Screening of immunocompromised patients at risk of strongyloidiasis in western Turkey using ELISA and real-time PCR

Authors: ESRA ERDEM KIVRAK, ESRA ATALAY ŞAHAR, HÜSEYİN CAN, MERT DÖŞKAYA, MÜMTAZ YILMAZ, HÜSNÜ PULLUKÇU, AYŞE CANER, HÜSEYİN TÖZ, ADNAN YÜKSEL GÜRÜZ, MELTEM IŞIKGÖZ TAŞBAKAN

Abstract: Background/aim: Strongyloides stercoralis causes life-threatening hyperinfection or disseminated strongyloidiasis in immunocompromised patients such as HIV-positive, organ transplantation, and cancer patients. This study investigated the presence of strongyloidiasis in immunocompromised patients for the first time in Turkey. Materials and methods: Serum and stool samples were collected from 108 patients (25.9% of them were chronic renal failure and 74.1% were renal transplantation patients) who were admitted to Ege University Medical School in İzmir, located in western Turkey. Serum samples were analyzed by ELISA (DRG, Germany) and the presence of 18S rRNA gene of S. stercoralis was detected in stool samples by real-time PCR. Results: The analysis of serum samples showed that only one patient was anti-S. stercoralis IgG antibody and real-time PCR positive (0.92%). The patient was treated twice with albendazole (400 mg/day for 3 days) at 2-week intervals. Follow up real-time PCR was negative and the patient became seronegative 6 months after the initial diagnosis. Conclusion: This screening showed that the prevalence of strongyloidiasis in this small group of patients who were at risk of strongyloidiasis was 0.92%. Overall, the results showed that more systematic studies are required in Turkey to show the prevalence of strongyloidiasis.

Keywords: Strongyloides stercoralis, ELISA, real-time PCR, diagnosis, Turkey

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