Carriage of Blastocystis spp. in travellers - A prospective longitudinal study

Jarne M. van Hattem; Maris S. Arcilla; Constance Schultsz; Martin C. Bootsma; Nienke Verhaar; Sjoerd P. Rebers; Abraham Goorhuis; Martin P. Grobusch; John Penders; Menno D. de Jong; Tom van Gool; Aldert Bart; Perry J. van Genderen; Damian C. Melles; Nicky Molhoek; Astrid M. Oude Lashof; Ellen E. Stobberingh; Henri A. Verbrugh; COMBAT Consortium

doi:10.1016/j.tmaid.2018.06.005

Carriage of Blastocystis spp. in travellers - A prospective longitudinal study

Jarne M. van Hattem^*, Maris S. Arcilla, Constance Schultsz, Martin C. Bootsma, Nienke Verhaar, Sjoerd P. Rebers, Abraham Goorhuis, Martin P. Grobusch, John Penders, Menno D. de Jong, Tom van Gool, Aldert Bart, Perry J. van Genderen, Damian C. Melles, Nicky Molhoek, Astrid M. Oude Lashof, Ellen E. Stobberingh, Henri A. Verbrugh, COMBAT Consortium

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Introduction: A lack of prospective and longitudinal data on pre- and post-travel carriage of Blastocystis spp. complicates interpretation of a positive WA post-travel. Therefore we studied dynamics of Blastocystis carriage in a cohort of Dutch travellers.

Methods: From the prospective, multicentre COMBAT study among 2001 Dutch travellers, a subset of 491 travellers was selected based on travel destination to 7 subregions (70 or 71 travellers each). Faecal samples taken directly before and after travel were screened for Blastocystis with qPCR, followed, when positive, by sequence analysis to determine subtypes.

Results: After exclusion of 12 samples with missing samples or inhibited qPCR-reactions, stool samples of 479 travellers were analysed. Before travel, 174 of them (36.3%) carried Blastocystis and in most of these, the same subtype was persistently carried. However, in 48/174 of those travellers (27.6%; CI95 20.8-36.6%) no Blastocystis or a different subtype was detected in the post-travel sample, indicating loss of Blastocystis during travel. Only 26 (5.4%; CI95 3.7%-8.0%) of all travellers acquired Blastocystis, including two individuals that were already positive for Blastocystis before travel but acquired a different subtype during travel.

Discussion: This study shows that Blastocystis carriage in travellers is highly dynamic. The observed acquisition and loss of Blastocystis could either be travel-related or reflect the natural course of Blastocystis carriage. We demonstrate that the majority of Blastocystis detected in post-travel samples were already carried before travel.

Original language	English
Pages (from-to)	87-91
Number of pages	5
Journal	Travel Medicine and Infectious Disease
Volume	27
DOIs	https://doi.org/10.1016/j.tmaid.2018.06.005
Publication status	Published - 2019

Keywords

Blastocystis
Carriage
Travel
Acquisition
Loss
Dynamics
GENETIC DIVERSITY
MOLECULAR EPIDEMIOLOGY
ZOO ANIMALS
HOMINIS
IDENTIFICATION
HUMANS
CLASSIFICATION
INFECTION
CHILDREN

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Cite this

van Hattem, J. M., Arcilla, M. S., Schultsz, C., Bootsma, M. C., Verhaar, N., Rebers, S. P., Goorhuis, A., Grobusch, M. P., Penders, J., de Jong, M. D., van Gool, T., Bart, A., van Genderen, P. J., Melles, D. C., Molhoek, N., Lashof, A. M. O., Stobberingh, E. E., Verbrugh, H. A., & COMBAT Consortium (2019). Carriage of Blastocystis spp. in travellers - A prospective longitudinal study. Travel Medicine and Infectious Disease, 27, 87-91. https://doi.org/10.1016/j.tmaid.2018.06.005

@article{e5fe685ab6064a1ab14dac746e57ee3e,

title = "Carriage of Blastocystis spp. in travellers - A prospective longitudinal study",

abstract = "Introduction: A lack of prospective and longitudinal data on pre- and post-travel carriage of Blastocystis spp. complicates interpretation of a positive WA post-travel. Therefore we studied dynamics of Blastocystis carriage in a cohort of Dutch travellers.Methods: From the prospective, multicentre COMBAT study among 2001 Dutch travellers, a subset of 491 travellers was selected based on travel destination to 7 subregions (70 or 71 travellers each). Faecal samples taken directly before and after travel were screened for Blastocystis with qPCR, followed, when positive, by sequence analysis to determine subtypes.Results: After exclusion of 12 samples with missing samples or inhibited qPCR-reactions, stool samples of 479 travellers were analysed. Before travel, 174 of them (36.3%) carried Blastocystis and in most of these, the same subtype was persistently carried. However, in 48/174 of those travellers (27.6%; CI95 20.8-36.6%) no Blastocystis or a different subtype was detected in the post-travel sample, indicating loss of Blastocystis during travel. Only 26 (5.4%; CI95 3.7%-8.0%) of all travellers acquired Blastocystis, including two individuals that were already positive for Blastocystis before travel but acquired a different subtype during travel.Discussion: This study shows that Blastocystis carriage in travellers is highly dynamic. The observed acquisition and loss of Blastocystis could either be travel-related or reflect the natural course of Blastocystis carriage. We demonstrate that the majority of Blastocystis detected in post-travel samples were already carried before travel.",

keywords = "Blastocystis, Carriage, Travel, Acquisition, Loss, Dynamics, GENETIC DIVERSITY, MOLECULAR EPIDEMIOLOGY, ZOO ANIMALS, HOMINIS, IDENTIFICATION, HUMANS, CLASSIFICATION, INFECTION, CHILDREN",

author = "{van Hattem}, {Jarne M.} and Arcilla, {Maris S.} and Constance Schultsz and Bootsma, {Martin C.} and Nienke Verhaar and Rebers, {Sjoerd P.} and Abraham Goorhuis and Grobusch, {Martin P.} and John Penders and {de Jong}, {Menno D.} and {van Gool}, Tom and Aldert Bart and {van Genderen}, {Perry J.} and Melles, {Damian C.} and Nicky Molhoek and Lashof, {Astrid M. Oude} and Stobberingh, {Ellen E.} and Verbrugh, {Henri A.} and {COMBAT Consortium}",

note = "Funding Information: We would like to thank Bob de Wever and Richard Molenkamp from the Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands for their advice on molecular techniques. The COMBAT study was funded by Netherlands Organisation for Health Research and Development (ZonMw, grant number 205200003 ). The funder had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2018 The Authors",

year = "2019",

doi = "10.1016/j.tmaid.2018.06.005",

language = "English",

volume = "27",

pages = "87--91",

journal = "Travel Medicine and Infectious Disease",

issn = "1477-8939",

publisher = "ELSEVIER SCI LTD",

}

van Hattem, JM, Arcilla, MS, Schultsz, C, Bootsma, MC, Verhaar, N, Rebers, SP, Goorhuis, A, Grobusch, MP, Penders, J, de Jong, MD, van Gool, T, Bart, A, van Genderen, PJ, Melles, DC, Molhoek, N, Lashof, AMO, Stobberingh, EE, Verbrugh, HA & COMBAT Consortium 2019, 'Carriage of Blastocystis spp. in travellers - A prospective longitudinal study', Travel Medicine and Infectious Disease, vol. 27, pp. 87-91. https://doi.org/10.1016/j.tmaid.2018.06.005

TY - JOUR

T1 - Carriage of Blastocystis spp. in travellers - A prospective longitudinal study

AU - van Hattem, Jarne M.

AU - Arcilla, Maris S.

AU - Schultsz, Constance

AU - Bootsma, Martin C.

AU - Verhaar, Nienke

AU - Rebers, Sjoerd P.

AU - Goorhuis, Abraham

AU - Grobusch, Martin P.

AU - Penders, John

AU - de Jong, Menno D.

AU - van Gool, Tom

AU - Bart, Aldert

AU - van Genderen, Perry J.

AU - Melles, Damian C.

AU - Molhoek, Nicky

AU - Lashof, Astrid M. Oude

AU - Stobberingh, Ellen E.

AU - Verbrugh, Henri A.

AU - COMBAT Consortium

N1 - Funding Information: We would like to thank Bob de Wever and Richard Molenkamp from the Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands for their advice on molecular techniques. The COMBAT study was funded by Netherlands Organisation for Health Research and Development (ZonMw, grant number 205200003 ). The funder had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Publisher Copyright: © 2018 The Authors

PY - 2019

Y1 - 2019

N2 - Introduction: A lack of prospective and longitudinal data on pre- and post-travel carriage of Blastocystis spp. complicates interpretation of a positive WA post-travel. Therefore we studied dynamics of Blastocystis carriage in a cohort of Dutch travellers.Methods: From the prospective, multicentre COMBAT study among 2001 Dutch travellers, a subset of 491 travellers was selected based on travel destination to 7 subregions (70 or 71 travellers each). Faecal samples taken directly before and after travel were screened for Blastocystis with qPCR, followed, when positive, by sequence analysis to determine subtypes.Results: After exclusion of 12 samples with missing samples or inhibited qPCR-reactions, stool samples of 479 travellers were analysed. Before travel, 174 of them (36.3%) carried Blastocystis and in most of these, the same subtype was persistently carried. However, in 48/174 of those travellers (27.6%; CI95 20.8-36.6%) no Blastocystis or a different subtype was detected in the post-travel sample, indicating loss of Blastocystis during travel. Only 26 (5.4%; CI95 3.7%-8.0%) of all travellers acquired Blastocystis, including two individuals that were already positive for Blastocystis before travel but acquired a different subtype during travel.Discussion: This study shows that Blastocystis carriage in travellers is highly dynamic. The observed acquisition and loss of Blastocystis could either be travel-related or reflect the natural course of Blastocystis carriage. We demonstrate that the majority of Blastocystis detected in post-travel samples were already carried before travel.

AB - Introduction: A lack of prospective and longitudinal data on pre- and post-travel carriage of Blastocystis spp. complicates interpretation of a positive WA post-travel. Therefore we studied dynamics of Blastocystis carriage in a cohort of Dutch travellers.Methods: From the prospective, multicentre COMBAT study among 2001 Dutch travellers, a subset of 491 travellers was selected based on travel destination to 7 subregions (70 or 71 travellers each). Faecal samples taken directly before and after travel were screened for Blastocystis with qPCR, followed, when positive, by sequence analysis to determine subtypes.Results: After exclusion of 12 samples with missing samples or inhibited qPCR-reactions, stool samples of 479 travellers were analysed. Before travel, 174 of them (36.3%) carried Blastocystis and in most of these, the same subtype was persistently carried. However, in 48/174 of those travellers (27.6%; CI95 20.8-36.6%) no Blastocystis or a different subtype was detected in the post-travel sample, indicating loss of Blastocystis during travel. Only 26 (5.4%; CI95 3.7%-8.0%) of all travellers acquired Blastocystis, including two individuals that were already positive for Blastocystis before travel but acquired a different subtype during travel.Discussion: This study shows that Blastocystis carriage in travellers is highly dynamic. The observed acquisition and loss of Blastocystis could either be travel-related or reflect the natural course of Blastocystis carriage. We demonstrate that the majority of Blastocystis detected in post-travel samples were already carried before travel.

KW - Blastocystis

KW - Carriage

KW - Travel

KW - Acquisition

KW - Loss

KW - Dynamics

KW - GENETIC DIVERSITY

KW - MOLECULAR EPIDEMIOLOGY

KW - ZOO ANIMALS

KW - HOMINIS

KW - IDENTIFICATION

KW - HUMANS

KW - CLASSIFICATION

KW - INFECTION

KW - CHILDREN

U2 - 10.1016/j.tmaid.2018.06.005

DO - 10.1016/j.tmaid.2018.06.005

M3 - Article

C2 - 29929001

SN - 1477-8939

VL - 27

SP - 87

EP - 91

JO - Travel Medicine and Infectious Disease

JF - Travel Medicine and Infectious Disease

ER -