Article
Recirculation of Giardia lamblia Assemblage A After Metronidazole Treatment in an Area With Assemblages A, B, and E Sympatric Circulation
Registro en:
FANTINATTI, Maria et al. Recirculation of Giardia lamblia Assemblage A After Metronidazole Treatment in an Area With Assemblages A, B, and E Sympatric Circulation. Frontiers in Immunology, v. 11, Article 571104, p. 1-9, Oct. 2020.
1664-302X
10.3389/fmicb.2020.571104
Autor
Fantinatti, Maria
Oliveira, Luiz Antonio Pimentel Lopes
Cascais-Figueredo, Tiara
Austriaco-Teixeira, Phelipe
Verissimo, Erika
Bello, Alexandre Ribeiro
Cruz, Alda Maria da
Resumen
Giardia lamblia is an intestinal protozoan subdivided into eight assemblages, labeled
alphabetically from A to H. Assemblages A, B, and E infect humans and can have
a sympatric circulation. We investigated the assemblage recirculation in children living
within a high prevalence area of Giardia infection. One hundred and ninety-four children
were evaluated and 85 tested positive for Giardia by PCR. These infected individuals
were recruited, treated with metronidazole and then reexamined for infections at 20
and 40 days after treatment that included PCR and the genotyping was performed
by sequencing beta-giardin and glutamate dehydrogenase gene targets. Giardia
assemblages A (n = 43), B (n = 21), E (n = 17), and A/E (n = 4) were identified in infected
children. Assemblage A was found in all reoccurrences of infection, including four that
had been infected by assemblages B and E. Since both persistence and reinfection
could account for the results, the level of nucleotide homology was determined before
and after treatment. Most suggested that reinfections were by the same strain, but four
presented a distinct genotypic profile. The results suggest that the differences in the
genotypic profiles were due to reinfections, which appear to occur with frequency in
high Giardia burden areas and soon after the end of therapy. It is not yet possible to
define whether the recurrent cases were related to parasite resistance. However, the
evidence of rapid reinfections and ready availability of treatment raises the potential for
creating resistant strains. This highlights the need to address how Giardia burden is
maintained within high prevalence areas.