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. 2025 Jun;31(6):1235-1238.
doi: 10.3201/eid3106.250076.

Prevalence of Nitroimidazole-Refractory Giardiasis Acquired in Different World Regions, Sweden, 2008-2020

Karin A Ydsten, Joanna Nederby Öhd, Urban Hellgren, Hilmir Asgeirsson

Prevalence of Nitroimidazole-Refractory Giardiasis Acquired in Different World Regions, Sweden, 2008-2020

Karin A Ydsten et al. Emerg Infect Dis. 2025 Jun.

Abstract

Treatment-refractory giardiasis is an emerging clinical problem. Of 4,285 giardiasis cases identified during 2008-2020 in Stockholm, Sweden, 102 (2.4%) were nitroimidazole refractory. Among cases acquired in India, the percentage was high (64/545 [12%]) and increased over time. The region of acquisition needs to be taken into consideration when managing patients.

Keywords: Giardia; India; Sweden; antimicrobial resistance; epidemiology; giardiasis; nitroimidazole; parasites; prevalence; refractory; treatment.

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References

    1. Mørch K, Hanevik K. Giardiasis treatment: an update with a focus on refractory disease. Curr Opin Infect Dis. 2020;33:355–64. 10.1097/QCO.0000000000000668 - DOI - PubMed
    1. Muñoz Gutiérrez J, Aldasoro E, Requena A, Comin AM, Pinazo MJ, Bardají A, et al. Refractory giardiasis in Spanish travellers. Travel Med Infect Dis. 2013;11:126–9. 10.1016/j.tmaid.2012.10.004 - DOI - PubMed
    1. Nabarro LE, Lever RA, Armstrong M, Chiodini PL. Increased incidence of nitroimidazole-refractory giardiasis at the Hospital for Tropical Diseases, London: 2008-2013. Clin Microbiol Infect. 2015;21:791–6. 10.1016/j.cmi.2015.04.019 - DOI - PubMed
    1. Requena-Méndez A, Goñi P, Rubio E, Pou D, Fumadó V, Lóbez S, et al. The use of quinacrine in nitroimidazole-resistant Giardia duodenalis: an old drug for an emerging problem. J Infect Dis. 2017;215:946–53. 10.1093/infdis/jix066 - DOI - PubMed
    1. Neumayr A, Schunk M, Theunissen C, Van Esbroeck M, Mechain M, Hatz C, et al. Efficacy and tolerability of quinacrine monotherapy and albendazole plus chloroquine combination therapy in nitroimidazole-refractory giardiasis: a TropNet study. Clin Infect Dis. 2021;73:1517–23. 10.1093/cid/ciab513 - DOI - PubMed

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