Genotyping of Cryptosporidium Species and Their Clinical Manifestations in Patients with Renal Transplantation and Human Immunodeficiency Virus Infection.

Asmita Dey,Ujjala Ghoshal,Vikas Agarwal,Uday Chand Ghoshal

doi:10.1155/2016/2623602

Asmita Dey, Ujjala Ghoshal + Show 2 more

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https://doi.org/10.1155/2016/2623602

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Abstract

In the present study we aimed to determine (i) frequency of Cryptosporidium species among patients with renal transplantation (RT) and human immunodeficiency virus (HIV) infection and (ii) relationship of the nature, severity, and duration of symptoms with different species and load of Cryptosporidium. Stool samples from 70 (42 RT and 28 HIV) and 140 immunocompromised patients with and without cryptosporidiosis by modified Kinyoun's staining were subjected to qPCR-melting curve analysis for identification of parasite species. qPCR detected one microscopically negative sample to be positive for cryptosporidiosis. C. hominis, C. parvum, and mixed infection were detected in 50/71 (70.4%), 19/71 (26.8%), and 2/71 (2.8%) patients, respectively. Patients with cryptosporidiosis had higher stool frequency (median, IQR: 4, 3–6/d versus 3, 2–4/d; P = 0.017) and watery stool (52/71 [73%] versus 64/139 [46%]; P = 0.003). Parasite load (median, IQR: Log10 6.37 (5.65–7.12), Log10 5.81 (4.26–6.65); P = 0.046) and nausea/vomiting (29/50 [58%] versus 5/19 [26%]; P = 0.032) were more frequent with C. hominis than with C. parvum infection. Thus, Cryptosporidium spp. (mainly C. hominis) is a common cause of diarrhoea in RT and HIV patients.

Highlights

The coccidian enteric parasite Cryptosporidium spp. is a common cause of gastroenteritis and diarrhoea in man [1, 2]
Clinical and laboratory parameters of patients with cryptosporidiosis were compared with 140 immunocompromised controls (60 human immunodeficiency virus (HIV) and 80 renal transplant (RT) recipients) without cryptosporidiosis (Figure 1)
Demographic, Clinical, and Laboratory Parameters of Patients and Controls. 70 immunocompromised patients were positive for Cryptosporidium spp. by both microscopy and quantitative Polymerase Chain Reaction (PCR) (qPCR) and one by qPCR alone

Summary

Introduction

The coccidian enteric parasite Cryptosporidium spp. is a common cause of gastroenteritis and diarrhoea in man [1, 2]. It causes severe, voluminous watery diarrhea in immunocompromised patients such as those infected with human immunodeficiency virus (HIV) [3, 4]. Some patients have severe symptoms over long duration while others recover in 1-2 weeks after a mild attack. The reasons for such diversity, which might be attributed to different genotypes or species of Cryptosporidium spp., or their varying load or host immunity, have not been adequately investigated so far

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