Abstract
Microsporidia cause opportunistic infections in highly immunodeficient individuals. Few studies on the epidemiology of these infections have been conducted in France. Between 2014 and 2016, we undertook a study to estimate the prevalence and circulating genotypes of this fungus-related micro-organism among the population of Strasbourg University Hospital. Samples were collected from hospitalized patients and analyzed using microscopy and molecular assays. Strains from positive subjects were sequenced for genotyping. Only 7/661 patients (1.1%) were positive for microsporidia, and the only species identified was Enterocytozoon bieneusi. Two patients presented immunodeficiency linked to AIDS, and five transplant recipients presented immunodeficiency linked to immunosuppressive therapies. Only five patients received specific antimicrosporidial treatment, but clinical outcomes were good in all cases. We identified four genotypes: A and D in patients with AIDS, and C and S9 in transplant recipients. To date, genotype S9 has been described only once. This genotype is similar to those found in farm animals in China. Because some of these animals have been introduced to Central Europe, we postulate that this genotype might be of Asian origin. Thus, genotyping microsporidial strains may be of epidemiological and clinical interest to identify potential outbreak sources depending on the infecting strains.
Highlights
Microsporidia are a group of unicellular fungi living as obligate intracellular parasites[1]
Clinical features Between January 2014 and December 2016, 661 samples were sent to the laboratory of the University Hospital of Strasbourg for microsporidia testing
Most patients were transplant recipients with marked immunodeficiency mediated by anti-organ-rejection therapies
Summary
Microsporidia are a group of unicellular fungi living as obligate intracellular parasites[1]. The first microsporidial species to be described, Nosema bombycis, was identified by Carl Wilhelm von Nägeli in 18572 as the causative agent of a silkworm disease. Approximately 1000–1500 microsporidial species have been described[1]. Over the past 150 years, microsporidia classification has been widely discussed, based on morphological, biochemical, and genetic characteristics. Initially placed Nosema bombycis in the fungal group, Schizomycetes, microsporidia were considered protozoans for more than a century[1]. Phylogenetic analyses of five gene sequences (mitochondrial HSP70, TATA-box protein, RNA polymerase II, and α-tubulin and β-tubulin) have supported classifying microsporidia within the fungi or as a sister-group with a common ancestor[1]
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