• 1.

    Singh A, Banerjee T, Kumar R, Shukla SK, 2019. Prevalence of cases of amebic liver abscess in a tertiary care centre in India: a study on risk factors, associated microflora and strain variation of Entamoeba histolytica. PLoS One 14: e0214880.

    • Search Google Scholar
    • Export Citation
  • 2.

    Dhawan VK, Cleveland KO, Cantey JR, 2019. Amebiasis Workup: Laboratory Studies, Radiography, Ultrasonography, CT, and MRI, Liver Aspiration. Available at: https://emedicine.medscape.com/article/212029-workup. Accessed October 23, 2019.

    • Search Google Scholar
    • Export Citation
  • 3.

    Creemers-Schild D, van Genderen PJJ, Visser LG, van Hellemond JJ, Wismans PJ, 2016. Recurrent amebic liver abscesses over a 16-year period: a case report. BMC Res Notes 9: 472.

    • Search Google Scholar
    • Export Citation
  • 4.

    Ghosh JK, Goyal SK, Behera MK, Tripathi MK, Dixit VK, Jain AK, Shukla R, 2016. Efficacy of aspiration in amebic liver abscess. Trop Gastroenterol 36: 251255.

    • Search Google Scholar
    • Export Citation
  • 5.

    Bansal D, Sehgal R, Chawla Y, Mahajan RC, Malla N, 2004. In vitro activity of antiamoebic drugs against clinical isolates of Entamoeba histolytica and Entamoeba dispar. Ann Clin Microbiol Antimicrob 3: 27.

    • Search Google Scholar
    • Export Citation
  • 6.

    Ramiro M, Moran P, Olvera H, Curiel O, Gonzalez E, Ramos F, Melendro EI, Ximénez C, 2000. Reincidence of amebic liver abscess: a case report. Arch Med Res 31: S1S3.

    • Search Google Scholar
    • Export Citation
  • 7.

    Hwang EW, Cheung L, Mojtahed A, Cartwright CA, 2011. Relapse of intestinal and hepatic amebiasis after treatment. Dig Dis Sci 56: 677680.

  • 8.

    Moran P, Rico G, Ramiro M, Olvera H, Ramos F, González E, Valadéz A, Curiel O, Melendro EI, Ximénez C, 2002. Defective production of reactive oxygen intermediates (ROI) in a patient with recurrent amebic liver abscess. Am J Trop Med Hyg 67: 632635.

    • Search Google Scholar
    • Export Citation
  • 9.

    Alauzet C, Mory F, Teyssier C, Hallage H, Carlier JP, Grollier G, Lozniewski A, 2010. Metronidazole resistance in Prevotella spp. and description of a new nim gene in Prevotella baroniae. Antimicrob Agents Chemother 54: 6064.

    • Search Google Scholar
    • Export Citation
  • 10.

    Piña-Vázquez C, Reyes-López M, Ortíz-Estrada G, De la Garza M, Serrano-Luna J, 2012. Host-parasite interaction: parasite-derived and-induced proteases that degrade human extracellular matrix. J Parasitol Res 2012: 748206.

    • Search Google Scholar
    • Export Citation
  • 11.

    Geurts N, Opdenakker G, Van den Steen PE, 2012. Matrix metalloproteinases as therapeutic targets in protozoan parasitic infections. Pharmacol Ther 133: 257279.

    • Search Google Scholar
    • Export Citation
  • 12.

    Thibeaux R, Ave P, Bernier M, Morcelet M, Frileux P, Guillen N, Labruyère E, 2014. The parasite Entamoeba histolytica exploits the activities of human matrix metalloproteinases to invade colonic tissue. Nat Commun 5: 5142.

    • Search Google Scholar
    • Export Citation
  • 13.

    Alam F, Salam MA, Hassan P, Mahmood I, Kabir M, Haque R, 2014. Amebic liver abscess in northern region of Bangladesh: sociodemographic determinants and clinical outcomes. BMC Res Notes 7: 625.

    • Search Google Scholar
    • Export Citation
  • 14.

    Khairnar K, Parija SC, 2007. A novel nested multiplex polymerase chain reaction (PCR) assay for differential detection of Entamoeba histolytica, E. moshkovskii and E. dispar DNA in stool samples. BMC Microbiol 7: 47.

    • Search Google Scholar
    • Export Citation
  • 15.

    Rekha R, Alam Rizvi M, Jaishree P, 2006. Designing and validation of genus-specific primers for human gut flora study. Electron J Biotechn 9: 505511.

    • Search Google Scholar
    • Export Citation
  • 16.

    Trinh S & Reysset G 1996. Detection by PCR of the nim genes encoding 5-nitroimidazole resistance in Bacteroides spp. J Clin Microbiol 34: 20782084.

    • Search Google Scholar
    • Export Citation
  • 17.

    Ali IKM, Zaki M, Clark CG, 2005. Use of PCR amplification of tRNA gene-linked short tandem repeats for genotyping Entamoeba histolytica. J Clin Microbiol 43: 58425847.

    • Search Google Scholar
    • Export Citation
  • 18.

    Singal DK, Mittal A, Prakash A, 2012. Recurrent amebic liver abscess. Indian J Gastroenterol 31: 271273.

  • 19.

    Nespola B 2015. First case of amebic liver abscess 22 years after the first occurrence. Parasite 22: 20.

  • 20.

    Laverdant C, Denee JM, Roue R, Molinie C, Daly JP, Flechaire A, Valmary J, Farret O, 1984. Hepatic amebiasis: study of 152 cases. Gastroenterol clin Biol 8: 838844.

    • Search Google Scholar
    • Export Citation
  • 21.

    Brailita DM, Lingvay I, Aung K, Ojha A, 2019. Amebic Liver/Hepatic Abscesses Treatment and Management. Available at: https://emedicine.medscape.com/article/183920-treatment. Accessed November 14, 2020.

    • Search Google Scholar
    • Export Citation
  • 22.

    Watanabe K, Gatanaga H, Escueta-de Cadiz A, Tanuma J, Nozaki T, Oka S, 2011. Amebiasis in HIV-1-infected Japanese men: clinical features and response to therapy. PLoS Negl Trop Dis 5: e1318.

    • Search Google Scholar
    • Export Citation
  • 23.

    Gregory PB, 1976. A refractory case of hepatic amoebiasis. Gastroenterology 70: 585588.

  • 24.

    Fotedar R, Stark D, Beebe N, Marriott D, Ellis J, Harkness J, 2007. Laboratory diagnostic techniques for Entamoeba species. Clin Microbiol Rev 20: 511532.

    • Search Google Scholar
    • Export Citation
  • 25.

    Banerjee T, Anupurba S, Filgona J, Singh DK, 2015. Vancomycin-resistance enterococcal colonization in hospitalized patients in relation to antibiotic Usage in a tertiary care hospital of North India. J Lab Physicians 7: 108111.

    • Search Google Scholar
    • Export Citation
  • 26.

    Löfmark S, Fang H, Hedberg M, Edlund C, 2005. Inducible metronidazole resistance and nim genes in clinical Bacteroides fragilis group isolates. Antimicrob Agents Chemother 49: 12531256.

    • Search Google Scholar
    • Export Citation
  • 27.

    Verma AK, Verma R, Ahuja V, Paul J, 2012. Real-time analysis of gut flora in Entamoeba histolytica infected patients of Northern India. BMC Microbiol 12: 183.

    • Search Google Scholar
    • Export Citation
  • 28.

    Rani R, Murthy RS, Bhattacharya S, Ahuja V, Rizvi MA, Paul J, 2006. Changes in bacterial profile during amebiasis: demonstration of anaerobic bacteria in ALA pus samples. Am J Trop Med Hyg 75: 880885.

    • Search Google Scholar
    • Export Citation
  • 29.

    Katsandri A, Avlamis A, Pantazatou A, Houhoula DP, Papaparaskevas J, 2006. Dissemination of nim-class genes, encoding nitroimidazole resistance, among different species of Gram-negative anaerobic bacteria isolated in Athens, Greece. J Antimicrob Chemother 58: 705706.

    • Search Google Scholar
    • Export Citation
  • 30.

    Gilchrist CA 2015. Role of the gut microbiota of children in diarrhea due to the protozoan parasite Entamoeba histolytica. J Infect Dis 213: 15791585.

    • Search Google Scholar
    • Export Citation
  • 31.

    Ngobeni R, Samie A, Moonah S, Watanabe K, Petri WA Jr., Gilchrist C, 2017. Entamoeba species in South Africa: correlations with the host microbiome, parasite burdens, and first description of Entamoeba bangladeshi outside of Asia. J Infect Dis 216: 15921600.

    • Search Google Scholar
    • Export Citation
  • 32.

    DeWitt J, Reining A, Allsworth JE, Peipert JF, 2010. Tuboovarian abscesses: is size associated with duration of hospitalization & complications? Obstet Gynecol Int 2010: 847041.

    • Search Google Scholar
    • Export Citation
  • 33.

    Bansal A, Bansal AK, Bansal V, Kumar A, 2016. Liver abscess: catheter drainage v/s needle aspiration. Int Surg J 2: 2025.

  • 34.

    Dietrick RB, 1984. Experience with liver abscess. Am J Surg 147: 288291.

  • 35.

    Gu ZD, Chen KN, Li M, Gu J, Li JY, 2005. Clinical significance of matrix metalloproteinase-9 expression in esophageal squamous cell carcinoma. World J Gastroenterol 11: 871874.

    • Search Google Scholar
    • Export Citation
  • 36.

    Ali IK, Mondal U, Roy S, Haque R, Petri WA, Clark CG, 2007. Evidence for a link between parasite genotype and outcome of infection with Entamoeba histolytica. J Clin Microbiol 45: 285289.

    • Search Google Scholar
    • Export Citation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Factors Associated with High Rates of Recurrence of Amebic Liver Abscess (ALA) in North India

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  • 1 Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;
  • 2 Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

ABSTRACT

Recurrence of amebic liver abscess (ALA), once considered unusual, is increasingly being reported, despite proper management. Realizing the endemicity of ALA in the study setup, this 2-year follow-up study was conducted to investigate the recurrent cases and study the associated factors. A total of 101 confirmed cases of ALA were followed up for a period of 2 years. Recurrent cases were studied for associated bacterial flora, presence of resistance genes (nim), level of matrix metalloproteinase 3 and MMP-9, and genotypes of Entamoeba histolytica and statistically compared with the nonrecurrent cases as controls. Recurrence rates of 8.9% (nine patients) were detected. The presence of Prevotella along with an increased level of MMP-9 in abscess fluid and large size of abscesses (11 × 10.8 cm) was found to be significantly associated with recurrence in ALA. Among the nine cases, the presence of nimE gene was detected in two (22.2%) patients. The genotyping of E. histolytica strains showed that in seven (77.7%) cases, the genotype of E. histolytica was the same in the primary and recurrent samples. This study reports a high rate of recurrence in the cases of ALA, hinting toward the gradual development of clinical resistance toward the commonly used drug. The presence of nim gene and Prevotella in abscess fluid along with increased MMP-9 levels and large abscess size could be important predictors of recurrent ALA.

Author Notes

Address correspondence to Tuhina Banerjee, Department of Microbiology Institute of Medical Sciences, Banaras Hindu University, Lanka Varanasi, 221005 India. E-mail: drtuhina@yahoo.com

Financial support: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors’ addresses: Aradhana Singh and Tuhina Banerjee, Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, E-mails: aradhanasingh.148@gmail.com and drtuhina@yahoo.com. Sunit Kumar Shukla, Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, E-mail: sunitshuklabhu@gmail.com.

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