Is the treatment of Enterobius vermicularis co-infection necessary to eradicate Dientamoeba fragilis infection?
OBJECTIVE
Dientamoeba fragilis is a pathogenic protozoan of the human gastrointestinal tract with a worldwide distribution, which has emerged as an important and misdiagnosed cause of chronic gastrointestinal illnesses such as diarrhea and 'irritable-bowel-like' gastrointestinal disease. Very little research has been conducted on the use of suitable antimicrobial compounds. Furthermore, higher rates of co-infection with Enterobius vermicularis have been described, suggesting that E. vermicularis could influence the treatment of D. fragilis-infected patients. To study this, the treatment of E. vermicularis and D. fragilis co-infected patients was evaluated.


METHODS
Forty-nine patients with a D. fragilis infection, including 25 (51.0%) patients co-infected with E. vermicularis, were studied. All of them were treated with metronidazole. Patients with E. vermicularis co-infection and/or an E. vermicularis-positive case in the family were treated with mebendazole.


RESULTS
Metronidazole treatment failure was significantly more frequent in patients with E. vermicularis co-infection and in patients with children in the family.


CONCLUSIONS
Co-infection with E. vermicularis may act as a factor favoring D. fragilis infection by preventing eradication measures. This suggests that both parasites should be treated simultaneously.
Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain.
José A
JA
Boga
Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain.
Susana
S
Rojo
Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain.
Jonathan
J
Fernández
Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain.
Mercedes
M
Rodríguez
Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain.
Carmen
C
Iglesias
Oficina de Investigación Biosanitaria (OIB) de Asturias, Oviedo, Spain; Universidad Autónoma de Chile, Santiago, Chile.
Pablo
P
Martínez-Camblor
Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain.
Fernando
F
Vázquez
Unidad de Medicina Tropical, Hospital Universitario Central de Asturias, Avenida Roma s/n 33011, Oviedo, Spain. Electronic address: azucenarodriguez@telecable.es.
Azucena
A
Rodríguez-Guardado
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage; D000981:Antiprotozoal Agents; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000188:drug therapy* / Q000469:parasitology; D004029:Dientamoeba / Q000187:drug effects* / Q000502:physiology; D004030:Dientamoebiasis / Q000188:drug therapy* / Q000469:parasitology; D017229:Enterobiasis / Q000188:drug therapy* / Q000469:parasitology; D004757:Enterobius / Q000187:drug effects* / Q000469:parasitology; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D008463:Mebendazole / Q000008:administration & dosage; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D055815:Young Adult
D000871:Anthelmintics; D000981:Antiprotozoal Agents; D008795:Metronidazole; D008463:Mebendazole
Dientamoeba fragilis; Enterobius vermicularis; Metronidazole; Parasite infection; Treatment