Microsporidia as emerging pathogens and the implication for public health: A 10-year study on HIV-positive and -negative patients

• Published in: International journal for parasitology Vol. 42; no. 2; pp. 197 - 205
• Main Authors: Lobo, Maria Luísa, Xiao, Lihua, Antunes, Francisco, Matos, Olga
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.02.2012; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Air. Soil. Water. Waste. Feeding; Biological and medical sciences; Child; Child, Preschool; Diagnosis; DNA, Fungal - chemistry; DNA, Fungal - genetics; DNA, Ribosomal Spacer - chemistry; DNA, Ribosomal Spacer - genetics; Encephalitozoon cuniculi; Encephalitozoon intestinalis; Enterocytozoon bieneusi; Environment. Living conditions; Feces - microbiology; Female; Fundamental and applied biological sciences. Psychology; HIV Infections - complications; HIV seronegative populations; HIV-infected patients; Human immunodeficiency virus; Human-infecting Microsporidia; Humans; Infant; Life cycle. Host-agent relationship. Pathogenesis; Male; Medical sciences; Microsporidia; Microsporidia - classification; Microsporidia - isolation & purification; Microsporidiosis - epidemiology; Middle Aged; Molecular epidemiology; Polymerase Chain Reaction; Portugal - epidemiology; Prevalence; Protozoa; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk factors; Sequence Analysis, DNA; Sputum - microbiology; Urine - microbiology; Young Adult; Portugal; HIV seronegative populations; Molecular epidemiology; Diagnosis; Human-infecting Microsporidia; HIV-infected patients; Risk factors; Human; Parasite; Retroviridae; Lentivirus; Microsporidia; Fungi; Virus; Mycoparasite; Pathogenicity; Risk factor; Human immunodeficiency virus; Public health
• ISSN: 0020-7519; 1879-0135
• DOI: 10.1016/j.ijpara.2011.12.002

[Display omitted] ► Human infecting microsporidia and implications for public health are evaluated. ► By molecular tools biological samples from HIV+ and HIV− patients are tested. ► Four potential human pathogenic microsporidian species were detected. ► Immunocompromised patients and children are at high risk for Microsporidia infection. ► Implementing Microsporidia diagnosis is of critical importance. Despite recent advances in the understanding and diagnosis of emerging microsporidian pathogens, more research is necessary to elucidate their complex epidemiology. In fact, studies that reflect true human-infecting microsporidian prevalence are still inadequate. The present 10-year study was undertaken to examine the occurrence of Microsporidia in 1989 stools, 69 urine and 200 pulmonary specimens from HIV-positive and HIV-negative patients using PCR and DNA sequencing. In stools, 12.0% were Microsporidia-positive. Prevalences of 13.9% and 8.5% were observed for HIV+ and HIV− samples, respectively. The percentage of children that were Microsporidia-positive (18.8%) was significantly higher than that of adults (10.2%). In stools, Enterocytozoon bieneusi (6.3%) and Vittaforma-like parasites (6.8%) were identified. Based on the internal transcribed spacer (ITS) region of E. bieneusi, Type IV (37.5%), Peru 6 (29.2%), D (12.5%), A (8.3%), C (6.3%) and PtEb II (6.3%) genotypes were identified. Microsporidia were detected in 1.5% and 1.0% of urine and pulmonary specimens, respectively. Encephalitozoonintestinalis was detected in urine. In pulmonary specimens, Encephalitozoon cuniculi and Vittaforma-like parasites were identified. An immunosuppressive condition and youth (children) appear to be risk factors for microsporidian infection. Microsporidia seems to have an important impact on public health in Portugal, highlighting the need to implement routine diagnosis.