Cryptosporidium infection in patients with gastroenteritis in sari, iran.

  • Shirzad Gholami Molecular and Cell Biology Research Center , Mazandaran University of Medical Sciences, Iran.
  • Majid Khanmohammadi Department of Laboratory Sciences, Marand Branch, Islamic Azad University, Iran.
  • Ehsan Ahmadpour Molecular and Cell Biology Research Center , Mazandaran University of Medical Sciences, Iran.
  • Abdol Sattar Pagheh Molecular and Cell Biology Research Center , Mazandaran University of Medical Sciences, Iran.
  • Sara Khadem Nakhjiri Gorgan Faculty of Medicine, Golestan University of Medical Sciences, Iran.
  • Hamidreza Ramazannipour Faculty of Basic Sciences, University of Mazandaran, Iran.
  • Abbas Shahbazi Tabriz Research Center of Infectious and Tropical Diseases, Tabriz University of Medical sciences, Iran.
Keywords: Cryptosporidium spp, Gastroenteritis Patients, Nested PCR


Background: Cryptosporidiosis is a common coccidian parasite infection in patients with diarrhea that has worldwide distribution especially in developed countries. Therefore,the aim of this study was to determine the occurrence of Cryptosporidium infection in patients with gastroenteritis admitted to hospitals of Mazandaran University of Medical Sciences by parasitological and molecular methods in Sari, Iran.Methods: Stool samples were collected from 348 patients with gastroenteritis admitted to the hospitals of Medical University in the Sari and Ghaemshahr cities in Mazandaran Province, Northern Iran in 2010-2011. Oocysts of Cryptosporidium identified using Formalin-Ether concentration method and stained by Aacid-fast staining (AFS)and Auramine phenol fluorescence (APF). Genomic DAN extracted from microscopically positive samples and nested PCR -RFLP by using SSU rRNA that identifies of the species of cryptosporidium.Results: In 348 patients with gastroenteritis, the most clinical symptoms were diarrhea, nausea, vomiting, dehydration, fever and weight loss. 2.3% (8 cases) of diarrheal samples tested by both microscopy and molecular methods were positive for the presence of cryptosporidium. Nested PCR products yielded unique bands of 846 bp, correspond to cryptosporidium. Species diagnosis carried out by digesting the secondary PCR product with SspI restriction enzyme, which noted 3 clearly bands of 449, 254, and 108 bp correspond to Cryptosporidium spp.Conclusion: The results of present study on Cryptosporidium spp. in this area can make a background data for control programs and further molecular analyses. Thus, further work needs to determine the origin of Cryptosporidium species in this area.


David Dawson T. Foodborne protozoan parasites. Int J Food Microbiol. 2005; 103: 207-227.

Griffiths JK. Human cryptosporidiosis: epidemiology, transmission, clinical disease, treatment, and diagnosis. Adv Parasito. 1998; 40: 37-85.

Fayer R, Morgan U, Upton SJ. Epidemiology of Cryptosporidium: transmission, detection and identification. Int J Parasitol. 2000; 30(12-13):1305-22.

Mosier DA, Oberst RD. Cryptosporidiosis. A global challenge. Ann N Y Acad Sci. 2000; 916: 102-111.

Caccio SM. Molecular epidemiology of human cryptosporidiosis. Parassitologia. 2005; 47 (2): 185-192.

Xiao L, Ryan UM. Cryptosporidiosis: an update in molecular epidemiology. Curr Opin Infect Dis. 2004; 17(5):483-490.

Current WL, Garcia LS. Cryptosporidiosis. Clin Microbiol Rev. 1991; 4(3): 325-358.

Gholami Sh, Hamzah Ali A, Khalilian A, Fakhar M, Daryani A, Sharif M, Gohardehi Sh, Ahmadpou A. The Frequency of Cryptosporidiosis Among Gastroenteritic Patients Referred to Mazandaran University of Medical Science Hospitals, During 2010-2011. J Mazand Univ Med Sci. 2012; (22): 263-272(Supple 1) (Persian).

Fayer R. Cryptosporidium; A water-born zoonotic parasite. Vet Parasitol. 2004; 126 (1- 2): 37-56.

Hazrati Tappeh KH, Gharavi MJ, Makhdoumi K, Rahbar M, Taghizadeh A. Prevalence of Cryptosporidium spp. Infection in Renal Transplant and Hemodialysis Patients. Iranian J Publ Health. 2006; 35(3):54-57.

Egyed Z, Sreter T, Varga I. Characterization of Cryptospordium spp-recent developments and future needs. Vet Parasitol. 2003; 111:103-114.

Nahrevanian H, Azarinoosh SA, Esfandiari B, Amirkhani A, Ziapoor SP, Shadifar M. The frequency of cryptosporidiosis among gastroenteritic patients in western cities of Mazandaran Province (2007-2009). Qazvin University of Medical Sciences. 2011; 1(58): 78-86 (Persian).

MCManus DP, Bowels J. Molecular genetic approaches to parasite identification: their value in diagnostic parasitology and systematic. Int J Parasitol. 1996; 26: 687-704.

Azami M, Moghaddam DD, Salehi R, Salehi M. The identification of Cryptosporidium species (Protozoan) in Isfahan, Iran by PCR-RFLP analysis of the 18 s rRNA gene. Molecul Biol. 2007; 41(5): 934-939.

Fallah S, Mahdavipoor B, Jamali R, Nahavidi KH, Asgharzadeh M. Molecular characterization of Cryptosporidium isolates form cattle in a slaughterhouse in Tabriz, northwestern Iran. J Biol Sci. 2008; 8(3): 639-643.

Keshavarz A, Thari A, Hughi A, Kazami B, Abadi A, Hoseini N, Nazmalhoseini Mojarad E, Kashi L . Genetic characterization of Cryptosporidium SPP. Among children with Diarrhea in Tehran and Qazvin province; Iran. Iranian J Parasito. 2008; 3(3): 30-36.

Hamedi Y, Safa O, Haidari M. Cryptosporidium infection in diarrheic children in southeastern Iran. Peditar Infect Dis J. 2005; 24(4): 86-88.

Thompson RC, Olson ME, Zhu G, Enomoto S, Abrahamsen MS, Hijjawi NS. Cryptosporidium and cryptosporidiosis. Adv Parasitol. 2005; 59: 77-158.

McLauchlin J, Pedraza-Diaz S, Amar- Hoetzeneder C, Nichols GL. Genetic characterization of Cryptosporidium strains from 218 patients with diarrhea diagnosed as having sporadic cryptosporidiosis. J Clin Microbiol. 1999; 37(10): 3153-8.

Afshari Safavi E, Reza Mohammadi GH, Naghibi A, Rad M. Prevalence of Cryptosporidium spp. infection in some dairy Herds of Mashhad (Iran) and its association with diarrhea in newborn calves. Comp Clin Pathol. 2011; 20: 103-107.

Kostrzynska M, Sankey M, Haack E, Power C, Aldom GE, Chagla AH, Unger S, Palmateer G, Lee H, Trevors JT, De Grandis SA. Three sample preparation protocols for polymerase chain reaction based detection of Cryptosporidium parvum in environment samples. J Microbiol Methods. 1999; 35(1): 65-71.

Van Soolingen D, de Haas PE, Hermans PW, Van Embden JD. DNA fingerprinting of Mycobacterium tuberculosis. Methods Enzymol. 1994; 235: 196-205.

Xiao L, Bern C, Limor J, Sulaiman I, Roberts J, Checkley W, Cabrera L, Gilman RH, Lal AA. Identification of 5 types of Cryptosporidium parasites in children in Lima, Peru. J Infect Dis. 2001; 183(3): 492-7.

Xiao L, Sulaiman IM, Ryan UM, Zhou L, Atwill ER, Tischler ML, et al. Host adaptation and host-parasite co-evolution in Cryptosporidium: implications for taxonomy and public health. Int J Parasitol. 2002; 32(14): 1773-85.

Fredrich, MA, Brent R, Kingstone RE, Moore DD, Seidman JG, Smith JA, Struhl K. Short Protocols in Molecular Biology. 5th ed. John Wiley and Sons; 2002. p.1504

Zali MR, Mehr AJ, Rezaian M, Meamar AR, Vaziri S, Mohraz M. Prevalence of intestinal parasitic pathogens among HIV-Positive Individuals in Iran. JPn J Infect Dis. 2004; 57(6):268-270.

Taghipour N, Nazemalhosseini- Mojarad E, Haghighi A, Rostami- Nejad M, Romani S, Keshavarz A, Alebouyeh M , Zali M. Molecular Epidemiology of Cryptosporidiosis in Iranian Children, Tehran, Iran. Iran J Parasitol. 2011; 6(4):41-45.

Guyot K, Follet-Dumoulin A, Lelievre E, Sarfati C, Rabodonirina M, Nevez G, Cailliez JC, Camus D, Dei-Cas E. Molecular characterization of Cryptosporidium isolates obtained fromhumans in France. J Clin Microbiol. 2001; 39(10): 3472-3480.

Wielinga PR, de Vries A, van der Goot TH, Mank T, Mars MH, Kortbeek LM, van der Giessen JW. Molecular epidemiology of Cryptosporidium in humans and cattle in The Netherlands. Int J Parasitol. 2008; 38(7): 809– 817.

Shahbazi A, Gholami Sh, Mirsamadi N, Nokhahi I, Ghazanchaii A, Kumar D, Wannigama L, Izadi S. Detection of Cyclospora, Microsporidia and Cryptosporidium by direct microscopy and PCR in stools specimens in Northwest, Iran. Res. Opin. Anim. Vet. Sci. 2012; 2(5): 352-359.

Nouri M, Mahdavi Rad S. Effect of nomadic shepherds and their sheep on the incidence of cryptosporidiosis in an adjacent town. J Infect. 1993; 26(1):105-6.

Fasihi Harandi M, Fotouhi Ardakani R. Cryptosporidium infection of farm animals: first identification of Cryptosporidium andersoni and Cryptosporidium parvum in Iran. 11th International Congress of Parasitology: Glasgow, Scotland; 2006.p. 6-11.

Meamar AR, Guyot K, Certad G, Dei-Cas E, Mohraz M, Mohebali M, Mohammad K, Mehboa AA, Rezaie S and Rezaian M. Molecular characterization of Cryptosporidium isolates from humans and animals in Iran. Appl Environ Microbiol. 2007; 73(3): 1033-1035.

Daryani A, Sharif M, Meigouni M, Mahmoudi FB, Rafiei A, Gholami Sh, Khalilian A, Gohardehi Sh, Mirabi AM. Prevalence of intestinal parasites and profile of CD4+ counts in HIV+/AIDS people in north of Iran, 2007- 2008. Pak J Biol Sci. 2009; 12(18):1277-81.

Sharif M, Daryani A, Asgarian F, Nasrolahei M. Intestinal parasitic infections among intellectual disability children in rehabilitation centers of northern Iran. Res Dev Disabil. 2010; 31(4):924-8.

Moghaddam AA. Symptomatic and Asymptomatic Cryptosporidiosis in Young Children in Iran. Pak J Biol Sci. 2007; 10(7):1108-1112.

Idris NS, Dwipoerwantoro PG, Kurniawan A, Said M. Intestinal parasitic infection of immunocompromised children with diarrhea: clinical profile and therapeutic response. J Infect Dev Ctries. 2010;4(5):309-17.

Al-Megrin WAI. Intestinal Parasites among Immunocompromised Patients in Riyadh, Saudi Arabia. Pak J Biol Sci. 2010; 13(8):390-394.

How to Cite
Gholami S, Khanmohammadi M, Ahmadpour E, Pagheh AS, Khadem Nakhjiri S, Ramazannipour H, Shahbazi A. Cryptosporidium infection in patients with gastroenteritis in sari, iran. IJPA. 9(2):226-32.