Parasitic Infection in Renal Transplant Recipients

Valar, C.; Keitel, Elizete; Prá, Ronivan Luis Dal; Gnatta, Diego; Santos, A Ribeiro dos; Bianco, P.D; Sukiennik, Teresa; Pêgas, Karla Laís; Bittar, A.E; Oliveira, Kaline; Garcı́a, Valter Duro

doi:10.1016/j.transproceed.2007.01.025

Cited by 48 publications

(44 citation statements)

References 13 publications

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“…An intermediate to low level of prevalence was found in comparison with data from prevalence studies carried out in other regions .8,9 In a recent study carried out on renal transplant recipients, the overall prevalence of intestinal parasites was 2.4%. 10 In the present study, E. coli was the first most prevalent parasite detected in both groups, without significant difference and followed by Endolimax nana and Giardia lamblia. In a recent study in Iran, rate of infection with E. coli, E. nana and G. lamblia in HIV patients have been reported 0.16%, 0% and 4.1%, respectively.…”

Section: Discussionsupporting

confidence: 42%

“…In other study carried out on renal transplant recipients in Brazil, G. lamblia was the third most prevalent parasite (3/16) and Strongyloides stercoralis was the common parasite (11/16) in these patients. 10 Cryptosporidium infection is prevalent in communities with overcrowding and low level sanitation, 11 and its prevalence reaches up to 36% in certain developing countries. 12 In Iran, the exact coccidian infection rates are not known and there are very few studies on cryptosporidiosis.…”

Section: Discussionmentioning

confidence: 99%

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Intestinal parasitic infections in renal transplant recipients

Azami¹,

Sharifi²,

Hejazi³

et al. 2010

Braz J Infect Dis

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We declare no conflict of interest. ABSTRACTThe impact of intestinal parasitic infection in renal transplant recipients requires careful consideration in the developing world. However, there have been very few studies addressing this issue in Iran. This study was conducted to determine the prevalence of intestinal parasitic infections in renal transplant recipients in Iran. Stool specimens from renal transplant recipients and control groups were obtained between June 2006 and January 2007. The samples screened for intestinal parasitic infections using direct smear, formalin-ether sedimentation, Sheather's flotation and modified Ziehl-Neelsen staining methods. Out of 150 renal transplant recipients, 33.3% (50), and out of 225 control group, 20% (45) were infected with one or more type of intestinal parasites. The parasites detected among patients included Entamoeba coli (10.6%), Endolimax nana (8.7%), Giardia lamblia (7.4%), Blastocystis spp. (4.7%), Iodamoeba butschlii (0.7%), Chilomastix mesnili (0.7%) and Ascaris lumbricoides (0.7%). Multiple infections were more common among renal transplant recipients group (p < 0.05). This study highlights the importance of testing for intestinal parasites among Iranian renal transplant recipients. Routine examinations of stool samples for parasites would significantly benefit the renal transplant recipients by contributing to reduce severe infections.

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Section: Discussionsupporting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Intestinal parasitic infections in renal transplant recipients

Azami¹,

Sharifi²,

Hejazi³

et al. 2010

Braz J Infect Dis

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“…However, several conditions may appear later in life that impair the function of the immune system and its ability to control the reactivation of T. gondii tissue cysts. These include infectious diseases such as human immunodeficiency virus infection (28-30) and treatment with immunosuppressive and chemotherapeutic agents commonly given to transplant and cancer patients, respectively (3,18,22,27,32,45). Reactivation of tissue cysts in these individuals leads to the recrudescence of T. gondii infection (15), a life-threatening condition that in the long term responds poorly to therapy and often develops into encephalitis (16,19,26,28,30,42).…”

mentioning

confidence: 99%

Temporal and Spatial Distribution of Toxoplasma gondii Differentiation into Bradyzoites and Tissue Cyst Formation In Vivo

et al. 2008

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During Toxoplasma gondii infection, a fraction of the multiplying parasites, the tachyzoites, converts into bradyzoites, a dormant stage, which form tissue cysts localized mainly in brain, heart, and skeletal muscles that persist for several years after infection. At this stage the parasite is protected from the immune system, and it is believed to be inaccessible to drugs. While the long persistence of tissue cysts does not represent a medical problem for healthy individuals, this condition represents a major risk for patients with a compromised immune system, who can develop recrudescent life-threatening T. gondii infections. We have investigated for the first time the dynamics and the kinetics of tachyzoite-to-bradyzoite interconversion and cyst formation in vivo by using stage-specific bioluminescent parasites in a mouse model. Our findings provide a new framework for understanding the process of bradyzoite differentiation in vivo. We have also demonstrated that complex molecules such as D-luciferin have access to tissue cysts and are metabolically processed, thus providing a rationale for developing drugs that attack the parasite at this developmental stage.Toxoplasma gondii is transmitted to humans by the ingestion of either undercooked meat containing tissue cysts or poorly washed vegetables contaminated with oocysts from cat feces. The infection normally progresses as a mild, self-resolving disease. Initially T. gondii multiplies rapidly inside cells of different tissues and organs in the form of tachyzoites. Within 2 to 3 weeks, infected individuals develop a potent immune response that effectively controls the growth of the parasite. Before being eliminated by the immune system, some of the tachyzoites develop into a dormant stage, the bradyzoites, which multiply at a much lower rate than tachyzoites and become progressively enclosed in a dense matrix surrounded by a thick wall, the tissue cyst (11,33,46). At this stage the parasite is much less vulnerable to attack by the immune system. Tissue cysts can persist for several years in the brain, the heart, and the skeletal muscle of individuals who had been previously infected with T. gondii (34,46,49). Tissue cysts do not cause major pathological damage, and parasites are eventually released as result of stochastic reactivation of the bradyzoites (14) yet are promptly eliminated by the immune system. Therefore, in healthy individuals the persistence of T. gondii cysts in tissues and organs does not represent a cause for concern. However, several conditions may appear later in life that impair the function of the immune system and its ability to control the reactivation of T. gondii tissue cysts. These include infectious diseases such as human immunodeficiency virus infection (28-30) and treatment with immunosuppressive and chemotherapeutic agents commonly given to transplant and cancer patients, respectively (3,18,22,27,32,45). Reactivation of tissue cysts in these individuals leads to the recrudescence of T. gondii infection (15), a life-threatening co...

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“…Higher mortality rates occur from extraintestinal strongyloidiasis, which in most of these cases are related to corticosteroid therapy to treat rejection (Keiser & Nutman, 2004). Renal transplants are most commonly associated with hyperinfection, which is related to immunosuppressive treatments (Devault et al, 1990;Rajapurkar et al, 2007;Valar et al, 2007). Cases of hyperinfection have been described in transplant recipients of other organs, such as the liver (Vilela et al, 2008;Rodrigues-Hernandez et al, 2009), heart (Schaeffer et al, 2004, pancreas (Ben-Yousseff et al, 2005), lung (Balagopal et al, 2009), and intestine (Patel et al, 2008).…”

Section: Transplantationmentioning

confidence: 99%