000061350 001__ 61350
000061350 005__ 20190819101354.0
000061350 0247_ $$2doi$$a10.1093/infdis/jix066
000061350 0248_ $$2sideral$$a98776
000061350 037__ $$aART-2017-98776
000061350 041__ $$aeng
000061350 100__ $$aRequena-Méndez, A.
000061350 245__ $$aThe Use of Quinacrine in Nitroimidazole-resistant Giardia Duodenalis: An Old Drug for an Emerging Problem.
000061350 260__ $$c2017
000061350 5060_ $$aAccess copy available to the general public$$fUnrestricted
000061350 5203_ $$aBackground:
There is little evidence regarding the management of refractory giardiasis after treatment with nitroimidazoles. This study estimates the proportion of persistent giardiasis in 3 hospitals in Barcelona, describes associated risk factors and genotype, and evaluates the efficacy rate of quinacrine in those with persistent giardiasis.
Methods:
A clinical, prospective, observational study was conducted in patients with giardiasis treated with nitroimidazoles. Those with persistent giardiasis were provided quinacrine. Molecular characterization of Giardia isolates was performed by polymerase chain reaction amplification of a fragment of tpi and bg genes.
Results:
Seventy-seven patients were recruited and treated with nitroimidazoles, and in 14 of 71 (20%) of patients followed up, Giardia persisted. Refractory giardiasis was associated with malaise (P = .007) and anorexia (P = .02), with previous giardiasis (P = .03), and with previous antibiotic (P = .02) or antiparasitic(P = .04) use. Quinacrine had an effectiveness rate of 100% in refractory giardiasis (n = 13; 95% confidence interval = 75-100). Molecular characterization showed that 17 (25%) Giardia isolates belonged to assemblage A, and 31 (43%) belonged to assemblage B. In refractory giardiasis, assemblage A and B were found responsible in 4 and 6 cases, respectively.
Conclusions:
Almost 20% of patients presented persistent giardiasis, belonging to both assemblages A and B, after nitroimidazole. Short course of quinacrine was effective in treating refractory cases. Further controlled studies should evaluate its efficacy and safety.
000061350 536__ $$9info:eu-repo/grantAgreement/ES/DGA/B124$$9info:eu-repo/grantAgreement/ES/MINECO/FIS/PI09-1585
000061350 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000061350 590__ $$a5.186$$b2017
000061350 591__ $$aIMMUNOLOGY$$b35 / 155 = 0.226$$c2017$$dQ1$$eT1
000061350 591__ $$aMICROBIOLOGY$$b20 / 125 = 0.16$$c2017$$dQ1$$eT1
000061350 591__ $$aINFECTIOUS DISEASES$$b9 / 88 = 0.102$$c2017$$dQ1$$eT1
000061350 592__ $$a3.302$$b2017
000061350 593__ $$aInfectious Diseases$$c2017$$dQ1
000061350 593__ $$aImmunology and Allergy$$c2017$$dQ1
000061350 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000061350 700__ $$0(orcid)0000-0003-0765-7227$$aGoñi, P.$$uUniversidad de Zaragoza
000061350 700__ $$0(orcid)0000-0002-9273-5885$$aRubio, E.$$uUniversidad de Zaragoza
000061350 700__ $$aPou, D.
000061350 700__ $$aFumadó, V.
000061350 700__ $$aLóbez, S.
000061350 700__ $$aAldasoro, E.
000061350 700__ $$aCabezos, J.
000061350 700__ $$aValls, M.E.
000061350 700__ $$aTreviño, B.
000061350 700__ $$aMartínez, Montseny, A.F.
000061350 700__ $$0(orcid)0000-0001-5829-9787$$aClavel, A.$$uUniversidad de Zaragoza
000061350 700__ $$aGascon, J.
000061350 700__ $$aMuñoz, J.
000061350 7102_ $$11008$$2660$$aUniversidad de Zaragoza$$bDpto. Microb.Med.Pr.,Sal.Públ.$$cÁrea Parasitología
000061350 7102_ $$11008$$2615$$aUniversidad de Zaragoza$$bDpto. Microb.Med.Pr.,Sal.Públ.$$cÁrea Medic.Prevent.Salud Públ.
000061350 773__ $$g215, 6 (2017), 946-953$$pJ. infect. dis.$$tJOURNAL OF INFECTIOUS DISEASES$$x0022-1899
000061350 8564_ $$s242861$$uhttps://zaguan.unizar.es/record/61350/files/texto_completo.pdf$$yVersión publicada
000061350 8564_ $$s131662$$uhttps://zaguan.unizar.es/record/61350/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000061350 909CO $$ooai:zaguan.unizar.es:61350$$particulos$$pdriver
000061350 951__ $$a2019-08-19-09:51:50
000061350 980__ $$aARTICLE