Neglected risk factors of childhood morbidity and mortality caused by Cryptosporidium infection

Molecular prevalence of Pneumocystis jirovecii and Cryptosporidium in patients with asthma

Asthma is characterized by chronic airway inflammation. In addition to allergens, microorganisms can affect the clinical course of asthma. It has been shown that some fungi play an important role in the progression of asthma. However, the effects of Pneumocystis jirovecii and Cryptosporidium spp., on the disease are little known. We investigated P. jirovecii and Cryptosporidium spp. in the sputum and stool sample of patients with asthma (n = 40) by microscopy and PCR compared to the healthy group (n = 40). P. jirovecii (12.5 %), and Cryptosporidium spp. (12.5 %) were detected in the sputum samples of only asthmatic patients (p = 0.029 and 0.029 respectively). However, Crpytosporidium spp. was detected equally in stool samples of both groups (p = 0.682). Our results indicate that P. jirovecii and Cryptosporidium spp. should be considered in patients with asthma and molecular screening of these neglected eukaryotes in respiratory tract samples may be beneficial in the clinical management of the disease.

Helminth infections and immunosenescence: The friend of my enemy

Age-associated alterations of the immune system, which known as "immunosenescence", is characterized by a decline in innate and adaptive immunity, which leading to increased susceptibility to age-associated diseases, such as infectious diseases, rheumatic disease and malignancies. On the other hand, helminth infections are among the most prevalent infections in older individuals, especially in the nursing homes. Most of helminth infections have minor clinical symptoms and usually causing chronic infections without treatment. Nevertheless, chronic helminthiasis alters immune responses somewhat similar to the immunosenescence. Some similarities also exist between helminth infections and immunosenescence: 1) both of them led to declining the immune responses; 2) undernutrition is a consequence of immunosenescence and helminthiasis; 3) vaccine efficacy declines in aging and individuals with helminth infections; 4) increase incidence and prevalence of infectious diseases in the elder individuals and patients with helminth infections; and 5) both of them promote tumorigenesis. Hence, it is probable that helminth infections in the elderly population can intensify the immunosenescence outcomes due to the synergistic immunoregulatory effects of each of them. It would be suggested that, diagnosis, treatment and prevention of helminth infections should be more considered in older individuals. Also, it would be suggested that helminths or their antigens can be used for investigation of immunosenescence because both of them possess some similarities in immune alterations. Taken together, this review offers new insights into the immunology of aging and helminth infections.

Prevalence and diversity of Cryptosporidium spp. in bamboo rats (Rhizomys sinensis) in South Central China

Cryptosporidium is one of the most prevalent zoonotic parasites and is responsible for the high burden of diarrheal disease across the globe. Rodents are globally overpopulated and are reservoirs for a variety of zoonotic pathogens. Bamboo rats are a common species of rodent that are bred for meat and wool in China. However, the genetic characterization of Cryptosporidium in bamboo rats in China is limited. The aim of this study was to determine the occurrence and genetic characterization of Cryptosporidium in bamboo rats from South Central China. From February2017to February 2018, 435 fecal samples were collected from bamboo rats in 13 farms located in 12 cities in South Central China. All fecal specimens were examined for Cryptosporidium by PCR, and through sequencing the partial small subunit of ribosomal DNA (SSU rRNA). C. parvum-positive samples were further subtyped through analysis of the 60-kDa glycoprotein (gp60) gene sequence. Meanwhile, all the new Cryptosporidium genotypes samples were selected for further sequence characterization at the 70-kDa heat shock protein (HSP70) gene and oocyst wall protein (COWP) gene as well as gp60 gene. Infection rates of 2.1% (9/435) were recorded for Cryptosporidium. Sequence analysis confirmed the presence of two Cryptosporidium species including C. parvum (n = 2), C. occultus (n = 1) and two new Cryptosporidium genotypes termed Cryptosporidium bamboo rat genotype I (n = 5) and Cryptosporidium bamboo rat genotype II (n = 1). Two subtypes of C. parvum were identified including IIdA15G1 and IIpA19 (one each).The discovery of zoonotic Cryptosporidium species/genotypes in bamboo rats suggests they have significant zoonotic potential and pose a threat to human health. The novel sequences discovered provide new insight into genotypic variations in Cryptosporidium in bamboo rats.

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This is the first report of the identification of Cryptosporidium in farmed bamboo rats in South Central China.

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2.1% (9/435) bamboo rats were PCR-positive for Cryptosporidium.

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Cryptosporidium parvum, C. occultus, Cryptosporidium bamboo rats I and II were identified.

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The possibility of transmission of Cryptosporidium between bamboo rats and humans was suggested.

Massive Cryptosporidium infections and chronic diarrhea in HIV-negative patients

Protozoa of the genus Cryptosporidium are common parasites of domestic and wild animals—mammals, birds, reptiles, and fishes. The invasive forms are thick-walled oocysts, which can be present in water supplies, on fruits, vegetables, or in the soil contaminated with feces. In this work, we describe three cases of middle-aged persons with massive Cryptosporidium hominis infection and chronic diarrhea with no immunological abnormalities and no history of previous travels to tropical countries. The lesions discovered during colonoscopy within the large intestine–cryptitis and the histopathological changes were related to massive cryptosporidiosis. All these statements indicate necessity of parasitological stool examination in cases with chronic diarrhea in which no etiological agents are detected, but not only in HIV positive individuals. Parasite’s eradication leads to symptom disappearance as well as improvement of histopathological mucosa alterations.

A retrospective molecular study of Cryptosporidium species and genotypes in HIV-infected patients from Thailand

Background

Opportunistic infections represent a serious health problem for HIV-infected people. Among enteric infections, cryptosporidiosis, a severe and life-threatening diarrheal disease, is of particular importance in low economic settings where access to anti-retroviral therapy is limited. Understanding transmission routes is crucial in establishing preventive measures, and requires the use of informative genotyping methods. In this study, we performed a retrospective analysis of Cryptosporidium species in 166 stool samples collected from 155 HIV-infected patients during 1999–2004 at the Siriraj Hospital in Bangkok, Thailand.

Results

Microscopic examination of stools identified 104 of the 155 patients as positive for Cryptosporidium. Other common pathogens identified were microsporidia, Isospora, Giardia, Strongyloides and Opisthorchis. All samples were tested by amplification of a fragment of the 18S rDNA locus, and sequencing showed the presence of Cryptosporidium hominis (n = 42), C. meleagridis (n = 20), C. canis (n = 12), C. felis (n = 7), C. suis (n = 6) and C. parvum (n = 5). Genotyping at the glycoprotein 60 (gp60) locus revealed substantial variability in isolates of C. hominis and C. meleagridis. Among C. hominis isolates, subtype IeA11G3T3 was the most prevalent, but allelic family Id was the more diverse with four subtypes described, two of which were identified for the first time. Among C. meleagridis isolates, seven subtypes, two of which were new, were found in the allelic family IIIb, along with new subtypes in allelic families IIIe and IIIg. In the four C. parvum isolates, subtype IIoA16G1, a rare subtype previously reported in a Swedish patient who had traveled to Thailand, was identified.

Conclusions

This study confirms the high susceptibility of HIV-infected individuals to infection with different Cryptosporidium species and subtypes, and further stresses the importance of surveillance for opportunistic intestinal protozoans.

Electronic supplementary material

The online version of this article (10.1186/s13071-019-3348-4) contains supplementary material, which is available to authorized users.