Evaluation of multiplex PCR assay against microscopy in diagnosing Entamoeba histolytica in stool samples at Assiut Governorate Hospitals, Egypt

Background: Entamoeba histolytica is a common pathogenic protozoan parasite causing a health problem both in Egypt and the whole world. There are many species of Entamoeba affecting humans including E. histolytica, E. dispar, E. moshkovskii and others. These species can’t be distinguished at the morphological level by microscopic examination. Not all these species are pathogenic to human and so their treatment with antiamoebic drugs is not indicated and may lead to drug resistance. Objective: Molecular assay was considered to differentiate between pathogenic and non- pathogenic Entamoeba species in Assuit Governorate. Patients and Methods: Fecal samples were collected and examined from 187 patients suffering from diarrhea and/or dysentery, and attending the outpatient clinics of the Assiut Governorate Hospitals. Stool samples were examined macroscopically and microscopically by saline wet mount preparations. Iodine, methylene blue and trichrome stains were used for parasite identification. Positive samples were preserved for Multiplex PCR assay. Results: Among 187 samples, 24 (12.8%) were positive for Entamoeba complex by microscopic examination. Multiplex PCR detected E. histolytica, E. moshkovskii and dispar was in 5 patients (2.7%), 2 samples (1.1%), and one sample (0.5%), respectively. Conclusion: Multiplex PCR is preferable in differentiating between Entamoeba spp. for better treatment strategies and successful control