Treatment of Dientamoeba fragilis infection with paromomycin.

Treatment with paromomycin (25-35 mg/kg/d for 7 days) was evaluated prospectively in 15 children with Dientamoeba fragilis infection after 1-month follow-up. At the end of the study, parasitologic effectiveness and clinical improvement were observed in 12/15 (80%) and 13/15 (87%) patients, respectively. Paromomycin appears to be an effective drug for treatment of D. fragilis infection in children.

Clinical and microbiological features of dientamoebiasis in patients suspected of suffering from a parasitic gastrointestinal illness: a comparison of Dientamoeba fragilis and Giardia lamblia infections.

OBJECTIVES: To describe the clinical and microbiological features of Dientamoeba fragilis and Giardia lamblia infected patients, and to analyze the genetic variation of D. fragilis strains. METHODS: For a period of two years, all stool samples collected from patients suspected of having a parasitic gastrointestinal infection were examined according to our specific triple feces test (TFT) protocol. A retrospective case-control study was performed on D. fragilis and G. lamblia infected patients. Furthermore, PCR and genotyping by restriction fragment length polymorphism (RFLP) were performed upon the former. RESULTS: D. fragilis (6.3%) and G. lamblia (7.1%) were the most common pathogenic protozoa isolated out of 448 patients studied. Symptoms most frequently encountered with D. fragilis and G. lamblia infection were abdominal pain (69.2% and 72.4%, respectively) and diarrhea (61.5% and 79.3%, respectively). However, patients with D. fragilis infections suffered significantly less frequently from nausea and/or vomiting, anorexia and weight loss. After treatment, all D. fragilis and G. lamblia infected patients presenting a negative TFT follow-up also reported a complete resolution of their symptoms. Only genotype 1 could be detected in D. fragilis infected patients. CONCLUSIONS: D. fragilis and G. lamblia were the most frequently encountered parasites in our study population. Improved diagnostic tests are essential tools to study the prevalence and pathogenesis of D. fragilis.

The role of Epsilonproteobacteria in children with gastroenteritis.

A polymerase chain reaction-denaturing gradient gel electrophoresis method was used to examine 50 stool samples from children in Belgium with gastroenteritis for an extensive range of Epsilonproteobacteria species. During the 3-month study period, Campylobacter concisus was the most common species. Our observations suggest that C. concisus displays similar microbiologic and clinical features as Campylobacter jejuni.

Improvement of routine diagnosis of intestinal parasites with multiple sampling and SAF-fixative in the triple-faeces-test.

BACKGROUND AND STUDY AIM: To perform optimal laboratory diagnosis of intestinal parasites is demanding. Because intestinal parasites are intermittently shedded, examination of multiple stools is imperative. For reliable detection of vegetative stages of protozoa, fresh stools should be examined direct after production, or stools should be preserved in a fixative. These aspects in routine practice are often neglected with as a result lower sensitivity of the diagnostic procedure. With application of the Triple-Faeces-Test (TFT) protocol, where both multiple sampling and a SAF-fixative are included, these practical problems could be overcome. The aim of this study was to compare the recovery of intestinal parasites in faecal specimens using TFT protocol versus the conventional diagnostic method (ether-sedimentation of one fresh stool sample). METHODS: During a three years period, results obtained in routine practice with the TFT protocol were compared with results from examination of sediment obtained with the ethyl-acetate-sedimentation technique of one unpreserved faeces specimen. RESULTS: From 2776 patients, 28.1% were positive for one or more intestinal parasites after examination of the TFT test, compared to 10.3% positivity with the conventional method (P < 0.05). Pathogenic species and non pathogenic species were observed respectively 191 and 449 times with TFT and 105 and 152 times with conventional method (P < 0.05). CONCLUSIONS: The application of the Triple-Faeces-Test in routine clinical practice significantly increased recovery of intestinal parasitic infections.

Arcobacter species in humans.

During an 8-year study period, Arcobacter butzleri was the fourth most common Campylobacter-like organism isolated from 67,599 stool specimens. Our observations suggest that A. butzleri displays microbiologic and clinical features similar to those of Campylobacter jejuni; however, A. butzleri is more frequently associated with a persistent, watery diarrhea.