Molecular identification and genetic characteristics of Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in human immunodeficiency virus/acquired immunodeficiency syndrome patients in Shanghai, China

Abstract

Background Opportunistic infections are a ubiquitous complication in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are common opportunistic intestinal pathogens in humans. In China, despite the number of HIV/AIDS patients being extremely large, only a few studies have investigated opportunistic infections caused by intestinal pathogens in this patient population. The aims of this study were to elucidate the occurrence and genetic characteristics of Cryptosporidium spp., G. duodenalis, and E. bieneusi in HIV/AIDS patients. Methods We collected fecal specimens from 155 HIV/AIDS patients (one from each patient). All of the specimens were examined for the presence of the pathogens by genotyping using polymerase chain reaction and sequencing of the small subunit ribosomal RNA gene for Cryptosporidium spp.; the triosephosphate isomerase, β-giardin and glutamate dehydrogenase genes for G. duodenalis; and the internal transcribed spacer region of the rRNA gene for E. bieneusi. The Cryptosporidium-positive specimens were further subtyped by polymerase chain reacion and sequencing of the 60-kDa glycoprotein gene. Results Six (3.9%), three (1.9%), and eight (5.2%) HIV/AIDS patients were positive for Cryptosporidium spp., G. duodenalis, and E. bieneusi, respectively. No statistical differences were observed in occurrence rate between the groups by gender, clinical symptom (diarrhea), and CD4+ cell count. Four Cryptosporidium species were identified: Cryptosporidium hominis (n = 2), Cryptosporidium parvum (n = 1), Cryptosporidium meleagridis (n = 1), and Cryptosporidium andersoni (n = 2). Furthermore, two C. hominis subtypes (IeA12G3T3 and IaA28R4) were detected. Three G. duodenalis-positive specimens were successfully amplified and sequenced at the triosephosphate isomerase and β-giardin loci, which led to the identification of assemblages C and B, respectively. Seven genotypes (D, Type IV, EbpC, Peru11, EbpD, A, and I) were identified in E. bieneusi-positive specimens. Conclusions Our findings should increase awareness of AIDS-related opportunistic intestinal pathogens, and indicate the need for routine examination in clinical practice for the detection of Cryptosporidium spp., G. duodenalis, and E. bieneusi. Homology analyses of the three intestinal pathogens at the nucleotide and/or amino acid levels indicated their zoonotic potential. Graphical Abstract

Occurrence and genetic characterization of Enterocytozoon bieneusi in pet dogs in Yunnan Province, China

“…In China, genotypes D and EbpC have been detected in humans and numerous wild, domestic, and companion animals from 26 provinces/municipalities [35]. Meanwhile, human E. bieneusi infection cases caused by genotypes D and EbpC were ranked first and second, respectively [13]. In addition, we also identified zoonotic genotypes Peru 8 (syn.…”

Genetic characterizations of Cryptosporidium spp. from children with or without diarrhea in Wenzhou, China: high probability of zoonotic transmission

“…Despite the scarcity of data on C. parvum gp60 subtypes in the population of China, the existing evidence has substantiated the ability of the IIdA19G1 subtype to infect human beings [ 13 , 34 ]. Moreover, this particular subtype has been identified in children and individuals afflicted with AIDS in China [ 13 – 15 , 35 ]. Simultaneously, it is observed that the prevalence of C. parvum infection in animals originating from China is extensive, with a notable abundance of gp60 subtypes.…”

Prevalence and Molecular Characterization of Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in Cattle in Heilongjiang Province, Northeast China

“…Cryptosporidium spp., Giardia duodenalis , and Enterocytozoon bieneusi are among the most common diarrhea-causing pathogens with a global distribution in humans and livestock. These intestinal protozoans can lead to severe chronic diarrhea, malnutrition, and sometimes even death in immunocompromised or deficient hosts [ 1 ]. The (oo)cysts/spores produced by these protozoans are widely distributed in the environment after they are excreted with the feces of hosts.…”