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

Int J Parasitol. 2012 Feb;42(2):197-205. doi: 10.1016/j.ijpara.2011.12.002. Epub 2012 Jan 8.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • DNA, Fungal / chemistry
  • DNA, Fungal / genetics
  • DNA, Ribosomal Spacer / chemistry
  • DNA, Ribosomal Spacer / genetics
  • Feces / microbiology
  • Female
  • HIV Infections / complications
  • Humans
  • Infant
  • Male
  • Microsporidia / classification*
  • Microsporidia / isolation & purification*
  • Microsporidiosis / epidemiology*
  • Middle Aged
  • Polymerase Chain Reaction
  • Portugal / epidemiology
  • Prevalence
  • Sequence Analysis, DNA
  • Sputum / microbiology
  • Urine / microbiology
  • Young Adult

Substances

  • DNA, Fungal
  • DNA, Ribosomal Spacer