MA BEHR, E KOKOSKIN, TW GYORKOS, L CÉDILOTTE, GM FAUBERT, JD MACLEAN. Laboratory diagnosis for MAIN RESULTS:For 152 previously collected stools, copro-antigen detection had a sensitivity of 73 of 74 (98.6%) and a specificity of 78 of 78 (100%). In clinical samples of 62 patients, eight of the 62 patients (13%) were diagnosed with G lamblia infection on microscopy. Copro-antigen diagnosis was accurate in symptomatic patients, with sensitivity of seven of eight (87.5%) and specificity of 52 of 54 (96.8%). Serology was less accurate. IgG response to G lamblia had sensitivity of four of seven and specificity of 24 of 50 (48%), and IgM response had sensitivity of three of six and specificity 27 of 48 (56%). Western blot had a sensitivity of five of seven and a specificity of 38 of 49 (78%). CONCLUSIONS: Copro-antigen diagnosis of G lamblia is highly accurate in patients with chronic gastrointestinal complaints, while serology is less accurate and appears to be less useful diagnostically.
The trophozoites of Giardia lamblia were gradually adapted to grow in both autoclaved and filtered Diamond's TYI-S-33 culture medium. Comparative growth studies indicated that the growth of organisms was significantly higher in filtered TYI-S-33 medium. In both types of media the exponential growth phase occurred between 48 and 96 h postinoculation. The mean number of trophozoites at 96 h was 1.94 × 105 and 4.82 × 105 cells/mL for autoclaved and filtered media, respectively. The generation times for the exponential growth phase were 9.66 h. for autoclaved and 7.69 h for filtered medium. The percentage of dead trophozoites was similar in both media and was 14% for the first 8 days postinoculation.
Administration of cyclosporin A (CyA) to mice prior to infection and at weekly intervals during the infection with Giardia muris resulted in an increase in cyst output and a delay of the elimination phase of the infection. A short term treatment (4 days) of infected mice with CyA induced a significantly higher cyst release after treatment. CyA did not affect the ability of immune mice to resist reinfection. Our findings indicate that CyA has compromised immunological control of the primary Giardia infection, but not the ability of the immune host to resist reinfection. We propose that the use of immunosuppressive drugs may be a contributing factor in transmission of giardiasis.
The sensitivity of three isolates of Trichinella spiralis (from pig, polar bear, and wolverine) and T. spiralis var. pseudospiralis to the anthelmintic thiabendazole (TBZ) was studied in male CD-1 mice. In vitro larval release by female worms isolated on day 7 following drug treatment (2–7 days) with various drug dosages (0.01–0.06%) showed that TBZ treatment resulted in sterility or a decrease in fecundity of the worms. Females of the pig isolate and T. spiralis var. pseudospiralis were chemosterilized with 0.05% TBZ and at 0.03% so were the two Arctic isolates (polar bear and wolverine), but chemosterilization was not permanent. Drug treatment during the disseminating phase (4–20 days) with low dosages (0.03–0.1%) was highly effective in reducing the number of muscle larvae at 40 days postinfection, a reduction that was similar for all Trichinella. Drug treatments (0.03–0.5%) during the early muscle phase (20–40 days) were ineffective with low dosages (<0.15%), but with a higher dosage (0.5%) 99 and 100% efficacy were noted for the two Arctic isolates and T. spiralis var. pseudospiralis, respectively. Larvae recovered at high dosages (>0.15%), were not infective to mice. Treatments with dosages of 0.03–0.1% from 40 to 60 days postinfection were only effective against the Arctic isolates. Of all the Trichinella studied, the pig isolate was the least sensitive to parenteral treatment.
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