Albendazole Stimulates the Excretion of Strongyloides stercoralis Larvae in Stool Specimens and Enhances Sensitivity for Diagnosis of Strongyloidiasis

• Published in: Journal of Clinical Microbiology Vol. 48; no. 11; pp. 4216 - 4220
• Main Authors: Anamnart, Witthaya, Pattanawongsa, Attarat, Intapan, Pewpan Maleewong, Maleewong, Wanchai
• Format: Journal Article
• Language: English
• Published: Washington, DC American Society for Microbiology 01.11.2010; American Society for Microbiology (ASM)
• Subjects: Adolescent; Adult; Aged; Albendazole - administration & dosage; Animals; Anthelmintics - administration & dosage; Biological and medical sciences; Child; Diseases caused by nematodes; Feces - parasitology; Fundamental and applied biological sciences. Psychology; Helminthic diseases; Humans; Infectious diseases; Larva - drug effects; Medical sciences; Microbiology; Middle Aged; Parasitic diseases; Parasitology; Parasitology - methods; Sensitivity and Specificity; Strongyloides stercoralis - drug effects; Strongyloides stercoralis - isolation & purification; Strongyloidiasis - diagnosis; Strongyloidiasis - parasitology; Strongyloidosis; Young Adult; Anthelmintic; Strongyloidiasis; Parasitosis; Helminthiasis; Infection; Sensitivity; Albendazole; Benzimidazole derivatives; Nematode disease; Strongyloides stercoralis; Helmintha; Digestive diseases; Parasiticide; Nemathelminthia; Diagnosis; Feces; Invertebrata; Nematoda
• ISSN: 0095-1137; 1098-660X; 1098-660X
• DOI: 10.1128/JCM.00852-10

We succeeded in stimulation of excretion of Strongyloides stercoralis larvae in stool by oral administration of a single dose of 400 mg albendazole to strongyloidiasis patients. This result overcame the false-negative results of stool examination due to low larval numbers. Stool samples were collected from 152 asymptomatic strongyloidiasis patients in the morning, prior to eating. After breakfast, they were given a dose of 400 mg albendazole, and stool samples were collected the following morning. Agar plate culture (APC), modified formalin-ether concentration technique (MFECT), and direct-smear (DS) methods were used to examine stool specimens within 3 h after defecation. The results before and after albendazole was taken were compared. All APCs that were positive became negative after albendazole administration, while MFECT showed a 1.4- to 18.0-fold increase in larval numbers in 97.4% (148/152) of the samples. The DSs were positive in 3 out of 3 smears at a larval number of ≥45 larvae per g (lpg) of stool, and in 1or 2 out of 3 smears at a larval number between 35 and 44 lpg. At a larval number of <35 lpg, the DS became negative. Interestingly 90.5% (19/21) of the samples that were negative by all methods before albendazole administration became positive by MFECT after the treatment. Thus, MFECT can be effectively used for diagnosis of strongyloidiasis with prior administration of albendazole to the subject.