title: Blastocystis: Genetic diversity and molecular methods for diagnosis and epidemiology.
abstract: Blastocystis, an unusual anaerobic, single-celled stramenopile, is a remarkably successful intestinal parasite of a vast array of host species including humans. Fecal Deoxyribonucleic acid (DNA) analysis by nucleic-acid based methods in particular has led to significant advances in Blastocystis diagnostics and research over the past few years enabling accurate identification of carriers and molecular characterization by high discriminatory power. Moreover, Blastocystis comprises a multitude of subtypes (STs) (arguably species) many of which have been identified only recently and molecular epidemiological studies have revealed a significant difference in the distribution of STs across host species and geographical regions. Having a cosmopolitan distribution, the parasite is a common laboratory finding in the stools of individuals with and without intestinal symptoms across the entire globe and while the parasite remains extremely difficult to eradicate and isolate in culture, appropriate molecular tools are now available to resolve important questions such as whether the clinical outcome of colonization is linked to ST and whether Blastocystis is transmitted zoonotically. This review summarizes some of the recent advances in the molecular diagnosis of Blastocystis and gives an introduction to Blastocystis STs, including a recommendation of subtyping methodology based on recent data and method comparisons. A few suggestions for future directions and research areas are given in the light of relevant technological advances and the availability of mitochondrial and nuclear genomes.
authors: Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors: Christen Rune
authors: CR
authors: Stensvold
keywords: Blastocystis; deoxyribonucleic acid; diagnosis; epidemiology; polymerase chain reaction
references: Am J Trop Med Hyg. 2001 Oct;65(4):393-6
references: 11693890
references: Intern Med J. 2012 Nov;42(11):1187-95
references: 22032439
references: Vet Parasitol. 2009 Mar 23;160(3-4):295-300
references: 19136214
references: J Clin Microbiol. 2012 Feb;50(2):540-1
references: 22090410
references: Protist. 2013 Jul;164(4):497-509
references: 23770574
references: Parasitol Res. 2009 Oct;105(5):1283-6
references: 19603182
references: J Parasitol. 2006 Oct;92(5):1081-7
references: 17152954
references: Parasitol Res. 2008 Aug;103(3):685-9
references: 18523804
references: J Clin Microbiol. 2012 Jun;50(6):1847-51
references: 22422846
references: Vet Parasitol. 2010 Apr 19;169(1-2):8-17
references: 20089360
references: BMC Bioinformatics. 2010 Dec 10;11:595
references: 21143983
references: Trop Med Int Health. 1997 Aug;2(8):771-8
references: 9294547
references: Parasitol Res. 2010 Jan;106(2):505-11
references: 19953268
references: J Clin Microbiol. 2000 Apr;38(4):1324-30
references: 10747102
references: Eur J Clin Microbiol Infect Dis. 2012 Jul;31(7):1689-96
references: 22350386
references: Trends Parasitol. 2011 Feb;27(2):53-8
references: 21168365
references: Mol Biol Evol. 2012 Jan;29(1):39-42
references: 21940643
references: J Clin Gastroenterol. 2010 Feb;44(2):85-90
references: 19834337
references: Diagn Microbiol Infect Dis. 2007 Nov;59(3):303-7
references: 17913433
references: ISME J. 2008 Dec;2(12):1183-93
references: 18670396
references: Arab J Gastroenterol. 2011 Dec;12(4):194-200
references: 22305500
references: Eur J Clin Microbiol Infect Dis. 2013 Mar;32(3):335-43
references: 22996007
references: Am J Trop Med Hyg. 2011 Jun;84(6):883-5
references: 21633023
references: Int J Parasitol. 2011 Sep;41(11):1113-20
references: 21854778
references: Parasitol Res. 2010 Sep;107(4):841-5
references: 20544220
references: Infect Genet Evol. 2012 Mar;12(2):263-73
references: 22116021
references: Nature. 2010 Mar 4;464(7285):59-65
references: 20203603
references: Proc Natl Acad Sci U S A. 1990 Jun;87(12):4576-9
references: 2112744
references: Exp Parasitol. 2007 Jun;116(2):111-9
references: 17266951
references: Parasitol Res. 2004 Jan;92(1):22-9
references: 14598169
references: Parasitol Res. 2011 Sep;109(3):613-9
references: 21340563
references: Ann Trop Med Parasitol. 2008 Apr;102(3):271-4
references: 18348782
references: Parasitol Res. 2006 Oct;99(5):597-601
references: 16688468
references: Vet Parasitol. 2004 Mar 25;120(3):235-42
references: 15041098
references: Genome Biol. 2011;12(3):R29
references: 21439036
references: Protist. 2011 Jul;162(3):525-41
references: 21295520
references: Parasitol Res. 2010 Apr;106(5):1033-8
references: 20177906
references: Parasitol Res. 2009 Nov;105(6):1589-92
references: 19685075
references: Protist. 2006 Feb;157(1):77-85
references: 16431158
references: Parasitol Res. 2009 Aug;105(2):413-21
references: 19290540
references: Emerg Infect Dis. 2012 Sep;18(9):1543-5
references: 22932710
references: J Eukaryot Microbiol. 1997 Mar-Apr;44(2):142-54
references: 9109261
references: Epidemiol Infect. 2009 Nov;137(11):1655-63
references: 19393117
references: Curr Opin Infect Dis. 2010 Oct;23(5):488-93
references: 20683263
references: Scand J Infect Dis. 2011 Feb;43(2):129-35
references: 20936912
references: J Clin Microbiol. 2004 Mar;42(3):1220-3
references: 15004079
references: Parasitol Int. 2008 Sep;57(3):300-6
references: 18337161
references: Parasitology. 2013 Jul;140(8):966-71
references: 23561720
references: Ann Trop Med Parasitol. 2008 Jan;102(1):85-8
references: 18186983
references: Int J Parasitol. 2009 Mar;39(4):473-9
references: 18755193
references: Mem Inst Oswaldo Cruz. 2009 Aug;104(5):724-7
references: 19820833
references: Trends Parasitol. 2007 Mar;23(3):93-6
references: 17241816
references: J Clin Microbiol. 2005 Jan;43(1):348-55
references: 15634993
references: Mol Cell Probes. 2008 Feb;22(1):24-9
references: 17669623
references: ISME J. 2013 Jul;7(7):1253-5
references: 23407309
references: Parasitol Res. 2011 Jul;109(1):205-12
references: 21210149
references: J Clin Microbiol. 2003 Mar;41(3):967-75
references: 12624017
references: Parasitol Res. 2009 Jan;104(2):341-5
references: 18923844
references: Parasitol Res. 2008 Dec;104(1):85-93
references: 18795333
references: Am J Trop Med Hyg. 2012 Dec;87(6):1046-52
references: 23091195
references: Clin Infect Dis. 2012 Nov 15;55(10):1431-2
references: 22893582
references: Parasitol Res. 2007 Dec;102(1):83-90
references: 17912552
references: Clin Microbiol Infect. 2009 Sep;15(9):869-74
references: 19624500
references: Parasitol Res. 2005 Jun;96(4):253-7
references: 15886995
references: Mol Biochem Parasitol. 1997 Jul;87(1):79-83
references: 9233675
references: J Clin Microbiol. 2005 Jan;43(1):214-22
references: 15634974
references: Parasitol Res. 2009 Oct;105(4):949-55
references: 19471964
references: Am J Trop Med Hyg. 2011 Dec;85(6):1050-3
references: 22144442
references: J Clin Microbiol. 2011 Mar;49(3):975-83
references: 21177897
references: Acta Trop. 2013 Apr;126(1):11-8
references: 23290980
references: Parasitol Res. 2012 Sep;111(3):1349-55
references: 22710524
references: Vet Parasitol. 2002 Jun 26;106(3):203-12
references: 12062509
references: Parasitol Res. 2012 Apr;110(4):1553-62
references: 22076050
references: Am J Trop Med Hyg. 2009 Apr;80(4):588-92
references: 19346381
references: Adv Parasitol. 2013;82:1-32
references: 23548084
references: Parasitol Int. 2007 Dec;56(4):281-6
references: 17627869
references: Trends Parasitol. 2009 Jan;25(1):23-9
references: 19013108
references: Parasitol Res. 2010 Aug;107(3):679-84
references: 20532564
references: J Clin Microbiol. 2013 Feb;51(2):472-80
references: 23175269
references: Parasitol Int. 2010 Sep;59(3):469-71
references: 20363362
references: Parasitol Res. 2008 Apr;102(5):853-60
references: 18193282
references: Clin Microbiol Infect. 2007 Aug;13(8):839-42
references: 17610603
references: Vet Parasitol. 2003 May 1;113(3-4):321-5
references: 12719144
references: Trends Parasitol. 2012 Aug;28(8):305
references: 22704911
references: J Clin Microbiol. 2013 Jan;51(1):190-4
references: 23115257
references: Parasitol Res. 2012 Dec;111(6):2311-5
references: 22948205
references: Parasitol Int. 2012 Dec;61(4):719-22
references: 22659011
references: Parasitol Res. 2008 Mar;102(4):663-70
references: 18064490
references: Parasitology. 2007 Mar;134(Pt 3):359-67
references: 17052374
references: Parasitol Res. 2009 Dec;106(1):263-8
references: 19847459