The Characteristics of Blastocystis Hominis Infection in Outpatient Health Surveys of a Medical Center in Taiwan

人芽胞囊蟲在台灣某醫學中心門診體檢的分佈特性

10.7023/TJFM.200309.0120

康世肇(Shih-Chao Kang)；陳曾基(Tzeng-Ji Chen)；黃信彰(Shinn-Jang Hwang)

blastocystis hominis ； immigrants ； natives ； health surveys

台灣家庭醫學雜誌

13卷3期（2003 / 09 / 01）

120 - 129

英文

Blastocystis hominis has not been endemic or epidemic in Taiwan, but with increasing immigration and international travel, this protozoan is found more frequently. We investigated the characteristics of B. hominis infection in Taiwan. Descriptive and retrospective analyses were performed in individuals who had undergone outpatient examinations in a medical center in Taiwan between January 1 and December 15, 2002. From the patients’ charts, we recorded their age, sex, occupation and/or residence, nationality, therapeutic medication and its effect on B. hominis infection, and associated risk factors. A total of 7,754 participants, including 220 immigrants, completed health surveys. Among them, 1,975 had undergone routine stool examination. Thirty-one(1.6%)had B. hominis infection. Their mean age was 34.4+-11.7 years(range:23 to 71 years), and they were predominantly younger than 30 years(51.6%), female(71.0%), immigrants(71.0%), and from southeastern Asia(45.2%). Nine subjects were Taiwanese, including six overseas volunterers and three native residents, all of whom had contact with immigrants in the past. All infected patients were asymptomatic except for one who had constipation. Fifteen(48.4%)were treated with metronidazole or mebendazole. In five(16.1%), the infection resolved spontaneously without medication, and 11(35.5%)were lost to follow-up. Only five subjects had systemic disease. Therapeutic choices differed significantly with sex(p=0.04)but not age or occupation(p＞0.1). In summary, B. hominis infection is not limited to immigrants to Taiwan, and transmission among native residents may occur. Thus, aggressive screening for B. hominis infection and active treatment are indicated.

Blastocystis hominis has not been endemic or epidemic in Taiwan, but with increasing immigration and international travel, this protozoan is found more frequently. We investigated the characteristics of B. hominis infection in Taiwan. Descriptive and retrospective analyses were performed in individuals who had undergone outpatient examinations in a medical center in Taiwan between January 1 and December 15, 2002. From the patients’ charts, we recorded their age, sex, occupation and/or residence, nationality, therapeutic medication and its effect on B. hominis infection, and associated risk factors. A total of 7,754 participants, including 220 immigrants, completed health surveys. Among them, 1,975 had undergone routine stool examination. Thirty-one(1.6%)had B. hominis infection. Their mean age was 34.4+-11.7 years(range:23 to 71 years), and they were predominantly younger than 30 years(51.6%), female(71.0%), immigrants(71.0%), and from southeastern Asia(45.2%). Nine subjects were Taiwanese, including six overseas volunterers and three native residents, all of whom had contact with immigrants in the past. All infected patients were asymptomatic except for one who had constipation. Fifteen(48.4%)were treated with metronidazole or mebendazole. In five(16.1%), the infection resolved spontaneously without medication, and 11(35.5%)were lost to follow-up. Only five subjects had systemic disease. Therapeutic choices differed significantly with sex(p=0.04)but not age or occupation(p＞0.1). In summary, B. hominis infection is not limited to immigrants to Taiwan, and transmission among native residents may occur. Thus, aggressive screening for B. hominis infection and active treatment are indicated.

1. Amenta M,Dalle Nogare ER,Colomba C(1999).Intestinal protozoa in HIV-infected patients: effect of rifaximin in Cryptosporidium parvum and Blastocystis hominis infections.J Chemother,11,391-395.
2. Ashford RW,Atkinson EA(1992).Epidemiology of Blastocystis hominis infection in Papua New Guinea: age-prevalence and associations with others parasites.Ann Trop Med Parasitol,86,129-136.
3. Cheng HS,Shin JW,Guo YL(2002).Symposium on Industrial Hygiene & Occupation Health.Taipei, Taiwan:
4. Cirioni O,Giacometti A,Drenaggi D,Ancarani F,Scalise G(1999).Prevalence and clinical relevance of Blastocystis hominis in diverse patient cohorts.Eur J Epidemiol,15,389-393.
5. Dagci H,Ustun S,Taner MS,Ersoz G,Karacasu F,Budak S(2002).Protozoon infections and intestinal permeability.Acta Tropica,81,1-5.
6. Giacometti A,Cirioni O,Fiorentini A,Fortuna M,Scalise G(1999).Irritable bowel syndrome in patients with Blastocystis hominis infection.Eur J Clin Microbiol Infect Dis,18,436-439.
7. Grossman I,Weiss LM,Simon D,Tanowitz HB,Wittner M(1992).Blastocystis hominis in hospital employees.Am J Gastroenterol,87,729-732.
8. Haresh K,Suresh K,Khairul Anus A,Saminathan S(1999).Isolate resistance of Blastocystis hominis to metronidazole.Trop Med Intl Health,4,274-277.
9. Herwaldt BL,de Arroyave KR,Wahlquist SP,de Merida AM,Lopez AS,Juranek DD(2001).Multiyear prospective study of intestinal parasitism in a cohort of Peace Corps volunteers in Guatemala.J Clin Microbiol,39,34-42.
10. Horiki N,Kaneda Y,Maruyama M,Fujita Y,Tachibana H(1999).Intestinal blockage by carcinoma and Blastocystis hominis infection.Am J Trop Med Hygiene,60,400-402.
11. Horiki N,Maruyama M,Fujita Y,Yonekura T,Minata S,Kaneda Y(1997).Epidemiologic survey of Blastocystis hominis in Japan.Am J Trop Med Hygiene,56,370-374.
12. Huang YH,Shin JW(2000).Blastocystis hominis: A long-term ignored intestinal parasite.Chin J Public Health,19,250-260.
13. Jelinek T,Peyerl G,Loscher T,von Sonnenburg F,Nothdurft HD(1997).The role of Blastocystis hominis as a possible interstinal pathogen in travelers.J Inf,35,63-66.
14. Martin-Sanchez AM,Canut-Blasco A,Rodriguez-Hernandez J,Montes-Martinez I,Garcia-Rodriguez JA(1992).Epidemiology and clinical significance of Blastocystis hominis in different population groups in Salamanca (Spain).Eur J Epidemiol,8,553-559.
15. Moe KT,Singh M,Howe J(1996).Observations on the ultrastructure and viability of the cystic stage of Blastocystis hominis from human feces.Parasitol Res,82,439-444.
16. Nimri L,Batchoun R(1994).Intestinal colonization of symptomatic and asymptomatic schoolchildren with Blastocystis hominis.J Clin Microbiol,32,2865-2866.
17. Nimri LF(1993).Evidence of an epidemic of Blastocystis hominis infections in preschool children in northern Jordan.J Clin Microbiol,31,2706-2708.
18. O`Gorman MA,Orenstein SR,Proujansky R,Wadowsky RM,Putnam PE,Kucoshis SA(1993).Prevalence and characteristics of Blastocystis hominis infection in children.Clin Pediatr,32,91-96.
19. Ok UZ,Girginkardesler N,Balcioglu C,Ertan P,Pirildar T,Kilimcioglu AA(1999).Effect of trimethoprim-sulfamethaxazole in Blastocystis hominis infection.Am J Gastroenterol,94,3245-3247.
20. Oyofo BA,Peruski LF,Ismail TF(1997).Enteropathogens associated with diarrhea among military personnel during Operation Bright Star 96, in Alexandria, Egypt.Military Med,162,396-400.
21. Shlim DR,Hoge CW,Rajah R,Rabold JG,Echeverria P(1995).Is Blastocystis hominis a cause of diarrhea in travelers? A prospective controlled study in Nepal.Clin Infect Dis,21,97-101.
22. Stenzel DJ,Boreham PF(1996).Blastocystis hominis revisited.Clin Microbiol Rev,9,563-584.
23. Taamasri P,Mungthin M,Rangsin R,Tongupprakam B,Areekul W,Leelayoova S(2000).Transmission of intestinal blastocystis related to the quality of drinking water.SE Asian J Trop Med Pub Health,31,112-117.
24. Tasova Y,Sahin B,Koltas S,Paydas S(2000).Clinical significance and frequency of Blastocystis hominis in Turkish patients with hematological malignancy.Act Med Okayama,54,133-136.
25. Udkow MP,Markell EK(1993).Blastocystis hominis: prevalence in asymptomatic versus symptomatic hosts.J Infect Dis,168,242-244.
26. Yoshikawa H,Abe N,Iwasawa M(2000).Genomic analysis of Blastocystis hominis strains isolated from two long-term health care facilities.J Clin Microbiol,38,1324-1330.