Parasitos entéricos oportunistas em crianças nefropatas crônicas submetidas à hemodialise

• Autor(a) principal: OLIVEIRA, Solimar Almeida de
• Data de Publicação: 2012
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tde/1741
• topic: Hemodiálise; Criança; Blastocystis hominis; Cryptosporidium sp; Cyclospora cayetanensis; Isospora belli; Hemodialysis; Child; Blastocystis hominis; Cryptosporidium sp; Cyclospora cayetanensis; Isospora belli; CNPQ::CIENCIAS DA SAUDE

Introduction: The chronic renal insufficiency is in between the transition epidemiologist illness, being able to be affected by the enteric opportunistic parasites for representing a population of immunosuppressed. Catalogued as emergent agents of opportunistic character, protozoan disease is responsible for important morbi-mortality rates, but little recognized on the part of the professionals of health and for the shortage of specialized laboratories in its diagnostics. They are caused mainly by protozoan, as the Blastocystis hominis, Cryptosporidium sp, Isospora belli, Cyclospora cayetanensis, amongst others. Objectives: Mapping world-wide studies through a systematic revision of literature concerned to the detection of these protozoan in hemodialysis patients. And, besides, to identify enteric opportunistic agents in immunosuppressed children with chronic nephropathies who were submitted to hemodialysis and also children patients who don t have chronic nephropathies, in the Clinical Hospital /UFG. Methods: The theoretical part, represented by the systematic revision of literature, was elaborated from standardized forms on the selection of scientific articles available in the Virtual Library in Health. This work, concerning the experimental part, was built in the period of October of 2009 to May of 2011 with analysis of the epidemiologic profiles of the patients and laboratorial detection of opportunistic enteroparasitosis in 229 fecal samples of 26 hemodialysis children (test-group) and of 59 children who haven t chronic nephropathies (control group), from the Hospital of the Clinics of the Federal University of Goiás. For further detection of the oocysts of coccids (Cryptosporidium sp, Cyclospora cayetanensis and Isospora belli), microscopic examination was used direct (fresh).It was also used the methods of Hoffman, Pons and Janer, Ridley or of concentration in formalin 10% - Acetate of Ethyl, Coloration of Kinyoun (hot), and, Ziehl-Neelsen (modified). With regard to the diagnosis of Blastocystis hominis, it was used the microscopic examination direct (fresh) and the technique of Coloration of Nair - Blue of Methylene. Results: In the systematic revision of literature, nine articles had been selected, and from the interpretation on these studies, the presence of enteric opportunistic protozoan in fecal samples of hemodialysis patients was evidenced. In the experimental part, the detection of protozoan for patients, in the test group and in the control group was, respectively, of: Blastocystis hominis in 9 (34,6%) and 13 (22%); Giardia lamblia in 3 (11,5%) and 2 (3,4%); Endolimax nana in 9 (34,6%) and 9 (15,3%); Entamoeba coli in 3 (11,5%) and 2 (3,4%). And still it had been detected only in the test group: Cryptosporidium sp in 1 (3,8%) patient and Entamoeba histolytica/dispar in 3 (11,5%). Regarding the quantitative analysis of fecal samples, it was collected 115 samples of the group of hemodialysis children and 114 samples of the group of children who don t have chronic nephropathies. The results gotten in this comparison had designated the presence of oocysts of intestinal protozoan in the test group and in the control group. Respectively, we have: Blastocystis hominis in 24 (20,87%) and 16 (14,04%) samples; Giardia lamblia in 3 (2,61%) and 2 (1,75%) samples; Endolimax nana 15 (13,4%) and 9 (7,89%) samples. Besides, it had been detected only in the test group: Cryptosporidium sp in 1 (0,87%) sample and Entamoeba histolytica/dispar in 3 (2,61%). With regard to the diarrheal feces analysis, it was detected in test group 1 sample (0,87%), and in the control group, 8 (7.02%). Conclusion: These findings demonstrate that such agents are present in our environment, reinforcing isolated infections or associates, between them or ahead of other opportunistic enteric parasites, providing a risk for the population of hemodialysis patient. They still disclose the urgency of an implantation of specialized laboratories with specific detection techniques of these infectum-parasitic agents.