Prevalence and climatic associated factors of Cryptosporidium sp. infections in savanna chimpanzees from Ugalla, Western Tanzania.

Studies about parasitization by Cryptosporidium in great apes have been scarce and mostly conducted in captivity. The present study reports the presence of Cryptosporidium sp. in wild chimpanzees (Pan troglodytes) from Ugalla, western Tanzania. Ugalla is one of the driest, most open, and seasonal habitats inhabited by chimpanzees. Cryptosporidium sp. was found in 8.9 % of the samples. The presence of the parasite was determined by preserving fecal samples in chemical conventional fixatives (MIF and alcohol absolute) staining them using a modified Zielh-Neelsen technique, and examining them with a light microscope. The number of fecal samples positive for Cryptosporidium was significantly higher during the rainy than during the dry season (p < 0.005). The results showed that feces collected in the rainy season were almost three times more likely to be positive for Cryptosporidium than those collected in the dry season (OR = 2.81). Cryptosporidium detection was significantly negatively affected by highest temperatures (>28.7 °C, p < 0.001). Cryptosporidiosis can cause serious health problems in humans and its potential effect on Ugalla chimpanzees is discussed.

Multiple introductions and recombination events underlie the emergence of a hyper-transmissible Cryptosporidium hominis subtype in the USA.

The parasite Cryptosporidium hominis is a leading cause of the diarrheal disease cryptosporidiosis, whose incidence in the United States has increased since 2005. Here, we show that the newly emerged and hyper-transmissible subtype IfA12G1R5 is now dominant in the United States. In a comparative analysis of 127 newly sequenced and 95 published C. hominis genomes, IfA12G1R5 isolates from the United States place into three of the 14 clusters (Pop6, Pop13, and Pop14), indicating that this subtype has multiple ancestral origins. Pop6 (IfA12G1R5a) has an East Africa origin and has recombined with autochthonous subtypes after its arrival. Pop13 (IfA12G1R5b) is imported from Europe, where it has recombined with the prevalent local subtype, whereas Pop14 (IfA12G1R5c) is a progeny of secondary recombination between Pop6 and Pop13. Selective sweeps in invasion-associated genes have accompanied the emergence of the dominant Pop14. These observations offer insights into the emergence and evolution of hyper-transmissible pathogens.

Differences in Drug-Susceptibility Patterns between Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium chimaera Clinical Isolates: Prospective 8.5-Year Analysis by Three Laboratories.

Background: It has been suggested that Mycobacterium avium, Mycobacterium intracellulare, and M. chimaera have differential drug susceptibility patterns. We prospectively analyzed and compared the drug susceptibility patterns among these species over an 8.5-year period. Methods: A microdilution method (Slomyco®) was performed for drug susceptibility testing of 402 M. avium, 273 M. intracellulare, and 139 M. chimaera clinical isolates. Results: M. avium showed significantly higher resistance to moxifloxacin, ciprofloxacin, rifampicin, ethambutol, streptomycin, linezolid, cotrimoxazole, and clarithromycin. M. avium also showed higher minimum inhibitory concentrations (MIC) than M. intracellulare and M. chimaera against all drugs except ethionamide, to which M. intracellulare and M. chimaera showed greater resistance. Conclusions: Our series demonstrated differential drug resistance patterns among the most frequent M. avium complex species. M. avium was more resistant than M. intracellulare and M. chimaera versus eight antibiotics and showed greater MIC values to most of the antibiotics studied. These data suggest that knowledge of the local distribution and susceptibility profiles of these pathogens is essential for adequate clinical management.

Prevalence and associated factors of intestinal parasitisation: a cross-sectional study among outpatients with gastrointestinal symptoms in Catalonia, Spain.

The aim of this study was to report the prevalence of intestinal parasites in stool specimens from outpatients in Catalonia (Spain), and to evaluate the association of age, seasonality, and gender on general parasitisation and by the most frequent detected species. A total of 13,913 samples from 8,313 patients (1-3 specimens per patient) reporting digestive disorders were examined between 1999 and 2005 as a part of medical examinations. Samples were fixed with MIF solution and microscopically examined as wet mounts. Permanent stain was obtained by the modified Ziehl-Neelsen technique for intestinal coccidia. Nineteen species of intestinal parasites were identified. Blastocystis hominis (585 patients) was the predominant species, followed by Giardia duodenalis (321), Dientamoeba fragilis (131), Entamoeba coli (60) and Cryptosporidium sp. (59). Prevalence of helminths was low, being Enterobius vermicularis as the most frequently reported helminth (49 patients). The overall parasitisation was 1,136/8,313 (13.7%); prevalence in adults was 19.8% with a maximum in spring (14.8%). In the adjusted models, age was the main factor associated with infection: adults, with B. hominis and Entamoeba coli (odds ratio (OR) = 6.0 and OR = 8.5, respectively) and children, with Cryptosporidium and Giardia (OR = 2.0 and OR = 3.3, respectively). However, seasonality cannot be considered related with infection. The total prevalence was low, taking into account that all the subjects examined presented gastrointestinal symptoms and that species traditionally considered as non-pathogenic were included in the study.

First Molecular Diagnosis of Clinical Cases of Gastric Anisakiosis in Spain.

Anisakiosis is a fish-borne disease with gastrointestinal and/or allergic symptoms caused by the consumption of raw or undercooked fish parasitized with nematode larvae of the genus Anisakis. In Europe, Anisakis pegreffii has been detected as the causative agent, although the sibling species Anisakis simplex sensu stricto (s.s.) is also known to cause the disease in other parts of the world, and discrepancies exist regarding their respective pathogenic potential. In Spain a high number of cases has been recorded, with marinated anchovies being the main source of infection, although no specific diagnosis has been documented in humans. In this study, we analyzed three cases of anisakiosis in patients from Barcelona (Spain) who had consumed undercooked hake. All patients described epigastric pain and several larval nematodes were removed endoscopically from their stomachs. Larvae were morphologically characterized as third-stage larvae of Anisakis simplex sensu lato (s.l.) and molecularly identified as A. simplex (s.s.) by means of PCR RFLP of the ITS region of the rDNA and sequencing of the elongation factor1 alpha1 (EF1 α-1) nDNA gen. This study represents the first specific identification of Anisakis larvae in clinical cases of anisakiosis reported in Spain. Specific molecular diagnosis is of crucial importance for assessing the health risk of Anisakis sibling species. Hake consumption stands out as a risk factor for anisakiosis, since this fish species can be highly parasitized.

Epidemiological distribution of genotypes of Giardia duodenalis in humans in Spain.

BACKGROUND: Although the distribution of Giardia duodenalis genotypes in humans has been increasingly reported in recent years, data on possible differences in pathogen transmission between age groups and virulence between genotypes are scarce. The purpose of this study is to investigate the genetic diversity of G. duodenalis in humans in Spain and compare the distribution of G. duodenalis assemblages A and B between children and adults and clinical presentations between the two genotypes. METHODS: In the present study, 125 microscopy-positive fecal samples were collected from humans in Spain over a 7-year period. PCR and sequence analyses of the triosephosphate isomerase, ß-giardin and glutamate dehydrogenase genes were used to identify the multilocus genotypes of G. duodenalis. RESULTS: Sequence analysis of three genetic loci identified both G. duodenalis assemblages A (29) and B (66), with co-infections of the two in two patients. Among the sequences obtained in this study, four multilocus genotypes (MLGs) of the sub-assemblage AII were observed within assemblage A. In contrast, 19 MLGs were detected within assemblage B due to the high sequence diversity at each locus. One MLG, however, was found in 51.9% (27/52) of assemblage B samples. Children were more commonly infected by assemblage B (44/53 or 83%) than adults (22/42 or 52.4%; χ2 = 10.371, df = 1, P = 0.001). Asymptomatic infection was more common in patients with assemblage A (4/29 or 13.8%) than in those with assemblage B (1/66 or 1.5%; χ2 = 6.091, df = 1, P = 0.029), and the frequency of abdominal pain occurrence was higher in assemblage B patients (65/66 or 98.5%) than assemblage A patients (25/29 or 86.2%; χ2 = 6.091, df = 1, P = 0.029). CONCLUSIONS: These results illustrate the existence of differences in genotype distribution between children and adults and clinical presentations between G. duodenalis genotypes. They are useful in understanding the transmission of G. duodenalis in humans in Spain.

Life cycle and description of a new species of brachylaimid (Trematoda: Digenea) in Spain.

The life cycle of Brachylaima llobregatensis n. sp. (Trematoda: Brachylaimidae) is elucidated. Embryonated, operculated, asymmetric eggs (30.9 x 18.2 microm) are eliminated with feces of natural hosts wood mouse Mus spretus; white-toothed shrew, Crocidura russula; and an experimental host, domestic mouse, Mus musculus var. domesticus. The eggs are ingested by the helicid gastropod Helix (Cornu) aspersa, the only natural and experimental first intermediate host. The miracidium hatches from the egg, infects the snails, and develops into a branched sporocyst in the digestive gland. Microcaudate cercariae emerge from this snail and develop into unencysted metacercariae in the kidney of second intermediate host snails H. (C.) aspersa and Otala punctata (natural hosts) and Theba pisana (experimental host). Ingestion of infected snails leads to the infection of definitive hosts, with the adults inhabiting the middle part of the small intestine. There is a chaetotaxic pattern specific on the acetabular (S(II) 5-6 papillae) and body (papillae absent on P(II)) levels. Three types of cercaria papillae were observed by scanning electron microscopy: argentophilic papillae with fingerlike processes (cephalic, body, and acetabular levels); argentophilic papillae with opening (2 papillae in the M body level); and nonargentophilic dome-shaped papillae (on the cephalic C(II) level, alternating with argentophilic S(II) papillae on the ventral sucker). Suckers are subequal, with the acetabulum located in the posterior part of the anterior third of body. Vitellaria extend from anterior margin of acetabulum to between middle level and anterior margin of anterior testis.

Life cycle of Brachylaima mascomai n. sp. (Trematoda: Brachylaimidae), a parasite of rats in the Llobregat delta (Spain).

The terrestrial triheteroxenous life cycle of Brachylaima mascomai n. sp. (Trematoda: Brachylaimidae) is elucidated. Operculated, assymetric, embryonated eggs (25.4 x 12.7 microm) are passed with feces of the natural (Rattus norvegicus and R. rattus) and experimental (albino and wild mice, albino rats, Apodemus sylvaticus, Mus spretus [Muridae] and the golden gerbil) definitive hosts and ingested by the helicid gastropod Pseudotachea splendida, the only natural and experimental first intermediate host. Microcaudate cercariae harbored in branched sporocysts in the digestive gland emerge from this snail and contact P. splendida, Otala punctata, Theba pisana, and Helix (C.) aspersa snails developing into unencysted infective metacercariae in the kidney. Definitive hosts are infected by ingestion of infected snails; the adult parasites inhabit the small intestine. Chaetotaxic cercarial pattern specific at acetabular (S(II) 8-10 papillae) and cephalic (C(III) 13-15 papillae, H 16 papillae) levels. Three types of cercarial papillae are observed by scanning electron microscopy (SEM) and their arrangement is correlated with chaetotaxy for the first time in trematodes: argentophilic papillae with fingerlike process (cephalic, body, and acetabular levels), argentophilic papillae with opening (2 papillae in the M body level), and nonargentophilic dome-shaped papillae (alternated with argentophilic S(II) papillae on the ventral sucker). SEM detected interlacing network of ridges covering the metacercarial body. Adults with multidigitate tegumentary spines were observed by SEM. Subequal suckers; the acetabulum located in the posterior part of anterior fifth of body. Vitellaria extend from between middle level and anterior margin of anterior testis to between middle level and posterior margin of acetabulum. Uterus almost reaches the intestinal bifurcation.

Parásitos intestinales en inmigrantes atendidos durante el 2007 en una Unidad de Medicina Tropical de Barcelona / No disponible

Introducción: El aumento de inmigración procedente de países de baja renta puede contribuir al aumento de ciertas enfermedades infecciosas, especialmente aquellas de distribución cosmopolita. Actualmente, existen pocos datos referentes al estado de salud de la población recién llegada. El objetivo fue determinar la prevalencia de parásitos intestinales en inmigrantes y describir la influencia de variables sociodemográficas y clínicas en la parasitación. Material y métodos: Estudio descriptivo de 173 muestras fecales de pacientes con y sin sintomatología digestiva, sometidos a cribado parasitológico en una unidad de medicina tropical de Barcelona, entre el 1 de enero y el 31 de mayo del 2007.Resultados: La prevalencia de parasitación fue del 52,6%. Se detectaron 8 especies de protozoos, 7 de helmintos y Blastocysitis hominis, pero ningún caso de Cryptosporidium sp. Los inmigrantes recién llegados (p=0,026) y los procedentes de África y Asia resultaron los más parasitados (p=0,017). Los pacientes con helmintos, especialmente frecuentes entre los africanos (p=0,004), presentaron elevados valores de eosinófilos (p<0.001). El 45,0% de pacientes atendidos eran portadores asintomáticos. Conclusiones: A pesar de la dificultad de diseminación en nuestro medio, las elevadas tasas detectadas de parasitación intestinal justificarían el cribado parasitológico sistemático en pacientes asintomáticos procedentes de países de baja renta (AU)

Background: Increase of immigrant population proceeding from low-income countries could contribute to the emergence of some infectious diseases, especially those with cosmopolitan distribution. Nowadays, scarce data are known about health situation of newly arrived immigrants. The aim of the study was to determine the prevalence of intestinal parasites in immigrants and to describe the influence of demographic and clinical factors in parasitation. Material and methods: A descriptive study was carried out among 173 faecal samples from patients with and without digestive disorders, screened in a tropical diseases unit in Barcelona, from 1st January to 31st May 2007.Results: The prevalence of parasitation was 52,6%. 8 protozoa species, 7 helminth species and Blastocystis hominis, have been identified. No positive samples of Crypstosporidium sp. were found. Newly arrived patients (p=0,026) and those proceeding from Africa and Asia werethe most parasitized (p=0,017). Helminths parasitation was mainly found in African patients(p=0,004) and those with high levels of eosinophils (p<0,001). 45,0% of patients were asymptomaticcarriers. Conclusions: In spite of the difficulty of dissemination in our country, the high rates of intestinal parasitation detected would justify systematic screening in asymptomatic patients proceeding from low-income countries (AU)