Acid-fast Staining Method Research Articles

First molecular investigation of Cryptosporidium spp. in young calves in Algeria.

To date, no information is available on the prevalence and genetic identity of Cryptosporidium spp. in cattle in Algeria. In this study, 17 dairy farms in the province of Batna, located in the northeast of the country, were visited to collect 132 fecal samples from young calves (< 8 weeks old). Samples were examined microscopically using the modified Ziehl-Neelsen acid-fast staining method, and at least one sample per farm was submitted for molecular analysis. Amplification of a fragment of the small subunit ribosomal RNA gene was positive for 24 of the 61 samples (40%), and sequence analysis identified three species, namely Cryptosporidium bovis (n = 14), C. ryanae (n = 6), and C. parvum (n = 4). The C. parvum IIaA13G2R1 subtype, an uncommon zoonotic subtype, was identified in two isolates from a single farm by sequencing a fragment of the GP60 gene. This is the first report about genotyping and subtyping of Cryptosporidium in calves in Algeria.

Investigation of Cryptosporidium sp. Oocysts in Erzurum’s Potable Water On Different Months

Objective: Cryptosporidium sp. is a protozoan which is highly resistant to external environmental conditions and chlorination and can lead to severe diarrhea in immunosuppressed persons. Oocysts of this parasite, is excreted by human and animal feces, lead to contamination of potable (drinking) water supplies in environments with poor sanitation. Our aim is to investigate the presence of oocysts in some potable water samples taken from different points of Erzurum city center and around on different months. Methods: Totally 120 water samples were collected from 40 random different points of Erzurum city center and around on April, May and July. Of the 120 samples, 45 were from city water system and 75 from fountain and wells water. Water samples collected within 5 liter tanks were filtered by using membrane filter. From each sample preparation were done by using modified acid fast staining method and then examined under microscope. Results: Cryptosporidium sp. oocysts were detected on 18 (15.0%) of total 120 water samples. 6 (13.3%) of these positive samples were from city water system and the other 12 (16.0%) were from fountains and wells. According to the seasonal distribution of positive samples 9 (22.5%) have been taken on April, 7 (17.5%) on May and 2 (5.0%) on July. Conclusion: Results of this study have shown that source of water supplies in our region are notably contaminated with Cryptosporidium sp. oocysts, and the rate of contamination is higher on April and May when compared with July.

The Frequency of Cryptosporidium spp. in Immunocompromised Patients by Modified Acid-Fast Staining, Cassette Kit and ELISA Methods: Comparison of the Diagnostic Techniques

Background: Cryptosporidiosis has been reported in both immunocompetent and immunocompromised patients from over 40 countries in six continents. Objectives: This study was carried out to determine the prevalence of Cryptosporidium spp. in immunocompromised patients by methods of modified acid fast staining, ELISA and Cassette Kit, and to also compare the three methods. Methods: The patients in different age groups admitted to Bitlis state hospital between June 23, 2011 and January 13, 2015 were enrolled. The study group was composed of 300 immunocompromised volunteer patients and the control group of 100 volunteers with normal immune system. In the study group, patients with hemodialysis, chronic renal failure, diabetes mellitus, diabetes insipidus, and cancer were enrolled. Formalin-ethyl acetate, modified acid fast staining and native-lugol were used for all stool samples; they were also investigated for Cryptosporidium antigens by the ELISA and Cassette Kit. Results: The highest prevalence rate of Cryptosporidium spp. is found to be 11.3%, which is obtained by ELISA and the lowest (0.7%) by Cassette Kit in the study group. All patients with cryptosporidiosis had diarrhea. The highest prevalence rate (20%) was observed in patients with diabetes insipidus and the second highest in patients with chronic renal failure (11.5%) by ELISA. The sensitivities and specificities of Cassette Kit and modified acid fast staining were 5.9%, 100%; and 50%, 100%, respectively. Conclusions: It is concluded that Cryptosporidium spp. should be considered in immunocompromised diarrheal patients and ELISA must be chosen for detection of this parasite. Modified acid fast staining and Cassette Kit techniques could be performed if ELISA is not available. The single use of the Cassette Kit will be inadequate for the diagnosis of cryptosporidiosis.

Occurrence of Cryptosporidium spp. and Giardia spp. in pigs at weaning

Cryptosporidium spp. and Giardia spp. are parasites and have been reported in many species of mammals, including humans. The goal of this research was to investigate the occurrence of Cryptosporidium spp. and Giardia spp. in 45-days-old pigs. Fecal samples of 107 pigs were collected at three alternate days in piggeries in Araçatuba, São Paulo State, Brazil. Cryptosporidium oocysts were observed in 4.7% (5/107) of animals by Kinyoun acid-fast stain method and cysts of Giardia spp. were observed in 1.9% (2/107) of the animals by the method of Faust. Of all animals, 85 presented feces with normal consistency and 22 showed diarrhea in at least one collection. Two diarrheic samples showed positivity for both Cryptosporidium spp. and Giardia spp. From these results it is possible to infer that the occurrence of Cryptosporidium and Giardia was low because of the good management practices and both protozoa were not associated the presence of symptoms.

Genetic Characterization of Cryptosporidium spp. among patients with gastrointestinal complaints referred to clinical laboratories of Tehran, Iran

Background : Cryptosporidium, an intracellular protozean parasite, is among the major causative agents of gastroenteritis disorders in humans and also causing water-borne and food-borne outbreaks of diarrheal diseases. This study investigated subtypes of Cryptosporidium in patients with gastrointestinal complaints in Tehran, Iran. Methods: A total of 1685 fecal samples were collected from patients with gastrointestinal complaints who had been referred to clinical laboratories Tehran, Iran. The primary diagnosis was established by detection of oocysts using the modified Ziehl-Neelsen acid-fast staining method and following that, the positive microscopically samples were selected for sequence analysis of partial 60 kDa glycoprotein (gp60) gene. Results: Out of 1685 collected samples, 7 (0.4 %) were positive for Cryptosporidium oocysts. Sequences analysis of gp60 gene in seven Cryptosporidium isolates revealed that, two subtype families were identified, IIa and IId. Five (of 7) isolates belonged to the subtype family IIa and remaining 2 isolates belonged to IId. Three sub-types were recognized within the subtype family IIa including IIaA16G2R1 (3/5), IIaA17G1R1 (2/5), while IIdA17G1d was the only subtype within IId subtype family. Conclusion: The predominance of zoonotic subtype families of C. parvum species (IIa, IId) in this study highlights the importance of zoonotic transmission of cryptosporidiosis in the country.

Cystoisospora sp. Infection Determined in Immunosuppressed and Immunocompetent Children: Three Cases Report

The aim of this study was to present three cystoisosporiasis cases diagnosed in pediatric patients of the Yuzuncu Yil University Medical Faculty. In the study, stool samples of the patients were evaluated by native-Lugol and modified acid-fast staining methods in the Parasitology Laboratory. The first case was a 4-year-old male child diagnosed with acute lymphoblastic leukemia (ALL). It was reported that the patient had abdominal pain, and permanent bloody and mucous diarrhea (8-10 times a day) was present for almost 1 week after the beginning of ALL treatment. The second case was a 10-year-old boy diagnosed with depression. The patient was brought to our hospital by his parents with complaints of abdominal pain, diarrhea, lack of appetite, weight loss, and fatigue persisting since 1 month in addition to headache, fear, sleeplessness, and waking up with cry. The third case was a 13-year-old boy who complained of abdominal pain, diarrhea (rare occasions), lack of appetite, and headache for 2 months. These patients had not traveled abroad. The cases were treated successfully with co-trimoxazole. Our results suggest that all patient groups with diarrhea and abdominal pain should also be considered in cystoisosporiasis.

Molecular characterization of cryptosporidium in children aged 0- 5 years with diarrhea in Jos, Nigeria.

IntroductionCryptosporidium is an important cause of diarrhea in children and immune-compromised individuals. Recent advances in molecular diagnostics have led to the discovery of subtype families that are thought to be more commonly associated with diarrhea. We aimed to isolate and characterize Cryptosporidium spp among children with diarrhea in Jos, Nigeria.MethodsStool samples were collected from165 children aged 0-5 years with diarrhea. Cryptosporidium oocysts were examined by wet mount preparation, using formalin ether and a modified acid fast staining method. DNA was extracted from positive samples using QIAamp DNA stool mini kit and PCR-RFLP assay was carried out after quantification. Genotyping and phylogenetic analysis were done to determine the subtype families and their relatedness.ResultsFrom the 165 children studied, 8 (4.8%) were infected with Cryptosporidium. PCR-RFLP assay and genotype characterization found the following Cryptosporidium species: C. hominis 6 (75%) and C. parvum 2 (25.0%), with family subtypes Id-5, Ie-1 and IIa-1, IId-1 respectively.The most common species was C. hominis and the frequent subtype was C. hominis-Id 5 (62.5%).ConclusionCryptosporidium is not an uncommon cause of diarrhea in children, with C. hominis being the dominant species. Also C. hominis Id is the commonest sub-family subtype. Put together, zoonotic species may be an important cause of diarrhea in children aged 0-5 years in Jos, Nigeria.

Molecular seasonal, age and gender distributions of Cryptosporidium in diarrhoeic Egyptians: distinct endemicity.

Cryptosporidiosis is a worldwide gastrointestinal disease caused by the protozoan Cryptosporidium parasite. It has a broad range of seasonal and age-related prevalence. We aimed to study the molecular prevalence and seasonality of Cryptosporidium over a period of 1 year in a cohort of Egyptian diarrhoeic patients. Stool samples were collected from 865 diarrhoeic patients attending outpatient clinics of Cairo University hospitals, from all age groups over a 12-month period, examined microscopically for faecal Cryptosporidium oocysts by the acid-fast staining method and for copro-DNA detection using nested polymerase chain reaction (nPCR) assays. PCR-positive samples were characterised molecularly by nPCR-restriction fragment length polymorphism (RFLP) to determine Cryptosporidium genotypes. Cryptosporidium copro-DNA was detected in 19.5% of the collected samples throughout the year, with a major peak in summer (August) and a small rise in spring (April). Infection was mainly C. hominis (95.8%) followed by C. parvum (3.0%), affecting all age groups, with predominance in the pre-school age group, and decrease with age. There were statistically significant associations between the detection of Cryptosporidium and season, diarrhoea, patient age and drinking water, while gender, contact with animals and presence of mucus in stool showed no association. Cryptosporidium in diarrhoeic Egyptians was of distinct endemicity, with the bi-model mostly influenced by population dynamics, with a clear high prevalence in pre-school children and predominating anthroponotic (C. hominis) transmission throughout the year. The obtained results highlight Cryptosporidium as a water contaminant and an important cause of health problems in Egypt, necessitating further studies of the risk factors.

Investigation of the presence of Encephalitozoon intestinalis and Enterocytozoon bieneusi in bone marrow transplant patients by IFA-MAbs method

Microsporidian pathogens are obligatory intracellular eukaryotic parasites which can be found worldwide. They have been represented in 144 genera and more than 1200 species that may cause infections in both vertebrate and invertebrate hosts. Enterocytozoon bieneusi and Encephalitozoon intestinalis are the most common species among 14 species of microsporidia identified as human pathogens and they cause infections in the gastrointestinal tract. These species may also cause chronic diarrhea particularly in immunocompromised patients, as well as disseminated infections with severe clinical conditions which can be life-threatening. Since the spores of microsporidia are quite small-sized structures, they frequently may be overlooked in routine stool examinations. Therefore, molecular methods and transmission electron microscopy, if possible, are used as the gold standard methods in laboratory diagnosis. In laboratories in which those methods could not be applied, immunofluorescence assay using monoclonal antibodies (IFA-MAbs) may be advantageous compared to conventional methods. The aim of this study was to investigate the presence of E.intestinalis and E.bieneusi in bone marrow transplant (BMT) patients by using IFA-MAbs method. A total of 200 BMT patients (134 male, 66 female; mean age: 43.2±15.01 years), of them 147 with diarrhea and 80 healthy subjects (43 male, 37 female; mean age: 31.9±11.76 years) as control group were included in the study. All of the stool samples were examined by a commercial IFA-MAbs (Bordier Affinity Products, Switzerland) method as well as conventional (native-lugol and modified acid-fast staining) methods. Of the patients 25.5% (51/200) were positive for E.intestinalis, 4% (8/200) for E.bieneusi and 9.5% (19/200) for both of them, giving a total positivity rate of 39% (78/200). Those rates were 5% (4/80), 2.5% (2/80), 3.8% (3/80) and 11.3% (9/80), respectively for control group. The difference between the patient and control groups in terms of positivity was found statistically significant (39% vs 11.3%, p<0.05). Among 78 positive BMT patients, 67 (85.9%) were suffering from diarrhea. The correlation between the presence of diarrhea and the presence of microsporidia was statistically significant (p<0.05). It was concluded that, BMT patients particularly those with gastrointestinal complaints, have to be evaluated for microsporidian pathogens regularly to improve quality of life and to decrease the problems during the treatment period.

The effects of intestinal parasites on anemia of children

In this case-control epidemiological study, we aimed to investigate the effects of intestinal parasites on the anemia of children and show the association between intestinal parasites and anemia. A total of 50 healthy and 50 malnourished children aged 0-72 months who went to physicians of Tilfindir Primary Health Care Center were enrolled in this study. The stool specimens were examined by using native-lugol, concentration, cellophane tape, and acid fast and trichrome staining methods. The complete blood count was measured by an automatic blood device. A total of 58% of the children were infected with intestinal parasites; 55.2% of these were infected with only one parasite, and 44.8% of them were infected with polyparasites. Also, 50.0% of the children with parasitic infection and 19.0% of children without parasitic infection were anemic. There was a positive association between intestinal parasites and anemia statistically (p<0.05). The mean hemoglobin level of the children with parasitic infection was 11.15±1.30, and the mean hemoglobin level of the children without parasitic infection was 12.13±1.47. There was a significant difference between mean hemoglobin levels of the two groups statistically (p<0.001). Consequently, this study emphasized that intestinal parasites can affect the anemia of children adversely, and there was a positive association between intestinal parasites and anemia of children.

Molecular characterization of bovine Cryptosporidium using Cryptosporidium oocyst wall protein (COWP) gene

Cryptosporidium is a globally distributed protozoan parasite and one of the most common causes of infection and diarrhea in humans and cattle. The aim of the present study was to determine the species of Cryptosporidium among cattle with diarrhea by a nested PCR-RFLP technique at Cryptosporidium oocyst wall protein ( COWP ). Fecal samples from 158 calves aged 1-20 weeks were collected from 10 dairy farms in Qazvin province, Iran. Initial identification of Cryptosporidium was carried out by Zeihl-Neelsen acid-fast staining method of stool samples. DNA was extracted from 26 (16.45 %) positive microscopically samples and Cryptosporidium genotypes were determined. Cryptosporidium parvum were identified in 80.8% of the positive samples and, Cryptosporidium andersoni in 19.2%. In conclusion the use of COWP primers could be sensitive enough to conduct a routine detection study. The nested PCR method using the COWP gene sequence can be an alternative diagnostic method to identify infected with Cryptosporidium and its genetic diversity.

Comparative evaluation of ziehl neelsen staining and knowledge, attitudes and practices of laboratory personnel in relation to ziehl nielsen.

To describe laboratory personnel's attitude and practices toward phenol exposure during Ziehl Neelsen (ZN) acid fast staining method and to evaluate the feasibility of an alternate modified Kinyoun cold (MKC) stain. A total of 187 sputum samples were collected from suspected tuberculosis cases and stained by the MKC method and ZN stain and were read by an experienced microscopist and a researcher. A cross-sectional questionnaire survey of 35 laboratory personnel was also conducted. Modified Kinyoun cold stain gave sensitivity, specificity, positive and negative predictive values of 100%, 99.4%, 94.1% and 100%, respectively. Both stains corresponded with an agreement rate of 99.5%. Almost 94.7% of respondents reported that they worked in a closed area when staining and 57.1% did the staining method without ventilation. Material safety data sheet (MSDS) of phenol was not known to 77.1% of laboratory personnel. All of the participants (100%) in this study welcomed a similar, non heating method for acid-fast bacillus (AFB). There was significant association between those not comfortable with phenol exposure (77.1%) and complaints of irritation (48.6%) and headache (2.9%) [c2 = 10.98, r = 0.55, p = 0.001]. The MKC is suitable for use as a substitute for the ZN method for the demonstration of AFB in the primary diagnosis and treatment assessment of pulmonary tuberculosis. Focus should be given on educating laboratory staff on the hazards, risks and precautions associated with the phenol/ZN method.

Molecular Characterization of Cryptosporidium spp. Isolated From Immunocompromised Patients and Children

Background:Cryptosporidium is known to be one of the most important causes of diarrhea in children and immunocompromised patients. Genotype characterization of Cryptosporidium species in each region would help in the treatment of this disease, as well as to locate the source of infection and to prevent the disease.Objectives:This current research was conducted in order to analyze the molecular characterization of isolated Cryptosporidium spp. in the Southwest of Iran.Materials and Methods:In this survey, 390 fecal samples were collected from immunocompromised individuals and children under five-years-of-age. Parasitic infection was evaluated using wet mount preparation, formalin ether, a modified acid fast staining method and microscopic examination. Finally, a PCR-RFLP assay was performed on the extracted DNA collected from fecal samples that were positive for Cryptosporidium by the acid fast method.Results:Among the 390 fecal samples, 16 cases (4.1%) were infected with Cryptosporidium. Molecular and genotype characterization found the following protozoan species; 11 Cryptosporidium parvum (68.8%), 4 C. hominis (25%), and one case of C. meleagridis (6.2%).Conclusions:The present study emphasized the public health importance of Cryptosporidium spp. in the study area. In addition, it seems that zoonotic species are the most important causes of infection in the region. As far as we are aware this the first report of a C. meleagridis infection in Iran.

New Subtype ofCryptosporidium cuniculusIsolated from Rabbits by Sequencing the Gp60 Gene

Given the paucity of literature available on rabbits infected with Cryptosporidium in Sichuan Province (China), 290 fecal samples were collected from rabbits in the animal house of Sichuan Agricultural University, China and examined for Cryptosporidium oocysts using the Sheather's sucrose flotation technique and a modified acid-fast staining method. Three samples tested positive (prevalence = 1.03%). The positive isolates were genotyped by sequence analysis of the 18S rRNA, HSP70, COWP, and Cp135 genes and characterized by PCR-restriction fragment length polymorphism (RFLP) analysis of the 18S rRNA gene. Phylogenetic analysis was established using the neighbor-joining (NJ) method. All the isolates were identified as Cryptosporidium cuniculus. Further subtyping of the positive isolates was performed by DNA sequencing of the 60-kDa glycoprotein (gp60) gene. Only 1 subtype family was detected, Va, which was proposed to be a new subtype, VaA31. This study is the first report about the prevalence, genetic identification, and Cp135 gene of C. cuniculus in rabbits in Sichuan Province, China. The obtained results indicate that the C. cuniculus subtype in rabbits in Sichuan Province is unique.

Investigation of Giardia and Cryptosporidium Prevalence with Different Methods in Adana Food Workers

Carriage detection in food workers is very important in protecting public health from Giardia and Cryptosporidium infections which are two of the major causes of food borne outbreaks. However, false negative results can be reported with routine methods such as native-lugol and acid-fast staining in the carriers. In this study, we aimed to determine the appropriate method for carrier screening by comparison of the different analyses used in the diagnosis of Giardia and Cryptosporidium in food workers. Stool specimens of 500 food worker who applied to our laboratory for carrier screening were investigate by routine microscopic examination with native-lugol and Kinyoun acid-fast stain method and searched for Giardia and Cryptosporidium antigens with Direct Fluorescent Antibody (DFA) and immunochromatographic assay. As a result of the study, Giardia spp. was detected with native-lugol staining method, immunochromatographic assay and DFA assay as 13 (2.6%), 8 (1.6%), 24 (4.8%) respectively of specimens whereas Cryptosporidium spp. was not determined. When DFA assay was considered the reference method, sensitivity and specificity of the native lugol method and immunochromatographic assay were found to be 54.1%, 100% and 33.3%, 100% respectively. In our study, we were found low sensitivity of immunochromatographic method and it is inappropriate as a test for detecting carriers in food workers. We concluded that, to be able to detect other parasites, the native-lugol method must be performed for screening şekilcarriers, and patients who were found Giardia and Cryptosporidium negative by this assay should be confirmed with more sensitive immunodiagnostic method.

Crypto-Giardia antigen rapid test versus conventional modified Ziehl-Neelsen acid fast staining method for diagnosis of cryptosporidiosis

ObjectiveTo evaluate the validity of Crypto-Giardia antigen rapid test (CA-RT) in comparison with the conventional modified Ziehl-Neelsen acid fast (MZN-AF) staining method for the diagnosis of cryptosporidiosis. MethodsFifteen preserved stool samples from previously confirmed infections were used as positive controls and 40 stool samples from healthy people were used as negative control. A total of 85 stool samples were collected from suspected patients with cryptosporidiosis over 6 months during the period from January till June, 2011. The study was conducted in the department of parasitology, central laboratory, Alnoor Specialist Hospital, Makkah, Saudi Arabia. All samples were subjected to CA-RT and conventional MZN-AF staining method. Validation parameters including sensitivity (SN), specificity (SP), accuracy index (AI), positive predictive value (PPV), and negative predictive value (NPV) were evaluated for both tests. ResultsOut of 15 positive controls, CA-RT detected 13 (86.7%) while MZN-AF detected 11(73.3%) positive cases. However, CA-RT detected no positive case in 40 normal controls but MZN-AF detected 2(5%) as positive cases. Based on the results, the SN, SP, AI, PPV and NPV were high in CA-RT than MZN-AF staining method, ie., 86.7%vs. 73.3%, 100%vs. 95%, 96.4%vs. 89.1%, 100%vs. 84.6% and 95.2%vs. 90.5%, respectively. Out of a total of 85 suspected specimens, CA-RT detected 7(8.2%) but MZN-AF detected 6(7.1%) cases as positive. ConclusionsCA-RT immunoassay is more valid and reliable than MZN-AF staining method.

A modified acid-fast staining method for rapid detection of Mycobacterium tuberculosis

A modified acid-fast staining method was developed for rapid detection of Mycobacterium tuberculosis and its L forms, wherein carbol fuchsin and dioxogen were mixed into the sputum smear. With this method, the dyeing time is shortened and heating is not required. The sensitivity, specificity, positive predictive value, negative predictive value, positive rate, and diagnostic efficiency of the new method were compared to those obtained by PCR using 50 clinical samples. Further, 468 clinical samples were analyzed using the new method, the modified intensified Kinyoun (IK) acid-fast staining method, and the traditional Ziehl–Neelsen acid-fast staining method. Differences among the positive detection rates of the three methods were analyzed using Student's t-test, and no significant differences were found between the new method and the modified IK acid-fast staining method, while the rates of both these methods were higher than that of the traditional acid-fast staining method. Additionally, the dyeing time in the new method was markedly less than that in the modified IK acid-fast staining method (5min and 24h, respectively).

The Distribution of Intestinal Parasites in People Admitted to the Yüzüncü Yıl University Parasitology Laboratory of Health Research and Training Hospital, in 2009

This study was performed to present the distribution of intestinal parasites in parients admitted to the Parasitology Laboratory of the Health Research and Training Hospital of Yüzüncü Yıl University in 2009. A total of 6267 patients (3037 female, 3230 male; 3798 of 13 years and under, 2469 of 14 years and over) were included. The stool samples were examined by native-Lugol, flotation and sedimentation methods in the Parasitology Laboratory of the hospital. Trichrome and modified acid-fast staining methods were also applied to suspicious stools. One or more than one parasite species were found in 28.5% of 6267 examined stool samples. Parasitosis was determined in 28% of female and 29% of male. Distribution of the parasites determined in the patients was as follows: 15.4% Blastocystis hominis, 6.6% Giardia intestinalis, 4.9% Entamoeba coli, 3.2% plenty B. hominis, 1.7% Chilomastix mesnili, 1.3% Hymenolepis nana, 0.7% Iodamoeba butschlii, 0.5% Ascaris lumbricoides, 0.1% Entamoeba histolytica/Entamoeba dispar, 0.1% Endolimax nana, 0.1% Enteromonas hominis, 0.1% Trichomonas hominis, 0.1% Cyclospora cayetanensis, 0.1% Enterobius vermicularis, 0.03% Entamoeba hartmanni, 0.03% Dicrocoelium dendriticum,0.03% Taenia saginata and 0.02% Trichuris trichiura. This research shows that the intestinal parasitosis problem still continues in the province.

Evaluation of demographic, clinic and treatment features of patients and a cross-sectional survey of cyclosporiasis in patients with diarrhea in Southeastern Turkey

In this research, we aimed at reporting the results of a cross-sectional epidemiological scanning performed on an outbreak of cyclosporiasis, occurring in a family and patients' socio-demographic epidemiological, clinical, diagnostic and therapeutic features, after detecting Cyclospora oocysts on stool sample of a person admitted to gastroenterology polyclinic. Scanning was performed in the neighborhood of the patient. The investigation group consisted of 75 individuals with diarrheal occurring from neighbor and family of patients. A questionnaire was performed for information on epicrisis of diarrheal persons and the samples were collected in stool containers. The samples were examined with native-lugol, sedimentation and modified acid fast staining methods. The stools were cultured in Salmonella-Shigella agar medium to investigate their bacteriological properties. The different vegetables from the mobile market place (peddler) founded in the neighborhood and water samples from house were collected to detect the infection source. Parasitosis (single or mix parasite) were encountered in 20 out of 75 persons in the examined samples (26.6%) and C. oocysts were detected in 13 out of 75 persons (17.3%). Out of the total number of patients having cyclosporiasis, none has immunodeficiency and chronic diseases. All cases were determined in the month of July. Oocysts were detected in six different families. Bacteria were not cultivated in stool cultures and occult blood was negative. The agent was not encountered in green vegetables, though water samples were examined to detect infection resource. Examination of the samples for Cyclospora was not neglected in diarrhea individuals; as such an examination was performed for the source of transmission of the infection.Cyclospora may generate family infection in individuals and if detected in one individual of a family, all the family individuals were examined for this infection. Key words: Cyclospora cayetanensis, diarrhea, familial transmission, Southeastern Turkey.

Intestinal Protozoa in Immunosuppression: A Medical Hassle

Introduction: Immunity forms the backbone of our very existence and opportunistic infections have plagued the immunosuppressed since long. A significant morbidity and mortality is attributable to intestinal parasitosis in the immunocompromised population. Objectives: This study aims to study the prevalence of intestinal protozoa in various immunosuppressed groups and to correlate degree of immunosuppression with protozoal infections. Material and Methods: The study was conducted on 400 patients divided into 4 groups: Group I (HIV patients), Group II (patients on chemotherapy/chemotherapy and radiotherapy for various malignancies), and Group III (diabetes patients) and Group IV included children presenting with diarrhea. Group I, II and III included patients with and without gastrointestinal symptoms. Stool samples were investigated microscopically for cysts/trophozoites after concentration with formol-ether method. Iodine wet mount and Modified acid fast staining methods were used. Result: Intestinal protozoa were detected in 40.75% (163/400); more commonly in patients with higher degree of immunosuppression (CD4 count 7: 95.3% in diabetics and moderate to severe malnutrition: 61.8%. Most common protozoa associated was Cryptosporidium in 66 patients (40.5%) followed by, Entamoeba histolytica in 48 (29.4%), Giardia lamblia in 35 (21.5%), Isosporabelliin 9 (5.5%), Blastocystis hominis in 4 (2.5%), Cyclospora cayetenensis in 1 (0.61%). Conclusion: High prevalence of intestinal protozoa was seen in all groups of immunosuppressed patients and a significant association seen between degree of immune suppression and protozoal infection. Focus needs to be on routine screening of all immunosuppressed patients and their immune reconstitution.