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Molecular diversity and frequency of the diarrheagenic enteric protozoan Giardia duodenalis and Cryptosporidium spp. in a hospital setting in Northern Spain

Identifieur interne : 000363 ( Main/Exploration ); précédent : 000362; suivant : 000364

Molecular diversity and frequency of the diarrheagenic enteric protozoan Giardia duodenalis and Cryptosporidium spp. in a hospital setting in Northern Spain

Auteurs : José Manuel Azcona-Gutiérrez [Espagne] ; Aida De Lucio [Espagne] ; Marta Hernández-De-Mingo [Espagne] ; Concepci N García-García [Espagne] ; Luis Miguel Soria-Blanco [Espagne] ; Lucía Morales [Espagne] ; María Aguilera [Espagne] ; Isabel Fuentes [Espagne] ; David Carmena [Espagne]

Source :

RBID : PMC:5472271

Abstract

Background

Human giardiosis and cryptosporidiosis are caused by the enteric protozoan parasites Giardia duodenalis and Cryptosporidium spp. Both pathogens are major contributors to the global burden of diarrhoeal disease, affecting primarily children and immunodebilitated individuals in resource-poor settings. Giardiosis and cryptosporidiosis also represent an important, often underestimate, public health threat in developed countries. In Spain only limited information is currently available on the epidemiology of these infections. Molecular data on the diversity, frequency, geographical distribution, and seasonality of G. duodenalis assemblages/sub-assemblages and Cryptosporidium species/sub-genotypes are particularly scarce.

Methods

A longitudinal molecular epidemiological survey was conducted between July 2015 to September 2016 in patients referred to or attended at the Hospital San Pedro (La Rioja, Northern Spain) that tested positive for G. duodenalis (N = 106) or Cryptosporidium spp. (N = 103) by direct microscopy and/or a rapid lateral flow immunochromatographic assay. G. duodenalis infections were subsequently confirmed by real-time PCR and positive isolates assessed by multi-locus sequence genotyping of the glutamate dehydrogenase and β-giardin genes of the parasite. Cryptosporidium species and sub-genotypes were investigated at the 60 kDa glycoprotein or the small subunit ribosomal RNA genes of the parasite. Sociodemographic and clinical parameters of infected patients were also gathered and analysed.

Principal findings

Out of 90 G. duodenalis-positive isolates by real-time PCR a total of 16 isolates were successfully typed. AII (44%, 7/16) was the most prevalent sub-assemblage found, followed by BIV (31%, 5/16) and BIII (19%, 3/16). A discordant genotype result AII/AIII was identified in an additional (6%, 1/16) isolate. No mixed infections A+B were detected. Similarly, a total of 81 Cryptosporidium spp. isolates were successfully typed, revealing the presence of C. hominis (81%, 66/81) and C. parvum (19%, 15/81). Obtained GP60 sequences were assigned to sub-type families Ib (73%, 59/81) within C. hominis, and IIa (7%, 6/81) and IId (2%, 2/81) within C. parvum. A marked inter-annual variation in Cryptosporidium cases was observed.

Conclusions

Human giardiasis and cryptosporidiosis are commonly identified in patients seeking medical care in Northern Spain and represent a more important health concern than initially thought. Assemblage A within G. duodenalis and sub-genotype IbA10G2 within C. hominis were the genetic variants of these parasite species more frequently found circulating in the population under study. Molecular data presented here seem to suggest that G. duodenalis and Cryptosporidium infections arise through anthroponotic rather than zoonotic transmission in this Spanish region.


Url:
DOI: 10.1371/journal.pone.0178575
PubMed: 28617836
PubMed Central: 5472271


Affiliations:


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Le document en format XML

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<title xml:lang="en" level="a" type="main">Molecular diversity and frequency of the diarrheagenic enteric protozoan
<italic>Giardia duodenalis</italic>
and
<italic>Cryptosporidium</italic>
spp. in a hospital setting in Northern Spain</title>
<author>
<name sortKey="Azcona Gutierrez, Jose Manuel" sort="Azcona Gutierrez, Jose Manuel" uniqKey="Azcona Gutierrez J" first="José Manuel" last="Azcona-Gutiérrez">José Manuel Azcona-Gutiérrez</name>
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<addr-line>Department of Biomedical Diagnostics, Hospital San Pedro, Logroño, La Rioja, Spain</addr-line>
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<name sortKey="De Lucio, Aida" sort="De Lucio, Aida" uniqKey="De Lucio A" first="Aida" last="De Lucio">Aida De Lucio</name>
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<name sortKey="Hernandez De Mingo, Marta" sort="Hernandez De Mingo, Marta" uniqKey="Hernandez De Mingo M" first="Marta" last="Hernández-De-Mingo">Marta Hernández-De-Mingo</name>
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<nlm:aff id="aff002">
<addr-line>Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid</wicri:regionArea>
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<name sortKey="Garcia Garcia, Concepci N" sort="Garcia Garcia, Concepci N" uniqKey="Garcia Garcia C" first="Concepci N" last="García-García">Concepci N García-García</name>
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<nlm:aff id="aff003">
<addr-line>Department of Infectious Diseases, Hospital San Pedro, Logroño, La Rioja, Spain</addr-line>
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<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Infectious Diseases, Hospital San Pedro, Logroño, La Rioja</wicri:regionArea>
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<name sortKey="Soria Blanco, Luis Miguel" sort="Soria Blanco, Luis Miguel" uniqKey="Soria Blanco L" first="Luis Miguel" last="Soria-Blanco">Luis Miguel Soria-Blanco</name>
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<nlm:aff id="aff001">
<addr-line>Department of Biomedical Diagnostics, Hospital San Pedro, Logroño, La Rioja, Spain</addr-line>
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<name sortKey="Morales, Lucia" sort="Morales, Lucia" uniqKey="Morales L" first="Lucía" last="Morales">Lucía Morales</name>
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<addr-line>Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain</addr-line>
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<name sortKey="Aguilera, Maria" sort="Aguilera, Maria" uniqKey="Aguilera M" first="María" last="Aguilera">María Aguilera</name>
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</nlm:aff>
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<wicri:regionArea>Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid</wicri:regionArea>
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<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
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<name sortKey="Fuentes, Isabel" sort="Fuentes, Isabel" uniqKey="Fuentes I" first="Isabel" last="Fuentes">Isabel Fuentes</name>
<affiliation wicri:level="3">
<nlm:aff id="aff002">
<addr-line>Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
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<author>
<name sortKey="Carmena, David" sort="Carmena, David" uniqKey="Carmena D" first="David" last="Carmena">David Carmena</name>
<affiliation wicri:level="3">
<nlm:aff id="aff002">
<addr-line>Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
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<title level="j">PLoS ONE</title>
<idno type="eISSN">1932-6203</idno>
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<date when="2017">2017</date>
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<front>
<div type="abstract" xml:lang="en">
<sec id="sec001">
<title>Background</title>
<p>Human giardiosis and cryptosporidiosis are caused by the enteric protozoan parasites
<italic>Giardia duodenalis</italic>
and
<italic>Cryptosporidium</italic>
spp. Both pathogens are major contributors to the global burden of diarrhoeal disease, affecting primarily children and immunodebilitated individuals in resource-poor settings. Giardiosis and cryptosporidiosis also represent an important, often underestimate, public health threat in developed countries. In Spain only limited information is currently available on the epidemiology of these infections. Molecular data on the diversity, frequency, geographical distribution, and seasonality of
<italic>G</italic>
.
<italic>duodenalis</italic>
assemblages/sub-assemblages and
<italic>Cryptosporidium</italic>
species/sub-genotypes are particularly scarce.</p>
</sec>
<sec id="sec002">
<title>Methods</title>
<p>A longitudinal molecular epidemiological survey was conducted between July 2015 to September 2016 in patients referred to or attended at the Hospital San Pedro (La Rioja, Northern Spain) that tested positive for
<italic>G</italic>
.
<italic>duodenalis</italic>
(N = 106) or
<italic>Cryptosporidium</italic>
spp. (N = 103) by direct microscopy and/or a rapid lateral flow immunochromatographic assay.
<italic>G</italic>
.
<italic>duodenalis</italic>
infections were subsequently confirmed by real-time PCR and positive isolates assessed by multi-locus sequence genotyping of the glutamate dehydrogenase and β-giardin genes of the parasite.
<italic>Cryptosporidium</italic>
species and sub-genotypes were investigated at the 60 kDa glycoprotein or the small subunit ribosomal RNA genes of the parasite. Sociodemographic and clinical parameters of infected patients were also gathered and analysed.</p>
</sec>
<sec id="sec003">
<title>Principal findings</title>
<p>Out of 90
<italic>G</italic>
.
<italic>duodenalis</italic>
-positive isolates by real-time PCR a total of 16 isolates were successfully typed. AII (44%, 7/16) was the most prevalent sub-assemblage found, followed by BIV (31%, 5/16) and BIII (19%, 3/16). A discordant genotype result AII/AIII was identified in an additional (6%, 1/16) isolate. No mixed infections A+B were detected. Similarly, a total of 81
<italic>Cryptosporidium</italic>
spp. isolates were successfully typed, revealing the presence of
<italic>C</italic>
.
<italic>hominis</italic>
(81%, 66/81) and
<italic>C</italic>
.
<italic>parvum</italic>
(19%, 15/81). Obtained
<italic>GP60</italic>
sequences were assigned to sub-type families Ib (73%, 59/81) within
<italic>C</italic>
.
<italic>hominis</italic>
, and IIa (7%, 6/81) and IId (2%, 2/81) within
<italic>C</italic>
.
<italic>parvum</italic>
. A marked inter-annual variation in
<italic>Cryptosporidium</italic>
cases was observed.</p>
</sec>
<sec id="sec004">
<title>Conclusions</title>
<p>Human giardiasis and cryptosporidiosis are commonly identified in patients seeking medical care in Northern Spain and represent a more important health concern than initially thought. Assemblage A within
<italic>G</italic>
.
<italic>duodenalis</italic>
and sub-genotype IbA10G2 within
<italic>C</italic>
.
<italic>hominis</italic>
were the genetic variants of these parasite species more frequently found circulating in the population under study. Molecular data presented here seem to suggest that
<italic>G</italic>
.
<italic>duodenalis</italic>
and
<italic>Cryptosporidium</italic>
infections arise through anthroponotic rather than zoonotic transmission in this Spanish region.</p>
</sec>
</div>
</front>
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<name sortKey="Amor Aramendia, A" uniqKey="Amor Aramendia A">A Amor-Aramendía</name>
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<author>
<name sortKey="Hernandez De Mingo, M" uniqKey="Hernandez De Mingo M">M Hernández-de Mingo</name>
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<name sortKey="Bailo, B" uniqKey="Bailo B">B Bailo</name>
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<author>
<name sortKey="Saugar, Jm" uniqKey="Saugar J">JM Saugar</name>
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<author>
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</div1>
</back>
</TEI>
<affiliations>
<list>
<country>
<li>Espagne</li>
</country>
<region>
<li>Communauté de Madrid</li>
</region>
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<li>Madrid</li>
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<name sortKey="Azcona Gutierrez, Jose Manuel" sort="Azcona Gutierrez, Jose Manuel" uniqKey="Azcona Gutierrez J" first="José Manuel" last="Azcona-Gutiérrez">José Manuel Azcona-Gutiérrez</name>
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<name sortKey="Aguilera, Maria" sort="Aguilera, Maria" uniqKey="Aguilera M" first="María" last="Aguilera">María Aguilera</name>
<name sortKey="Carmena, David" sort="Carmena, David" uniqKey="Carmena D" first="David" last="Carmena">David Carmena</name>
<name sortKey="De Lucio, Aida" sort="De Lucio, Aida" uniqKey="De Lucio A" first="Aida" last="De Lucio">Aida De Lucio</name>
<name sortKey="Fuentes, Isabel" sort="Fuentes, Isabel" uniqKey="Fuentes I" first="Isabel" last="Fuentes">Isabel Fuentes</name>
<name sortKey="Garcia Garcia, Concepci N" sort="Garcia Garcia, Concepci N" uniqKey="Garcia Garcia C" first="Concepci N" last="García-García">Concepci N García-García</name>
<name sortKey="Hernandez De Mingo, Marta" sort="Hernandez De Mingo, Marta" uniqKey="Hernandez De Mingo M" first="Marta" last="Hernández-De-Mingo">Marta Hernández-De-Mingo</name>
<name sortKey="Morales, Lucia" sort="Morales, Lucia" uniqKey="Morales L" first="Lucía" last="Morales">Lucía Morales</name>
<name sortKey="Soria Blanco, Luis Miguel" sort="Soria Blanco, Luis Miguel" uniqKey="Soria Blanco L" first="Luis Miguel" last="Soria-Blanco">Luis Miguel Soria-Blanco</name>
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</tree>
</affiliations>
</record>

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