioedema Crónico e Infección por Blastocystis Hominis. Rev Gastroenterol del Perú [Internet]. 2007;27(2):191–3.
  30. Dogruman-Al F, Turk S, Adiyaman-Korkmaz G, Hananel A, Levi L, Kopelowitz J, et al. A novel ELISA test for laboratory diagnosis of Blastocystis spp. in human stool specimens. Parasitol Res. 2014;114(2):495–500.
  31. Stensvold CR, Lebbad M, Verweij JJ. The impact of genetic diversity in protozoa on molecular diagnostics. Trends Parasitol [Internet]. Elsevier Ltd; 2011;27(2):53–8.
  32. Van Hellemond JJ, Molhoek N, Koelewijn R, Wismans PJ, van Genderen PJJ. Is paromomycin the drug of choice for eradication of Blastocystis in adults? J Infect Chemother. 2013;19(3):545–8.
  33. Andersen LO, Stensvold CR. Blastocystis in Health and Disease: Are We Moving from a Clinical to a Public Health Perspective? J Clin Microbiol [Internet]. 2016 Mar [cited 2016 Mar 11];54(3):524–8.
  34. Kurt Ö, Doğruman Al F, Tanyüksel M. Eradication of blastocystis in humans: Really necessary for all? Parasitol Int [Internet]. 2016;
  35. Moghaddam DD, Ghadirian E, Azami M. Blastocystis hominis and the evaluation of efficacy of metronidazole and trimethoprim/sulfamethoxazole. Parasitol Res. 2005;96(4):273–5.
  36. Frealle E, El Safadi D, Cian A, Aubry E, Certad G, Osman M, et al. Acute blastocystis-associated appendicular peritonitis in a child, Casablanca, Morocco. Emerg Infect Dis. 2015;21(1):91–4.
  37. Long HY, Handschack A, König W, Ambrosch A. Blastocystis hominis modulates immune responses and cytokine release in colonic epithelial cells. Parasitol Res. 2001;87(12):1029–30.
  38. Roberts T, Ellis J, Harkness J, Marriott D, Stark D. Treatment failure in patients with chronic Blastocystis infection. J Med Microbiol. 2014;63(PART 2):252–7.
  39. Nagel R, Bielefeldt-Ohmann H, Traub R. Clinical pilot study: efficacy of triple antibiotic therapy in Blastocystis positive irritable bowel syndrome patients. Gut Pathog [Internet]. 2014;6:34.
  40. Stojšić M. Pedijatrijski aspekti primene Saccharomyces boulardi u Srbiji. Prev Pedijatr. 2017;3(1):70 – 74.
  41. Roberts T, Stark D, Harkness J, Ellis J. Update on the pathogenic potential and treatment options for Blastocystis sp. Gut Pathog [Internet]. 2014;6(1):17.
  42. Nassir E, Awad J, Abel AB, Khoury J, Shay M, Lejbkowicz F. Blastocystis hominis as a cause of hypoalbuminemia and anasarca. Eur J Clin Microbiol Infect Dis. 2004;23(5):399–402.
  43. Ok UZ, Girginkardeşler N, Balcioğlu C, Ertan P, Pirildar T, Kilimcioğlu AA. Effect of trimethoprim-sulfamethaxazole in Blastocystis hominis infection. Am J Gastroenterol. 1999;94(11):3245–7.
  44. Stensvold CR, Smith H V, Nagel R, Olsen KEP, Traub RJ. Eradication of Blastocystis carriage with antimicrobials: reality or delusion? J Clin Gastroenterol [Internet]. 2010;44(2):85–90.
  45. Lucia JF, Aguilar C, Betran A. Blastocystis hominis colitis in a haemophilic patient as a cause of lower gastrointestinal bleeding. Haemophilia. 2007;13(2):224–5.
  46. Kearney DJ, Steuerwald M, Koch J, Cello JP. A prospective study of endoscopy in HIV ­ associated diarrhea. Am J Gastroenterol. 1999;94(3):595–602.
  47. Haresh K, Suresh K, Khairul Anus A, Saminathan S. Isolate resistance of Blastocystis hominis to metronidazole. Trop Med Int Health. 1999;4(4):274–7.
  48. Ohnishi K, Sakamoto N, Kobayashi K-I, Iwabuchi S, Nakamura-Uchiyama F, Ajisawa A, et al. Subjective adverse reactions to metronidazole in patients with amebiasis. Parasitol Int. 2014;63(5):698–700.
  49. Haresh K, Suresh K, Anuar AK, Saminathan S, Kumar GS. Isolate resistance of Blastocystis hominis to metronidazole. Trop Med Int Heal. 1999;4(4):274–7.

UDK: 616.993.1-085.33-053.2
615.33-053.2
COBISS.SR-ID 245429516



PDF Stojšić M. and Kolarović J. • MD-Medical Data 2017;9(3): 177-180

 

 

 

Naslovna | Revija | Galerija | Dešavanja | Instrukcije | Redakcija | Izdavač | Prijatelji sajta | Saradnja | Kontakt | Site Map


Back to content | Back to main menu