Persistent Occurrence of Cryptosporidium hominis and Giardia duodenalis Subtypes in a Welfare Institute

Abstract

Few data are available on the transmission dynamics of intestinal protozoa in children in welfare institutes. In this study, fecal specimens were collected from 396 children in a welfare institute in Shanghai, China during December 2011 (207 specimens), June 2012 (78 specimens), and September 2013 (111 specimens), and examined for Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi by PCR analysis of the small subunit rRNA, triosephosphate isomerase, and internal transcribed spacer genes, respectively. The Cryptosporidium hominis and G. duodenalis assemblage A identified were further subtyped by multilocus sequence typing. Altogether, Cryptosporidium was detected in 39 (9.8%) children, with infection rates of 11.6% (24/207), 9.0% (7/78), and 7.2% (8/111) in December 2011, June 2012, and September 2013, respectively. Infection rates were higher in children of 0–12 months (20.4% compared to 0–7.3% in other age groups, P = 0.0001) and those with diarrhea (17.9% compared to 7.7% in those with no diarrhea, P = 0.006). In contrast, G. duodenalis was detected in 161/396 (40.7%), with infection rates of 48.3% (100/207), 35.9% (28/78), and 29.7% (33/111) in December 2011, June 2012, and September 2013, respectively. There were no significant gender- or diarrhea-associated differences, but the G. duodenalis infection rate in children of 13–24 months (50%) was significantly higher than in the age groups of 0–12 months and > 48 months (29.8–36.5%, P = 0.021). Co-infection of Cryptosporidium and G. duodenalis was seen in 19 (4.8%) children, but no E. bieneusi infection was detected in this study. All Cryptosporidium-positive specimens belonged to the subtype IaA14R4 of C. hominis, while all G. duodenalis-positive specimens belonged to sub-assemblage AII. Both were the same subtypes in a previous outbreak of cryptosporidiosis and giardiasis in a hospital ward hosting children from the welfare institute. Results of the study indicate that there was a persistent occurrence of limited C. hominis and G. duodenalis subtypes in the small enclosed community, with differences in age distribution and association with diarrhea occurrence between cryptosporidiosis and giardiasis.

Genetic Diversity and Prevalence of Giardia duodenalis in Qatar

“…In addition, the sequence of isolates S15 and S52 was classified as a novel variant of subtype A2 since a single point mutation is sufficient for the description of a new subtype ( Sprong et al., 2009 ; Faria et al., 2017 ). These findings are consistent with previous reports that A2 subtype is the main subtype found in humans in many countries ( Wang et al., 2018 ; Wang et al., 2019 ). Host adaption at the genotype and subtype levels has been suggested ( Xiao and Feng, 2017 ); however, influence of assemblages and subtypes on clinical phenotypes are still controversial.…”

Prevalence and Genotype Distribution of Giardia duodenalis in Rabbits in Shandong Province, Eastern China

“…Moreover, two mixed G. duodenalis assemblages (assemblages A and E, assemblages B and E) were identified in rabbits, and the assemblage A was firstly detected in rabbits in China in the present study. e G. duodenalis assemblage A was also reported in humans [9,22].…”

“…e structure of eight assemblages is similar, but the genotypes are distinct [8]. Among assemblages A-H, both of the assemblages A and B are usually identified in various mammals, including humans [9], while the remaining assemblages mainly occur in the relatively specific groups of animals [10,11].…”

Giardia duodenalis in patients with diarrhea and various animals in northeastern China: prevalence and multilocus genetic characterization

“…In China, epidemiological investigations and case reports on G. duodenalis infection in humans are common, with approximately 28.5 million cases of G. duodenalis infection estimated in 2005 [ 26 ]. Since genotyping and subtyping tools were used in the identification of human cases of giardiasis in 2000, molecular epidemiological investigations of human G. duodenalis infection have been carried out in five provinces/municipalities, with three assemblages (A, B, and C) being identified [ 25 , 27 , 28 ]. However, the prevalence of G. duodenalis in diarrheal patients in China is unclear.…”