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Abstract：
BACKGROUND: Enteric parasite infections are underestimated due to the limited sensitivity and specificity of microscopy, which remains the diagnostic gold standard in routine clinical practice. This could be a major problem in high-income countries, where the burden of parasitic diseases is low. In recent years, Multiplex Real-Time polymerase chain reaction (RT-PCR) based methods have been implemented. Therefore, the aim of this study was to evaluate the prevalence of four enteric protozoan species detected by RT-PCR in non-native children in Italy, and to describe their clinical characteristics.
METHODS: Adopted and immigrant children, evaluated for migration health assessment between 2017 and 2020 in a tertiary care children\'s hospital in Italy, were enrolled. Molecular analysis for Giardia lamblia, Dientamoeba fragilis, Blastocystis hominis, and Entamoeba histolytica, was conducted by in-house RT-PCR.
RESULTS: Overall, 209 children were enrolled and 70% of them resulted positive by RT-PCR for at least one enteric parasite. B. hominis (47.8%) was the most commonly identified protozoa, followed by D. fragilis (44.5%). Co-infections with multiple pathogens were detected in 35.4% of the samples. Almost 80% of parasite-positive children were asymptomatic and the most common symptom was flatulence (60.7% of symptomatic children). Eosinophils were significantly increased in RT-PCR positive children compared to the negative ones and children with D. fragilis presented the highest eosinophils count.
CONCLUSIONS: The In-house Multiplex RT-PCR assay provides a valid molecular detection system for selected enteric parasites. This novel and accurate diagnostic method can help in increasing the detection rate of parasite infection, especially in high-risk population.
METHODS: Adopted and immigrant children, evaluated for migration health assessment between 2017 and 2020 in a tertiary care children\'s hospital in Italy, were enrolled. Molecular analysis for Giardia lamblia, Dientamoeba fragilis, Blastocystis hominis, and Entamoeba histolytica, was conducted by in-house RT-PCR.
RESULTS: Overall, 209 children were enrolled and 70% of them resulted positive by RT-PCR for at least one enteric parasite. B. hominis (47.8%) was the most commonly identified protozoa, followed by D. fragilis (44.5%). Co-infections with multiple pathogens were detected in 35.4% of the samples. Almost 80% of parasite-positive children were asymptomatic and the most common symptom was flatulence (60.7% of symptomatic children). Eosinophils were significantly increased in RT-PCR positive children compared to the negative ones and children with D. fragilis presented the highest eosinophils count.
CONCLUSIONS: The In-house Multiplex RT-PCR assay provides a valid molecular detection system for selected enteric parasites. This novel and accurate diagnostic method can help in increasing the detection rate of parasite infection, especially in high-risk population.
摘要：
背景：由于显微镜的敏感性和特异性有限，肠道寄生虫感染被低估了，这仍然是常规临床实践中的诊断金标准。这在高收入国家可能是个大问题,寄生虫病负担较低的地方。近年来,已经实现了基于多重实时聚合酶链反应(RT-PCR)的方法。因此,这项研究的目的是评估通过RT-PCR在意大利非本地儿童中检测到的四种肠原生动物的患病率，并描述其临床特征。
方法：收养和移民儿童，对2017年至2020年在意大利一家三级保健儿童医院进行的移民健康评估进行了评估，已注册。蓝氏贾第鞭毛虫的分子分析，脆弱的变形虫，人芽囊原虫,和溶组织内阿米巴，通过内部RT-PCR进行。
结果：总体而言，209名儿童入组，其中70％的儿童通过RT-PCR对至少一种肠寄生虫呈阳性。人类芽孢杆菌(47.8%)是最常见的原生动物，其次是D.fragilis（44.5%）。在35.4%的样本中检测到与多种病原体的共感染。几乎80％的寄生虫阳性儿童无症状，最常见的症状是胀气（有症状的儿童占60.7％）。与阴性儿童相比，RT-PCR阳性儿童的嗜酸性粒细胞显着增加，而脆弱D.fragilis儿童的嗜酸性粒细胞计数最高。
结论：内部多重RT-PCR检测为选定的肠道寄生虫提供了有效的分子检测系统。这种新颖而准确的诊断方法有助于提高寄生虫感染的检出率，尤其是高危人群。
方法：收养和移民儿童，对2017年至2020年在意大利一家三级保健儿童医院进行的移民健康评估进行了评估，已注册。蓝氏贾第鞭毛虫的分子分析，脆弱的变形虫，人芽囊原虫,和溶组织内阿米巴，通过内部RT-PCR进行。
结果：总体而言，209名儿童入组，其中70％的儿童通过RT-PCR对至少一种肠寄生虫呈阳性。人类芽孢杆菌(47.8%)是最常见的原生动物，其次是D.fragilis（44.5%）。在35.4%的样本中检测到与多种病原体的共感染。几乎80％的寄生虫阳性儿童无症状，最常见的症状是胀气（有症状的儿童占60.7％）。与阴性儿童相比，RT-PCR阳性儿童的嗜酸性粒细胞显着增加，而脆弱D.fragilis儿童的嗜酸性粒细胞计数最高。
结论：内部多重RT-PCR检测为选定的肠道寄生虫提供了有效的分子检测系统。这种新颖而准确的诊断方法有助于提高寄生虫感染的检出率，尤其是高危人群。
