{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:52:03Z","timestamp":1778925123032,"version":"3.51.4"},"reference-count":21,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Blastocystis is a common intestinal protist with a global distribution, frequently found in humans and various animals. Despite its prevalence, its role in human health remains debated, oscillating between being a harmless commensal and a potential pathogen. It has also been associated with gastrointestinal disorders such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). In Italy, the genetic and spatial diversity of Blastocystis remains understudied, despite the country\u2019s diverse urbanized and environmental landscapes. This study investigates the haplotypic and spatial diversity of clinical isolates of Blastocystis across two different Italian regions, with an emphasis on subtype distribution and genetic variation. Using a network-based haplotype analysis, the study reveals a heterogeneous subtype distribution, with subtype ST4 (47.3%) being the most prevalent, followed by ST3 (20%), ST1 (16.4%), ST2 (12.7%), ST6 (1.8%) and ST7 (1.8%). The overall infection rate detected from symptomatic patients is 9.75%. Notably, ST4 shows limited haplotypic variation, suggesting a more stable population structure that is potentially linked to a human-adapted lineage. In contrast, ST1 and ST2 exhibit greater haplotypic diversity, likely due to ongoing zoonotic transmission. These findings enhance our understanding of the epidemiology of Blastocystis in Italy and underscore the need for further research on its pathogenic potential and transmission dynamics.<\/jats:p>","DOI":"10.3390\/pathogens14020139","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T04:36:51Z","timestamp":1738557411000},"page":"139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Spatial and Genetic Diversity of Clinical Isolates of Blastocystis in Italy: A Network Analysis"],"prefix":"10.3390","volume":"14","author":[{"given":"Isabel","family":"Guadano-Procesi","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences and Translational Medicine, Faculty of Medicine, University of \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3952-4787","authenticated-orcid":false,"given":"Federica","family":"Berrilli","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Translational Medicine, Faculty of Medicine, University of \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Di Cave","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Translational Medicine, Faculty of Medicine, University of \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1017\/S0950268809002672","article-title":"Blastocystis: Unravelling potential risk factors and clinical significance of a common but neglected parasite","volume":"137","author":"Stensvold","year":"2009","journal-title":"Epidemiol. Infect."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1017\/S0031182017002347","article-title":"Genetic diversity of Blastocystis in non-primate animals","volume":"145","author":"Betts","year":"2018","journal-title":"Parasitology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1017\/S0950268815001697","article-title":"Molecular epidemiology and genetic diversity of Blastocystis infection in humans in Italy","volume":"144","author":"Mattiucci","year":"2016","journal-title":"Epidemiol. Infect."},{"key":"ref_4","unstructured":"Santin, M., Figueiredo, A., Molokin, A., George, N.S., K\u00f6ster, P.C., Dashti, A., Gonz\u00e1lez-Barrio, D., Carmena, D., and Maloney, J.G. (2024). Division of Blastocystis ST10 into three new subtypes: ST42-ST44. J. Eukaryot. Microbiol., 7."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.meegid.2011.11.002","article-title":"Levels of genetic diversity vary dramatically between Blastocystis subtypes","volume":"12","author":"Stensvold","year":"2012","journal-title":"Infect. Genet. Evol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.protis.2005.12.001","article-title":"DNA barcoding of Blastocystis","volume":"157","author":"Scicluna","year":"2006","journal-title":"Protist"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"124","DOI":"10.12688\/wellcomeopenres.14826.1","article-title":"Open-access bacterial population genomics: BIGSdb software, the PubMLST.org website and their applications","volume":"3","author":"Jolley","year":"2018","journal-title":"Wellcome Open Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3022","DOI":"10.1093\/molbev\/msab120","article-title":"MEGA11: Molecular Evolutionary Genetics Analysis Version 11","volume":"38","author":"Tamura","year":"2021","journal-title":"Mol. Biol. Evol."},{"key":"ref_9","unstructured":"IBM Corp (2019). IBM SPSS Statistics for Windows, Version 26.0, IBM Corp."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3299","DOI":"10.1093\/molbev\/msx248","article-title":"DnaSP 6: DNA Sequence Polymorphism Analysis of Large Data Sets","volume":"34","author":"Rozas","year":"2017","journal-title":"Mol. Biol. Evol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1093\/genetics\/123.3.585","article-title":"Statistical method for testing the neutral mutation hypothesis by DNA polymorphism","volume":"123","author":"Tajima","year":"1989","journal-title":"Genetics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1111\/2041-210X.12410","article-title":"POPART: Full-feature software for haplotype network construction","volume":"6","author":"Leigh","year":"2015","journal-title":"Methods Ecol. Evol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1093\/oxfordjournals.molbev.a026036","article-title":"Median-joining networks for inferring intraspecific phylogenies","volume":"16","author":"Bandelt","year":"1999","journal-title":"Mol. Biol. Evol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105085","DOI":"10.1016\/j.meegid.2021.105085","article-title":"Epidemiology and subtype distribution of Blastocystis in humans: A review","volume":"95","author":"Popruk","year":"2021","journal-title":"Infect. Genet. Evol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"883","DOI":"10.4269\/ajtmh.2011.11-0005","article-title":"Blastocystis sp. subtype 4 is common in Danish Blastocystis-positive patients presenting with acute diarrhea","volume":"84","author":"Stensvold","year":"2011","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.pt.2013.08.006","article-title":"Blastocystis: Getting to grips with our guileful guest","volume":"29","author":"Scanlan","year":"2013","journal-title":"Trends Parasitol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"110325","DOI":"10.1016\/j.vetpar.2024.110325","article-title":"Cats and dogs as hosts of Blastocystis\u2014What is the evidence?","volume":"332","author":"Popruk","year":"2024","journal-title":"Vet. Parasitol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s00436-011-2294-7","article-title":"Molecular subtyping of Blastocystis sp. isolates from symptomatic patients in Italy","volume":"109","author":"Meloni","year":"2011","journal-title":"Parasitol. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1038\/s41424-018-0027-2","article-title":"Characteristics of the bacterial microbiome in association with common intestinal parasites in irritable bowel syndrome","volume":"9","author":"Krogsgaard","year":"2018","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4554","DOI":"10.1016\/j.cell.2024.06.018","article-title":"Intestinal Blastocystis is linked to healthier diets and more favorable cardiometabolic outcomes in 56,989 individuals from 32 countries","volume":"187","author":"Piperni","year":"2024","journal-title":"Cell"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Aykur, M., Malatyal\u0131, E., Demirel, F., C\u00f6mert-Ko\u00e7ak, B., Gentekaki, E., Tsaousis, A.D., and Dogruman-Al, F. (2024). Blastocystis: A Mysterious Member of the Gut Microbiome. Microorganisms, 12.","DOI":"10.3390\/microorganisms12030461"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/2\/139\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:26:03Z","timestamp":1760027163000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/2\/139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":21,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["pathogens14020139"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14020139","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,3]]}}}