Subtype distribution and molecular characterization of Blastocystis from hemodialysis patients in Turkey

  • Baris Gulhan Department of Medical Microbiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
  • Merve Aydin Department of Medical Microbiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
  • Mehtap Demirkazik Department of Medical Parasitology, Faculty of Medicine, Cukurova University, Adana, Turkey
  • Ismail Soner Koltas Department of Medical Parasitology, Faculty of Medicine, Cukurova University, Adana, Turkey
  • Aytekin Cikman Department of Medical Microbiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey
  • Kultigin Turkmen Department of Internal Medicine, Division of Nephrology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
  • Tugce Duran Department of Medical Genetics, Faculty of Medicine, KTO Karatay University, Konya, Turkey
Keywords: Blastocystis, hemodialysis patients, molecular characterization, ST6, subtype

Abstract

Introduction: The aim of this study was to determine the Blastocystis prevalence and subtypes in hemodialysis patients in Turkey.

Methodology: Eighty-four patients diagnosed with end-stage renal failure who were undergoing hemodialysis and 20 healthy volunteers were enrolled. Blastocystis presence was investigated by native-Lugol, trichrome staining, PCR using STS primers, and DNA sequencing analysis.

Results: Among the stool samples from the hemodialysis patients, 9.52% (8/84) were found to be Blastocystis-positive with the native-Lugol and trichrome staining. Seven of the eight Blastocystis isolates were subtyped using STS primers. Blastocystis subtype distribution was as follows: one had ST1, two had ST2, two had ST3, two had ST3+ST6, and one was not subtyped. Blastocystis positivity was detected in two healthy control (2/20, %10), one subject had ST1, and the other was not subtyped. All subtypes identified by PCR were confirmed by the sequencing analysis. In the two samples that had mixed subtypes (ST3+ST6) when using the STS primers, only ST3 was detected in the sequencing analysis. Although some patients have multiple symptoms, the most common symptoms in Blastocystis positive patients were bloating (5/8), diarrhea (4/8), nausea and vomiting (2/8), and gas and weight loss (1/8). Also, only one patient had Giardia intestinalis.

Conclusions: This was the first study to determine the Blastocystis subtypes in hemodialysis patients. A rare subtype, ST6, was identified in two of the patients. Thus, the ST6 infections were attributable to transmission from poultry infections. The presence of this unusual subtype suggests the need for further extensive studies of hemodialysis patients.

Published
2020-12-31
How to Cite
1.
Gulhan B, Aydin M, Demirkazik M, Koltas IS, Cikman A, Turkmen K, Duran T (2020) Subtype distribution and molecular characterization of Blastocystis from hemodialysis patients in Turkey. J Infect Dev Ctries 14:1448-1454. doi: 10.3855/jidc.12650
Section
Original Articles