Identification of opportunistic enteric parasites among immunocompetent patients with diarrhoea from Northern India and genetic characterisation of Cryptosporidium and Microsporidia.
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Date
2016-01
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Abstract
Purpose: Enteric parasitic infestation is a major public health problem in developing countries. Parasites such
as Cryptosporidium spp., Cyclospora spp., Cystoisospora spp. and Microsporidia may cause severe diarrhoea
among immunocompromised patients. There is scanty data on their frequency among immunocompetent patients.
Accordingly, we studied the frequency of enteric opportunistic parasites among immunocompetent patients with
diarrhoea from northern India; we also performed genetic characterisation of Cryptosporidia and Microsporidia among
them. Patients and Methods: Stool samples from 80 immunocompetent patients with diarrhoea, and 110 healthy controls
were examined. Parasites were detected by direct microscopy, modified acid-fast (Kinyoun’s) and modified trichrome
stain. Polymerase chain reaction – restriction fragment length polymorphism was used for genetic characterisation of
selected species such as Cryptosporidia and Microsporidia. Results: Enteric parasites were detected in 16/80 (20%)
patients (mean age 28.8 ± 20 years, 45, 56% males) and in 2/110 (1.8%) healthy controls (P = 0.00007). Parasites detected
were Cryptosporidium spp. (8/16, 50.0%), Cystoisospora spp. (4/16, 25%), Microsporidia (1/16, 6.25%), Cyclospora spp.
(1/16, 6.25%) and Giardia spp. (1/16, 6.25%). One patient had mixed infection with Cystoisospora spp. and Giardia spp.
The species of Cryptosporidia and Microsporidia detected were Cryptosporidium hominis and Enterocytozoon bieneusi,
respectively. Parasites were more often detected in younger patients (≤20 years of age) than in older. Most of the parasite
infected patients presented with chronic diarrhoea. Conclusion: Opportunistic enteric parasitic infestation was more
common among immunocompetent patients with diarrhoea than healthy subjects. Special staining as well as molecular
methods are essential for appropriate diagnosis of these parasites.
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Keywords
Coccidian parasites, diarrhoea, immunocompetent, Microsporidia
Citation
Ghoshal U, Dey A, Ranjan P, Khanduja S, Agarwal V, Ghoshal U C. Identification of opportunistic enteric parasites among immunocompetent patients with diarrhoea from Northern India and genetic characterisation of Cryptosporidium and Microsporidia. Indian Journal of Medical Microbiology. 2016 Jan-Mar; 34(1): 60-66.