Identification and Subtyping of Cryptosporidium parvum and Cryptosporidium hominis in Cancer Patients, Isfahan Province, Central Iran
,
Abstract
Background: Cryptosporidium spp. are protozoan parasites that cause diarrhea in humans and animals. Subtyping data about Cryptosporidium spp. in Isfahan, Iran is limited; therefore, we aimed to study the prevalence rate of Cryptosporidium spp. in cancer patients, associated risk factors, and subtypes of Cryptosporidium spp.
Methods: Fecal samples were collected from 187 cancer patients from the Oncology Department of Seyed-al-Shohada Hospital, Isfahan University of Medical Sciences during 2014–2020 and screened for Cryptosporidium spp. using microscopical techniques. Nested PCR amplifying 18S rRNA gene was used to detect Cryptosporidium spp. in samples, followed by subtyping using nested PCR amplifying gp60 sequences.
Results: Overall, the rate of infection with Cryptosporidium spp. was 4.3% (n=8). Five samples out of eight samples were identified as Cryptosporidium spp. using a nested PCR for the 18S rRNA gene, two subtypes of C. parvum named IIaA18G3R1 (n = 2) and IIaA17G2R1 (n = 2), and one subtype of C. hominis named IbA6G3 were identified by sequencing of the gp60. The IbA6G3 subtype has rarely been detected in other investigations.
Conclusion: This is the first survey on the subtyping of Cryptosporidium spp. in this region. The results of the present survey show both zoonotic and anthroponotic transmission routes in the region.
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12. Izadi S, Mohaghegh MA, Ghayour-Najafabadi Z, et al. Frequency and molecular identification of Cryptosporidium species among immunocompromised patients referred to hospitals, central Iran , 2015–16. Iran J Parasitol. 2020;15:31.
13. Ranjbar R, Mirhendi H, Izadi M, Behrouz B, Mohammadi Manesh R. Molecular identification of Cryptosporidium spp. in Iranian dogs using seminested pcr: A first report. Vector Borne Zoonotic Dis. 2018;18:96-100.
14. Alves M, Xiao L, Sulaiman I, Lal AA, Matos O, Antunes F. Subgenotype analysis of Cryptosporidium isolates from humans, cattle, and zoo ruminants in Portugal. J Clin Microbiol. 2003;41:2744-2747.
15. Garcia-R JC, Pita AB, Velathanthiri N, French NP, Hayman DT. Species and genotypes causing human cryptosporidiosis in New Zealand. Parasitol Res. 2020;119:2317-2326.
16. Azami M, Moghaddam D, Salehi R, Salehi M. The identification of Cryptosporidium species (protozoa) in Isfahan, Iran by pcr-rflp analysis of the 18s rrna gene. Mol Biol (Mosk). 2007;41:934-939.
17. Zhang N, Yu X, Zhang H, et al. Prevalence and genotyping of Cryptosporidium parvum in gastrointestinal cancer patients. J Cancer. 2020;11:3334-3339.
18. Zabolinejad N, Berenji F, Bayati Eshkaftaki E, et al. Intestinal Parasites in Children with Lymphohematopoietic Malignancy in Iran, Mashhad. Jundishapur J Microbiol. 2013;6(6):e7765.
19. Meamar AR, Rezaian M, Mohraz M, Zahabian F, Hadighi R, Kia EB. A Comparative Analysis of Intestinal Parasitic Infections between HIV+/AIDS Patients and Non-HIV Infected Individuals. Iran J Parasitol. 1;2(1):1-6.
20. Guy RA, Yanta CA, Muchaal PK, et al. Molecular characterization of Cryptosporidium isolates from humans in Ontario, Canada. Parasit Vectors. 2021;14:1-14.
21. Nic Lochlainn LM, Sane J, Schimmer B, et al. Risk factors for sporadic cryptosporidiosis in the Netherlands: Analysis of a 3-year population based case-control study coupled with genotyping, 2013–2016. J Infect Dis. 2019;219:1121-1129.
22. Gerace E, Presti VDML, Biondo C. Cryptosporidium infection: Epidemiology, pathogenesis, and differential diagnosis. Eur J Microbiol Immunol (Bp). 2019;9:119-123.
23. Mohtashamipour M, Hoseini SGG, Pestehchian N, Yousefi H, Fallah E, Hazratian T. Intestinal parasitic infections in patients with diabetes mellitus: A case-control study. J Anal Res Clin Med. 2015;3:157-163.
24. Scorza V, Tangtrongsup S. Update on the diagnosis and management of Cryptosporidium spp. infections in dogs and cats. Top Companion Anim Med. 2010;25:163-169.
25. Bahrami F, Haghighi A, Zamini G, Khademerfan M. Zoonotic transmission of Cryptosporidium and microsporidia in individuals of the Kurdistan province, west of Iran . J Parasitol. 2020;106:464-470.
26. Braima K, Zahedi A, Oskam C, et al. Retrospective analysis of Cryptosporidium species in western Australian human populations (2015–2018), and emergence of the C. hominis ifa12g1r5 subtype. Infect Genet Evol. 2019;73:306-313.
27. Loeck BK, Pedati C, Iwen PC, et al. Genotyping and subtyping Cryptosporidium to identify risk factors and transmission patterns—Nebraska, 2015–2017. MMWR Morb Mortal Wkly Rep. 2020;69:335.
28. O’Leary JK, Blake L, Corcoran GD, Sleator RD, Lucey B. Increased diversity and novel subtypes among clinical Cryptosporidium parvum and Cryptosporidium hominis isolates in southern Ireland. Exp Parasitol. 2020;218:107967.
29. Ng JS, Eastwood K, Walker B, et al. Evidence of Cryptosporidium transmission between cattle and humans in northern New South Wales. Exp Parasitol. 2012;130:437-441.
30. Nazemalhosseini-Mojarad E, Feng Y, Xiao L. The importance of subtype analysis of Cryptosporidium spp. in epidemiological investigations of human cryptosporidiosis in Iran and other mideast countries. Gastroenterol Hepatol Bed Bench. 2012;5:67.
31. Kiani H, Haghighi A, Seyyedtabaei SJ, et al. Prevalence, clinical manifestations and genotyping of Cryptosporidium spp. in patients with gastrointestinal illnesses in western Iran. Iran J Parasitol. 2017;12:169.
32. Zintl A, Proctor A, Read C, Dewaal T, Shanaghy N, Fanning S, Mulcahy G. The prevalence of Cryptosporidium species and subtypes in human faecal samples in Ireland. Epidemiol Infect. 2009;137:270-277.
33. Chalmers RM, Smith RP, Hadfield SJ, Elwin K, Giles M. Zoonotic linkage and variation in Cryptosporidium parvum from patients in the United Kingdom. Parasitol Res. 2011;108:1321-1325.
34. Insulander M, Silverlås C, Lebbad M, Karlsson L, Mattsson J, Svenungsson B. Molecular epidemiology and clinical manifestations of human cryptosporidiosis in Sweden. Epidemiol Infect. 2013;141:1009-1020.
35. de Lucio A, Merino FJ, Martínez-Ruiz R, et al. Molecular genotyping and sub-genotyping of Cryptosporidium spp. isolates from symptomatic individuals attending two major public hospitals in Madrid, Spain. Infect Genet Evol. 2016;37:49-56.
36. Naguib D, El-Gohary AH, Roellig D, et al. Molecular characterization of Cryptosporidium spp. and Giardia duodenalis in children in egypt. Parasit Vectors. 2018;11:1-9.
37. Polubotho P, Denvir L, Connelly L, Anderson E, Alexander CL. The first UK report of a rare Cryptosporidium hominis genetic variant isolated during a complex scottish swimming pool outbreak. J Med Microbiol. 2021:001289.
38. Ong CS, Chow S, Gustafson R, et al. Cryptosporidium hominis subtype associated with aquatic center use. Emerg Infect Dis. 2008;14:1323.
39. Pintar K, Pollari F, Waltner-Toews D, Charron D, McEwen S, Fazil A, Nesbitt A. A modified case-control study of cryptosporidiosis (using non-Cryptosporidium-infected enteric cases as controls) in a community setting. Epidemiol Infect. 2009;137:1789-1799.
2. Mohaghegh MA, Hejazi SH, Ghomashlooyan M, Kalani H, Mirzaei F, Azami M. Prevalence and clinical features of Cryptosporidium infection in hemodialysis patients. Gastroenterol Hepatol Bed Bench. 2017;10:137.
3. Seyrafian S, Pestehchian N, Kerdegari M, Yousefi HA, Bastani B. Prevalence rate of Cryptosporidium infection in hemodialysis patients in Iran. Hemodial Int. 2006;10:375-379.
4. Snelling WJ, Xiao L, Ortega-Pierres G, et al. Cryptosporidiosis in developing countries. J Infect Dev Ctries. 2007;1:242-256.
5. Feng Y, Ryan UM, Xiao L. Genetic diversity and population structure of Cryptosporidium. Trends Parasitol. 2018;34:997-1011.
6. Ayres Hutter J, Dion R, Irace-Cima A, et al. Cryptosporidium spp.: Human incidence, molecular characterization and associated exposures in québec, canada (2016-2017). PLoS One. 2020;15:e0228986.
7. Sulżyc-Bielicka V, Kołodziejczyk L, Jaczewska S, et al. Colorectal cancer and Cryptosporidium spp. Infection. PLoS One. 2018;13:e0195834.
8. Ghoshal U, Kalra SK, Tejan N, Ranjan P, Dey A, Nityanand S. Prevalence and genetic characterization of Cryptosporidium and microsporidia infecting hematological malignancy patients. Acta Parasitol. 2020:1-9.
9. Kalantari N, Gorgani-Firouzjaee T, Ghaffari S, Bayani M, Ghaffari T, Chehrazi M. Association between Cryptosporidium infection and cancer: A systematic review and meta-analysis. Parasitol Int. 2020;74:101979.
10. Khan A, Shaik JS, Grigg ME. Genomics and molecular epidemiology of Cryptosporidium species. Acta Trop. 2018;184:1-14.
11. Waldron LS, Dimeski B, Beggs PJ, Ferrari BC, Power ML. Molecular epidemiology, spatiotemporal analysis, and ecology of sporadic human cryptosporidiosis in Australia. Appl Environ Microbiol. 2011;77:7757-7765.
12. Izadi S, Mohaghegh MA, Ghayour-Najafabadi Z, et al. Frequency and molecular identification of Cryptosporidium species among immunocompromised patients referred to hospitals, central Iran , 2015–16. Iran J Parasitol. 2020;15:31.
13. Ranjbar R, Mirhendi H, Izadi M, Behrouz B, Mohammadi Manesh R. Molecular identification of Cryptosporidium spp. in Iranian dogs using seminested pcr: A first report. Vector Borne Zoonotic Dis. 2018;18:96-100.
14. Alves M, Xiao L, Sulaiman I, Lal AA, Matos O, Antunes F. Subgenotype analysis of Cryptosporidium isolates from humans, cattle, and zoo ruminants in Portugal. J Clin Microbiol. 2003;41:2744-2747.
15. Garcia-R JC, Pita AB, Velathanthiri N, French NP, Hayman DT. Species and genotypes causing human cryptosporidiosis in New Zealand. Parasitol Res. 2020;119:2317-2326.
16. Azami M, Moghaddam D, Salehi R, Salehi M. The identification of Cryptosporidium species (protozoa) in Isfahan, Iran by pcr-rflp analysis of the 18s rrna gene. Mol Biol (Mosk). 2007;41:934-939.
17. Zhang N, Yu X, Zhang H, et al. Prevalence and genotyping of Cryptosporidium parvum in gastrointestinal cancer patients. J Cancer. 2020;11:3334-3339.
18. Zabolinejad N, Berenji F, Bayati Eshkaftaki E, et al. Intestinal Parasites in Children with Lymphohematopoietic Malignancy in Iran, Mashhad. Jundishapur J Microbiol. 2013;6(6):e7765.
19. Meamar AR, Rezaian M, Mohraz M, Zahabian F, Hadighi R, Kia EB. A Comparative Analysis of Intestinal Parasitic Infections between HIV+/AIDS Patients and Non-HIV Infected Individuals. Iran J Parasitol. 1;2(1):1-6.
20. Guy RA, Yanta CA, Muchaal PK, et al. Molecular characterization of Cryptosporidium isolates from humans in Ontario, Canada. Parasit Vectors. 2021;14:1-14.
21. Nic Lochlainn LM, Sane J, Schimmer B, et al. Risk factors for sporadic cryptosporidiosis in the Netherlands: Analysis of a 3-year population based case-control study coupled with genotyping, 2013–2016. J Infect Dis. 2019;219:1121-1129.
22. Gerace E, Presti VDML, Biondo C. Cryptosporidium infection: Epidemiology, pathogenesis, and differential diagnosis. Eur J Microbiol Immunol (Bp). 2019;9:119-123.
23. Mohtashamipour M, Hoseini SGG, Pestehchian N, Yousefi H, Fallah E, Hazratian T. Intestinal parasitic infections in patients with diabetes mellitus: A case-control study. J Anal Res Clin Med. 2015;3:157-163.
24. Scorza V, Tangtrongsup S. Update on the diagnosis and management of Cryptosporidium spp. infections in dogs and cats. Top Companion Anim Med. 2010;25:163-169.
25. Bahrami F, Haghighi A, Zamini G, Khademerfan M. Zoonotic transmission of Cryptosporidium and microsporidia in individuals of the Kurdistan province, west of Iran . J Parasitol. 2020;106:464-470.
26. Braima K, Zahedi A, Oskam C, et al. Retrospective analysis of Cryptosporidium species in western Australian human populations (2015–2018), and emergence of the C. hominis ifa12g1r5 subtype. Infect Genet Evol. 2019;73:306-313.
27. Loeck BK, Pedati C, Iwen PC, et al. Genotyping and subtyping Cryptosporidium to identify risk factors and transmission patterns—Nebraska, 2015–2017. MMWR Morb Mortal Wkly Rep. 2020;69:335.
28. O’Leary JK, Blake L, Corcoran GD, Sleator RD, Lucey B. Increased diversity and novel subtypes among clinical Cryptosporidium parvum and Cryptosporidium hominis isolates in southern Ireland. Exp Parasitol. 2020;218:107967.
29. Ng JS, Eastwood K, Walker B, et al. Evidence of Cryptosporidium transmission between cattle and humans in northern New South Wales. Exp Parasitol. 2012;130:437-441.
30. Nazemalhosseini-Mojarad E, Feng Y, Xiao L. The importance of subtype analysis of Cryptosporidium spp. in epidemiological investigations of human cryptosporidiosis in Iran and other mideast countries. Gastroenterol Hepatol Bed Bench. 2012;5:67.
31. Kiani H, Haghighi A, Seyyedtabaei SJ, et al. Prevalence, clinical manifestations and genotyping of Cryptosporidium spp. in patients with gastrointestinal illnesses in western Iran. Iran J Parasitol. 2017;12:169.
32. Zintl A, Proctor A, Read C, Dewaal T, Shanaghy N, Fanning S, Mulcahy G. The prevalence of Cryptosporidium species and subtypes in human faecal samples in Ireland. Epidemiol Infect. 2009;137:270-277.
33. Chalmers RM, Smith RP, Hadfield SJ, Elwin K, Giles M. Zoonotic linkage and variation in Cryptosporidium parvum from patients in the United Kingdom. Parasitol Res. 2011;108:1321-1325.
34. Insulander M, Silverlås C, Lebbad M, Karlsson L, Mattsson J, Svenungsson B. Molecular epidemiology and clinical manifestations of human cryptosporidiosis in Sweden. Epidemiol Infect. 2013;141:1009-1020.
35. de Lucio A, Merino FJ, Martínez-Ruiz R, et al. Molecular genotyping and sub-genotyping of Cryptosporidium spp. isolates from symptomatic individuals attending two major public hospitals in Madrid, Spain. Infect Genet Evol. 2016;37:49-56.
36. Naguib D, El-Gohary AH, Roellig D, et al. Molecular characterization of Cryptosporidium spp. and Giardia duodenalis in children in egypt. Parasit Vectors. 2018;11:1-9.
37. Polubotho P, Denvir L, Connelly L, Anderson E, Alexander CL. The first UK report of a rare Cryptosporidium hominis genetic variant isolated during a complex scottish swimming pool outbreak. J Med Microbiol. 2021:001289.
38. Ong CS, Chow S, Gustafson R, et al. Cryptosporidium hominis subtype associated with aquatic center use. Emerg Infect Dis. 2008;14:1323.
39. Pintar K, Pollari F, Waltner-Toews D, Charron D, McEwen S, Fazil A, Nesbitt A. A modified case-control study of cryptosporidiosis (using non-Cryptosporidium-infected enteric cases as controls) in a community setting. Epidemiol Infect. 2009;137:1789-1799.
| Files | ||
| Issue | Vol 17 No 4 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijpa.v17i4.11277 | |
| Keywords | ||
| Cryptosporidium Genotypes Subtyping Cancer | ||
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How to Cite
1.
Pestechian N, Mohammadi Manesh R, Tavakoli S, Mokarian F, Rahmani M. Identification and Subtyping of Cryptosporidium parvum and Cryptosporidium hominis in Cancer Patients, Isfahan Province, Central Iran. Iran J Parasitol. 2022;17(4):497-505.
