BACKGROUND Entamoeba infections have major impact on millions of the people worldwide. Entamoeba histolytica has long been accepted as the only pathogenic species. However, recent reports of other Entamoeba spp. in symptomatic cases have raised questions on their pathogenicity. METHODOLOGY/PRINCIPAL FINDINGS Total 474 stool samples and 125 liver aspirates from patients with intestinal and extra intestinal manifestations and from community were included. Sewage samples from the hospital and the city were also included. Microscopic examination and molecular detection were performed to detect presence of E. histolytica/ dispar/ moshkovskii/ bangladeshi. The associated demographic and socioeconomic factors were statistically analyzed with the presence of Entamoeba. Microscopy detected Entamoeba spp. in 5.4% stool and 6.4% liver aspirate samples. Through nested multiplex PCR, prevalence of Entamoeba spp. in intestinal and extra-intestinal cases was 6.6% (20/301) and 86.4% (108/125) respectively and in asymptomatic population was 10.5% (13/123). Sewage samples did not show presence of any Entamoeba spp. Uneducated subjects, low economic conditions, untreated drinking water, consumption of raw vegetables and habit of not washing hands before meals were significantly associated with presence of Entamoeba spp. CONCLUSIONS E. histolytica still remains the only Entamoeba spp. in invasive extra intestinal infections. E. dispar was detected in both asymptomatic and symptomatic intestinal infections. Routine identification of Entamoeba spp. should incorporate PCR based detection methods.

中文翻译：

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临床相关内阿米巴属的流行病学。（E. histolytica/dispar/moshkovskii/bangladeshi）：来自北印度的横断面研究。

背景内阿米巴感染对全世界数百万人具有重大影响。长期以来，溶组织内阿米巴一直被认为是唯一的致病菌种。然而，最近关于其他内阿米巴属的报道。在有症状的病例中，对其致病性提出了质疑。方法学/主要发现 共有 474 份粪便样本和 125 份来自肠道和肠外表现患者以及来自社区的肝吸出物。医院和城市的污水样本也包括在内。进行显微镜检查和分子检测以检测 E.histolytica/dispar/moshkovskii/bangladeshi 的存在。相关的人口统计和社会经济因素在存在内阿米巴的情况下进行了统计分析。显微镜检出内阿米巴属。在 5.4% 的粪便和 6.4% 的肝吸出物样本中。通过巢式多重 PCR，内阿米巴属的流行。在肠道和肠外病例中分别为 6.6% (20/301) 和 86.4% (108/125)，在无症状人群中为 10.5% (13/123)。污水样本未显示任何内阿米巴属。未受过教育的受试者、经济状况不佳、饮用水未经处理、食用生蔬菜和饭前不洗手的习惯与内阿米巴属的存在显着相关。结论 E. histolytica 仍然是唯一的内阿米巴属。在侵入性肠外感染中。在无症状和有症状的肠道感染中均检测到 E. dispar。内阿米巴属的常规鉴定。应结合基于 PCR 的检测方法。分别为 6% (20/301) 和 86.4% (108/125)，在无症状人群中为 10.5% (13/123)。污水样本未显示任何内阿米巴属。未受过教育的受试者、经济状况不佳、饮用水未经处理、食用生蔬菜和饭前不洗手的习惯与内阿米巴属的存在显着相关。结论 E. histolytica 仍然是唯一的内阿米巴属。在侵入性肠外感染中。在无症状和有症状的肠道感染中均检测到 E. dispar。内阿米巴属的常规鉴定。应结合基于 PCR 的检测方法。分别为 6% (20/301) 和 86.4% (108/125)，在无症状人群中为 10.5% (13/123)。污水样本未显示任何内阿米巴属。未受过教育的受试者、经济状况不佳、饮用水未经处理、食用生蔬菜和饭前不洗手的习惯与内阿米巴属的存在显着相关。结论 E. histolytica 仍然是唯一的内阿米巴属。在侵入性肠外感染中。在无症状和有症状的肠道感染中均检测到 E. dispar。内阿米巴属的常规鉴定。应结合基于 PCR 的检测方法。食用生蔬菜和饭前不洗手的习惯与内阿米巴属的存在显着相关。结论 E. histolytica 仍然是唯一的内阿米巴属。在侵入性肠外感染中。在无症状和有症状的肠道感染中均检测到 E. dispar。内阿米巴属的常规鉴定。应结合基于 PCR 的检测方法。食用生蔬菜和饭前不洗手的习惯与内阿米巴属的存在显着相关。结论 E. histolytica 仍然是唯一的内阿米巴属。在侵入性肠外感染中。在无症状和有症状的肠道感染中均检测到 E. dispar。内阿米巴属的常规鉴定。应结合基于 PCR 的检测方法。