Prevalence and genetic characterization of Cryptosporidium, Enterocytozoon, Giardia and Cyclospora in diarrheal outpatients in china

Abstract

BackgroundCryptosporidium spp., Enterocytozoon spp., Giardia spp. and Cyclospora spp. are important intestinal protozoan parasites causing diarrhea in humans, livestocks and wildlife and have a significant impact on public health. No reports exist about simultaneous prevalence rates or genotyping data of these four parasites in outpatients from China.MethodsFecal specimens from 252 diarrhea patients in a pediatric clinic (n = 169) and an intestinal clinic (n = 83) of a hospital in Shanghai, China, were collected between October 2012 and March 2013. All samples were examined for the presence of the four parasites by using molecular methods.ResultsIn total, 76/252 (30.16%) patients were positive for at least one intestinal parasite, of which Cryptosporidium spp., Enterocytozoon bieneusi and Giardia intestinalis were detected by nested PCR in 34 (13.49%), 34 (13.49%) and 17 (6.75%) of the fecal specimens, respectively. Sequence analysis showed that all Cryptosporidium-positive specimens were C. andersoni and that most G. intestinalis- positive patients were infected by assemblage C, which is usually found in canids, while only one sample was from assemblage B. Eight patients were co-infected with Cryptosporidium spp. and Enterocytozoon, while one was co-infected with Cryptosporidium and Giardia.ConclusionsThe patients infected with Cryptosporidium and Enterocytozoon bieneusi had higher infection rates in winter than in spring in this area. Data indicated that C. andersoni is the fourth major Cryptosporidium species infecting humans in addition to C. hominis, C. parvum and C. meleagridis. Our study also revealed a short-term outbreak of cryptosporidiosis and microsporidiosis and sporadic cases of giardiasis that occurred among humans in Shanghai, China.

Identification and genotyping of Enterocytozoon bieneusi among human immunodeficiency virus infected patients

“…This is in accordance with previously published reports worldwide [2,20,[27][28][29][30]. Conversely, in a study from India, E. intestinalis has been detected as the most common cause of infection among HIV-infected patients with diarrhea [5].…”

Predominance of Cryptosporidium parvum genotype among diarrheic children from Egypt as an indicator for zoonotic transmission

“…In tropical countries, the highest prevalence of Cryptosporidium infection is usually associated with the rainy season, and water-borne transmission is considered a major route in these areas (Ajjampur et al 2010). On the other hand, Liu et al (2014) reported higher infection rates in winter than in spring in Shanghai, China.…”

Genetic characterization of Cryptosporidium in animal and human isolates from Jordan

“…C. andersoni is a gastric parasite which has been associated with reduced milk yield in dairy cattle and decreased weight gain in post weaned calves (Olson et al 2004) and is occasionally detected in humans (Leoni et al, 2006;Morse et al, 2007;Waldron et al, 2011;Agholi et al, 2013;Jiang et al, 2014;Liu et al, 2014). Two studies in China by the same research group have reported that C. andersoni was the most prevalent Cryptosporidium species detected in humans Liu et al, 2014). However, further research is required to better understand the zoonotic importance of C. andersoni and it has not been identified in humans in Jordan in the one previous genotyping study (Hijjawi et al, 2010).…”