İshalli hastalarda direkt fluoresan antikor-dfa yöntemi ile giardia ve cryptosporidium spp. araştırılması

Aim. Cryptosporidium spp. and Giardia intestinalis are important parasitic protozoan causing diarrhea in developing and developed countries. Diagnosis of the Cryptosporidium oocyst in stool samples by conventional microscopy is labor-intensive and time-consuming. Thus, we aimed the presence of these protozoa in patients with diarrhea and to evaluate the usefulness of direct fluoresan antibody (DFA) test in detecting Cryptosporidium spp and G.intestinalis. from fecal specimens. Methods. For this aim, microscopy and specific antigen detection methods were used to determine Cryptosporidium spp. and G.intestinalis. One hundred stool specimens were examıned taken from patients with diarrhea whose ages ranged from 0 to 80 of applied to Hospital of Cumhuriyet University, Numune and Goverment Hospital in Sivas. All samples were tested for Cryptosporidium spp. G.intestinalis antigen by DFA and oocysts via gold Standard modified acidfast staining for Cryptosporidium spp.and G.intestinalis direct microscopy. Results. One specimen was found to be positive by modified acid-fast staining method and four specimens by DFA method were found to be positive for cryptosporidiosis. On the other hand two specimens were found to be positive both direct microscopy and DFA for giardiosis. Conclusion. The results of DFA test indicate that the simple, rapid, reliable, and standardized test is sensitive and specific for routine diagnosis and may be useful for large-scale epidemiological studies of cryptosporidiosis and giardiosis

Özet

Amaç. Cryptosporidium spp. ve Giardia intestinalis insanda ishal nedeni olabilen önemli protozoonlardır. Bu parazitozların tanısında etkensel tanı yöntemlerinin yanında antijen tarama testleri de kullanılabilmektedir. Çalışmamızda ishalli hastalarda konvansiyonel yöntemlerle birlikte Direkt Fluoresan Antikor (DFA) yöntemi ile G.intestinalis ve Cryptosporidium spp. varlığının saptanması ve bu iki protozoonun gastroenterit olgularındaki rolünün araştırılması amaçlanmıştır. Yöntem. Sivas il merkezindeki üç hastanenin (Cumhuriyet Üniversitesi Uygulama ve Araştırma Hastanesi, Sivas Numune ve Sivas Devlet Hastanesi) çeşitli servislerine enterit yakınmalarıyla başvuran 32’si kadın, 68’i erkek toplam 100 ishalli hastaya ait dışkı örneklerinde direkt inceleme ve asit-fast boyama yöntemi ile yapılan mikroskobik incelemelerde parazitlere ait kist ve/veya ookistler, DFA yöntemi ile parazitlere ait antijenler araştırılmıştır. İncelenen grupta yer alan hastalar 0-80 yaş aralığında bulunmaktadır. Bulgular. Çalışmada, ishalli 100 dışkı örneğinin 2’sinde direkt mikroskobide G.intestinalis görülmüştür. Asit-fast boyama ile birinde Cryptosporidium spp. görülürken, DFA ile 4’ünde (%4,0) Cryptosporidium spp., 2’sinde (%2,0) G. intestinalis antijenlerine rastlanmıştır. Cryptosporidium spp. saptanan hastaların erişkin yaş grubunda yer alması ilginç bulunmuştur. Sonuç. Cryptosporidium spp. ve G. intestinalis’in ikisini de içeren DFA testleri rutin çalışmalarda ve prevalans araştırmalarında kullanılabilen kolay, duyarlı ve güvenilir bir testtir. Diğer taraftan enterit nedenleri arasında sayılan bu iki protozoon incelenen hasta grubunda toplam %6 oranında bulunmuştur.

Anahtar sözcükler: Cryptosporidium spp., giardia intestinalis, DFA, ishal

 

Abstract

Aim. Cryptosporidium spp. and Giardia intestinalis are important parasitic protozoan causing diarrhea in developing and developed countries. Diagnosis of the Cryptosporidium oocyst in stool samples by conventional microscopy is labor-intensive and time-consuming. Thus, we aimed the presence of these protozoa in patients with diarrhea and to evaluate the usefulness of direct fluoresan antibody (DFA) test in detecting Cryptosporidium spp and G.intestinalis. from fecal specimens. Methods. For this aim, microscopy and specific antigen detection methods were used to determine Cryptosporidium spp. and G.intestinalis. One hundred stool specimens were examıned taken from patients with diarrhea whose ages ranged from 0 to 80 of applied to Hospital of Cumhuriyet University, Numune and Goverment Hospital in Sivas. All samples were tested for Cryptosporidium spp. G.intestinalis antigen by DFA and oocysts via gold Standard modified acid-fast staining for Cryptosporidium spp.and G.intestinalis direct microscopy. Results. One specimen was found to be positive by modified acid-fast staining method and four specimens by DFA method were found to be positive for cryptosporidiosis. On the other hand two specimens were found to be positive both direct microscopy and DFA for giardiosis. Conclusion. The results of DFA test indicate that the simple, rapid, reliable, and standardized test is sensitive and specific for routine diagnosis and may be useful for large-scale epidemiological studies of cryptosporidiosis and giardiosis.

Keywords: Cryptosporidium spp., giardia intestinalis, DFA, diarrhea