Prevalence and genetic characteristics of Blastocystis hominis and Cystoisospora belli in HIV/AIDS patients in Guangxi Zhuang Autonomous Region, China.

Blastocystis hominis and Cystoisospora belli are considered to be common opportunistic intestinal protozoa in HIV/AIDS patients. In order to investigate the prevalence and genetic characteristics of B. hominis and C. belli in HIV/AIDS patients, a total of 285 faecal samples were individually collected from HIV/AIDS patients in Guangxi, China. B. hominis and C. belli were investigated by amplifying the barcode region of the SSU rRNA gene and the internal transcribed spacer 1 (ITS-1) region of the rRNA gene, respectively. Chi-square test or Fisher's exact test were conducted to assess the risk factors related to B. hominis and C. belli infection. The prevalence of B. hominis and C. belli was 6.0% (17/285) and 1.1% (3/285) respectively. Four genotypes of B. hominis were detected, with ST3 (n = 8) and ST1 (n = 6) being predominant, followed by ST6 (n = 2) and ST7 (n = 1). Females had a statistically higher prevalence of B. hominis (11.6%) than males (4.2%). The statistical analysis also showed that the prevalence of B. hominis was significantly associated with age group and educational level. Our study provides convincing evidence for the genetic diversity of B. hominis, which indicates its potential zoonotic transmission and is the first report on the molecular characteristics of C. belli in HIV/AIDS patients in China.

Pitfalls in Morphologic Diagnosis of Pathogens: Lessons Learned From the Pseudo-Cystoisospora Epidemic.

Multiple groups have recently reported involvement of the gallbladder mucosa of immunocompetent patients by cystoisospora organisms. However, this has recently been disproved with the support of molecular and ultrastructural studies. Here we present a summary of these events, recounting how this pseudo-Cystoisospora epidemic began and ended. This review also highlights the important role played by ancillary techniques in supplementing the morphologic diagnosis of pathogens.

Clinical and Pathological Aspects of Systemic Isospora Infection in Blue-crowned Laughing Thrushes (Garrulax courtoisi) at Jersey Zoo.

Based on a review of species mortalities, systemic Isospora species was identified as the primary cause of death in 22% (19 of 87) of blue-crowned laughing thrushes (BCLTs; Garrulax courtoisi) at the Jersey Zoo between 1997 and 2016. Fifty-eight percent of the affected birds were between 1 and 2 years old, and in 89% of cases, death occurred between August and December. Abnormal clinical findings in BCLTs with Isospora species infections included hepatomegaly and pectoral muscle myositis in 79% of the cases. The results of diagnostic blood testing in 90% of infected BCLTs 30 days before death were consistent with a severe leukocytosis with greater than 20% of mononuclear cells infected by merozoites. The most common lesions identified during gross necropsy examination were splenomegaly (100%), hepatomegaly (95%), and multifocal, raised, white foci in pectoral (84%) and heart (79%) muscle. Lymphohistiocytic inflammation was identified in the liver, heart, spleen, lung, striated muscle, and kidney tissue of birds with positive results for Isospora species. Merozoites were often observed in spleen, liver, pectoral muscle, and hearts of infected BCLTs. Polymerase chain reaction diagnostic testing that targeted the cytochrome c oxidase subunit, followed by Sanger sequencing, was used to confirm Isospora species in all 14 birds tested. Of samples tested, the highest genetic correlation was with GenBank accession number KT203397 (Isospora species JRB-2016 mitochondrion).

Occurrence, clinical involvement and zoonotic potential of endoparasites infecting Swiss pigs.

In order to estimate the diversity, clinical involvement and zoonotic potential of parasites in pigs submitted for diagnosis to the PathoPig project of the Swiss Federal Food Safety and Veterinary Office, faeces (n=125) from suckling piglets (n=39), weaners (n=60) and piglets beginning fattening (n=26) from 74 Swiss farms were examined by 3 coproscopical methods (i.e. sedimentation/zinc chloride-flotation; SAFC and Ziehl-Neelsen staining). Samples microscopically positive for Cryptosporidium were further tested by PCR/sequencing for species assessment. The most frequently detected parasite was Balantidium coli, a facultative pathogenic ciliate with zoonotic potential, in 5.1, 36.7 and 50.0% of suckling, weaners and fatteners and 43.2% of farms; however, no association with disease was observed. Isospora (syn. Cystoisospora) suis infections were detected in 13.3 and 11.1% of suckling piglets with and without diarrhoea, and in 10.0 and 13.3% of weaners and fatteners with diarrhoea, respectively, and were significant associated with emaciation. Cryptosporidium infections were detected in 10.3, 15.0 and 19.2% of sucklings, weaners and fatteners, respectively, and in 18.9% of the farms. Interestingly, two age-related species were identified: C. suis in younger piglets (2 to 6weeks) and C. scrofarum in older ones (6 to 17weeks). None of the pigs infected with C. scrofarum (n=8), but 3 of 4 piglets infected with C. suis (co-infection with I. suis in 2 cases) had diarrhoea. The zoonotic species C. parvum was not detected, nevertheless, sporadic cases of human infection with the porcine-adapted species have been reported. Ascaris suum, Trichuris suis and Strongylida were rarely detected (<4%) in all age categories.

Isosporiasis in a tertiary care center of North India.

BACKGROUND: Cystoisospora (Isospora) belli is a coccidian, protozoan parasite that resides in the gastrointestinal tract of humans. It is mainly reported from HIV-positive individuals. However, a few cases have been reported in other immunosuppressed individuals including renal transplant patients, and those with lymphoma and leukemia. MATERIALS AND METHODS: During a period of 5 years (2008-2012), approximately 1700 stool samples of immunosuppressed patients were screened for the presence of opportunistic parasitic infections by a modified acid fast staining technique. RESULTS: A total of 41 C. belli were reported, out of which 30 were HIV-positive individuals while 11 were HIV negative. The latter individuals were also immunosuppressed due to prolonged use of steroids or other immunosuppressive drugs. Twenty-six out of 30 HIV-positive patients and all the HIV-negative individuals with C. belli infection had diarrhea. CONCLUSION: All immunosuppressed individuals should be examined for the presence of opportunistic coccidian parasitic infections and treated accordingly and alternatively, isolation of opportunistic parasites should trigger a hunt for immunocompromised state to reduce the morbidity and mortality in such patients.

Cystoisospora and cyclospora.

PURPOSE OF REVIEW: The present review focuses on recent epidemiological and diagnostic advances in cystoisosporiasis and cyclosporiasis. RECENT FINDINGS: Continuous outbreaks of these parasites occur worldwide. Sporadic cases in the United States are travel acquired, but also domestically acquired. New molecular diagnostic methods allow for accurate early diagnosis in humans, and might potentially decrease the burden of disease by detecting these parasites in vehicles of transmission. SUMMARY: Better understanding of the epidemiology of Cyclospora cayetanensis and to a less extent to Cystoisospora belli has been gained recently. However, several gaps still remain in knowledge on the transmission and on mechanisms of persistent infection in immunosuppressed patients and prevention. New molecular methods might help in filling these gaps and in controlling transmission.

Coccidia species in endemic and native New Zealand passerines.

New Zealand native passerines are hosts to a large variety of gastrointestinal parasites, including coccidia. Coccidian parasites are generally host-specific, obligate intracellular protozoan parasites. In passerine birds, members of the genus Isospora are most common. Under natural conditions, these parasites seldom pose a threat, but stressors such as quarantine for translocation, overcrowding, or habitat changes may cause an infection outbreak that can severely affect wild populations. Although coccidia are important pathogens and have caused mortalities in kiwi (Apteryx spp.) and hihi (Notiomystis cincta), their prevalence, epidemiology, life cycles, and taxonomic relationships are still widely unknown in native New Zealand songbirds. Over a period of 3 years (2007-2009), we examined 330 fecal samples of six native passerine species: tui (Prosthemadera novaeseelandiae), North Island saddleback (Philesturnus carunculatus rufusater), North Island robin (Petroica longipes), silvereye (Zosterops lateralis), and fantail (Rhipidura fuliginosa). The overall prevalence by flotation of coccidian infection in the New Zealand bird species examined was 21-38 %, 21 % in North Island robin, 38 % in tui, and 25 % in saddleback. Similar to prior studies in other countries, preliminary sequencing results suggest that coccidia in passerines in New Zealand are members of the family Eimeriidae, unlike the phenotypically similar genus Cystisospora of mammals. Using molecular methods, we identified at least five new genetically distinct Isospora species in the examined birds (three in tui and one each in saddlebacks and North Island robins).

Prevalence of Cryptosporidium, Giardia and Isospora species infections in pet cats with clinical signs of gastrointestinal disease.

This study reports the prevalence of Cryptosporidium, Giardia and Isospora species in cats showing signs of gastrointestinal disease. Records from a United Kingdom commercial diagnostic laboratory between December 2003 and December 2005 were reviewed. Of 1355 cats, Cryptosporidium species oocysts were found in 13 cats (1%), Giardia species trophozoites in 74 (6%), and Isospora felis oocysts in 46 (3%). In a second group of 48 cats, prevalence of Giardia species was 15% using an immunoassay for detection of antigen compared to 4% detected with microscopy. Prevalence of Giardia (9%) and Isospora (9%) species was higher in cats less than 6 months old. Gender and breed did not affect prevalence. There was a trend for Cryptosporidium and Isospora species infections to be detected in late autumn and early winter. Regional differences in prevalence were not detected. None of these organisms show a characteristic pattern of clinical signs. This study demonstrates that enteric protozoal infection is common in domestic cats showing signs of alimentary disease.

Seasonal profile and level of CD4+ lymphocytes in the occurrence of cryptosporidiosis and cystoisosporidiosis in HIV/AIDS patients in the Triângulo Mineiro region, Brazil.

Patients with AIDS are particularly susceptible to infection with intestinal coccidia. In this study the prevalence of infections with Cryptosporidium sp and Cystoisospora belli were evaluated among HIV/AIDS patients in the Triângulo Mineiro region, Brazil. Between July 1993 and June 2003 faecal samples from 359 patients were collected and stained by a modified Ziehl-Neelsen method, resulting in 19.7% of positivity for coccidian (8.6% with Cryptosporidium sp, 10.3% with Cystoisospora belli and 0.8% with both coccidian). Patients with diarrhoea and T CD4+ lymphocyte levels < or =200 cells/mm3 presented higher frequency of these protozoans, demonstrating the opportunistic profile of these infections and its relationship with the immunological status of the individual. It was not possible to determine the influence of HAART, since only 8.5% of the patients positive for coccidian received this therapy regularly. Parasitism by Cryptosporidium sp was more frequent between December and February and thus was characterised by a seasonal pattern of infection, which was not observed with Cystoisospora belli.

Seasonal profile and level of CD4+ lymphocytes in the occurrence of cryptosporidiosis and cystoisosporidiosis in HIV/AIDS patients in the Triângulo Mineiro region, Brazil

Patients with AIDS are particularly susceptible to infection with intestinal coccidia. In this study the prevalence of infections with Cryptosporidium sp and Cystoisospora belli were evaluated among HIV/AIDS patients in the Triângulo Mineiro region, Brazil. Between July 1993 and June 2003 faecal samples from 359 patients were collected and stained by a modified Ziehl-Neelsen method, resulting in 19.7 percent of positivity for coccidian (8.6 percent with Cryptosporidium sp, 10.3 percent with Cystoisospora belli and 0.8 percent with both coccidian). Patients with diarrhoea and T CD4+ lymphocyte levels < 200 cells/mm3 presented higher frequency of these protozoans, demonstrating the opportunistic profile of these infections and its relationship with the immunological status of the individual. It was not possible to determine the influence of HAART, since only 8.5 percent of the patients positive for coccidian received this therapy regularly. Parasitism by Cryptosporidium sp was more frequent between December and February and thus was characterised by a seasonal pattern of infection, which was not observed with Cystoisospora belli.

Pacientes com AIDS são particularmente susceptíveis a infecção por coccídios intestinais e nesse estudo foi avaliada a freqüência de Cryptosporidium sp. e Cystoisospora belli entre pacientes HIV/AIDS na região do Triângulo Mineiro, Brasil. No período de julho de 1993 a junho de 2003, amostras de fezes de 359 pacientes foram submetidas à coloração pelo método de Ziehl-Neelsen modificado, sendo detectada a presença de coccídios em 19,7 por cento destas (8,6 por cento de Cryptosporidium sp, 10,3 por cento de Cystoisospora belli e 0,8 por cento de ambos coccídios). Pacientes com diarréia e níveis de linfócitos T CD4+ < 200 células/mm3 apresentaram maior frequência destes protozoários, demonstrando o perfil oportunista destas infecções e a relação com o status imunológico do indivíduo. Não foi possível determinar a influência da HARRT, pois apenas 8,5 por cento dos pacientes positivos para coccídios fazriam uso regular desta terapia. Parasitismo por Cryptosporidium sp foi mais freqüente no período compreendido de dezembro a fevereiro caracterizando padrão sazonal desta infecção, fato não observado com Cystoisospora belli.