\u201cEnterocytozoon bieneusi and Cryptosporidium: a cross-sectional study conducted throughout Thailand\u201d

Rapeepun Prasertbun,Supaluk Popruk,Katsuro Hagiwara,Aongart Mahittikorn,Yaowalark Sukthana,Hirotake Mori,Teera Kusolsuk

doi:10.1186/s12879-019-4422-4

Abstract

BackgroundEnterocytozoon bieneusi and Cryptosporidium spp. are prevalent zoonotic parasites associated with a high burden among children. To date only limited molecular epidemiological data on E. bieneusi and Cryptosporidium spp. in humans living in Thailand has been published.MethodsPCR-based tools were used to detect and characterize E. bieneusi and Cryptosporidium spp. The internal transcribed spacer (ITS) region of the rRNA gene was used to investigate E. bieneusi, and the small subunit (SSU) rRNA gene was used to investigate Cryptosporidium spp., and 697 fecal samples from villagers and school children in rural areas in Thailand were analyzed.ResultsThe infection rates were 2.15% (15/697) for E. bieneusi and 0.14% (1/697) for Cryptosporidium spp. The prevalence of E. bieneusi was significantly high in Loei province. Sequence analysis indicated that the Cryptosporidium isolate was C. parvum. Nine E. bieneusi genotypes were identified, EbpC, Peru12, TMH6, TMH3, TMH7, H, D, and two novel genotypes TMLH1 and TMLH2. E. bieneusi prevalence was significantly higher in male participants than in female participants, and in children aged 3–15 years than in participants aged > 15 years.ConclusionsThe prevalence, genotypes, and zoonotic potential of E. bieneusi were found to vary significantly high even in one country. Transmission routes and key animal carriers of E. bieneusi may be associated with differences in hygiene, sanitation, and cultural behaviors. Further molecular studies including longitudinal studies will be required to unveil epidemiological characteristics of these opportunistic intestinal protozoa in all over the countries.

Highlights

Enterocytozoon bieneusi and Cryptosporidium spp. are prevalent zoonotic parasites associated with a high burden among children
The prevalence of E. bieneusi was significantly higher in Loei (18.9%) than it was in Tak (2.6%) and Ratchaburi (2.4%)
The present study is the first molecular epidemiological investigation of Cryptosporidium in communities throughout Thailand, and the results suggest the epidemiological risks of Cryptosporidium may be minimal

Summary

Introduction

Enterocytozoon bieneusi and Cryptosporidium spp. are prevalent zoonotic parasites associated with a high burden among children. To date only limited molecular epidemiological data on E. bieneusi and Cryptosporidium spp. in humans living in Thailand has been published. Opportunistic intestinal protozoa such as Cryptosporidium spp. and Enterocytozoon bieneusi can cause diarrhea in humans [1], and are associated with increased mortality and short survival in immunocompromised people, especially AIDS patients [2]. Intestinal cases of infection with these parasites have reportedly increased in non-HIV-infected populations such as organ-transplant recipients, patients with malignant diseases, and diabetes patients [3]. They are considered opportunistic pathogens, several outbreaks. The prevalence and zoonotic potential of intestinal protozoa can vary by country and by location within a country

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