Strongyloides stercoralis infection: an underlying cause of invasive bacterial infections of enteric origin. Results from a prospective cross-sectional study of a northern Italian tertiary hospital.

Gardini, Giulia; Froeschl, Guenter; Gurrieri, Francesca; De Francesco, Maria Antonia; Cattaneo, Chiara; Marchese, Valentina; Piccinelli, Giorgio; Corbellini, Silvia; Pagani, Chiara; Santagiuliana, Marzia; Fumarola, Benedetta; Gulletta, Maurizio; Perandin, Francesca; Castelli, Francesco; Matteelli, Alberto

Purpose of the study: We assessed the prevalence of S. stercoralis in a cohort of inpatients with invasive bacterial infections of enteric origin to investigate whether the parasite may facilitate these bacterial infections even in the absence of larval hyperproliferation. Methods: We performed a prospective cross-sectional study in a hospital in northern Italy. Subjects admitted due to invasive bacterial infection of enteric origin and potential previous exposure to S. stercoralis were systematically enrolled over a period of 10 months. S. stercoralis infection was investigated with an in-house PCR on a single stool sample and with at least one serological method (in-house IFAT and/or ELISA Bordier). Univariate, bi-variate and logistic regression analyses were performed. Results: Strongyloidiasis was diagnosed in 14/57 patients (24.6%; 95% confidence interval 14.1–37.8%) of which 10 were Italians (10/49, 20.4%) and 4 were migrants (4/8, 50.0%). Stool PCR was performed in 43/57 patients (75.4%) and no positive results were obtained. Strongyloidiasis was found to be significantly associated (p ≤ 0.05) with male gender, long international travels to areas at higher endemicity, deep extra-intestinal infectious localization and solid tumors. In the logistic regression model, increased risk remained for the variables deep extra-intestinal infectious localization and oncologic malignancy. Conclusions: Our findings suggest a new role of chronic strongyloidiasis in favoring invasive bacterial infections of enteric origin even in the absence of evident larval dissemination outside the intestinal lumen. Further well-designed studies should be conducted to confirm our results, and possibly establish the underlying mechanisms.

ITALY; DIAGNOSIS of bacterial diseases; HELMINTHIASIS; STATISTICS; CONFIDENCE intervals; CROSS-sectional method; INTESTINAL diseases; MIXED infections; RESEARCH funding; ENZYME-linked immunosorbent assay; POLYMERASE chain reaction; LOGISTIC regression analysis; LONGITUDINAL method

Infection, 2023, Vol 51, Issue 5, p1541

0300-8126

Academic Journal

10.1007/s15010-023-02072-1