Enterocytozoon Bieneusi Infects Children With Inflammatory Bowel Disease Undergoing Immunosuppressive Treatment

Abstract

Objectives: Patients with inflammatory bowel disease (IBD) are susceptible to intestinal opportunistic infections due to both defective mucosal immunity and altered immune response resulting from immunosuppressive treatment. Microsporidia infecting the gastrointestinal tract and causing diarrhoea can potentially affect the course of IBD.Methods: Stool samples (90 IBD children and 121 healthy age-matched controls) were screened for Encephalitozoon spp. and Enterocytozoon bieneusi by microscopy and polymerase chain reaction followed by sequencing.Results:E. bieneusi genotype D was found in seven out of 90 (7.8%) IBD children. No children from the control group were infected, making the pathogen prevalence in the IBD group significant (P = 0.002). Furthermore, infection was confirmed only in patients receiving immunosuppressive treatment (P = 0.013).Conclusions: Children with IBD are at risk of intestinal E. bieneusi infection, especially when receiving immunosuppressive treatment. Therefore, microsporidia should be considered as a significant infectious agent in this group of patients.

Global prevalence and risk factors of Enterocytozoon bieneusi infection in humans: a systematic review and meta-analysis

“…Enterocytozoon bieneusi is one of the common pathogens that causes chronic diarrhea in the human body, especially in people with immunodeficiency or low immunity (such as people with HIV, organ transplant recipients, bone marrow transplant recipients, patients with tumors, elderly people, and children) [ 83 , 94 , 100 ]. In the statistical analysis of people at different ages, compared with other groups, the infection rates of young people and the elderly were higher.…”

Microsporidian obligate intracellular parasites subvert autophagy of infected mammalian host cells to promote their own growth

“…Microsporidia are increasingly appreciated to be ubiquitous in the environment and to infect host from all the animal taxa including humans (Stentiford et al, 2016). Indeed, a recent study identified a high prevalence (14.9%) of infection by the Microsporidian specie E. bieneusi among children with IBD treated with various immunosuppressants (Zajączkowska et al, 2021). The altered barrier functions of the epithelium characteristic of IBD (McCole, 2014) could contribute to a higher susceptibility to Microsporidian infections.…”