https://doi.org/10.4081/mm.2024.12585

Epidemiology and diagnostics of intestinal parasitic infections in Italy: a multicentric survey

Vol. 39 No. 2 (2024)
Submitted: 23 April 2024
Accepted: 13 September 2024
Published: 20 November 2024
Epidemiology, intestinal parasites, Giemsa stain, microscopy
Abstract Views: 369
PDF: 44
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Authors

Libera Clemente
libera.clemente@asugi.sanita.fvg.it
https://orcid.org/0000-0002-2264-6967
SSD Laboratorio SPOKE Area Isontina, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italy.
Raffaele Gargiulo
https://orcid.org/0000-0002-2053-7492
Laboratorio Provinciale di Microbiologia Clinica, Azienda USL, Modena, Italy.
Daniele Crotti
Freelance in Parassitologia Medica, Perugia, Italy.
Stefania Varani
https://orcid.org/0000-0003-0862-4937
Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Italy.
Nicola Menegotto
UOC Microbiologia e Virologia, AULSS2 Marca Trevigiana, Treviso, Italy.
Francesco Bernieri
https://orcid.org/0009-0008-9598-2874
Consulente per la Parassitologia e la Batteriologia del “Centro di Riferimento Regionale per la Valutazione Esterna della Qualità” della Regione Toscana, Firenze, Italy.
Ester Oliva
https://orcid.org/0009-0009-2724-6549
SC Microbiologia, AUSL IRCCS Santa Maria Nuova, Reggio Emilia, Italy.
Valeria Besutti
UOC Microbiologia, Azienda Ospedale-Università Padova, Italy.
Maria Grazia Coppola
U.O.C. Microbiologia e Virologia, Azienda Ospedaliera dei Colli di Napoli, Italy.
Luciana Petrullo
U.O.C. Microbiologia e Virologia, Azienda Ospedaliera dei Colli di Napoli, Italy.
Francesco Fontana
https://orcid.org/0000-0002-9363-0575
SSD Laboratorio SPOKE Area Isontina, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italy.
Annibale Raglio
https://orcid.org/0009-0002-3842-8857
USC Microbiologia e Virologia, ASST Papa Giovanni XXIII, Bergamo, Italy.
Luca Masucci
Dipartimento di Scienze di Laboratorio ed Ematologiche, Policlinico Universitario A. Gemelli, Rome; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.

Background and Aims: parasitic infections are becoming more common in non-endemic countries because of intensified immigration and international travels; however, the parasitic disease burden is often underestimated because of underdiagnosis and lack of surveillance in industrialized countries. Also, in Italy, epidemiological data on intestinal parasites affecting humans are scarce and scattered in different areas of the country. The aim of this retrospective, observational study was to evaluate the prevalence of intestinal parasitic infections employing Parasitological Stool Examination (PSE) and to verify the quality of the diagnostic methodologies adopted to identify intestinal parasites in Italian laboratories.

Materials and Methods: the study involved 28 Italian diagnostic laboratories and 36389 patients, from June 2015 to May 2016.

Results: our data showed that 3173 out of 36389 subjects (8.7%) were carriers of one or more pathogenic or non-pathogenic protozoa or helminths. When only organisms known to cause intestinal disease were considered, an overall positive rate of 3.8% was found (1400/36389). Among the 1400 patients carrying one or more pathogenic species, protozoan infections predominated and were identified in 1138 subjects (3.1%); Dientamoeba fragilis and Giardia duodenalis represent the main intestinal pathogens. Concerning parasitic worms, only 262 individuals (0.7%) exhibited helminth infection; the most frequent finding was represented by Enterobius vermicularis, followed by Taenia spp. 

Conclusions: this survey also indicated that not all diagnostic laboratories can guarantee proper performance for parasitological diagnosis. In this context, close collaboration between physicians and clinical microbiologists is warranted to improve the diagnostics of intestinal parasitic infections, thus ensuring good quality service.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
Alum A, Rubino JR, Ijaz MK. The global war against intestinal parasites--should we use a holistic approach? Int J Infect Dis. 2010;14:e732-8. DOI: https://doi.org/10.1016/j.ijid.2009.11.036
Barratt JLN, Harkness J, Marriott D, et al. A review of Dientamoeba fragilis carriage in humans: Several reasons why this organism should be considered in the diagnosis of gastrointestinal illness. Gut Microbes. 2011;2:3-12. DOI: https://doi.org/10.4161/gmic.2.1.14755
Bartolini A, Zorzi G, Besutti V. Prevalence of intestinal parasitoses detected in Padua teaching hospital, Italy, March 2011 - February 2013. Infez Med. 2017;25133-41.
Belli A, Coppola MG, Petrullo L, et al. The current spectrum and prevalence of intestinal parasitosis in Campania (region of southern Italy) and their relationship with migration from endemic countries. International Journal of Infectious Diseases. 2014;29:42-7. DOI: https://doi.org/10.1016/j.ijid.2014.04.021
Bernieri F, Galli D, Giordano S. Indagine nazionale AMCLI-CoSP sulla diffusione delle parassitosi intestinali. Microbiologia Medica. 1994;9:415-8.
Bernieri F, Crotti D, Galli D, Raglio A. Manuale illustrato di diagnostica parassitologica. Selecta Medica; Cagliari, Italy; 2001. 266 pp.
Briancesco R, Bonadonna L. An Italian study on Cryptosporidium and Giardia in wastewater, fresh water and treated water. Environ Monit Assess. 2005;104:445-57. DOI: https://doi.org/10.1007/s10661-005-2282-4
Centers for Disease Control (CDC). DPDx - Enterobiasis. 2019. Available from: https://www.cdc.gov/dpdx/enterobiasis/index.html
Cook GC. Enterobius vermicularis infection. Gut. 1994;35:1159-62. DOI: https://doi.org/10.1136/gut.35.9.1159
Crotti D. Parassitosi intestinali autoctone nella II metà degli anni ’90: considerazioni critiche diagnostiche. Microbiologia Medica. 2001;17:7-13.
Crotti D. Le parassitosi intestinali ed uro genitali. 2005. Available from: http://www.medicalsystems.it/wp-content/uploads/2015/10/206_parassitosi.pdf
Crotti D, Bernieri F, Raglio A, et al. Epidemiology of intestinal parasitosis in Italy between 2005 and 2008: diagnostic techniques and methodologies. Microbiologia Medica. 2013;28;2274. DOI: https://doi.org/10.4081/mm.2013.2274
Crotti D, D’Annibale ML. Dientamoeba fragilis: suo ruolo nelle infezioni intestinali umane. Le Infezioni in Medicina. 2007;1:30-9.
Crotti D, D’Annibale ML, Fonzo G, Lalle M, Cacciò SM, Pozio E. Dientamoeba fragilis is more prevalent than Giardia duodenalis in children and adults attending a day care centre in Central Italy. Parasite. 2005;12:165-70. DOI: https://doi.org/10.1051/parasite/2005122165
Fletcher SM, Stark D, Harkness J, Ellis J. Enteric protozoa in the developed world: a public health perspective. Clin Microbiol Rev. 2012;25:420-49. DOI: https://doi.org/10.1128/CMR.05038-11
Franceschelli A, Bonadonna L, Cacciò SM, et al. An outbreak of cryptosporidiosis associated with drinking water in north-eastern Italy, August 2019: microbiological and environmental investigations. Eurosurveillance. 2022;27;2200038. DOI: https://doi.org/10.2807/1560-7917.ES.2022.27.35.2200038
Garcia LS, Arrowood M, Kokoskin E, et al. Practical guidance for clinical microbiology laboratories: laboratory diagnosis of parasites from the gastrointestinal tract. Clin Microbiol Rev. 2018;31:e00025-17. DOI: https://doi.org/10.1128/CMR.00025-17
Guidetti C, Ricci L, Vecchia L. Prevalence of intestinal parasitosis in Reggio Emilia (Italy) during 2009. Infez Med. 2010;18:154-61.
Kantzanou M, Karalexi MA, Vrioni G, Tsakris A. prevalence of intestinal parasitic infections among children in europe over the last five years. Trop Med Infect Dis. 2021;6:160. DOI: https://doi.org/10.3390/tropicalmed6030160
Masucci L, Graffeo R, Bani S, et al. Intestinal parasites isolated in a large teaching hospital, Italy, 1 May 2006 to 31 December 2008. Eurosurveillance. 2011;16;19891. DOI: https://doi.org/10.2807/ese.16.24.19891-en
Mbong Ngwese M, Prince Manouana G, Nguema Moure PA, et al. Diagnostic techniques of soil-transmitted helminths: impact on control measures. Trop Med Infect Dis. 2020;5:E93. DOI: https://doi.org/10.3390/tropicalmed5020093
Page W, Judd JA, Bradbury RS. The unique life cycle of strongyloides stercoralis and implications for public health action. Trop Med Infect Dis. 2018;3:E53. DOI: https://doi.org/10.3390/tropicalmed3020053
Resi D, Varani S, Sannella AR, et al. A large outbreak of giardiasis in a municipality of the Bologna province, north-eastern Italy, November 2018 to April 2019. Euro Surveill. 2021;26:2001331. DOI: https://doi.org/10.2807/1560-7917.ES.2021.26.35.2001331
Silvestri C, Greganti G, Arzeni D, et al. Intestinal parasitosis: data analysis 2006-2011 in a teaching hospital of Ancona, Italy. Infez Med. 2013;21:34-9.
Stark D, Barratt J, Roberts T, et al. Comparison of microscopy, two xenic culture techniques, conventional and real-time PCR for the detection of Dientamoeba fragilis in clinical stool samples. Eur J Clin Microbiol Infect Dis. 2010;29:411-6. DOI: https://doi.org/10.1007/s10096-010-0876-4
Verweij JJ, Mulder B, Poell B, et al. Real-time PCR for the detection of Dientamoeba fragilis in fecal samples. Molecular and Cellular Probes. 2007;21:400-4. DOI: https://doi.org/10.1016/j.mcp.2007.05.006
Wong SS, Fung KS, Chau S, et al. Molecular diagnosis in clinical parasitology: when and why? Exp Biol Med (Maywood). 2014;239:1443-60. DOI: https://doi.org/10.1177/1535370214523880
World Health Organization (WHO). Prevention and control of intestinal parasitic infections: WHO Technical Report Series N°749. 1987. Available from: https://www.who.int/publications-detail-redirect/WHO-TRS-749
World Health Organization (WHO). Changing history: the world health report 2004. 2004. Available from: https://iris.who.int/bitstream/handle/10665/42891/924156265X.pdf
World Health Organization (WHO). Soil-transmitted helminth infections. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth-infections

How to Cite

Clemente, L., Gargiulo, R., Crotti, D., Varani, S., Menegotto, N., Bernieri, F., Oliva, E., Besutti, V., Coppola, M. G., Petrullo, L., Fontana, F., Raglio, A., & Masucci, L. (2024). Epidemiology and diagnostics of intestinal parasitic infections in Italy: a multicentric survey. Microbiologia Medica, 39(2). https://doi.org/10.4081/mm.2024.12585
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