IJCRR - Vol 08 Issue 01, January, 2016
IMPACT OF IMMUNOSUPPRESSIVE DRUGS ON SUDANESE RENAL TRANSPLANT RECIPIENTS INFECTED WITH INTESTINAL PARASITES
Author: Lienda Bashier Eltayeb, Hisham Ali Waggiallah
Objectives:Enteric parasites are important agents of disease throughout the world. And they increasingly have significant role in transplant candidates. Intestinal parasites that are asymptomatic before transplantation may become clinically significant under immunosuppressive treatment. In the other hand some immunosuppressive regimens has anti-parasitic effects that may result, in lower rates of parasitic infections. Methods: Stool samples were collected from renal transplant recipients attending Sudanese Kidney Association hospital and from a control group from January 2012 to April 2012. For the detection of parasites, fresh stool samples were separated into two samples; one was preserved in SAF fixative. From this sample smears were made for permanent stains. The second sample was examined by wet preparation. Modified trichrome staining method was used for permanent smears for microsporidia. Result: All (200) renal transplant recipients were on immunosuppressant drugs; (76.5%) of the study patients were on tacrolimus (prograf) therapy and only (23.5 %) were on cyclosporine A (CsA) therapy. Of the total patients on tacrolimus there (22.5%) were diagnosed with intestinal parasites and only (1.5%) of them were on Cyclosporine therapy. There was statistically significance between immunosuppressant agents and infection with intestinal parasites positivity in group I (P value= 0.019). All details are summarized in (Table 2). Multiple parasitic infections were observed in a total of 5/200 (2.5%) renal transplant recipients and 1/100(1%) controls (p < 0.05). G lamblia,and B. hominiswas frequently seen species as multiple infections in renal transplant recipients. Conclusion: Intestinal parasitic infections should not ignore in renal transplant recipients, So Cyclosporine therapy should be recommended as first line immunosuppressant drugs as well as prophylactic against wide range of parasitic diseases.
Keywords: Immunosuppressive drugs, Transplants, Intestinal parasites
Lienda Bashier Eltayeb, Hisham Ali Waggiallah. IMPACT OF IMMUNOSUPPRESSIVE DRUGS ON SUDANESE RENAL TRANSPLANT RECIPIENTS INFECTED WITH INTESTINAL PARASITES International Journal of Current Research and Review. Vol 08 Issue 01, January, 20-24
1. Fantry L. Gastrointestinal infections in the immunocompromised host. Current Opinion in Gastroenterology 2002; 18(1):34-9.
2. Barsoum RS. Parasitic infections in organ transplantation. Exp Clin Transplant 2004; 2 (2):258-67.
3. Syafinaz AN, Hamat RA, Malina O, Siti NM, Niazlin MT, Jamal F Hymenolepis nana in a renal transplant recipient: to treat or not to treat? Med J Malaysia 2011 Aug; 66(3):259-60.
4. Kiran Kumar Mukku, Sreebhushan Raju And Ramesh Yelanati, Refractory Giardiasis In Renal Transplantation: A Case Report Nephrology 20 (2015) 44–48.
5. C. N. Kottona R. Lattesb and the AST Infectious Diseases Community of PracticeParasitic Infections in Solid Organ Transplant Recipients. American Journal of Transplantation 2009; 9 (Suppl 4): S234–S251Wiley Periodicals Inc.
6. Barsoum RS. Parasitic infections in organ transplantation. Exp Clin Transplant 2004; 2: 258–267.
7. Udgiri N, Minz M, Kashyap R et al. Intestinal cryptosporidiosis in living related renal transplant recipients. Transplant Proc 2004; 36: 2128–2129
8. Jay A. Fishman, Infection in Solid-Organ Transplant Recipients. N Engl J Med 2007; 357:2601-14
9. Eltayeb LB, BirarSl, Waggiallah HA. Prevalence of Intestinal Parasites among Renal Transplant Recipients in Khartoum State. IJHSR. 2015; 5(11): 90-95.
10. Linda BashierEltayeb, Sara LaviniaBrair, Awad Ahmed Nasr. Frequency of intestinal parasites with emphasis on opportunistic parasites among renal transplant recipients with and without diarrhea in Sudan 2012. Sudanese Journal of Public Health. 2013; 8 (4): 135-140.
11. Cheesbrough M. District Medical laboratory manual of tropical countries part 1publishied by tropical health technology and butterworth- heinemannlt second edition 1987; 200-214.
12. Patil K, De A, Mathur M. Comparison of Weber Green and Ryan Blue modified trichrome staining for the diagnosis of microsporidial spores from stool samples of HIV-positive patients with diarrhoea. Indian J Med Microbiol. 2008; 26(4):407
13. Chappell LH, Wastling JM. Cyclosporin A: antiparasite drug, modulator of the hostparasite relationship and immunosuppressant. Parasitology 1992; 105 Suppl: S25-40.
14. M Nateghi Rostami, H Keshavarz, E Eskandari, EB Kia, M Rezaeian Intestinal. Parasitic Infections in Renal Transplant Recipients. Iranian J Parasitol 2007; 2(3)16-23209.
15. Valar C, Keitel E, Dal Pra RL, Gnatta D, Santos AF. Parasitic infection in renal transplant recipients. Transplant Proc 2007; 39 (2): 460-2.
16. Mehdi A, MehranSh, Sayed H, Mehdi T. Intestinal parasitic infections in renal transplant recipients. Braz J Infect Dis 2010; 14(1):15-18.
17. Fantry L. Gastrointestinal infections in the immunocompromised host. Current Opinion in Gastroenterology 2002; 18(1):34-9.