CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES >
Establishment and evaluation of modified Wright-Giemsa staining for detection of Blastocystis hominis
Received date: 2025-03-16
Revised date: 2025-07-23
Online published: 2025-10-22
Supported by
Futian Healthcare Research Project(FTWS2023020)
Fecal samples were collected from patients admitted to The Eighth Affiliated Hospital of Sun Yat-sen University from April 2021 to December 2024, and a total of 131 cases tested positive for Blastocystis hominis infections using PCR assay and 50 cases tested negative were randomly divided into the experimental group (92 cases tested positive, 35 cases tested negative) and validation group (39 cases tested positive, 15 cases tested negative) using a random number table. Each fecal sample of experimental group was prepared into suspensions, and 50, 100, and 150 μl of suspensions were sampled for preparation of thin smears. Compared to conventional Wright-Giemsa staining, which involves an additional drying step, they dried at 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, and 80 ℃. The smears were stained with Wright-Giemsa stains for 5 to 10 minutes and then observed under an optical microscope. The diagnostic performance of the modified Wright-Giemsa staining method was evaluated using PCR amplification and genotyping results with B. hominis-specific primers BhRDr/RD5 as a reference standard. The validation group used both the modified Wright-Giemsa staining method and PCR method for simultaneous detection of B. hominis. The sensitivity, specificity, Youden index, predictive values (positive/negative), kappa coefficient, and concordance rate were as reference standards to evaluate the diagnostic performance of the modified method. The optimal fecal smear volume was 50 μl, and the most suitable drying temperature was (70 ± 5) ℃. PCR amplification produced a specific band at approximately 600 bp, with ST3 as the predominant genotype, followed by ST7, ST1, ST6, and ST2. The diagnostic sensitivity, specificity, kappa coefficient and concordance rate of the modified Wright-Giemsa staining method were 98.9% (95% CI: 94.0% to 100.0%), 97.1% (95% CI: 85.3% to 99.9%), 0.961 (95% CI: 0.906 to 1.000), and 98.4% (125/127) in the experimental group, showing high consistency with PCR assay. McNemar’s test was used to compare the differences in detection results between the two methods in the validation group, and the differences were not statistically significant (P > 0.05). The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, Youden index, kappa coefficient and concordance rate of the modified Wright-Giemsa staining method were 97.4% (95% CI: 86.2% to 99.9%), 86.7% (95% CI: 59.5% to 98.3%), 95.0% (95% CI: 83.8% to 99.5%), 92.9% (95% CI: 69.8% to 99.8%), 0.841 (95% CI: 0.662 to 1.000), 0.858 (95% CI: 0.703 to 1.000), and 94.4% (51/54), respectively. The modified Wright-Giemsa staining method established in this study is simple to operate, yields stable results, and shows high consistency with PCR assay, which is suitable for rapid screening of B. hominis in grassroots medical institutions and field epidemiological investigations.
LIU Xiaoqing , ZOU Xiaohong , WANG Huiting , ZHOU Chen , LI Zhenhua , SHI Liang . Establishment and evaluation of modified Wright-Giemsa staining for detection of Blastocystis hominis[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2025 , 43(5) : 731 -735 . DOI: 10.12140/j.issn.1000-7423.2025.05.021
| [1] | Stenzel DJ, Boreham PF. Blastocystis hominis revisited[J]. Clin Microbiol Rev, 1996, 9(4): 563-584. |
| [2] | Tan KSW. Blastocystis in humans and animals: New insights using modern methodologies[J]. Vet Parasitol, 2004, 126(1/2): 121-144. |
| [3] | Duda A, Kosik-Bogacka D, Lanocha N, et al. Blastocystis hominis: Parasites or commensals?[J]. Ann Acad Med Stetin, 2014, 60(1): 23-28. |
| [4] | Piperni E, Nguyen LH, Manghi P, et al. Intestinal Blastocystis is linked to healthier diets and more favorable cardiometabolic outcomes in 56 989 individuals from 32 countries[J]. Cell, 2024, 187(17): 4554-4570. e18. |
| [5] | Taşova Y, Sahin B, Koltaş S, et al. Clinical significance and frequency of Blastocystis hominis in Turkish patients with hematological malignancy[J]. Acta Med Okayama, 2000, 54(3): 133-136. |
| [6] | Mohamed AM, Ahmed MA, Ahmed SA, et al. Predominance and association risk of Blastocystis hominis subtype in Ⅰ colorectal cancer: A case control study[J]. Infect Agents Cancer, 2017, 12(1): 21. |
| [7] | 陈萌, 陶洪, 李彦忠, 等. 云南省布朗族聚居地区人群肠道寄生虫感染情况调查[J]. 中国寄生虫学与寄生虫病杂志, 2024, 42(5): 623-628. |
| Chen M, Tao H, Li YZ, et al. Investigation of intestinal parasitic infections among the population in areas inhabited by Bulang nationality in Yunnan Province[J]. Chin J Parasitol Parasit Dis, 2024, 42(5): 623-628. (in Chinese) | |
| [8] | Kök M, Çekin Y, Çekin AH, et al. The role of Blastocystis hominis in the activation of ulcerative colitis[J]. Turk J Gastroenterol, 2019, 30(1): 40-46. |
| [9] | 李琳, 蔡玉春, 俞铖航, 等. 炎症性肠病与肠易激综合征患者合并人芽囊原虫感染研究进展[J]. 中国血吸虫病防治杂志, 2023, 35(4): 413-420, 426. |
| Li L, Cai YC, Yu CH, et al. Progress of researches on Blastocystis hominis infection among patients with inflammatory bowel disease and irritable bowel syndrome[J]. Chin J Schisto Control, 2023, 35(4): 413-420, 426. (in Chinese) | |
| [10] | Wawrzyniak I, Poirier P, Viscogliosi E, et al. Blastocystis, an unrecognized parasite: An overview of pathogenesis and diagnosis[J]. Ther Adv Infect Dis, 2013, 1(5): 167-178. |
| [11] | 朱名超, 朱娅, 赵建忠, 等. 天门市长期住院患者人芽囊原虫感染情况分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(1): 121-124. |
| Zhu MC, Zhu Y, Zhao JZ, et al. Analysis of Blastocystis hominis infection in long-term hospitalized patients in Tianmen City[J]. Chin J Parasitol Parasit Dis, 2023, 41(1): 121-124. (in Chinese) | |
| [12] | Ajjampur SSR, Tan KSW. Pathogenic mechanisms in Blastocystis spp.: Interpreting results from in vitro and in vivo studies[J]. Parasitol Int, 2016, 65(6 Pt B): 772-779. |
| [13] | Deng L, Wojciech L, Gascoigne NRJ, et al. New insights into the interactions between Blastocystis, the gut microbiota, and host immunity[J]. PLoS Pathog, 2021, 17(2): e1009253. |
| [14] | Popruk S, Adao DEV, Rivera WL. Epidemiology and subtype distribution of Blastocystis in humans: A review[J]. Infect Genet Evol, 2021, 95: 105085. |
| [15] | Rauff-Adedotun AA, Meor Termizi FH, Shaari N, et al. The coexistence of Blastocystis spp. in humans, animals and environmental sources from 2010-2021 in Asia[J]. Biology, 2021, 10(10): 990. |
| [16] | 张富强, 王沛, 冯霞, 等. 全球人群人芽囊原虫感染情况及基因亚型研究进展[J]. 中国血吸虫病防治杂志, 2021, 33(1): 84-94. |
| Zhang FQ, Wang P, Feng X, et al. Progress of researches on global prevalence of Blastocystis hominis human infections and its subtypes[J]. Chin J Schisto Control, 2021, 33(1): 84-94. (in Chinese) | |
| [17] | 胡缨, 刘登宇, 卢作超. 人芽囊原虫病原学检查方法比较及形态观察[J]. 中国病原生物学杂志, 2013, 8(2): 155-157. |
| Hu Y, Liu DY, Lu ZC. Comparison of the effectiveness of 3 methods of detecting Blastocystis hominis[J]. J Pathog Biol, 2013, 8(2): 155-157. (in Chinese) | |
| [18] | 胡主花, 钱科, 彭国华, 等. HIV/AIDS患者人芽囊原虫3种检测方法评价[J]. 中国热带医学, 2020, 20(3): 285-287. |
| Hu ZH, Qian K, Peng GH, et al. Evaluation of three methods for detecting Blastocystis hominis in HIV/AIDS patients[J]. China Trop Med, 2020, 20(3): 285-287. (in Chinese) | |
| [19] | 刘静, 辛致炜, 裴培, 等. 人芽囊原虫感染大鼠的方式改良及病理切片观察[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(2): 161-166, 172. |
| Liu J, Xin ZW, Pei P, et al. A modified method to infect Blastocystis hominis in rats and the pathological changes after infection[J]. Chin J Parasitol Parasit Dis, 2019, 37(2): 161-166, 172. (in Chinese) | |
| [20] | Scicluna SM, Tawari B, Clark CG. DNA barcoding of Blastocystis[J]. Protist, 2006, 157(1): 77-85. |
| [21] | Rudzińska M, Kowalewska B, Szostakowska B, et al. First report on the occurrence and subtypes of Blastocystis in pigs in Poland using sequence-tagged-site PCR and barcode region sequencing[J]. Pathogens, 2020, 9(7): 595. |
| [22] | Poirier P, Wawrzyniak I, Albert A, et al. Development and evaluation of a real-time PCR assay for detection and quantification of Blastocystis parasites in human stool samples: Prospective study of patients with hematological malignancies[J]. J Clin Microbiol, 2011, 49(3): 975-983. |
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