The prevalence of Cryptosporidium spp. and other intestinal parasites in elderly patients

Year 2023, Volume: 48 Issue: 4, 1333 - 1338, 29.12.2023

Filiz Orak , Adem Doğaner , Murat Aral , Hulusi Güven , Şermin İnal , Büşra Pembe

https://doi.org/10.17826/cumj.1349781

Abstract

Purpose: Cryptosporidiosis is a self-limiting infection in individuals with immune competence, but it can have serious and life-threatening consequences in the elderly and immune-compromised individuals. In this study, we aimed to investigate the prevalence of Cryptosporidium spp. and other intestinal parasites and their relationship with symptoms in elderly patients.
Materials and Methods: The distribution of Cryptosporidium spp. and other intestinal parasites was prospectively evaluated in elderly patients admitted to different clinics of the university hospital between September 2018 and September 2019.
The study group included 40 elderly patients (18 females and 22 males; mean age: 73.35 ±6.55years) with gastrointestinal complaints and a control group consisting of 44 elderly patients without gastrointestinal complaints. Stool samples were examined using wet mount, and Kinyoun acid fast staining.
Results: The most frequently isolated parasites were amoeba cysts and trophozoites in elderly patients. Cryptosporidium spp. cysts were detected in 9 (22.5%) of patients with gastrointestinal symptoms, and in 13 (40.6%) of those with other complaints and in the control group. Cryptosporidium spp. cysts were found more common in those with a solid stool consistency than others with a watery stool consistency.
Conclusion: Cryptosporidiosis could be a life-threatening condition in a high-risk population, such as the elderly with co-morbidities, and physicians should have increased awareness.

Keywords

Cryptosporidium, parasite, elderly

Project Number

Yok

Yaşlı hastalarda Cryptosporidium spp. ve diğer bağırsak parazitlerinin yaygınlığı

Abstract

Amaç: Kriptosporidyoz, bağışıklık yetkinliğine sahip bireylerde kendini sınırlayan bir enfeksiyondur, ancak yaşlı ve bağışıklığı baskılanmış kişilerde ciddi ve hayatı tehdit edici sonuçlara yol açabilir. Bu çalışmada yaşlı hastalarda, Cryptosporidium spp. ve diğer bağırsak parazitlerinin prevalansını ve semptomlarla ilişkilerini araştırmayı amaçladık.
Gereç ve Yöntem: Eylül 2018 ile Eylül 2019 tarihleri arasında üniversite hastanesinin farklı kliniklerine başvuran yaşlı hastalarda Cryptosporidium spp. ve diğer bağırsak parazitlerinin dağılımı prospektif olarak değerlendirildi.
Çalışma grubuna gastrointestinal şikayetleri olan 40 yaşlı hasta (18 kadın ve 22 erkek; ortalama yaş: 73,35 ±6,55 yıl) ve gastrointestinal şikayeti olmayan 44 yaşlı hastadan oluşan kontrol grubu dahil edildi.
Gaita örnekleri ıslak bakı ve modifiye Kinyoun asit hızlı boyama kullanılarak incelendi.
Bulgular: En sık izole edilen parazitler amip kistleri ve trofozoitleri oldu. Gastrointestinal semptomları olan hastaların 9 (% 22.5)’ unda ve diğer şikayetleri olanlar ile kontrol grubunun 13 (% 40.6)' ünde Cryptosporidium spp. kistleri saptandı. Cryptosporidium spp. kistleri katı dışkı kıvamında olanlarda sulu dışkı kıvamına sahip olanlara göre anlamlı derecede daha yaygın bulundu.
Sonuç: Kriptosporidyoz, altta eşlik eden hastalık varlığında yaşlılar gibi yüksek riskli bir popülasyonda hayatı tehdit eden bir durum yaratabilir ve doktorlar bu konuda farkındalığı arttırmalıdır.

Supporting Institution

Yok

Project Number

Yok

References

• Arserim SK, Limoncu ME, Gündüz T, Balcıoğlu IC. Investigation of intestinal parasites in living nursing home. Turkiye Parazitol Derg. 2019;43:74-7.
• Lin E, Lin K, and Katz S. Serious and opportunistic infections in elderly patients with inflammatory bowel disease. Gastroenterol Hepatol. 2019;15;593-605.
• Naumova EN, Egorov AI, Morris RD, Griffiths JK. The elderly and waterborne cryptosporidium infection: gastroenteritis hospitalizations before and during the 1993 Milwaukee Outbreak. J Emerg Infect Dis. 2003;9:418-25.
• Ryan UM, Feng Y, Fayer R, Xiao L. Taxonomy and molecular epidemiology of Cryptosporidium and Giardia. A 50 year perspective (1971–2021) Int J Parasitol. 2021;51:1099-119.
• Bogan JE. Disinfection techniques for Cryptosporidium. Journal of Dairy and Veterinary Sciences. 2018;7:JDVS.MS.ID.555718.
• Helmy YA, Hafez, HM. Cryptosporidiosis: From prevention to treatment, a narrative review. Microorganisms. 2022;10:2456.
• Kurniawan A, Dwintasari SW, Connelly L, Nichols RAB, Yunihastuti E, Karyadi T, et al. Cryptosporidium species from human immunodeficiency infected patients with chronic diarrhea in Jakarta, Indonesia. Ann Epidemiol. 2013;23:720-3.
• Chalmers RM, Alexander C. Defining the diagnosis of cryptosporidiosis. Lancet. 2021;21:589-90.
• Darlan DM, Rozi MF, Andriyani Y, Yulfi H, Saragih RH, Nerdy N. Cryptosporidium sp. findings and its symptomatology among immuno-compromised patients. Open Access Maced J Med Sci. 2019;7:1567-71.
• Dharmarajan TS, Sohagia A, Pitchumoni CS. The gastrointestinal system and aging In: Geriatric Gastroenterology (Eds CS Pitchumoni, TS Dharmarajan):33-47. New York, Springer, 2012.
• Fuentes E, Fuentes M, Alarcon M, Palomo I. Immune system dysfunction in the elderly. An Acad Bras Cienc. 2017;89:285-99.
• Engroffa P, Elyb LS, da Silvac AB, Viegasd K, Loureiroe F, Gomese I, et al. Prevalence of intestinal parasites in the elderly enrolled in the family health strategy in porto Alegre, Brazil. Geriatr Gerontol Aging. 2016;10:132-9.
• Vejdanih M, Mansour R, Hamzavi Y, Vejdani S, Nazeri N, Michaeli A. Immunofluorescence assay and PCR analysis of Cryptosporidium oocysts and species from human feacal specimens. Jundishapur J Microbiol. 2014;7:e10284.
• Crannell ZA, Castellanos-Gonzalez A, Irani A, Rohrman B, White AC, Richards-Kortum R. Nucleic acid test to diagnose cryptosporidiosis: lab assessment in animal and patient specimens. Anal Chem. 2014;86:2565-71.
• Cengiz ZT, Yılmaz H, Şahin IH, Kapmaz M, Ekici P. The frequency of cryptosporidium spp. in immuno-compromised patients by modified acid-fast staining, cassette kit and ELISA methods: comparison of the diagnostic techniques. Jundishapur J Microbiol. 2017;10:e36479.
• Abdel Gawad SS, Ismail MAM, Imam NFA, Eassa AHA, Abu-Sarea EY. Detection of Cryptosporidium spp. in diarrheic immunocompetent patients in Beni-Suef, Egypt: insight into epidemiology and diagnosis. Korean J Parasitol. 2018;56:113-19.
• Tamomh AG, Agena AM, Elamin E, Suliman MA, Elmadani M, Omara AB, et al. Prevalence of cryptosporidiosis among children with diarrhea under five years admitted to Kosti teaching hospital, Kosti City, Sudan. BMC Infect Dis. 2021;21:349.
• Mohammad SM, Ali M, Abdel-Rahman SA, Moustafa RA, Salama MA. Molecular prevalence of Cryptosporidium isolates among Egyptian children with cancer. J Parasit Dis. 2021;45:746-53.
• Ramadan MAE, Kamal MY, Tolba MM, Mohamed EAE. Study of cryptosporidiosis in children with hematological and solid malignancies suffering from diarrhea. J Med Sci Clin Res. 2017;5:24571-6.
• Shad S, Hanif F, Ul Haq M, Luck NH, Aziz T, Mubarak M. Frequencies of common infectious organisms causing chronic diarrhea in renal transplant patients. Exp Clin Transplant. 2019;17)Suppl 1):212-5.
• Mor SM, DeMaria A Griffiths JK, Naumova EN. Cryptosporidiosis in the elderly population of the United States. Clin Infect Dis. 2009;48:698–705.
• Mathialagan R, Hariraj R. Gastroenterology in the elderly. Medicine. 2015;43:352-5.