Morphological and Molecular Identification of Emerged Lophomonas blattarum Infection in Mazandaran Province, Northern Iran: First Registry-Based Study.
Lophomoniasis
Microscopic examination
National Registry Center
rRNA PCR
Journal
Acta parasitologica
ISSN: 1896-1851
Titre abrégé: Acta Parasitol
Pays: Switzerland
ID NLM: 9301947
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
15
01
2021
accepted:
19
05
2021
pubmed:
12
6
2021
medline:
15
12
2021
entrez:
11
6
2021
Statut:
ppublish
Résumé
In the last decade, several cases of bronchopulmonary lophomoniasis (BPL) have been recorded. Little information is available about epidemiological aspects on Lophomonas infection among BPL patients. The present study was aimed to investigate the prevalence of Lophomonas spp. infection in patients who were referred to the Iranian National Registry Center for Lophomoniasis (INRCL), using morphological and molecular tests. We examined patients enrolled in the INRCL from 2017 to 2019 at the Mazandaran University of Medical Sciences, northern Iran. All bronchoalveolar lavage fluid (BALF) and two nasal discharges of the patients were examined by both microscopic and small-subunit ribosomal RNA (SSU rRNA) PCR methods. To confirm the species of Lophomonas, two positive samples were sequenced. In this study, 321 specimens (including 319 BALF and 2 nasal discharges) were microscopically examined. Lophomonas spp. was found in 45(14%) (n = 44 BAL; n = 1 nasal discharge). The mean age of infected patients was 54.9 ± 17.1 years. The following morphological characteristics were observed in both fresh and Papanicolaou-stained smears to identify Lophomonas spp. All microscopically positive specimens were confirmed with genus-specific PCR technique. The obtained sequences were deposited in Gen Bank under the accession numbers (MN243135-36). The BLAST analysis of our two sequences with the only available sequence in the Gen Bank of the Thailand strain of L. blattarum, showed identity of 99-100% and 98.51%, respectively. To the best of our knowledge, this is the first registry-based study regarding lophomoniasis worldwide. According to our study, the conventional PCR test is an available and reliable tool for confirming the Lophomonas parasite in clinical samples. Moreover, the results confirmed that L. blattarum is circulating at least in our region.
Sections du résumé
BACKGROUND
BACKGROUND
In the last decade, several cases of bronchopulmonary lophomoniasis (BPL) have been recorded. Little information is available about epidemiological aspects on Lophomonas infection among BPL patients. The present study was aimed to investigate the prevalence of Lophomonas spp. infection in patients who were referred to the Iranian National Registry Center for Lophomoniasis (INRCL), using morphological and molecular tests.
SUBJECTS AND METHODS
METHODS
We examined patients enrolled in the INRCL from 2017 to 2019 at the Mazandaran University of Medical Sciences, northern Iran. All bronchoalveolar lavage fluid (BALF) and two nasal discharges of the patients were examined by both microscopic and small-subunit ribosomal RNA (SSU rRNA) PCR methods. To confirm the species of Lophomonas, two positive samples were sequenced.
RESULTS
RESULTS
In this study, 321 specimens (including 319 BALF and 2 nasal discharges) were microscopically examined. Lophomonas spp. was found in 45(14%) (n = 44 BAL; n = 1 nasal discharge). The mean age of infected patients was 54.9 ± 17.1 years. The following morphological characteristics were observed in both fresh and Papanicolaou-stained smears to identify Lophomonas spp. All microscopically positive specimens were confirmed with genus-specific PCR technique. The obtained sequences were deposited in Gen Bank under the accession numbers (MN243135-36). The BLAST analysis of our two sequences with the only available sequence in the Gen Bank of the Thailand strain of L. blattarum, showed identity of 99-100% and 98.51%, respectively.
CONCLUSION
CONCLUSIONS
To the best of our knowledge, this is the first registry-based study regarding lophomoniasis worldwide. According to our study, the conventional PCR test is an available and reliable tool for confirming the Lophomonas parasite in clinical samples. Moreover, the results confirmed that L. blattarum is circulating at least in our region.
Identifiants
pubmed: 34115281
doi: 10.1007/s11686-021-00422-3
pii: 10.1007/s11686-021-00422-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1510-1516Subventions
Organisme : Mazandaran University of Medical Sciences
ID : 2969
Informations de copyright
© 2021. Witold Stefański Institute of Parasitology, Polish Academy of Sciences.
Références
Gile GH, Slamovits CH (2012) Phylogenetic position of Lophomonas striata bütschli (parabasalia) from the hindgut of the cockroach periplaneta americana. Protist 163(2):274–283. https://doi.org/10.1016/j.protis.2011.07.002
doi: 10.1016/j.protis.2011.07.002
pubmed: 21840257
Gullan PJ, Cranston PS (2014) The insects: an outline of entomology. Wiley, Hoboken
Martinez-Giron R, van Woerden HC (2013) Lophomonas blattarum and bronchopulmonary disease. J Med Microbiol 62(11):1641–1648. https://doi.org/10.1099/jmm.0.059311-0
doi: 10.1099/jmm.0.059311-0
pubmed: 23946475
Rr KUDO (1931) Handbook of protozoology, charles c. Thomas Springfield, Illinois
Xue J, Li Y-L, Yu X-M, Li D-K, Liu M-F, Qiu J-F, Xue J-J (2014) Bronchopulmonary infection of Lophomonas blattarum: a case and literature review. Korean J Parasitol 52(5):521
doi: 10.3347/kjp.2014.52.5.521
Ribas A, Martínez-Girón R, Ponte-Mittelbrum C, Alonso-Cuervo R, Iglesias-Llaca F (2007) Immunosupression, flagellated protozoa in the human airways and metronidazole: observations on the state of the art. Transpl Int 20(9):811–812. https://doi.org/10.1111/j.1432-2277.2007.00521.x
doi: 10.1111/j.1432-2277.2007.00521.x
pubmed: 17617178
Martínez-Girón R, Doganci L (2010) Lophomonas blattarum: A bronchopulmonary pathogen. Acta Cytol 54(5):1050–1051
pubmed: 21053597
Martínez-Girón R, Ribas A, Astudillo-González A (2007) Flagellated protozoa in cockroaches and sputum: the unhygienic connection? Allergy Asthma Proc 28:608–609. https://doi.org/10.2500/aap2007.28.3042
doi: 10.2500/aap2007.28.3042
pubmed: 18034985
Zerpa R, Ore E, Patiño L, Espinoza Y (2010) Lophomonas sp. In respiratory tract secretions in hospitalized children with severe lung disease. Rev Peru Med Exp Salud Publica 27(4):575–577. https://doi.org/10.1590/s1726-46342010000400013
doi: 10.1590/s1726-46342010000400013
pubmed: 21308198
Kilimcioglu AA, Havlucu Y, Girginkardesler N, Çelik P, Yereli K, Özbilgin A (2014) Putative bronchopulmonary flagellated protozoa in immunosuppressed patients. Biomed Res Int. https://doi.org/10.1155/2014/912346
doi: 10.1155/2014/912346
pubmed: 24804259
pmcid: 3996290
Verma S, Verma G, Singh DV, Mokta J, Negi RS, Jhobta A, Kanga A (2015) Dual infection with pulmonary tuberculosis and Lophomonas blattarum in india. Int J tuberc Lung Dis Off J Int Union Against Tuberc Lung Dis 19(3):368. https://doi.org/10.5588/ijtld.14.0513
doi: 10.5588/ijtld.14.0513
Saldaña NG, Mendoza FJO, Larrauri FR, Trujillo DMG, Montoya EV, De La Garza EA, Olguín HJ (2017) Bronchopulmonary infection by Lophomonas blattarum in a pediatric patient after hematopoietic progenitor cell transplantation: First report in mexico. J Thorac Dis 9(10):E899. https://doi.org/10.21037/jtd.2017.09.19
doi: 10.21037/jtd.2017.09.19
pubmed: 29268431
pmcid: 5723799
Berenji F, Parian M, Fata A, Bakhshaee M, Fattahi F (2016) First case report of sinusitis with Lophomonas blattarum from iran. Case Rep Infect Dis. https://doi.org/10.1155/2016/2614187
doi: 10.1155/2016/2614187
pubmed: 26966601
pmcid: 4757678
Ghafarian N, Bakhtiari E, Berenji F, Nakhaei M, Nakhaei B, Jamali-Behnam F, Sayedi J (2018) The study of Lophomonas blattarum infection in children with respiratory symptoms: a descriptive clinical study in north east of Iran. Int J Pediatr 6(6):779–802. https://doi.org/10.22038/IJP.2018.29199.2555
doi: 10.22038/IJP.2018.29199.2555
Mirzazadeh F, Berenji F, Amini M, Salehi M, Shamsian A, Fata A, Parian M, Nakhaei M, Ghofraniha L (2017) Lophomonas blattarum in asthmatic patients and control group. J Res Med Dent Sci 5(5):1–5
Talebian M, Berenji F, Amini M, Sayedi SJ, Shamsian A, Afzalaghaee M, Fata A, Parian M, Nakhaei M, Farash BRH (2018) A study about clinical symptoms and laboratory signs of adult and pediatric patients with Lophomonas blattarum. J Res Med Dent Sci 6(1):312–317
Martínez-Girón R, Esteban J, Ribas A, Doganci L (2008) Protozoa in respiratory pathology: a review. Eur Respir J 32(5):1370–1354. https://doi.org/10.1183/09031936.00022008
doi: 10.1183/09031936.00022008
Salehzadeh A, Tavacol P, Mahjub H (2007) Bacterial, fungal and parasitic contamination of cockroaches in public hospitals of hamadan, Iran. J Vector Borne Dis 44(2):105
pubmed: 17722863
Motevalli-Haghi SF, Shemshadian A, Nakhaei M, Faridnia R, Dehghan O, Shafaroudi MM, Kelarijani MN, Nikookar SH, Kalani H, Fakhar M (2021) First report of Lophomonas spp. In german cockroaches (blattella germanica) trapped in hospitals, northern Iran. J Parasit Dis. https://doi.org/10.1007/s12639-021-01381-2
doi: 10.1007/s12639-021-01381-2
pubmed: 34789975
Mahjouri E (2001) Historical geography of Mazandaran Province. Geographical Organization Press, Tehran
Fakhar M, Nakhaei M, Sharifpour A, Kalani H, Banimostafavi ES, Abedi S, Safanavaei S, Aliyali M (2019) First molecular diagnosis of lophomoniasis: the end of a controversial story. Acta Parasitol. https://doi.org/10.2478/s11686-019-00084-2
doi: 10.2478/s11686-019-00084-2
pubmed: 31848842
Ghaffari J, Khademloo M, Saffar M, Rafiei A, Masiha F (2010) Hypersensitivity to house dust mite and cockroach is the most common allergy in north of Iran. Iran J Immunol 7(4):234–239
pubmed: 21189446
Ghaffari J, Mohammadzadeh I, Khalilian A, Rafatpanah H, Mohammadjafari H, Davoudi A (2012) Prevalence of asthma, allergic rhinitis and eczema in elementary schools in sari (Iran). Casp J Int Med 3(1):372
Liu J, Li S, Li H, Fan Y, Yang H, Xu H, Shen Y, Zhao S (2017) Bronchopulmonary disease caused by flagellated protozoa infection in 15 Chinese children. Pediatr Infect Dis J 36(4):392–397. https://doi.org/10.1097/inf.0000000000001455
doi: 10.1097/inf.0000000000001455
pubmed: 28187061
Bernin H, Lotter H (2014) Sex bias in the outcome of human tropical infectious diseases: Influence of steroid hormones. J Infect Dis 209(suppl_3):S107-113. https://doi.org/10.1093/infdis/jit610
doi: 10.1093/infdis/jit610
pubmed: 24966190
Fischer J, Jung N, Robinson N, Lehmann C (2015) Sex differences in immune responses to infectious diseases. Infection 43(4):399–403. https://doi.org/10.1007/s15010-015-0791-9
doi: 10.1007/s15010-015-0791-9
pubmed: 25956991
Klein SL (2004) Hormonal and immunological mechanisms mediating sex differences in parasite infection. Parasite Immunol 26(6–7):247–264. https://doi.org/10.1111/j.0141-9838.2004.00710.x
doi: 10.1111/j.0141-9838.2004.00710.x
pubmed: 15541029
Muenchhoff M, Goulder PJ (2014) Sex differences in pediatric infectious diseases. J infect Dis 209(suuppl_3):S120-126. https://doi.org/10.1093/infdis/jiu232
doi: 10.1093/infdis/jiu232
pubmed: 24966192
pmcid: 4072001
Nasirian H (2017) Infestation of cockroaches (insecta: Blattaria) in the human dwelling environments: a systematic review and meta-analysis. Acta Trop 167:86–97. https://doi.org/10.1016/j.actatropica.2016.12.019
doi: 10.1016/j.actatropica.2016.12.019
pubmed: 28012906
Holgate ST (2010) Disruption of airway epithelium in asthma pathogenesis: are protozoa responsible? Proc Am Thorac Soc 7(2):161. https://doi.org/10.1513/pats.7.2.161a
doi: 10.1513/pats.7.2.161a
Yang J-X, Tang Y-Y, Fang Z-M, Tong Z-Z, Li Y-L, Wang T (2014) Investigation on Lophomonas blattarum infection in periplaneta americana in wuhan city. Zhongguo ji sheng chong xue yu ji sheng chong bing za zhi = Chin J Parasitol Parasit Dis 32(2):161–162
Martínez-Girón R, Van Woerden HC (2014) Bronchopulmonary lophomoniasis: emerging disease or unsubstantiated legend? Parasit Vectors 7(1):284. https://doi.org/10.1186/1756-3305-7-284
doi: 10.1186/1756-3305-7-284
pubmed: 24957324
pmcid: 4077114
Tyagi R, Anand KB, Teple K, Negi RS (2016) Lophomonas blattarum infection in immunocompetent patient. Lung India Off Organ Indian Chest Soc 33(6):667. https://doi.org/10.4103/0970-2113.192867
doi: 10.4103/0970-2113.192867
D’Amato M, Molino A, Calabrese G, Cecchi L, Annesi-Maesano I, D’Amato G (2018) The impact of cold on the respiratory tract and its consequences to respiratory health. Clin Transl Allergy 8(1):1–8. https://doi.org/10.1186/s13601-018-0208-9
doi: 10.1186/s13601-018-0208-9
Li X-X, Zhou X-N (2013) Co-infection of tuberculosis and parasitic diseases in humans: a systematic review. Parasit Vectors 6(1):1–12. https://doi.org/10.1186/1756-3305-6-79
doi: 10.1186/1756-3305-6-79
Alam-Eldin YH, Abdulaziz AM (2015) Identification criteria of the rare multi-flagellate Lophomonas blattarum: comparison of different staining techniques. Parasitol Res 114(9):3309–3314. https://doi.org/10.1007/s00436-015-4554-4
doi: 10.1007/s00436-015-4554-4
pubmed: 26032944
Li R, Gao ZC (2016) Lophomonas blattarum infection or just the movement of ciliated epithelial cells? Chin Med J 129(6):739. https://doi.org/10.4103/0366-6999.178025
doi: 10.4103/0366-6999.178025
pubmed: 26960379
pmcid: 4804422
Wang Y, Tang Z, Ji S, Zhang Z, Chen J, Cheng Z, Cheng D, Liu Z, Li L (2006) Pulmonary Lophomonas blattarum infection in patients with kidney allograft transplantation. Transpl Int 19(12):1006–1013. https://doi.org/10.1111/j.1432-2277.2006.00380.x
doi: 10.1111/j.1432-2277.2006.00380.x
pubmed: 17081231
Morgan U, Thompson R (1999) Molecular detection of parasitic protozoa. Parasitology 117(07):73–85. https://doi.org/10.1017/s0031182099004102
doi: 10.1017/s0031182099004102
Martínez-Girón R, van Woerden HC, Doganci L (2011) Lophomonas misidentification in bronchoalveolar lavages. Int Med (Tokyo, Japan) 50(21):2721–2723. https://doi.org/10.2169/internalmedicine.50.5878
doi: 10.2169/internalmedicine.50.5878