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Bujila I, Troell K, Ögren J, Hansen A, Killander G, Agudelo L, Lebbad M, Beser J. Cryptosporidium species and subtypes identified in human domestic cases through the national microbiological surveillance programme in Sweden from 2018 to 2022. BMC Infect Dis 2024; 24:146. [PMID: 38291399 PMCID: PMC10826111 DOI: 10.1186/s12879-024-09049-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/23/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The intestinal protozoan parasite Cryptosporidium is an important cause of diarrheal disease worldwide. A national microbiological surveillance programme was implemented in Sweden in 2018 in order to increase knowledge of the molecular epidemiology of human cryptosporidiosis to better understand transmission patterns and potential zoonotic sources. This article summarises the results of the first five years of the surveillance programme. METHODS Cryptosporidium-positive faecal and DNA samples from domestically acquired infections were collected from clinical microbiological laboratories in Sweden. Species and subtype determination was performed using 60 kDa glycoprotein and/or small subunit ribosomal RNA gene analysis. RESULTS Between 2018 and 2022, 1654 samples were analysed and 11 different species were identified: C. parvum (n = 1412), C. mortiferum (n = 59), C. hominis (n = 56), C. erinacei (n = 11), C. cuniculus (n = 5), C. meleagridis (n = 3), C. equi (n = 2), C. ubiquitum (n = 2), and one each of C. canis, C. ditrichi and C. felis. Subtyping revealed seven subtype families of C. parvum (new subtype families IIy and IIz) and 69 different subtypes (11 new subtypes). The most common C. parvum subtypes were IIdA22G1c, IIdA24G1, IIdA15G2R1 and IIaA16G1R1b. For C. hominis, four different subtype families and nine different subtypes (two new subtypes) were identified. For additional species, two new subtype families (IIIk and VId) and nine new subtypes were identified. All successfully subtyped C. mortiferum cases were subtype XIVaA20G2T1, confirming previous findings in Sweden. Several outbreaks were identified of which the majority were foodborne and a few were due to direct contact with infected animals. CONCLUSION Infection with C. parvum is the leading cause of human cryptosporidiosis acquired in Sweden, where more than 90% of domestic cases are caused by this zoonotic species and only a small proportion of cases are due to infection with other species. The rodent-associated C. mortiferum is considered an emerging zoonotic species in Sweden and the number of domestically acquired human cases has surpassed that of infection with C. hominis. A high diversity of species and subtypes, as well as diversity within the same subtype, was detected. Also, cryptosporidiosis appears to affect adults to a great extent in Sweden.
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Affiliation(s)
- Ioana Bujila
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden.
| | - Karin Troell
- Department of Microbiology, National Veterinary Agency, Uppsala, Sweden
- Norwegian Veterinary Institute, Ås, Norway
| | - Jessica Ögren
- Division of Clinical Microbiology, Laboratory Medicine, Jönköping County, Jönköping, Sweden
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Anette Hansen
- Department of Communicable Disease Control and Health Protection, Unit of Zoonoses and Antibiotic Resistance, Public Health Agency of Sweden, Solna, Sweden
| | - Gustav Killander
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden
| | - Lady Agudelo
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden
| | - Marianne Lebbad
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden
| | - Jessica Beser
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden
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Toriro R, Pallett S, Woolley S, Bennett C, Hale I, Heylings J, Wilkins D, Connelly T, Muia K, Avery P, Stuart A, Morgan L, Davies M, Nevin W, Quantick O, Robinson G, Elwin K, Chalmers R, Burns D, Beeching N, Fletcher T, O’Shea M. Outbreak of Diarrhea Caused by a Novel Cryptosporidium hominis Subtype During British Military Training in Kenya. Open Forum Infect Dis 2024; 11:ofae001. [PMID: 38250201 PMCID: PMC10798851 DOI: 10.1093/ofid/ofae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Background We report clinical, epidemiological, and laboratory features of a large diarrhea outbreak caused by a novel Cryptosporidium hominis subtype during British military training in Kenya between February and April 2022. Methods Data were collated from diarrhea cases, and fecal samples were analyzed on site using the multiplex polymerase chain reaction (PCR) BioFire FilmArray. Water was tested using Colilert kits (IDEXX, UK). DNA was extracted from feces for molecular characterization of Cryptosporidium A135, Lib13, ssu rRNA, and gp60 genes. Results One hundred seventy-two of 1200 (14.3%) personnel at risk developed diarrhea over 69 days. One hundred six primary fecal samples were tested, and 63/106 (59.4%; 95% CI, 0.49%-0.69%) were positive for Cryptosporidium spp. Thirty-eight had Cryptosporidium spp. alone, and 25 had Cryptosporidium spp. with ≥1 other pathogen. A further 27/106 (25.5%; 95% CI, 0.18%-0.35%) had non-Cryptosporidium pathogens only, and 16/106 (15.1%; 95% CI, 0.09%-0.23%) were negative. C. hominis was detected in 58/63 (92.1%) Cryptosporidium spp.-positive primary samples, but the others were not genotypable. Twenty-seven C. hominis specimens were subtypable; 1 was gp60 subtype IeA11G3T3, and 26 were an unusual subtype, ImA13G1 (GenBank accession OP699729), supporting epidemiological evidence suggesting a point source outbreak from contaminated swimming water. Diarrhea persisted for a mean (SD) of 7.6 (4.6) days in Cryptosporidium spp. cases compared with 2.3 (0.9) days in non-Cryptosporidium cases (P = .001). Conclusions Real-time multiplex PCR fecal testing was vital in managing this large cryptosporidiosis outbreak. The etiology of a rare C. hominis gp60 subtype emphasizes the need for more genotypic surveillance to identify widening host and geographic ranges of novel C. hominis subtypes.
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Affiliation(s)
- Romeo Toriro
- Army Medical Services, Robertson House, Royal Military Academy Sandhurst, Camberley, Surrey, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Scott Pallett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Stephen Woolley
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Charlie Bennett
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Isra Hale
- 3 Medical Regiment, Fulwood Barracks, Preston, Lancashire, UK
| | - Jennifer Heylings
- 28 (C-CBRN) Engineer Regiment, Rock Barracks, Woodbridge, Suffolk, UK
| | - Daniel Wilkins
- 2nd Battalion the Rifles, Thiepval Barracks, Lisburn, UK
| | - Thomas Connelly
- 29 Public Health Division Medical Group, HQ 3 (UK) Division, Bulford, Wiltshire, UK
| | - Kennedy Muia
- British Army Training Unit (Kenya), Nanyuki, Kenya
| | - Patrick Avery
- Defence Primary Healthcare, Medical Centre, Nanyuki, Kenya
| | - Andrew Stuart
- Defence Primary Healthcare, Medical Centre, Nanyuki, Kenya
| | - Laura Morgan
- HQ 1st (UK) Division, Imphal Barracks, York, Yorkshire, UK
| | - Mark Davies
- British Army Training Unit (Kenya), Nanyuki, Kenya
| | - William Nevin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | | | - Guy Robinson
- Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Sketty, Swansea, Wales, UK
- Swansea University Medical School, Swansea, Wales, UK
| | - Kristin Elwin
- Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Sketty, Swansea, Wales, UK
| | - Rachel Chalmers
- Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Sketty, Swansea, Wales, UK
- Swansea University Medical School, Swansea, Wales, UK
| | - Daniel Burns
- Royal Centre for Defence Medicine, Birmingham, UK
| | - Nicholas Beeching
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Thomas Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
- Royal Centre for Defence Medicine, Birmingham, UK
| | - Matthew O’Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
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Potes-Morales C, Crespo-Ortiz MDP. Molecular diagnosis of intestinal protozoa in young adults and their pets in Colombia, South America. PLoS One 2023; 18:e0283824. [PMID: 37220135 DOI: 10.1371/journal.pone.0283824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/20/2023] [Indexed: 05/25/2023] Open
Abstract
Intestinal parasitic infections have been considered a relevant public health problem due to the increased incidence worldwide. In developing countries, diarrhea and gastrointestinal symptoms cause impaired work capacity in adults and delayed rate growth in children. Enteric infections of unknown etiology can often lead to misdiagnosis, increased transmission, and morbidity. The aim of this study was to determine the prevalence of intestinal parasites in a young adult population and their pets. Stool samples from 139 university students and 44 companion animals were subjected to microscopy diagnosis using wet mounts, concentration by zinc sulphate flotation and staining techniques (Kinyoun and trichrome stain). Molecular diagnosis of protozoa was also performed by conventional PCR. The mean age was 24 years, 54% individuals were female, 46% were men, and 66% had at least one pet. The overall prevalence for at least one parasite was 74.8% and the rate of polyparasitism was 37.5%. Eighty-three patients (59.7%) were positive for Blastocystis spp., followed by Cryptosporidium spp. 24.5%, Endolimax nana 13.6%, Entamoeba dispar/E. moshkovskii 7.8% and Giardia intestinalis 1.4%. Molecular diagnosis substantially improved Cryptosporidium spp. and Blastocystis spp. detection and allowed to distinguish E. histolytica from commensals in the Entamoeba complex. Student's pets were also examined for parasitism. Samples from 27 dogs, 15 cats, one rabbit and one hen were analyzed, and parasites were detected in 30 (68.2%) as follows: Cryptosporidium spp. (24) Giardia spp. (4), hookworm (3), Endolimax nana (2) and Toxoplasma gondii (1). Overall, university students showed high prevalence of parasitism and polyparasitism suggesting exposure to parasite infected animals and contaminated environments. Cryptosporidium spp. was the predominant pathogen in human and domestic animals, and it was only detected by PCR, pointing out the need for sensitive tests in diagnosis and surveillance. Control strategies to prevent the effects of parasitic infections in young population should consider pets as reservoirs and transmission source.
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Affiliation(s)
- Caterine Potes-Morales
- Department of Microbiology, Section of Parasitology, Universidad del Valle, Cali, Colombia
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Boks M, Lilja M, Widerström M, Karling P, Lindam A, Sjöström M. Persisting symptoms after Cryptosporidium hominis outbreak: a 10-year follow-up from Östersund, Sweden. Parasitol Res 2023:10.1007/s00436-023-07866-8. [PMID: 37199767 DOI: 10.1007/s00436-023-07866-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023]
Abstract
In late 2010, an outbreak of Cryptosporidium hominis affected 27,000 inhabitants (45%) of Östersund, Sweden. Previous research shows that abdomen and joint symptoms commonly persist up to 5 years post-infection. It is unknown whether Cryptosporidium is associated with sequelae for a longer duration, how persisting symptoms present over time, and whether sequelae are associated with prolonged infection. In this prospective cohort study, a randomly selected cohort in Östersund was surveyed about cryptosporidiosis symptoms in 2011 (response rate 69.2%). A case was defined as a respondent reporting new diarrhoea episodes during the outbreak. Follow-up questionnaires were sent after 5 and 10 years. Logistic regressions were used to examine associations between case status and symptoms reported after 10 years, with results presented as adjusted odds ratios (aOR) with 95% confidence intervals. Consistency of symptoms and associations with case status and number of days with symptoms during outbreak were analysed using X2 and Mann-Whitney U tests. The response rate after 10 years was 74% (n = 538). Case status was associated with reporting symptoms, with aOR of ~3 for abdominal symptoms and ~2 for joint symptoms. Cases were more likely to report consistent symptoms. Cases with consistent abdominal symptoms at follow-up reported 9.2 days with symptoms during the outbreak (SD 8.1), compared to 6.6 days (SD 6.1) for cases reporting varying or no symptoms (p = 0.003). We conclude that cryptosporidiosis was associated with an up to threefold risk for reporting symptoms 10 years post-infection. Consistent symptoms were associated with prolonged infection.
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Affiliation(s)
- Marije Boks
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
| | - Mikael Lilja
- Unit of Research, Education and Development - Östersund, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Pontus Karling
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anna Lindam
- Unit of Research, Education and Development - Östersund, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Malin Sjöström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Detection of unusual Cryptosporidium parvum subtype in patients with gastrointestinal cancer in Egypt. Parasitol Res 2023; 122:597-606. [PMID: 36539638 DOI: 10.1007/s00436-022-07761-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
While the importance of cryptosporidiosis in immunocompromised persons is well known, the prevalence of Cryptosporidium spp. in cancer patients is not clear. The current study was designed to assess the occurrence and genetic characteristics of Cryptosporidium spp. in patients with gastrointestinal (GI) cancer in Egypt. Stool samples were collected from 100 patients with GI malignancies and 20 healthy individuals without any GI manifestations (control group). They were screened by microscopy and the immunochromatographic RIDA®QUICK Cryptosporidium kit. Subtyping of Cryptosporidium spp. was conducted by sequence analysis of the glycoprotein 60 (gp60) locus. Sociodemographic, environmental data and information on GI symptoms, cancer types, and clinical treatment were obtained via a questionnaire. By microscopy and RIDA®QUICK, only 7% (7/100) of GI cancer patients were positive for Cryptosporidium, compared with 40% (40/100) by gp60 nPCR. No positives were obtained from the control group. Male sex (P = 0.02) and younger age (P = 0.004) were major Cryptosporidium risk factors for infection. The occurrence of Cryptosporidium was also significantly more frequent (P = 0.003) in watery stool samples. Sequence analysis of the gp60 amplicons (~ 400 bp) identified a novel C. parvum subtype with nine TCA repeats and eleven ACATCA repeats. A formal subtype designation could not be made due to the short sequence length. More studies should be conducted to verify the common occurrence of this unusual C. parvum subtype and establish its genetic identity.
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Ryan U, Hill K, Deere D. Review of generic screening level assumptions for quantitative microbial risk assessment (QMRA) for estimating public health risks from Australian drinking water sources contaminated with Cryptosporidium by recreational activities. WATER RESEARCH 2022; 220:118659. [PMID: 35635918 DOI: 10.1016/j.watres.2022.118659] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/26/2022] [Accepted: 05/21/2022] [Indexed: 06/15/2023]
Abstract
As urban communities continue to grow, demand for recreational access (including swimming) in drinking water sources have increased, yet relatively little is understood about the public health implications this poses for drinking water consumers. Preventative risk-based approaches to catchment management, informed by quantitative microbial risk assessment (QMRA), requires accurate input data to effectively model risks. A sound understanding of the knowledge gaps is also important to comprehend levels of uncertainty and help prioritise research needs. Cryptosporidium is one of the most important causes of waterborne outbreaks of gastroenteritis globally due to its resistance to chlorine. This review was undertaken by Water Research Australia to provide the most up-to-date information on current Cryptosporidium epidemiological data and underlying assumptions for exposure assessment, dose response and risk assessment for generic components of QMRA for Cryptosporidium and highlights priorities for common research. Key interim recommendations and guidelines for numerical values for relatively simple screening level QMRA modelling are provided to help support prospective studies of risks to drinking water consumers from Cryptosporidium due to body-contact recreation in source water. The review does not cover site-specific considerations, such as the levels of activity in the source water, the influence of dilution and inactivation in reservoirs, or water treatment. Although the focus is Australia, the recommendations and numerical values developed in this review, and the highlighted research priorities, are broadly applicable across all drinking source water sources that allow recreational activities.
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Affiliation(s)
- U Ryan
- Harry Butler Institute, Murdoch University, 90 South Street, Perth, Australia.
| | - Kelly Hill
- Water Research Australia, 250 Victoria Square, Adelaide, South Australia, Australia
| | - Dan Deere
- Water Futures, Sydney, Australia and Water Research Australia, Australia
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Molecular identification of Cryptosporidium species from domestic ruminants and wild reptiles in Cyprus. Parasitol Res 2022; 121:2193-2198. [PMID: 35488924 PMCID: PMC9055218 DOI: 10.1007/s00436-022-07527-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/18/2022] [Indexed: 11/14/2022]
Abstract
The presence of Cryptosporidium species in faecal samples of 32 sheep (Aries bovis), 10 goats (Capra circus), 1 blunt nose viper (Macrovipera lebetina lebetina), 3 Kotschy’s geckos (Mediodactylus kotschyi) and 6 wild stellagamas (Stellagama stellio cypriaca) in Cyprus were investigated by polymerase chain reaction (PCR) and sequencing. Cryptosporidium species were found in 9/32 sheep, 5/10 goats, 2/3 Kotschy’s geckos and 2/6 stellagamas faecal samples based on the sequencing of the 18S rRNA gene. Subtyping was achieved based on the sequencing of the gp60 gene. Four different species have been identified: Cryptosporidium parvum in goats (subtype IIaA15G1R1), C. xiaoi (subtypes XXIIId and XXIIIl) and C. ubiquitum (subtype XIIa) in sheep and C. varanii and C. parvum in lizards; the viper snake sample was negative. This is the first report on the molecular identification of a variety of Cryptosporidium species from domestic ruminants and wild reptiles in the Republic of Cyprus.
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Sjöström M, Arvidsson M, Söderström L, Lilja M, Lindh J, Widerström M. Outbreak of Cryptosporidium hominis in northern Sweden: persisting symptoms in a 5-year follow-up. Parasitol Res 2022; 121:2043-2049. [PMID: 35451705 PMCID: PMC9192462 DOI: 10.1007/s00436-022-07524-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/13/2022] [Indexed: 11/28/2022]
Abstract
In 2010-2011, a waterborne outbreak of the parasite, Cryptosporidium hominis, affected approximately 27,000 inhabitants in the city of Östersund, Sweden. Previous research suggested that post-infectious symptoms, such as gastrointestinal symptoms and joint pain, could persist for up to 2 years after the initial infection. In this study, we investigated whether the parasite caused post-infectious sequelae for up to 5 years after the outbreak. Prospective cohort study. A randomly selected cohort of individuals residing in Östersund at the time of the outbreak was sent a postal questionnaire in 2011. Responders were sent a follow-up questionnaire in 2016 and completed items on whether they experienced a list of symptoms. We examined whether outbreak cases were more likely than non-cases to report post-infectious symptoms 5 years later. We analysed data using logistic regression and calculated odds ratios with 95% confidence intervals. The analysis included 626 individuals. Among the 262 individuals infected during the outbreak, 56.5% reported symptoms at follow-up. Compared to non-cases, outbreak cases were more likely to report watery diarrhoea, diarrhoea, swollen joints, abdominal pain, bloating, joint discomfort, acid indigestion, alternating bowel habits, joint pain, ocular pain, nausea, and fatigue at the follow-up, after adjusting for age and sex. Our findings suggested that cryptosporidiosis was mainly associated with gastrointestinal- and joint-related post-infectious symptoms for up to 5 years after the infection.
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Affiliation(s)
- Malin Sjöström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
| | - M Arvidsson
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - L Söderström
- Unit of Research, Education and Development-Östersund Hospital, Östersund, Sweden
| | - M Lilja
- Department of Public Health and Clinical Medicine, Unit of Research, Education, and Development, Östersund Hospital, Umeå University, Umeå, Sweden
| | - J Lindh
- Department of Cell and Molecular Biology, BMC, Uppsala University, Uppsala, Sweden
| | - M Widerström
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
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Hoque S, Mavrides DE, Pinto P, Costas S, Begum N, Azevedo-Ribeiro C, Liapi M, Kváč M, Malas S, Gentekaki E, Tsaousis AD. High Occurrence of Zoonotic Subtypes of Cryptosporidiumparvum in Cypriot Dairy Farms. Microorganisms 2022; 10:microorganisms10030531. [PMID: 35336110 PMCID: PMC8951114 DOI: 10.3390/microorganisms10030531] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 12/04/2022] Open
Abstract
Cryptosporidium parvum is one of the major causes of neonatal calf diarrhoea resulting in reduced farm productivity and compromised animal welfare worldwide. Livestock act as a major reservoir of this parasite, which can be transmitted to humans directly and/or indirectly, posing a public health risk. Research reports on the prevalence of Cryptosporidium in ruminants from east Mediterranean countries, including Cyprus, are limited. This study is the first to explore the occurrence of Cryptosporidium spp. in cattle up to 24 months old on the island of Cyprus. A total of 242 faecal samples were collected from 10 dairy cattle farms in Cyprus, all of which were screened for Cryptosporidium spp. using nested-PCR amplification targeting the small subunit of the ribosomal RNA (18S rRNA) gene. The 60 kDa glycoprotein (gp60) gene was also sequenced for the samples identified as Cryptosporidium parvum-positive to determine the subtypes present. The occurrence of Cryptosporidium was 43.8% (106/242) with at least one positive isolate in each farm sampled. Cryptosporidium bovis, Cryptosporidium ryanae and C. parvum were the only species identified, while the prevalence per farm ranged from 20–64%. Amongst these, the latter was the predominant species, representing 51.8% of all positive samples, followed by C. bovis (21.7%) and C. ryanae (31.1%). Five C. parvum subtypes were identified, four of which are zoonotic—IIaA14G1R1, IIaA15G1R1, IIaA15G2R1 and IIaA18G2R1. IIaA14G1R1 was the most abundant, representing 48.2% of all C. parvum positive samples, and was also the most widespread. This is the first report of zoonotic subtypes of C. parvum circulating in Cyprus. These results highlight the need for further research into the parasite focusing on its diversity, prevalence, host range and transmission dynamics on the island.
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Affiliation(s)
- Sumaiya Hoque
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK; (S.H.); (P.P.); (S.C.); (N.B.); (C.A.-R.)
| | - Daphne E. Mavrides
- Department of Basic Sciences, University of Nicosia Medical School, Nicosia 2408, Cyprus; (D.E.M.); (S.M.)
| | - Pedro Pinto
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK; (S.H.); (P.P.); (S.C.); (N.B.); (C.A.-R.)
| | - Silvia Costas
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK; (S.H.); (P.P.); (S.C.); (N.B.); (C.A.-R.)
| | - Nisa Begum
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK; (S.H.); (P.P.); (S.C.); (N.B.); (C.A.-R.)
| | - Claudia Azevedo-Ribeiro
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK; (S.H.); (P.P.); (S.C.); (N.B.); (C.A.-R.)
| | - Maria Liapi
- Veterinary Services of Cyprus, Nicosia 1417, Cyprus;
| | - Martin Kváč
- Biology Centre CAS, Institute of Parasitology, Czech Academy of Sciences, 370 05 České Budějovice, Czech Republic;
- Faculty of Agriculture, University of South Bohemia, 370 05 České Budějovice, Czech Republic
| | - Stavros Malas
- Department of Basic Sciences, University of Nicosia Medical School, Nicosia 2408, Cyprus; (D.E.M.); (S.M.)
| | - Eleni Gentekaki
- School of Science, Mae Fah Luang University, Chiang Rai 57100, Thailand;
- Gut Microbiome Research Group, Mae Fah Luang University, Chiang Rai 57100, Thailand
| | - Anastasios D. Tsaousis
- Laboratory of Molecular and Evolutionary Parasitology, RAPID Group, School of Biosciences, University of Kent, Canterbury CT2 7NJ, UK; (S.H.); (P.P.); (S.C.); (N.B.); (C.A.-R.)
- Department of Basic Sciences, University of Nicosia Medical School, Nicosia 2408, Cyprus; (D.E.M.); (S.M.)
- Correspondence: or
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Ryan U, Zahedi A, Feng Y, Xiao L. An Update on Zoonotic Cryptosporidium Species and Genotypes in Humans. Animals (Basel) 2021; 11:3307. [PMID: 34828043 PMCID: PMC8614385 DOI: 10.3390/ani11113307] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022] Open
Abstract
The enteric parasite, Cryptosporidium is a major cause of diarrhoeal illness in humans and animals worldwide. No effective therapeutics or vaccines are available and therefore control is dependent on understanding transmission dynamics. The development of molecular detection and typing tools has resulted in the identification of a large number of cryptic species and genotypes and facilitated our understanding of their potential for zoonotic transmission. Of the 44 recognised Cryptosporidium species and >120 genotypes, 19 species, and four genotypes have been reported in humans with C. hominis, C. parvum, C. meleagridis, C. canis and C. felis being the most prevalent. The development of typing tools that are still lacking some zoonotic species and genotypes and more extensive molecular epidemiological studies in countries where the potential for transmission is highest are required to further our understanding of this important zoonotic pathogen. Similarly, whole-genome sequencing (WGS) and amplicon next-generation sequencing (NGS) are important for more accurately tracking transmission and understanding the mechanisms behind host specificity.
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Affiliation(s)
- Una Ryan
- Harry Butler Institute, Murdoch University, Perth, WA 6152, Australia;
| | - Alireza Zahedi
- Harry Butler Institute, Murdoch University, Perth, WA 6152, Australia;
| | - Yaoyu Feng
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China; (Y.F.); (L.X.)
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou 510642, China
| | - Lihua Xiao
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China; (Y.F.); (L.X.)
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou 510642, China
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Yin YL, Yang X, Zhao GH. Response to comments on our article (Yin YL et al., Parasit Vectors, 10.1186/s13071-021-04739-w) by Yuqing Wang and colleagues. Parasit Vectors 2021; 14:484. [PMID: 34548103 PMCID: PMC8456634 DOI: 10.1186/s13071-021-04996-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/08/2021] [Indexed: 11/24/2022] Open
Abstract
This letter responds to comments on our article (Yin YL et al., Parasit Vectors, 10.1186/s13071-021-04739-w) by Yuqing Wang and colleagues, who wrote a letter entitled "Microarray analysis of circular RNAs in HCT-8 cells infected with Cryptosporidium parvum" and discussed statistical procedures for microarray analysis during C. parvum infection. To further confirm our data, in this letter, a common R package for analyses of differentially expressed genes, namely DESeq2, with Benjamini-Hochberg correction, was used to analyze our microarray data and identified 26 significantly differentially expressed circRNAs using adjusted P value < 0.05 and | Log2 (fold change [FC]) | ≥ 1.0, including our circRNA ciRS-7 of interest. Therefore, the protocol for selecting circRNAs of interest for further study in our article is acceptable and did not affect the subsequent scientific findings in our article.
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Affiliation(s)
- Yan-Ling Yin
- Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Xin Yang
- Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Guang-Hui Zhao
- Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, China
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Opportunities and Challenges in Developing a Cryptosporidium Controlled Human Infection Model for Testing Antiparasitic Agents. ACS Infect Dis 2021; 7:959-968. [PMID: 33822577 PMCID: PMC8154424 DOI: 10.1021/acsinfecdis.1c00057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cryptosporidiosis is a leading cause of moderate-to-severe diarrhea in low- and middle-income countries, responsible for high mortality in children younger than two years of age, and it is also strongly associated with childhood malnutrition and growth stunting. There is no vaccine for cryptosporidiosis and existing therapeutic options are suboptimal to prevent morbidity and mortality in young children. Recently, novel therapeutic agents have been discovered through high-throughput phenotypic and target-based screening strategies, repurposing malaria hits, etc., and these agents have a promising preclinical in vitro and in vivo anti-Cryptosporidium efficacy. One key step in bringing safe and effective new therapies to young vulnerable children is the establishment of some prospect of direct benefit before initiating pediatric clinical studies. A Cryptosporidium controlled human infection model (CHIM) in healthy adult volunteers can be a robust clinical proof of concept model for evaluating novel therapeutics. CHIM could potentially accelerate the development path to pediatric studies by establishing the safety of a proposed pediatric dosing regimen and documenting preliminary efficacy in adults. We present, here, perspectives regarding the opportunities and perceived challenges with the Cryptosporidium human challenge model.
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Small ruminants and zoonotic cryptosporidiosis. Parasitol Res 2021; 120:4189-4198. [PMID: 33712929 DOI: 10.1007/s00436-021-07116-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/04/2021] [Indexed: 12/19/2022]
Abstract
Sheep and goats are commonly infected with three Cryptosporidium species, including Cryptosporidium parvum, Cryptosporidium ubiquitum, and Cryptosporidium xiaoi, which differ from each in prevalence, geographic distribution, and public health importance. While C. parvum appears to be a dominant species in small ruminants in European countries, its occurrence in most African, Asian, and American countries appear to be limited. As a result, zoonotic infections due to contact with lambs and goat kids are common in European countries, leading to frequent reports of outbreaks of cryptosporidiosis on petting farms. In contrast, C. xiaoi is the dominant species elsewhere, and mostly does not infect humans. While C. ubiquitum is another zoonotic species, it occurs in sheep and goats at much lower frequency. Host adaptation appears to be present in both C. parvum and C. ubiquitum, consisting of several subtype families with different host preference. The host-adapted nature of C. parvum and C. ubiquitum has allowed the use of subtyping tools in tracking infection sources. This has led to the identification of geographic differences in the importance of small ruminants in epidemiology of human cryptosporidiosis. These tools have also been used effectively in linking zoonotic transmission of C. parvum between outbreak cases and the suspected animals. Further studies should be directly elucidating the reasons for differences in the distribution and public health importance of major Cryptosporidium species in sheep and goats.
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Madbouly N, El Amir A, Abdel Kader A, Rabee I, Farid A. The immunomodulatory activity of secnidazole-nitazoxanide in a murine cryptosporidiosis model. J Med Microbiol 2021; 70. [PMID: 33625354 DOI: 10.1099/jmm.0.001327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Cryptosporidium parvum causes intestinal parasitic infections affecting both immunosuppressed and immunocompetent individuals.Gap statement. Given the absence of effective treatments for cryptosporidiosis, especially in immunodeficient patients, the present study was designed to assess the therapeutic efficacy of secnidazole (SEC) and its combination with nitazoxanide (NTZ) in comparison to single NTZ treatment in relation to the immune status of a murine model of C. parvum infection.Methodology. The infected groups were administered NTZ, SEC or NTZ-SEC for three or five successive doses. At days 10 and 12 post-infection (p.i.), the mice were sacrificed, and the efficacy of the applied drugs was evaluated by comparing the histopathological alterations in ileum and measuring the T helper Th1 (interferon gamma; IFN-γ), Th2 [interleukin (IL)-4 and IL-10] and Th17 (IL-17) cytokine profiles in serum.Results. The NTZ-SEC combination recorded the maximal reduction of C. parvum oocyst shedding, endogenous stages count and intestinal histopathology, regardless of the immune status of the infected mice. The efficacy of NTZ-SEC was dependent on the period of administration, as the 5 day-based treatment protocol was also more effective than the 3 day-based one in terms of immunocompetence and immunosuppression. The present treatment schedule induced an immunomodulatory effect from SEC that developed a protective immune response against C. parvum infection with reduced production of serum IL-17, IFN-γ, IL-4 and IL-10.Conclusions. Application of NTZ-SEC combined therapy may be useful in treatment of C. parvum, especially in cases involving immunosuppression.
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Affiliation(s)
- Neveen Madbouly
- Department of Zoology, Faculty of Science, Cairo University, Giza, Egypt
| | - Azza El Amir
- Department of Zoology, Faculty of Science, Cairo University, Giza, Egypt
| | - Asmaa Abdel Kader
- Department of Parasitology, Theodore Bilharz Research Institute, Giza, Egypt
| | - Ibraheem Rabee
- Department of Parasitology, Theodore Bilharz Research Institute, Giza, Egypt
| | - Alyaa Farid
- Department of Zoology, Faculty of Science, Cairo University, Giza, Egypt
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Identification of novel anti-cryptosporidial inhibitors through a combined approach of pharmacophore modeling, virtual screening, and molecular docking. INFORMATICS IN MEDICINE UNLOCKED 2021. [DOI: 10.1016/j.imu.2021.100583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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