Prevalence and Genetic Characterization of Cryptosporidium and Microsporidia Infecting Hematological Malignancy Patients

Abstract

Purpose

To evaluate the prevalence of Cryptosporidium and Microsporidia, associated risk factors and species identification in patients with haematological malignancies (HM).

Methods

A total of 148 consecutive patients with HM and 101 healthy subjects were evaluated for Cryptosporidium and Microsporidia using modified Kinyoun and modified Trichrome staining. Clinical, demographic and laboratory parameters were studied. The species of Cryptosporidium and Microsporidia were studied using PCR–RFLP.

Results

Of 148 HM patients initially screened, 47 were excluded from the final analysis due to inadequate clinical records. Patients with HM [n = 101, 63 (62.4%) male] more often had Cryptosporidium than healthy subjects [n = 101, 65 (74.4%) male] [3/101 (3%) vs. 0/101 (0%), p = 0.02]. Two of 101 (2%) HM patients and none of the healthy subjects had Microsporidia (p = 0.155). Diarrhea was more prevalent in HM patients with Cryptosporidium than those without [3, 100% vs. 39/96, 40.62%; p = 0.04). Both patients infected with Microsporidia presented with persistent diarrhea and fever. Cryptosporidium hominis was identified in all the three HM patients. Enterocytozoon bieneusi was identified in one HM patient infected with Microsporidia, which was classified as genotype Ind2.

Conclusion

Cryptosporidium and Microsporidia may infect HM patients leading to overwhelming diarrhea. The commonest species of Cryptosporidium and Microsporidia found to infect HM patients are C. hominis and E. bieneusi.

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Acknowledgements

Ujjala Ghoshal would like to thank European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Clinical Parasitology group for their kind support. Sonali K. Kalra would also like to acknowledge ICMR fellowship (80/829/2013-ECD-I). This work was funded by Indian Council of Medical Research, New Delhi, India (reference no. 5/3/3/3/2008-ECD-I).

Funding

This study was supported by a grant to UG from Indian Council of Medical Research, New Delhi, India (reference no. 5/3/3/3/2008-ECD-I).

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Ujjala Ghoshal(UG) concieved and designed the study. Material preparation, data collection and analysis were performed by SKK, AD, PR and NT. The first draft of the manuscript was written by UG and SKK. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ujjala Ghoshal.

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The study was approved by Institutional Ethics Committee (PGI/DIR/RC/1085/2007).

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Consent was taken from patients while filling predesigned questionnaire.

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Ghoshal, U., Kalra, S.K., Tejan, N. et al. Prevalence and Genetic Characterization of Cryptosporidium and Microsporidia Infecting Hematological Malignancy Patients. Acta Parasit. (2020). https://doi.org/10.1007/s11686-020-00307-x

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Keywords

  • Cryptosporidiosis
  • Intestinal microsporidiosis
  • Diarrhea
  • Malignancy