TY - JOUR

T1 - Dientamoeba fragilis, a commensal in children in Danish day care centers

AU - Jokelainen, Pikka

AU - Jensen, Betina Hebbelstrup

AU - Andreassen, Bente Utoft

AU - Petersen, Andreas Munk

AU - Röser, Dennis

AU - Krogfelt, Karen A.

AU - Nielsen, Henrik V.

AU - Stensvold, Christen R.

PY - 2017/6

Y1 - 2017/6

N2 - Dientamoeba fragilis is an intestinal protozoan of debated clinical significance. Here, we present cross-sectional and longitudinal observations on D. fragilis in children aged 0 to 6 years from a 1-year multi-day-care-center cohort study set in Copenhagen, Denmark. The inclusion period for the cohort was 2009 through 2012. Stool samples collected from the children were accompanied by questionnaires completed by the parents or guardians of the children. Using real-time PCR, D. fragilis was detected in the first stool sample from 97 of 142 (68.3%) children. We evaluated the associations between seven plausible risk factors (age, sex, having siblings, having domestic animals at home, having had infant colic, recent history of intake of antibiotics, and recent history of travel abroad) as well as six reported symptoms (lack of appetite, nausea, vomiting, abdominal pain, weight loss, and diarrhea) and testing positive for D. fragilis. The final multivariable model identified being >3 years old and having a history of recent travel abroad as risk factors for testing positive for D. fragilis. Moreover, univariable analyses indicated that having siblings was a risk factor. There was no statistical association between a recent history of gastrointestinal symptoms and testing positive for D. fragilis. Among the 108 children who were represented by ≥2 samples and thus included in the longitudinal analysis, 32 tested negative on the first sample and positive later, and the last sample from each of the 108 children was positive. The results are in support of D. fragilis being a common enteric commensal in this population.

AB - Dientamoeba fragilis is an intestinal protozoan of debated clinical significance. Here, we present cross-sectional and longitudinal observations on D. fragilis in children aged 0 to 6 years from a 1-year multi-day-care-center cohort study set in Copenhagen, Denmark. The inclusion period for the cohort was 2009 through 2012. Stool samples collected from the children were accompanied by questionnaires completed by the parents or guardians of the children. Using real-time PCR, D. fragilis was detected in the first stool sample from 97 of 142 (68.3%) children. We evaluated the associations between seven plausible risk factors (age, sex, having siblings, having domestic animals at home, having had infant colic, recent history of intake of antibiotics, and recent history of travel abroad) as well as six reported symptoms (lack of appetite, nausea, vomiting, abdominal pain, weight loss, and diarrhea) and testing positive for D. fragilis. The final multivariable model identified being >3 years old and having a history of recent travel abroad as risk factors for testing positive for D. fragilis. Moreover, univariable analyses indicated that having siblings was a risk factor. There was no statistical association between a recent history of gastrointestinal symptoms and testing positive for D. fragilis. Among the 108 children who were represented by ≥2 samples and thus included in the longitudinal analysis, 32 tested negative on the first sample and positive later, and the last sample from each of the 108 children was positive. The results are in support of D. fragilis being a common enteric commensal in this population.

KW - Denmark

KW - Dientamoebiasis

KW - Infants

KW - Preschoolers

KW - Risk factors

KW - Symptoms

KW - Toddlers

U2 - 10.1128/JCM.00037-17

DO - 10.1128/JCM.00037-17

M3 - Journal article

C2 - 28330885

AN - SCOPUS:85019540535

VL - 55

SP - 1707

EP - 1713

JO - Journal of Clinical Microbiology

JF - Journal of Clinical Microbiology

SN - 0095-1137

IS - 6

ER -