Strongyloides stercoralis in Alcoholic Patients: Implications of Alcohol Intake in the Frequency of Infection and Parasite Load

Souza, Robson da Paixão de; Oliveira, C.; Araujo, Weslei Almeida Costa; Souza, A.B.S.; Silva, Mônica L. S.; Cruz, Irlana D. R. da; Sampaio, Larissa Mota; Santos, Juliane S. B. dos; Teixeira, Márcia Cristina Aquino; Soares, Neci Matos

doi:10.3390/pathogens9060422

Cited by 7 publications

(12 citation statements)

References 25 publications

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“…The detection rate of S. stercoralis by APC is higher than other traditional methods [ 32 ]. In this study, the detection rate of S. stercoralis by APC was 10.9%, which is consistent with 13.1% in Japan [ 11 ], but it is lower than 17.14% in Bangkok, Thailand [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

et al. 2022

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Background Strongyloides stercoralis is an intestinal parasite that can cause chronic infection, hyperinfection and/or a dissemination syndrome in humans. The use of techniques targeting ova fails to detect S. stercoralis, as only larvae of the parasite are excreted in faeces. Due to the absence of “Gold” standard diagnostic method for S. stercoralis, there is a paucity of reported data worldwide. Objective This study aimed to evaluate the performance of diagnostic methods of S. stercoralis infection by taking the composite reference as a “Gold” standard. Methods A cross-sectional study was conducted among 844 schoolchildren in Amhara Region, Ethiopia, from April to December 2019. Stool samples were collected and processed with formol-ether concentration technique (FECT), spontaneous tube sedimentation technique (STST), Baermann concentration technique (BCT), agar plate culture (APC) and real-time polymerase chain reaction (RT-PCR). Sensitivity, specificity, positive predictive value, and negative predictive value of each diagnostic method were computed against the composite reference. The agreements of diagnostic methods were evaluated by Kappa value at 95% CI. Results The composite detection rate of S. stercoralis by the five diagnostic methods was 39.0% (329/844). The detection rate of the parasite from stool samples by FECT, STST, BCT, APC and RT-PCR was 2.0% (17/844), 4.0% (34/844), 10.2% (86/844), 10.9% (92/844) and 28.8% (243/844), respectively. The highest detection rate (37.8%; 319/844) of S. stercoralis was recorded by a combination of BCT, APC, and RT-PCR followed by a combination of STST, BCT, APC and RT-PCR (37.3%; 315/844). The sensitivity of FECT, STST, BCT, APC and RT-PCR against the composite reference was 5.2%, 10.3%, 26.4%, 28.0% and 73.9%, respectively. The diagnostic agreements of RT-PCR, APC, BCT, STST and FECT with the composite reference in detection of S. stercoralis were substantial (0.775), fair (0.321), fair (0.305), slight (0.123), and slight (0.062), respectively. Conclusion RT-PCR detected the highest number of S. stercoralis infections. A combination of RT-PCR with APC and/or BCT better detected S. stercoralis from stool samples compared to other combinations or single diagnostic methods. Therefore, RT-PCR and combination of RT-PCR with APC and/or BCT diagnostic methods should be advocated for detection of S. stercoralis infection.

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Section: Discussionmentioning

confidence: 99%

Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

et al. 2022

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“…Our patient was a daily wage earner of low socioeconomic status, with multiple associated conditions, namely chronic alcoholism, uncontrolled type II diabetes mellitus and pulmonary tuberculosis, which could have contributed to his waning cell-mediated immune response. In fact, there is a five times higher risk of strongyloidiasis in chronic alcoholics, with or without cirrhosis [ 10 ]. The above-mentioned predisposing factors, along with walking bare feet, may have led to the chronic S. stercoralis infection in this patient.…”

Section: Discussionmentioning

confidence: 99%

A fatal combination of disseminated strongyloidiasis with two bacterial infections in an immunocompromised host

Vini

Antony

Jacob

et al. 2021

Access Microbiology

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Introduction. Strongyloides stercoralis is an intestinal nematode that is endemic in tropical countries. It can have a variable presentation ranging from asymptomatic eosinophilia in immunocompetent hosts to disseminated disease with sepsis in immunocompromised hosts. Case report. We report a case of chronic diarrhoea and decreased appetite in a 53-year-old man. He was a chronic alcoholic with diabetes, hypertension and dyslipidaemia and had earlier been treated for pulmonary tuberculosis. He was treated symptomatically for loose stools at a primary health care facility without relief. Following referral to our tertiary care centre, microscopic examination of the stool showed numerous larvae and a few eggs of Strongyloides stercoralis. Additionally, Aeromonas sobria was isolated from stool culture. The patient was discharged following improvement with a combination therapy of ivermectin, albendazole and ciprofloxacin. However, within 3 days, he was readmitted and succumbed to Escherichia coli sepsis. Conclusion. Strongyloidiasis can be diagnosed easily using a very simple but often neglected investigation, namely stool microscopy. This provides an early diagnosis, based on which prompt treatment with the appropriate antihelminthics can be started, thereby reducing the probability of disseminated infection. Disseminated strongyloidiasis is a medical emergency with a poor prognosis, especially in an immunocompromised state. Such patients should be treated aggressively with antihelminthics. They must be monitored for sufficient duration in the hospital for early signs of complication. Their discharge from hospital should be planned based on a negative stool microscopy report in addition to clinical improvement, so as to decrease the mortality reported for both untreated and treated individuals.

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“…Outro fator que também deve ser levado em conta, é que o consumo crônico de álcool possui efeito tóxico nas proteínas contráteis do músculo do intestino delgado e na função vagal, fazendo com que haja redução do trânsito gastrointestinal, o que favorece a permanência da larva rabditoide no lúmen do intestino do hospedeiro. 26…”

Section: Aspectos Epidemiológicosunclassified

“A MORTE PEDE CARONA”: Klebsiella pneumoniae COMO AGRAVANTE NA INFECÇÃO POR Strongyloides stercoralis

Moreno

Nascimento

Azevedo

et al. 2022

RUC

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Introdução: Durante o ciclo evolutivo alguns helmintos realizam Ciclo de Loss, fenômeno que pode estar relacionado a um intrigante mecanismo de “carona” translocando bactérias intestinais para o pulmão. Neste contexto, há a associação entre Gram-negativa Klebsiella pneumoniae e o parasito nematódeo Strongyloides stercoralis, um evento mais comum que o documentado. K. pneumoniae está “intimamente” relacionada a elevadas taxas de sepse neonatal, infecção intestinal. Por outro lado, o geohelminto S. stercoralis causa a verminose com maior fator de risco para imunocomprometidos. Objetivo: Discutir a interação entre patógenos de domínios distintos, que quando presentes no mesmo hospedeiro agravam o desfecho clínico. Metodologia: Trata-se de uma revisão integrativa baseada no modelo PRISMA, evidenciando aspectos como epidemiologia, fatores de virulência e resistência, bem como relatos de casos de co-infecção entre S. stercoralis e K. pneumoniae. Resultado: A análise dos dados sugere que a translocação intestinal bacteriana é agravante em casos de estrongiloidíase, relacionada a quadros graves de coinfecções. Estudos apontam K. pneumoniae como uma das principais bactérias intestinais realocada por S. stercoralis. Considerações finais: São escassas as fontes de inquérito da coinfecção por esses organismos, o que pode prejudicar a interpretação dos desfechos clínicos, do controle e vigilância, além de limitar abordagens terapêuticas mais eficientes.

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Strongyloides stercoralis in Alcoholic Patients: Implications of Alcohol Intake in the Frequency of Infection and Parasite Load

Cited by 7 publications

References 25 publications

Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

A fatal combination of disseminated strongyloidiasis with two bacterial infections in an immunocompromised host

“A MORTE PEDE CARONA”: Klebsiella pneumoniae COMO AGRAVANTE NA INFECÇÃO POR Strongyloides stercoralis

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