Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13071-021-04749-8
Title: Prevalence and molecular subtyping of Blastocystis in patients with Clostridium difficile infection, Singapore
Authors: Deng, Lei 
Tay, Huiyi
Peng, Guangneng
Lee, Jonathan W. J. 
Tan, Kevin S. W. 
Keywords: Blastocystis
Clostridium difficile
Diarrhea
Pathogenicity
ST7
Issue Date: 24-May-2021
Publisher: BioMed Central Ltd
Citation: Deng, Lei, Tay, Huiyi, Peng, Guangneng, Lee, Jonathan W. J., Tan, Kevin S. W. (2021-05-24). Prevalence and molecular subtyping of Blastocystis in patients with Clostridium difficile infection, Singapore. Parasites and Vectors 14 (1) : 277. ScholarBank@NUS Repository. https://doi.org/10.1186/s13071-021-04749-8
Rights: Attribution 4.0 International
Abstract: Background: Blastocystis is a common anaerobic colonic protist in humans with controversial pathogenicity. Clostridium difficile (C. difficile) is the commonest cause of infectious diarrhea in healthcare settings. The prevalence and subtype (ST) characteristics of Blastocystis in patients with C. difficile infection (CDI) are rarely documented. Therefore, the present study was conducted to investigate the prevalence and subtype characteristics of Blastocystis in patients with suspicion of CDI in Singapore. Methods: Fecal samples were collected from 248 patients presenting with suspected CDI from a single tertiary hospital in Singapore. C. difficile was diagnosed through positive glutamate dehydrogenase (GDH) with or without toxin A/B using enzyme immunoassay methods. The prevalence and subtype genetic characteristics of Blastocystis were determined by polymerase chain reaction (PCR) amplification and analysis of the barcode region of the SSU rRNA gene. Results: The proportion of C. difficile in patients with healthcare-associated diarrhea in this study was 44% (109/248). Among the 109 C. difficile-positive patients, 59 (54.1%, 59/109) tested positive for toxigenic C. difficile, which was considered CDI. Based on the sequence analyses of the barcode region of the SSU rRNA gene, 10.1% (25/248) of the patients were found to be Blastocystis-positive, and three subtypes were identified: ST7 (64%, 16/25), ST1 (20%, 5/25), and ST3 (16%, 4/25). Remarkably, we found five patients with Blastocystis and C. difficile coinfection, and further subtype analysis showed two with ST7, two with ST1, and one with ST3. Conclusions: To the best of our knowledge, this is the first study to investigate the subtype distributions of Blastocystis in patients with CDI in Singapore. We found ST7 to be the predominant subtype in diarrheal patients. The pathogenicity of ST7 has been strongly suggested in previous in vitro and mouse model experiments, further confirming its potential pathogenicity to humans. [Figure not available: see fulltext.] © 2021, The Author(s).
Source Title: Parasites and Vectors
URI: https://scholarbank.nus.edu.sg/handle/10635/232326
ISSN: 1756-3305
DOI: 10.1186/s13071-021-04749-8
Rights: Attribution 4.0 International
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