粪便显微镜检查是诊断肠道寄生虫的传统方法。最近,使用分子测试来识别粪便原生动物已成为以色列大多数临床实验室使用的主要工具。这项研究旨在评估以色列肠道寄生虫的患病率,并在使用分子测试的实验室与使用显微镜的实验室中比较这种患病率。通过实时PCR(RT-PCR)或显微镜分析了从2021年1月至10月在七个实验室收集的样品。多重小组包括以下病原体:蓝氏贾第鞭毛虫,溶组织内阿米巴,隐孢子虫。,环孢菌,脆弱的变形虫,和囊胚菌属。总的来说,通过RT-PCR检测了138,415个粪便样本,通过显微镜检测了6,444个粪便样本。与显微镜测试样品的4.6%相比,在28.4%的PCR测试样品中至少鉴定出一种原生动物。D.fragilis是最常见的PCR鉴定物种(29%)。D.脆弱,G.Lamblia,和隐孢子虫。主要见于儿科人群,而囊胚菌属。在成年人中最普遍(P<0.001)。在21,480个样本的子队列中,在4,113(19.15%)样本中发现了共同感染,带芽囊原虫。D.fragilis是最常见的(14.9%)对。与显微镜相比,分子粪便测试被证明更敏感。D.fragilis是最常见的病原体。上述特征是在COVID大流行期间发现的,当时旅行受到高度限制,很可能代表当地循环的原生动物。
目的:本研究揭示了以色列粪便寄生虫的流行情况。此外,这项研究表明,从显微镜分析到分子测试的转变改善了原生动物的诊断。
Stool examination using microscopy was the traditional method for the diagnosis of intestinal parasites. Recently, the use of molecular tests to identify stool protozoa has become the main tool used in most clinical laboratories in Israel. This study aimed to evaluate the prevalence of intestinal parasites in Israel and to compare this prevalence in laboratories that use molecular tests vs a laboratory that uses microscopy. Samples collected from January to October 2021 at seven laboratories were analyzed by real-time PCR (RT-PCR) or by microscopy. The multiplex panel included the following pathogens: Giardia lamblia, Entamoeba histolytica, Cryptosporidium spp., Cyclospora, Dientamoeba fragilis, and Blastocystis spp. Overall, 138,415 stool samples were tested by RT-PCR and 6,444 by microscopy. At least one protozoa species was identified in 28.4% of the PCR-tested samples compared to 4.6% of the microscopy-tested samples. D. fragilis was the most common PCR-identified species (29%). D. fragilis, G. lamblia, and Cryptosporidium spp. were mainly found in pediatric population, while Blastocystis spp. was most prevalent among adults (P < 0.001). In a sub-cohort of 21,480 samples, co-infection was found in 4,113 (19.15%) samples, with Blastocystis spp. and D. fragilis being the most common (14.9%) pair. Molecular stool testing proved more sensitive compared to microscopy. D. fragilis was the most commonly detected pathogen. The above profile was identified during the COVID pandemic when traveling was highly restricted and most likely represents the locally circulating protozoa.
OBJECTIVE: This study sheds light on the prevalence of stool parasites in Israel. Additionally, this study indicates that the shift from microscope analysis to molecular tests improved protozoa diagnosis.