Prevalence and Associated-Factors for Entamoeba gingivalis in Adolescents in Southeastern Iran by Culture and PCR, 2017
Background: This study aimed to identify the prevalence and potential factors associated with Entamoeba gingivalis in adolescents in the city of Kerman, southeastern Iran, 2017.
Methods: In this descriptive cross-sectional study, 315 adolescents (mean age; 15 yr) consisting of 189 males and 126 females were randomly selected. For each adolescent, two specimens were collected for culturing and examination by polymerase chain reaction (PCR). Univariate and multivariate logistic regression models were performed to explore any association with demographic and clinical variables.
Results: The prevalence of E. gingivalis was 11.7%. Totally, 30 (15.9%) males and 7 (5.6%) females were infected with E. gingivalis. The rate of infection in males was 2.8 times higher than that in females (P<0.001). Statistical analysis identified 4 major factors including sex (OR=4.12, P<0.001), gingival index with severe inflammation (OR = 50, P<0.001), Candida spp. infection (OR=4.41, P<0.001) and decay-missing- filled teeth [DMFT (OR=3.27, P<0.001)]. In contrast to the aforementioned factors, adolescents with history of antibiotic consumption were significantly protected from E. gingivalis infection (OR= 3.24, P<0.001). Culture media detected 9.2% (n= 29), whilst PCR identified 11.4% (n= 36) of infection.
Conclusion: The present findings clearly demonstrate a positive association between E. gingivalis and distinct demographic and clinical risk determinants. Therefore, dental practitioners and health surveillance personnel should be aware of these confounding factors to rigorously detect and critically manage oral health issues in school-age children in order to prevent or at least minimize the eventual periodontal complications in later life.
Keywords: Prevalence; Adolescents; Associated factors; Iran
2. Bogitsh BJ, Carter CE, Oeltmann TN (2013). General characteristics of the Trematoda. Human parasitology, 4th edn. Academic Press, Waltham, 153-178.
3. Ghapanchi J, Kamali F, Moattari A et al (2015). In vitro comparison of cytotoxic and antibacterial effects of 16 commercial toothpastes. J Int Oral Health, 7(3): 39-43.
4. El-Dardiry MA (2016). Detection of Entamoeba gingivalis trophozoites in patients suffering from gingivitis versus healthy. Adv Environ Biol, 10(12): 222-226.
5. Luszczak J, Bartosik M, Rzymowska J et al (2016). The occurrence of Entamoeba gingivalis among patients with periodontal disease. Pharm Med Sci, 29 (2):86-9.
6. Trim RD, Skinner MA, Farone MB et al (2011). Use of PCR to detect Entamoeba gingivalis in diseased gingival pockets and demonstrate its absence in healthy gingival sites. Parasitol Res. 109 (3):857-64.
7. Cembranelli SB, Souto FO, Ferreira-Paim K et al (2013). First evidence of genetic intraspecific variability and occurrence of Entamoeba gingivalis in HIV (+)/AIDS. PloS One, 8 (12):e82864.
8. Kashefi P, Amighi A, Khalifesoltani M (2015). Prevalence of hemodynamic, acid and base, coagulation, electrolytes, and blood glucose disturbances and requiring inotropic support in patients with brain death on arrival at hospital intensive care unit. J Isfahan Med Sch, 33 (2):337.
9. Burt B (2005). Epidemiology of periodontal Diseases. J Periodontol, 76(8): 1406-1419.
10. Halfon N, Larson K, Slusser W (2013). Associations between obesity and comorbid mental health, developmental, and physical health conditions in a nationally representative sample of US children aged 10 to 17. Acad pediatr, 13 (1):6-13.
11. Kumar PS, Leys EJ, Bryk JM et al (2006). Changes in periodontal health status are associated with bacterial community shifts as assessed by quantitative 16S cloning and sequencing. J Clinic Microbiol, 44 (10):3665-73.
12. Al-hamiar AK, Kezar MY, Al-Khafaji YA (2011). Prevalence of Oral Protozoa in Periodontitis and Gingivitis Patients Whose Attended to Clinics Periodontics, Dentistry College\Babylon Univ. Al-Kufa J Biol, 3 (1):223-225.
13. Bhaijee F, Bell D (2011). Entamoeba gingivalis in Acute Osteomyelitis of the Mandible. J Med Case Rep, 2011 (3): 229-303.
14. Andrews JH, Hecht EP, Bashirian S (1982). Association between the fungus Acremonium curvulum and Eurasian water milfoil, Myriophyllum spicatum. Canadian Journal of Botany, 60 (7):1216-21.
15. Sharma K, Kaur H (2015). Oral health in relation to nutritional status, age and sex among 14-18 years children of Naraingarh, Haryana. Braz Dent Sci, 18(3):68-76.
16. PAri A, Ilango P, Subbareddy V, Katamreddy V, Parthasarthy H (2014). Gingival diseases in childhood–a review. J Clin Diagn Res, 8(10): ZE01–ZE04.
17. Ghabanchi J, Zibaei M, Afkar MD, Sarbazie A (2010). Prevalence of oral Entamoeba gingivalis and Trichomonas tenax in patients with periodontal disease and healthy population in Shiraz, southern Iran. Indian J Dent Res, 21(1):89-91.
18. Elith J, Graham CH, Anderson RP et al (2006). Novel methods improve prediction of species' distributions from occurrence data. Ecography, 29(2):129-51.
19. Schuster FL, Sullivan JJ (2002). Cultivation of clinically significant hemoflagellates. Clin Microbiol Rev, 15(3):374-89.
20. Clark CG, Diamond LS (2002). Methods for cultivation of luminal parasitic protists of clinical importance. Clin Microbiol Rev, 15(3):329-41.
21. McHardy IH, Wu M, Shimizu-Cohen R, Couturier MR (2014). Humphries RM. Detection of intestinal protozoa in the clinical laboratory. J Clin Microbiol, 52(3):712-20.
22. Untergasser A, Cutcutache I, Koressaar T et al (2012). Primer3—new capabilities and interfaces. Nucleic Acids Res, 40(15):e115.
23. Ye J, Coulouris G, Zaretskaya I et al (2012). Primer-BLAST: a tool to design target-specific primers for polymerase chain reaction. BMC Bioinformatics, 13(1):134.
24. Baker JL, Bor B, Agnello M, Shi W, He X (2017). Ecology of the oral microbiome: beyond bacteria. Trends Microbiol, 25(5):362-74.
25. Marty M, Lemaitre M, Kemoun P, Morrier J-j, Monsarrat P (2017). Trichomonas tenax and periodontal diseases: a concise review. Parasitology, 144(11):1417-25.
26. Chomicz L, Padzik M, Szaflik JP et al (2014). Monitoring of in vitro dynamics of Acanthamoeba strains isolated from infected eyes as a useful tool in keratitis management. Exp parasitol, 145(3):S73-S77.
27. Vaccarino V, Badimon L, Corti R et al (2011). Ischaemic heart disease in women: are there sex differences in pathophysiology and risk factors? Position paper from the working group on coronary pathophysiology and microcirculation of the European Society of Cardiology. Cardiovasc Res, 90 (1):9-17.
28. Gharavi M, Hekmat S, Ebrahimi A, Jahani M (2006). Buccal cavity protozoa in patients referred to the faculty of dentistry in Tehran, Iran. Iran J Parasitol, 1 (1):43-6.
29. Rahdar M, Maraghi S, Azizi A, Mousanejad F, Vazirianzadeh B (2013). A study on the frequency of buccal cavity protozoa in patients with periodontitis and gingivitis in Ahvaz, southwest of Iran in 2009. Jundishapur J Health Sci, 4(4):85-89.
30. Shahrzad S, SS, ApS, M-JK (2017). The prevalence of Trichomonas tenax and Entamoeba gingivalis in mental disabilities children at Ahvaz welfare centers, Iran. Arvand J Health Med Sci, 2(2):71-4.
31. Onyido A, Amadi E, Olofin I, Onwumma A, Okoh I, Chikwendu C (2011). Prevalence of Entamoeba gingivalis and Trichomonas tenax among dental patients attending Federal School of Dental Technology and Therapy clinic, Enugu, Nigeria. Oral Dis, 11 (9): 350-358.
32. Bergquist R (2009). Parasitic infections affecting the oral cavity. Periodontol 2000, 49 (1):96-105.
33. Lucht E, Albert J, Linde A et al (1993). Human immunodeficiency virus type 1 and cytomegalovirus in saliva. J Med Virol, 39 (2):156-62.
34. Swidergall M, Solis NV, Lionakis MS, Filler SG (2018). EphA2 is an epithelial cell pattern recognition receptor for fungal β-glucans. Nat Microbiol, 3(1):53-61.
35. Beltrán-Aguilar ED1, Barker LK, Canto MT et al (2005). Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis: United States, 1988-1994 and 1999-2002. MMWR Surveill Summ, 54(3);1-43.
36. Mielnik-Błaszczak M, Rzymowska J, Michałowski A, Skawińska-Bednarczyk A, Błaszczak J (2018). Entamoeba gingivalis–prevalence and correlation with dental caries in children from rural and urban regions of Lublin Province, Eastern Poland. Ann Agric Environ Med, 25(4): 656-658.
37. Rowan-Legg A (2013). Oral health care for children–a call for action. Paediatr Child Health,18 (1):37-43.
38. Winkelhoff AJV, Rams TE, Slots J (1996). Systemic antibiotic therapy in periodontics. J Periodontol, 10(1):45-78.
39. Guerrero A, Griffiths GS, Nibali Let al (2005). Adjunctive benefits of systemic amoxicillin and metronidazole in non surgical treatment of generalized aggressive periodontitis: a randomized placebocontrolled clinical trial. J Clin Periodontol, 32(10):1096-107.