1
|
Barrera JP, Carmena D, Rodríguez E, Checa R, López AM, Fidalgo LE, Gálvez R, Marino V, Fuentes I, Miró G, Montoya A. The red fox (Vulpes vulpes) as a potential natural reservoir of human cryptosporidiosis by Cryptosporidium hominis in Northwest Spain. Transbound Emerg Dis 2020; 67:2172-2182. [PMID: 32302466 DOI: 10.1111/tbed.13569] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 12/31/2022]
Abstract
Giardia duodenalis and Cryptosporidium spp. are ubiquitous intestinal protozoa that parasitize domestic and wild animals, as well as human beings. Due to their zoonotic potential, the objective of the present study was to determine the presence of these pathogens in the fox population (Vulpes vulpes) located in Northwest Spain. A total of 197 faecal samples from legally hunted foxes were collected in the autonomous region of Galicia. The presence of G. duodenalis and Cryptosporidium spp. was investigated by PCR-based methods amplifying the small subunit ribosomal RNA (ssu rRNA) gene of the parasites. Attempts to genotype obtained positive samples were subsequently conducted at the glutamate dehydrogenase (gdh) and β-giardin (bg) genes of G. duodenalis, and the 60 kDa glycoprotein (gp60) gene of Cryptosporidium. Giardia duodenalis and Cryptosporidium spp. were identified in 19 (9.6%) and 12 (6.1%) of the investigated samples, respectively. However, five Cryptosporidium species were detected at the ssu rRNA locus: C. hominis (33.4%, 4/12), C. canis (25.0%, 3/12), C. parvum (16.7%, 2/12), C. ubiquitum (8.3%, 1/12) and C. suis (8.3%, 1/12). An additional Cryptosporidium-positive sample was identified at the genus level only. Typing and subtyping of Giardia- and Cryptosporidium-positive samples were unsuccessful. The detection of C. hominis in wild foxes indicates the probable overlapping of sylvatic and domestic cycles of this parasite in rural settings. Besides, this finding raises the question of whether red foxes may act as natural reservoirs of C. hominis. The detection of C. parvum and C. suis is suggestive of active transmission events between farm and wild animals, opening up the possibility of transmission to human beings.
Collapse
Affiliation(s)
- Juan P Barrera
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - David Carmena
- Laboratorio de Referencia e Investigación en Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Elena Rodríguez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Rocío Checa
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana M López
- Departamento de Ciencias Clínicas Veterinarias, Facultad de Veterinaria, Universidad de Lugo, Lugo, Spain
| | - Luis E Fidalgo
- Departamento de Ciencias Clínicas Veterinarias, Facultad de Veterinaria, Universidad de Lugo, Lugo, Spain
| | - Rosa Gálvez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Valentina Marino
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Isabel Fuentes
- Laboratorio de Referencia e Investigación en Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Guadalupe Miró
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Montoya
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
2
|
King P, Tyler KM, Hunter PR. Anthroponotic transmission of Cryptosporidium parvum predominates in countries with poorer sanitation: a systematic review and meta-analysis. Parasit Vectors 2019; 12:16. [PMID: 30621759 PMCID: PMC6323761 DOI: 10.1186/s13071-018-3263-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022] Open
Abstract
Background Globally cryptosporidiosis is one of the commonest causes of mortality in children under 24 months old and may be associated with important longterm health effects. Whilst most strains of Cryptosporidium parvum are zoonotic, C. parvum IIc is almost certainly anthroponotic. The global distribution of this potentially important emerging infection is not clear. Methods We conducted a systematic review of papers identifying the subtype distribution of C. parvum infections globally. We searched PubMed and Scopus using the following key terms Cryptospor* AND parvum AND (genotyp* OR subtyp* OR gp60). Studies were eligible for inclusion if they had found C. parvum within their human study population and had subtyped some or all of these samples using standard gp60 subtyping. Pooled analyses of the proportion of strains being of the IIc subtype were determined using StatsDirect. Meta-regression analyses were run to determine any association between the relative prevalence of IIc and Gross Domestic Product, proportion of the population with access to improved drinking water and improved sanitation. Results From an initial 843 studies, 85 were included in further analysis. Cryptosporidium parvum IIc was found in 43 of these 85 studies. Across all studies the pooled estimate of relative prevalence of IIc was 19.0% (95% CI: 12.9–25.9%), but there was substantial heterogeneity. In a meta-regression analysis, the relative proportion of all C. parvum infections being IIc decreased as the percentage of the population with access to improved sanitation increased and was some 3.4 times higher in those studies focussing on HIV-positive indivduals. Conclusions The anthroponotic C. parvum IIc predominates primarily in lower-income countries with poor sanitation and in HIV-positive individuals. Given the apparent enhanced post-infectious virulence of the other main anthroponotic species of Cryptosporidium (C. hominis), it is important to learn about the impact of this subtype on human health. Electronic supplementary material The online version of this article (10.1186/s13071-018-3263-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Philippa King
- The Norwich Medical School, University of East Anglia, Norwich, UK
| | - Kevin M Tyler
- The Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Paul R Hunter
- The Norwich Medical School, University of East Anglia, Norwich, UK. .,Department of Environmental Health, Tshwane University of Technology, Pretoria, South Africa.
| |
Collapse
|
3
|
Millán R, Köster PC, Fuentes I, Carmena D. Cryptosporidium hominis IbA12G3: First report of a rare sub-genotype in Spain. Enferm Infecc Microbiol Clin 2018; 37:279-281. [PMID: 29861275 DOI: 10.1016/j.eimc.2018.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 04/17/2018] [Accepted: 04/19/2018] [Indexed: 10/14/2022]
Affiliation(s)
- Rosario Millán
- Microbiology and Clinical Parasitology Service, University Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Madrid, Spain
| | - Isabel Fuentes
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Madrid, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Madrid, Spain.
| |
Collapse
|
4
|
de Lucio A, Merino FJ, Martínez-Ruiz R, Bailo B, Aguilera M, Fuentes I, Carmena D. Molecular genotyping and sub-genotyping of Cryptosporidium spp. isolates from symptomatic individuals attending two major public hospitals in Madrid, Spain. INFECTION GENETICS AND EVOLUTION 2015; 37:49-56. [PMID: 26518912 DOI: 10.1016/j.meegid.2015.10.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 10/09/2015] [Accepted: 10/26/2015] [Indexed: 02/04/2023]
Abstract
Infections by members of the protozoan genus Cryptosporidium are among the most common causes of human gastrointestinal illness worldwide. In Spain cryptosporidiosis is not a compulsory notifiable disease, so the actual burden of the infection in both clinical and general populations remains largely unknown. We present here data on the diversity and frequency of the Cryptosporidium species and sub-genotypes identified in symptomatic individuals seeking medical care in two major hospitals in Madrid, Spain, between December 2013 and January 2015. Initial detection of the parasite was conducted on a total of 122 stool samples collected from 120 patients by microscopy with modified Ziehl-Neelsen and/or immunochromatographic tests. We used immunofluorescence, PCR-based methods and sequence analyses of the 60-kDa (GP60) glycoprotein and the small subunit ribosomal RNA (SSU rRNA) genes for confirmatory purposes and to characterize Cryptosporidium isolates. A total of 110 patients were confirmed with cryptosporidiosis. Overall, 101 isolates were successfully sub-genotyped at the GP60 locus, and an additional seven at the SSU rRNA locus. The analyses of all amplicons defined 10 distinct sequence types representing the GP60 family sub-genotypes IbA10G2 (78.7%), IeA11G3T3 (3.7%) of C. hominis, and the GP60 family sub-types IIaA15G2R1 (5.6%), IIaA18G6R1 (0.9%), IIcA5G3a (0.9%), IIdA18G1 (0.9%), IIdA19G1 (0.9%), IIdA21G1 (0.9%), and IIdA22G1 (0.9%) of C. parvum. A single isolate was assigned to C. felis (0.9%), two C. parvum isolates (1.9%) could not be characterized at the sub-genotype level and an additional four isolates (3.7%) were not typable. These results strongly suggest that transmission of cryptosporidiosis is mostly anthroponotic in origin in the clinical sample under study. We expect that our molecular epidemiological data will make a significant contribution to unravel the actual epidemiological situation of cryptosporidiosis in Spain, providing health care and policy makers with solid baseline information to unavoidably improve the national surveillance system and allocate additional resources to research, diagnosis, and treatment of cryptosporidiosis.
Collapse
Affiliation(s)
- Aida de Lucio
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Majadahonda, Madrid, Spain
| | - Francisco J Merino
- Microbiology Service, University Hospital Severo Ochoa, Leganés, Madrid, Spain
| | - Rocío Martínez-Ruiz
- Microbiology and Clinical Parasitology Service, University Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Begoña Bailo
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Majadahonda, Madrid, Spain
| | - María Aguilera
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Majadahonda, Madrid, Spain
| | - Isabel Fuentes
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Majadahonda, Madrid, Spain
| | - David Carmena
- Parasitology Service, National Centre for Microbiology, Carlos III Health Institute, Majadahonda, Madrid, Spain.
| |
Collapse
|
5
|
Segura R, Prim N, Montemayor M, Valls ME, Muñoz C. Predominant virulent IbA10G2 subtype of Cryptosporidium hominis in human isolates in Barcelona: a five-year study. PLoS One 2015; 10:e0121753. [PMID: 25816024 PMCID: PMC4376526 DOI: 10.1371/journal.pone.0121753] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 02/04/2015] [Indexed: 11/21/2022] Open
Abstract
Background Cryptosporidium infection is a worldwide cause of diarrheal disease. To gain insight into the epidemiology of the infection in a certain geographic area, molecular methods are needed to determine the species/genotypes and subtypes. Methodology/Principal Findings From 2004 to 2009, 161 cryptosporidiosis cases were detected in two hospitals in Barcelona. Diagnosis was performed by microscopic observation of oocysts in stool specimens following modified Ziehl-Neelsen staining. Most cases (82%) occurred in children. The number of cases increased in summer and autumn. Molecular characterization of Cryptosporidium was performed in 69 specimens, and C. hominis and C. parvum were identified in 88.4% and 10.1% of the cases, respectively. C. meleagridis was detected in one specimen. Subtyping based on the gp60 polymorphism showed six subtypes, four C. hominis and two C. parvum. Subtype IbA10G2 was the most prevalent subtype corresponding to 90% of all C. hominis isolates. This is the first report on the distribution of specific Cryptosporidium subtypes from humans in Spain. Conclusions/Significance In our geographic area, the anthroponotic behavior of C. hominis, the lower infective dose, and the higher virulence of certain subtypes may contribute to the high incidence of human cryptosporidiosis caused by the IbA10G2 subtype. Further studies should include populations with asymptomatic shedding of the parasite.
Collapse
Affiliation(s)
- Remedios Segura
- Servei de Microbiologia, Hospital de La Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - Núria Prim
- Servei de Microbiologia, Hospital de La Santa Creu i Sant Pau, 08041, Barcelona, Spain
- * E-mail:
| | - Michel Montemayor
- Servei de Microbiologia, Hospital de La Santa Creu i Sant Pau, 08041, Barcelona, Spain
| | - María Eugenia Valls
- Servei de Microbiologia, Hospital Clínic de Barcelona, 08036, Barcelona, Spain
| | - Carme Muñoz
- Servei de Microbiologia, Hospital de La Santa Creu i Sant Pau, 08041, Barcelona, Spain
- Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
6
|
Goñi P, Almagro-Nievas D, Cieloszyk J, Lóbez S, Navarro-Marí JM, Gutiérrez-Fernández J. Cryptosporidiosis outbreak in a child day-care center caused by an unusual Cryptosporidium hominis subtype. Enferm Infecc Microbiol Clin 2015; 33:651-5. [PMID: 25770777 DOI: 10.1016/j.eimc.2015.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This work describes the genetic characterization of Cryptosporidium and Giardia involved in an outbreak in a nursery school in Granada, Spain, that affected seven children under the age of 4. METHODS Nucleic acids were extracted from the seven stool samples positive to Cryptosporidium or Giardia by microscopy and/or immunochromatography. The species and subtypes of Cryptosporidium were identified by PCR-RFLP and PCR of the SSUrRNA and gp60 genes, respectively. The assemblages of Giardia duodenalis isolates were characterized by PCR of the tpi gene. PCR products were sequenced and analyzed. RESULTS All of the isolates were positive for Cryptosporidium hominis. Five of them belonged to subtype IaA11R2, one to subtype IbA10G2R2, and the other could not be identified. Three of these samples were positive for G. duodenalis by PCR, two belonging to the assemblage A, and the other one to assemblage B. DISCUSSION This is the first report of Cryptosporidium hominis subtype IaA11R2 as a cause of an outbreak in Europe where subtype IbA10G2R2 is the most frequently identified. In the case of Giardia, an outbreak could not be confirmed because of the low number of positive samples and the low genetic variability of the amplified fragments for assemblage A of tpi gene. CONCLUSIONS A new subtype, of Cryptosporidium hominis named IaA11R2, has been described as a cause of an outbreak in a nursery school in Granada, Spain. However an outbreak of giardiasis could not be confirmed.
Collapse
Affiliation(s)
- Pilar Goñi
- Area of Parasitology, Department of Microbiology, Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, C/ Domingo Miral s/n, Zaragoza, Spain.
| | - Diego Almagro-Nievas
- Metropolitan District of Granada's Epidemiology and Programs Unit, C/ Gustavo Dore, no. 3, Bajo, Granada, Spain
| | - Joanna Cieloszyk
- Area of Parasitology, Department of Microbiology, Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, C/ Domingo Miral s/n, Zaragoza, Spain
| | - Silvia Lóbez
- Area of Parasitology, Department of Microbiology, Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, C/ Domingo Miral s/n, Zaragoza, Spain
| | | | - José Gutiérrez-Fernández
- Department of Microbiology, University Hospital Virgen de las Nieves, Granada, Spain; Department of Microbiology, Faculty of Medicine, University of Granada, Avenida de Madrid, s/n, Granada, Spain
| |
Collapse
|
7
|
Aetiology and epidemiology of human cryptosporidiosis cases in Galicia (NW Spain), 2000–2008. Epidemiol Infect 2015; 143:3022-35. [DOI: 10.1017/s0950268815000163] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYCryptosporidiuminfects millions of people worldwide causing acute gastroenteritis, but despite its remarkable epidemiological and economic impact, information on the epidemiological trends of human cryptosporidiosis is still scarce in most countries. Here we investigate a panel of 486 cases collected in Galicia (NW Iberian Peninsula) between 2000 and 2008, which sheds new light on the epidemiology in this region of the South Atlantic European façade. Incidence rates in Galicia are one order of magnitude higher than those reported in other regions of Spain, suggesting that this parasite remains largely underdiagnosed in this country, and are also larger than those typical of other European countries with available data. Two species dominate our dataset,Cryptosporidium hominis(65%) andC. parvum(34%). The sex ratio of patients infected by either species was 0·5, butC. hominiswas significantly more common in younger males.C. parvuminfections were more acute and required more specialized medical attention, which suggests a differential adaptation of each species to human hosts. The parasites display strong seasonal and geographical variation.C. parvumincidence peaked during summer and was mainly detected in rural areas whileC. hominisinfections were more frequent in autumn and exhibited a more even geographical distribution. Such differences probably reflect their distinct sources of infection – C. parvumis mainly zoonotic andC. hominisanthroponotic – and the effects of climatic variables, like temperature and rainfall.
Collapse
|
8
|
Ramo A, Quílez J, Del Cacho E, Sánchez-Acedo C. Optimization of a fragment size analysis tool for identification of Cryptosporidium species and Gp60 alleles infecting domestic ruminants. Vet Parasitol 2014; 205:466-71. [PMID: 25224787 DOI: 10.1016/j.vetpar.2014.08.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/22/2014] [Accepted: 08/23/2014] [Indexed: 11/28/2022]
Abstract
A capillary electrophoresis (CE)-based DNA fragment analysis tool was optimized to identify in a single capillary the most common Cryptosporidium species and Cryptosporidium parvum GP60 alleles infecting domestic ruminants. For this purpose, a panel of genomic DNA samples including six Cryptosporidium species (C. parvum, C. bovis, C. ryanae, C. andersoni, C. ubiquitum, and C. hominis) and 18 C. parvum GP60 subtypes belonging to the subtype families IIa and IId was used. All these samples had been characterized previously by sequencing of SSU rRNA and GP60 genes. Isolates were re-amplified by PCR at these loci using sets of newly designed primers and subjected to CE. Fragment sizes were adjusted after comparison with sizes obtained by sequence analysis. The optimized CE-based approach provided fragments of different size for most Cryptosporidium species, but did not differentiate C. bovis and C. ryanae. Many of the GP60 subtypes (11/18) were also readily differentiated by CE, although overlapping in fragment sizes between IIa and IId subtypes was noticed. The CE-based tool was subsequently used to analyze Cryptosporidium isolates from naturally infected calves (n: 123) and lambs (n: 113) from farms in northern Spain. All isolates provided fragments typical of C. parvum. Fragment analysis at the GP60 locus differentiated a total of 10 alleles within isolates from calves (6 alleles) and lambs (8 alleles), with all but three alleles being host-associated. These findings support the validity of the optimized CE approach as a discriminatory and time- and cost-saving alternative to sequencing for identification of Cryptosporidium species and GP60 alleles in domestic ruminants.
Collapse
Affiliation(s)
- Ana Ramo
- Department of Animal Pathology, Faculty of Veterinary Sciences, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Joaquín Quílez
- Department of Animal Pathology, Faculty of Veterinary Sciences, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain.
| | - Emilio Del Cacho
- Department of Animal Pathology, Faculty of Veterinary Sciences, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Caridad Sánchez-Acedo
- Department of Animal Pathology, Faculty of Veterinary Sciences, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
| |
Collapse
|