CLINICAL PREDICTORS OF SHORT-TERM PREDICTION OF THE EFFECTIVENESS OF BLASTOCYSTOSIS TREATMENT WITH NIFURTATEL
DOI:
https://doi.org/10.11603/1681-2727.2025.3.15593Keywords:
blastocystosis, clinic, therapy effectiveness, prognosisAbstract
SUMMARY. The issue of individualisation of patient treatment is an urgent problem of modern medicine. One of the ways to solve this problem is to develop predictors of the efficacy of drugs prescribed, including nifurtel in the treatment of blastocystosis.
Patients and methods. In order to establish the prognostic significance of clinical symptoms, a retrospective analysis was performed in 69 patients with blastocystosis aged 17 to 54 years who were treated with nifurtem in combination with symptomatic therapy. All patients were divided into alternative groups: with good (group A, n=41) and satisfactory (group B, n=28) therapeutic effect.
Group A included patients with a degree of regression of clinical manifestations of the disease ≥31 % in 1 month after the start of treatment, and group B − with ≤30 %. The effectiveness of treatment after 1 month from the start of treatment was used as a criterion for the short-term prognosis.
Results and discussion. The preliminary analysis revealed significant differences in most symptoms between the groups, which gave rise to the development of predictors of the effectiveness of nifurtem therapy using the heterogeneous sequential Wald-Henkin procedure.
It was found that high prognostic informativeness was revealed by the degree of manifestation of clinical symptoms (J=3.74), duration of the disease (J=2.05), patient’s age (J=1.60), dizziness (J=3.08), lymphadenopathy (J=2.85), headache (J=2.75) and joint pain (J=2.66), dyspeptic syndrome (J=2.62), memory impairment (J=2.42), right hypochondrium heaviness (J=2.41), muscle pain (J=1.67), body temperature (J=1.38), tachycardia (J=1.07) and vegetative-visceral syndrome (J=1.02). Moderate prognostic value was observed for decreased work capacity (J=0.82) and heart pain (J=0.50), and low prognostic value for abdominal pain (J=0.45), spleen enlargement (J=0.44) and liver enlargement (J=0.23). No predictive properties were found for symptoms such as gender (J=0.14), skin manifestations (J=0.07), convulsions (J=0.04) and jaundice (J=0.01).
The test of the prognostic algorithm on the training group (n=69) revealed high reliability, as the number of false predictions was 4.3 % and did not exceed 5 % (p<0.05) of the specified level of reliability, correct predictions were 81.2 %, and uncertain predictions were 14.5 % of cases.
Conclusions. An algorithm for short-term prognosis (up to 1 month) of the effectiveness of nifurtem therapy in patients with blastocystosis was developed using the heterogeneous sequential Wald-Henkin procedure, which determined the values of prognostic coefficients for each of the symptom gradations and their overall prognostic information content.
The most diagnostically informative were clinical symptoms such as the degree of manifestation of clinical symptoms (J=3.74), dizziness (J=3.08), lymphadenopathy (J=2.85), headache (J=2.75) and joint pain (J=2.66).
Testing the algorithm on the training group (n=69) at 95 % reliability level revealed its high efficiency, and the proportion of false predictions was 4.3 %, which did not exceed the specified level of reliability, while the correct predictions were 81.2 %, and uncertain – 14.5 %.
References
Tan, K. S. (2008). New insights on classification, identification, and clinical relevance of Blastocystis spp. Clinical Microbiology Reviews, 21(4), 639–665. https://doi.org/10.1128/CMR.00022-08 DOI: https://doi.org/10.1128/CMR.00022-08
Clark, C. G., van der Giezen, M., Alfellani, M. A., & Stensvold, C. R. (2013). Recent developments in Blastocystis research. Advances in Parasitology, 82, 1–32. https://doi.org/10.1016/B978-0-12-407706-5.00001-0 DOI: https://doi.org/10.1016/B978-0-12-407706-5.00001-0
Arisue, N., Hashimoto, T., Yoshikawa, H., Nakamura, Y., Nakamura, G., Nakamura, F., Yano, T. A., & Hasegawa, M. (2002). Phylogenetic position of Blastocystis hominis and of stramenopiles inferred from multiple molecular sequence data. Journal of Eukaryotic Microbiology, 49(1), 42–53. https://doi.org/10.1111/j.1550-7408.2002.tb00339.x DOI: https://doi.org/10.1111/j.1550-7408.2002.tb00339.x
Andersen, L. O., & Stensvold, C. R. (2016). Blastocystis in health and disease: Are we moving from a clinical to a public health perspective? Journal of Clinical Microbiology, 54(3), 524–528. https://doi.org/10.1128/JCM.02520-15 DOI: https://doi.org/10.1128/JCM.02520-15
Wawrzyniak, I., Poirier, P., Viscogliosi, E., Dionigia, M., Texier, C., Delbac, F., & Alaoui, H. E. (2013). Blastocystis, an unrecognized parasite: An overview of pathogenesis and diagnosis. Therapeutic Advances in Infectious Disease, 1(5), 167–178. https://doi.org/10.1177/2049936113504754 DOI: https://doi.org/10.1177/2049936113504754
Sheehan, D. J., Raucher, B. G., & McKitrick, J. C. (1986). Association of Blastocystis hominis with signs and symptoms of human disease. Journal of Clinical Microbiology, 24(4), 548–550. https://doi.org/10.1128/jcm.24.4.548-550.1986 DOI: https://doi.org/10.1128/jcm.24.4.548-550.1986
Doyle, P. W., Helgason, M. M., Mathias, R. G., & Proctor, E. M. (1990). Epidemiology and pathogenicity of Blastocystis hominis. Journal of Clinical Microbiology, 28(1), 116–121. https://doi.org/10.1128/jcm.28.1.116-121.1990 DOI: https://doi.org/10.1128/jcm.28.1.116-121.1990
Qadri, S. M., al-Okaili, G. A., & al-Dayel, F. (1989). Clinical significance of Blastocystis hominis. Journal of Clinical Microbiology, 27(11), 2407–2409. https://doi.org/10.1128/jcm.27.11.2407-2409.1989 DOI: https://doi.org/10.1128/jcm.27.11.2407-2409.1989
Miller, R. A., & Minshew, B. H. (1988). Blastocystis hominis: An organism in search of a disease. Reviews of Infectious Diseases, 10(5), 930–938. https://doi.org/10.1093/clinids/10.5.930 DOI: https://doi.org/10.1093/clinids/10.5.930
Udkow, M. P., & Markell, E. K. (1993). Blastocystis hominis: Prevalence in asymptomatic versus symptomatic hosts. Journal of Infectious Diseases, 168(1), 242–244. https://doi.org/10.1093/infdis/168.1.242 DOI: https://doi.org/10.1093/infdis/168.1.242
Poirier, P., Wawrzyniak, I., Vivarès, C. P., Delbac, F., & El Alaoui, H. (2012). New insights into Blastocystis spp.: A potential link with irritable bowel syndrome. PLoS Pathogens, 8(3), e1002545. https://doi.org/10.1371/journal.ppat.1002545 DOI: https://doi.org/10.1371/journal.ppat.1002545
Doğruman-Al, F., Kustimur, S., Yoshikawa, H., Tuncer, C., Şimşek, Z., Tanyüksel, M., Araz, E., & Boorom, K. (2009). Blastocystis subtypes in irritable bowel syndrome and inflammatory bowel disease in Ankara, Turkey. Memórias do Instituto Oswaldo Cruz, 104(5), 724–727. https://doi.org/10.1590/s0074-02762009000500011 DOI: https://doi.org/10.1590/S0074-02762009000500011
Giacometti, A., Cirioni, O., Fiorentini, A., Fortuna, M., & Scalise, G. (1999). Irritable bowel syndrome in patients with Blastocystis hominis infection. European Journal of Clinical Microbiology & Infectious Diseases, 18(6), 436–439. https://doi.org/10.1007/s100960050314 DOI: https://doi.org/10.1007/s100960050314
Nagler, J., Brown, M., & Soave, R. (1993). Blastocystis hominis in inflammatory bowel disease. Journal of Clinical Gastroenterology, 16(2), 109–112. https://doi.org/10.1097/00004836-199303000-00006 DOI: https://doi.org/10.1097/00004836-199303000-00006
Beghini, F., Pasolli, E., Truong, T. D., Putignani, L., Cacciò, S. M., & Segata, N. (2017). Large-scale comparative metagenomics of Blastocystis, a common member of the human gut microbiome. The ISME Journal, 11(12), 2848–2863. https://doi.org/10.1038/ismej.2017.139 DOI: https://doi.org/10.1038/ismej.2017.139
Audebert, C., Even, G., Cian, A., Loywick, A., Merlin, S., Viscogliosi, E., & Chabé, M.; Blastocystis Investigation Group. (2016). Colonization with the enteric protozoa Blastocystis is associated with increased diversity of human gut bacterial microbiota. Scientific Reports, 6, 25255. https://doi.org/10.1038/srep25255 DOI: https://doi.org/10.1038/srep25255
Iebba, V., Santangelo, F., Totino, V., Pantanella, F., Monsia, A., Di Cristanziano, V., Di Cave, D., Schippa, S., Berrilli, F., & D’Alfonso, R. (2016). Gut microbiota related to Giardia duodenalis, Entamoeba spp. and Blastocystis hominis infections in humans from Côte d’Ivoire. Journal of Infection in Developing Countries, 10(9), 1035–1041. https://doi.org/10.3855/jidc.8179 DOI: https://doi.org/10.3855/jidc.8179
Nourrisson, C., Scanzi, J., Pereira, B., Nkoud-Mongo, C., Wawrzyniak, I., Cian, A., Viscogliosi, E., Livrelli, V., Delbac, F., Dapoigny, M., & Poirier, P. (2014). Blastocystis is associated with decrease of fecal microbiota protective bacteria: Comparative analysis between patients with irritable bowel syndrome and control subjects. PLoS ONE, 9(11), e111868. https://doi.org/10.1371/journal.pone.0111868 DOI: https://doi.org/10.1371/journal.pone.0111868
Stensvold, C. R., Suresh, G. K., Tan, K. S., Thompson, R. C., Traub, R. J., Viscogliosi, E., Yoshikawa, H., & Clark, C. G. (2007). Terminology for Blastocystis subtypes–a consensus. Trends in Parasitology, 23(3), 93–96. https://doi.org/10.1016/j.pt.2007.01.004 DOI: https://doi.org/10.1016/j.pt.2007.01.004
Malatyalı, E., & Özçelik, S. (2011). Isolation of Blastocystis spp. from human hosts and in vitro determination of different morphological forms. Türkiye Parazitoloji Dergisi, 35(1), 19–22. https://doi.org/10.5152/tpd.2011.05 DOI: https://doi.org/10.5152/tpd.2011.05
Petti, S., Andreasen, J. O., Glendor, U., & Andersson, L. (2022). NA0D – The new traumatic dental injury classification of the World Health Organization. Dental Traumatology, 38(3), 170–174. https://doi.org/10.1111/edt.12753 DOI: https://doi.org/10.1111/edt.12753
Lepczyńska, M., Białkowska, J., Dzika, E., Piskorz-Ogórek, K., & Korycińska, J. (2017). Blastocystis: How do specific diets and human gut microbiota affect its development and pathogenicity? European Journal of Clinical Microbiology & Infectious Diseases, 36(9), 1531–1540. https://doi.org/10.1007/s10096-017-2965-0 DOI: https://doi.org/10.1007/s10096-017-2965-0
Gubler, E. V. (1978). Computational methods for the analysis and recognition of pathological processes. Meditsina.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 І. П. Бодня
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal Infectious Disease (Infektsiini Khvoroby) allows the author(s) to hold the copyright without registration
Users can use, reuse and build upon the material published in the journal but only for non-commercial purposes
This journal is available through Creative Commons (CC) License BY-NC "Attribution-NonCommercial" 4.0
