Association between molecularly detected Entamoeba species and fecal calprotectin level among a cohort of diarrheic patients

Document Type : Original Article

Authors

1 Departments of Medical Parasitology Faculties of Medicine ,Cairo University, and Modern University for Technology and Information

2 Departments of Internal Medicine , Faculties of Medicine ,Kafrelsheikh University Kafrelsheikh, Egypt

3 Departments of Medical Parasitology Faculties of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt

Abstract

Background: Differentiation between Entamoeba species can be molecularly achieved, especially since
E. histolytica has been linked to high morbidity and mortality. Fecal calprotectin (FC) as an inflammatory
marker may be linked to amoebiasis.
Objective: The present study aimed at investigating the association of calprotectin in amoebiasis.
Patients and Methods: Stool samples were collected from 294 patients attending Internal Medicine
Outpatient Clinic in Kafrelsheikh University, Egypt; suffering from diarrhea with or without other
gastrointestinal manifestations. Samples were subjected to coproscopy, quantification of fecal calprotectin
level and multiplex nested PCR for Entamoeba species differentiation.
Results: Detection rate of E. histolytica complex was 16.6% by microscopic examination and only 14.6%
proved to be positive by nested multiplex polymerase chain reaction (PCR): E. histolytica (3.7%), E. dispar
(6.4%) and E. moshkovskii (4.5%). Statistical analysis including several variables showed no significance
except for the presence of blood and mucus. Fecal calprotectin was positive in 10.5% of the study
population and 81.8% in association with E. histolytica indicating intestinal inflammation. Frequency of
males infected with E. histolytica and E. dispar was higher than in females who showed a higher infection
rates with E. moshkovskii.
Conclusion: The association between E. histolytica and positivity of FC level is a crucial indicator for
disease severity and efficacy of therapeutic regimen.

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