Epidemiology of E. histolytica and E. dispar infections in a non-endemic area (Parma, Italy) during 2003-2006.

objectives Since E. histolytica is morphologically indistinguishable from E. dispar, a reassessment of the worldwide prevalence of amoebic infection based on methods able to differentiate the two species was strongly recommended by World Health Organization (Tanyuksel and Petri, 2003). The area in which our laboratory is located (Northern Italy) has seen in recent years an increase of people travelling to tropical countries, a significant flow of immigration and the adoption of children from the same areas which has led to a parallel increase in imported tropical infections. The aim of this study was to assess the occurrence of E. histolytica and E. dispar infection among the patients with suspected intestinal parasitosis presenting to University Hospital of Parma as diagnosed by the combination of traditional and molecular methods (PCR and Real-Time PCR) (Calderaro et al., 2006) . methods During 2003–2006, 7281 clinical samples belonging to 5322 patients were sent to our laboratory with the suspicion of intestinal parasitosis and subjected to parasitological examination for intestinal parasites. DNA was extracted from the specimens in which microscopy evidenced structures resembling E. histolytica/ E. dispar or gastrointestinal parasites sharing the same transmission route, and from the specimens belonging to patients presenting risk factors or clinical findings suggestive of amoebiasis (a total of 511 samples – 496 faeces, 7 liver abscess samples, 8 intestinal biopsies - belonging to 306 patients). results Eight patients (2.61%) proved to be infected by E. histolytica (3 with amoebic liver abscess and 5 with amoebic dysentery; 5 with imported amoebiasis and 3 with the disease acquired in Italy) and 22 by E. dispar (7.18%). conclusion Though rare, the detection of E. histolytica infections in a non-endemic area like Italy emphasizes that our country needs to expand its range of parasitology laboratories with adequate molecular diagnostic assays. Moreover, a parasitological check-up on arrival in Italy for adopted children and adult immigrants from developing countries to identify carriers of faecal–oral transmitted infections like amoebiasis might be useful to enhance the individuals’ health by treating intestinal parasitic infections as well as to protect the public health of the community.