Abstract：
OBJECTIVE: The aim of this study was to assess the clinical significance of Dientamoeba fragilis (DF) and Blastocystis species (Bs) in human stool.
METHODS: Observational study of patients ≥18 years, who were tested by stool multiplex PCR for bacteria and parasites between April 2019 and March 2022. Although DF and Bs are part of the PCR kit, these results are not routinely reported to the patient or the ordering physician. The main outcomes were the incidence of symptoms during 14 days before the referral to stool PCR test, and the incidence of several clinical outcomes during 60 days after the PCR test (symptoms, referrals to further evaluation, prescription of symptomatic, or antibiotic treatment).
RESULTS: A total of 27 918 patients were tested by stool PCR during the 3 study years. A total of 6215 (22.3%) and 5337 (19.2%) were positive for DF and Bs, respectively. The incidence of symptoms before the test was similar in those positive for Bs or DF and those with all-negative PCR (adjusted OR and 95% CI of 0.87 [0.80-0.95] and 0.82 [0.76-0.88] for Bs and DF, respectively), whereas significantly higher (2.47 [2.23-2.73]) in those positive for the other multiplex PCR assay components. During the 60 days after the test, the prevalence of any of the outcomes was similar in those positive for Bs or DF and those with negative PCR (adjusted OR and 95% CI of 0.92 [0.83-1.02] and 0.89 [0.81-0.97] for symptoms, 0.84 [0.75-0.94] and 0.93 [0.85-1.01] for referrals, 0.88 [0.75-1.03] and 0.82 [0.71-0.94] for symptomatic treatment, and 0.88 [0.75-1.02] and 0.86 [0.75-0.98] for antibiotic treatment in the Bs and DF positive individuals, respectively). The PCR cycle threshold was not associated with any of the outcomes.
CONCLUSIONS: Positive stool PCR for DF or Bs was not associated with any of the measured clinical outcomes.
METHODS: Observational study of patients ≥18 years, who were tested by stool multiplex PCR for bacteria and parasites between April 2019 and March 2022. Although DF and Bs are part of the PCR kit, these results are not routinely reported to the patient or the ordering physician. The main outcomes were the incidence of symptoms during 14 days before the referral to stool PCR test, and the incidence of several clinical outcomes during 60 days after the PCR test (symptoms, referrals to further evaluation, prescription of symptomatic, or antibiotic treatment).
RESULTS: A total of 27 918 patients were tested by stool PCR during the 3 study years. A total of 6215 (22.3%) and 5337 (19.2%) were positive for DF and Bs, respectively. The incidence of symptoms before the test was similar in those positive for Bs or DF and those with all-negative PCR (adjusted OR and 95% CI of 0.87 [0.80-0.95] and 0.82 [0.76-0.88] for Bs and DF, respectively), whereas significantly higher (2.47 [2.23-2.73]) in those positive for the other multiplex PCR assay components. During the 60 days after the test, the prevalence of any of the outcomes was similar in those positive for Bs or DF and those with negative PCR (adjusted OR and 95% CI of 0.92 [0.83-1.02] and 0.89 [0.81-0.97] for symptoms, 0.84 [0.75-0.94] and 0.93 [0.85-1.01] for referrals, 0.88 [0.75-1.03] and 0.82 [0.71-0.94] for symptomatic treatment, and 0.88 [0.75-1.02] and 0.86 [0.75-0.98] for antibiotic treatment in the Bs and DF positive individuals, respectively). The PCR cycle threshold was not associated with any of the outcomes.
CONCLUSIONS: Positive stool PCR for DF or Bs was not associated with any of the measured clinical outcomes.
摘要：
目的：这项研究的目的是评估人类粪便中脆弱的Dientamoeba（DF）和囊胚（Bs）的临床意义。
方法：对≥18岁患者的观察性研究，他们在2019年4月至2022年3月期间通过粪便多重PCR检测了细菌和寄生虫。虽然DF和Bs是PCR试剂盒的一部分，这些结果不会常规报告给患者或主治医师.主要结果为：转诊至粪便PCR检测前14天的症状发生率，以及PCR测试后60天内几种临床结果的发生率(症状，提交进一步评估，对症或抗生素治疗的处方）。
结果：在三个研究年中，有27,918名患者通过粪便PCR进行了检测。6,215(22.3%)和5,337(19.2%)的DF和Bs呈阳性，分别。在Bs或DF阳性和PCR全阴性的患者中，测试前症状的发生率相似（校正OR（aOR）和95％置信区间（CI）为0.87（0.80-0.95）和0.82（0.76-0.88）。分别)，而在其他多重PCR测定成分阳性的人群中明显更高（2.47（2.23-2.73））。在测试后的60天内，Bs或DF阳性者和PCR阴性者的任何结果的患病率相似（aOR和95％CI为0.92（0.83-1.02）和0.89（0.81-0.97）症状，转介0.84（0.75-0.94）和0.93（0.85-1.01），Bs和DF阳性个体的对症治疗为0.88（0.75-1.03）和0.82（0.71-0.94），抗生素治疗为0.88（0.75-1.02）和0.86（0.75-0.98），分别)。PCR循环阈值与任何结果无关。
结论：DF或Bs的粪便PCR阳性与任何测得的临床结局无关。
方法：对≥18岁患者的观察性研究，他们在2019年4月至2022年3月期间通过粪便多重PCR检测了细菌和寄生虫。虽然DF和Bs是PCR试剂盒的一部分，这些结果不会常规报告给患者或主治医师.主要结果为：转诊至粪便PCR检测前14天的症状发生率，以及PCR测试后60天内几种临床结果的发生率(症状，提交进一步评估，对症或抗生素治疗的处方）。
结果：在三个研究年中，有27,918名患者通过粪便PCR进行了检测。6,215(22.3%)和5,337(19.2%)的DF和Bs呈阳性，分别。在Bs或DF阳性和PCR全阴性的患者中，测试前症状的发生率相似（校正OR（aOR）和95％置信区间（CI）为0.87（0.80-0.95）和0.82（0.76-0.88）。分别)，而在其他多重PCR测定成分阳性的人群中明显更高（2.47（2.23-2.73））。在测试后的60天内，Bs或DF阳性者和PCR阴性者的任何结果的患病率相似（aOR和95％CI为0.92（0.83-1.02）和0.89（0.81-0.97）症状，转介0.84（0.75-0.94）和0.93（0.85-1.01），Bs和DF阳性个体的对症治疗为0.88（0.75-1.03）和0.82（0.71-0.94），抗生素治疗为0.88（0.75-1.02）和0.86（0.75-0.98），分别)。PCR循环阈值与任何结果无关。
结论：DF或Bs的粪便PCR阳性与任何测得的临床结局无关。
