Prevalence of Cryptosporidium species and subtypes in paediatric oncology and non-oncology patients with diarrhoea in Jordan

Abstract

Cryptosporidiosis is a protozoan parasitic disease which affects human and animals worldwide. In adult immunocompetent individuals, cryptosporidiosis usually results in acute and self-limited diarrhoea; however, it can cause life threatening diarrhoea in children and immunocompromised individuals. In the present study, we compared the prevalence of Cryptosporidium species and gp60 subtypes amongst paediatric oncology patients with diarrhoea (n=160) from King Hussein Medical Centre for Cancer in Jordan, and non-oncology paediatric patients with diarrhoea (n=137) from Al-Mafraq paediatric hospital. Microscopy results using modified acid fast staining identified a significantly (p≤0.05) higher prevalence of Cryptosporidium in paediatric oncology patients with diarrhoea (14.4% - 23/160), compared to non-oncology paediatric patients with diarrhoea only (5.1% - 7/137). With the exception of one sample, all microscopy-positive samples (n=29) and an additional 3/30 microscopy-negative controls were typed to species and subtype level at the 18S and gp60 loci, respectively. All Cryptosporidium positives were typed as C. parvum. Of the 22 typed Cryptosporidium positives from the paediatric oncology patients, 21 were subtyped as IIaA17G2R1 and one as IIaA16G2R1 C. parvum subtypes. The 7 typed positives from the paediatric patients from Al-Mafraq hospital were subtyped as IIaA17G2R1 (n=5) and IIaA16G2R1 (n=2). The 3 additional positives from the 30 microscopy negative control samples were subtyped as IIaA17G2R1. The high prevalence of the IIaA17G2R1 subtype, particularly amongst oncology patients, suggests that an outbreak of cryptosporidiosis may have been occurring in oncology patients during the collection period (April to December, 2016). New therapies for cryptosporidiosis in immunocompromised patients are urgently required.

Prevalence and Genotyping of Cryptosporidium parvum in Gastrointestinal Cancer Patients

“…Previously, IIaA15G2R1 (one case) and IIcA5G3 (two cases) subtypes in colorectal cancer, and IIaA16G2R1 (one case) and IIaA17G2R1 (22 cases) subtypes in paediatric oncology have been identified [5,23,32]. However, the subtypes responsible for C. parvum infections in other gastrointestinal cancers have not been determined yet.…”

“…The primer sequences and PCR conditions were used as previously described [22]. The positive samples were further characterized for the subtypes of C. parvum by nested PCR amplifying gp60 sequences as previously described [23]. DNA extracted from C. parvum (IIa A15G2R1) was used as positive control, while ddH2O served as negative control.…”

Cryptosporidiosis among Hemodialysis Patients in Jordan: First Preliminary Screening Surveillance

“…Cryptosporidiosis is usually self-resolving in immunocompetent individuals; however, it might lead to life-threatening complications in immunocompromised patients [2]. Cryptosporidiosis causes acute diarrhea with elevated morbidity and mortality in children, immunocompromised patients, such as AIDS patients, cancer patients and hemodialysis patients [3,[9][10][11].…”

“…Microscopy using acid-fast staining, with or without stool concentration, is the most widely used screening technique globally for the diagnosis of Cryptosporidium since it is cheap and accessible especially in rural settings and shows high sensitivity in comparison with other parasitological, immunological and even molecular techniques [2,10,12].…”

Natural killer cell activity irreversibly decreases after Cryptosporidium gastroenteritis in neonatal mice

“…The goal of the study was to investigate the postponed effects of neonatal Cryptosporidium gastroenteritis on C3HA mice innate immunity and growth. The interest to this problem was fuelled by the studies indicating that neonatal cryptosporidiosis may trigger hyperpolyploid cardiomyopathy, hepatopathy, and malignancy in rodents [32][33][34][35] and by the data confirming that the immune system impairment plays a key role in the development of these diseases. [36][37][38] Currently, the nature of the relationships between cryptosporidiosis and the immune system state of the infected animal remains poorly understood.…”