First identification and genotyping of Enterocytozoon bieneusi in humans in Myanmar

Yujuan Shen,Yanchen Wu,Xiaohua Liu,Aiqin Liu,Fengkun Yang,Jie Xu,Xiaofan Zhang,Jianping Cao,Baiyan Gong

doi:10.1186/s12866-019-1694-1

Yujuan Shen, Yanchen Wu + Show 7 more

Open Access

https://doi.org/10.1186/s12866-019-1694-1

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Abstract

BackgroundIntestinal pathogen infections are widespread among impoverished populations. Enterocytozoon bieneusi is the most common pathogen of intestinal microsporidian species in humans worldwide. However, no epidemiological information is available on E. bieneusi infection in humans in Myanmar. The present study comprised the first identification and genotyping of E. bieneusi in humans conducted in Myanmar.ResultsA total of 172 fecal specimens were collected from the Wa people (one each) in four villages of Pangsang Township of the Matman District of Shan State, Myanmar, and each participant completed a questionnaire. E. bieneusi was identified and genotyped using polymerase chain reaction (PCR) and sequence analysis of the internal transcribed spacer (ITS) region of the ribosomal RNA (rRNA) gene. The average prevalence of E. bieneusi was 8.72% (15/172), ranging from 3.85 to 13.89% by village. E. bieneusi infection was not related to any of the risk factors studied. Six genotypes were identified, comprising two known genotypes Peru6 (n = 10) and D (n = 1) and four novel genotypes (MMR23, MMR25, MMR86, and MMR87) (one each), and two people infected with genotype Peru6 were from the same family. A phylogenetic analysis based on a neighbor-joining tree of the ITS sequences of E. bieneusi indicated that all the six genotypes were clustered into group 1.ConclusionsThis is the first identification and genotyping of E. bieneusi in humans in Myanmar. The observations that the two people infected with genotype Peru6 were from the same family, and that all six genotypes obtained in the present study fell into zoonotic group 1, showed the potential for anthropogenic and zoonotic transmissions. The present data argue for the importance of epidemiological control and prevention from medical sectors.

Highlights

Intestinal pathogen infections are widespread among impoverished populations
Relationship of E. bieneusi infection and risk factors as well as gastrointestinal symptoms In the present study, with the help of the local Center for Disease Control and Prevention (CDC) and the people at Health Without Borders, all the participants, including 97 children, 41 teenagers, and 34 adults, responded to the questionnaires after they received an oral explanation of the study objectives and procedures, and provided complete information in writing
There were no significant relationships between E. bieneusi infection and each of the risk factors listed in Table 2 and Fig. 2

Summary

Introduction

Enterocytozoon bieneusi is the most common pathogen of intestinal microsporidian species in humans worldwide. No epidemiological information is available on E. bieneusi infection in humans in Myanmar. The present study comprised the first identification and genotyping of E. bieneusi in humans conducted in Myanmar. Two studies conducted in a Thai orphanage provided evidence of person-to-person transmission of E. bieneusi, based on the findings that genotype A was detected in all E. bieneusi-positive fecal samples of the orphans [8, 9]. Most human infections of E. bieneusi are considered to result from fecal-oral transmission of infective spores from infected hosts through contaminated food or water [3]. Contact with contaminated water is considered an important risk factor related to E. bieneusi infection in epidemiological studies [4]

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