A case of severe diarrhoea caused by Cyclospora cayetanensis in an immunocompromised patient in northern Spain

Alkorta, Miriam; Manzanal, Ayla; Ceberio, Izaskun

doi:10.1099/acmi.0.000313

Cited by 6 publications

(9 citation statements)

References 11 publications

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“…A total of 47.6% were males and more than 50% of the cases were outpatients (56.1%). The age was categorized into 18 groups [ 20 ]; The two largest groups involved in this study were the participants with age group less than 5 years ( N = 57/207, 27.5%) and more than 60 years ( N = 72/207, 34.8%) (Figure S1 ).…”

Section: Resultsmentioning

confidence: 99%

Enhancing enteric pathogen detection: implementation and impact of multiplex PCR for improved diagnosis and surveillance

Mohtar,

Mallah,

Mardirossian

et al. 2024

BMC Infect Dis

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Background Syndromic surveillance of acute gastroenteritis plays a significant role in the diagnosis and management of gastrointestinal infections that are responsible for a substantial number of deaths globally, especially in developing countries. In Lebanon, there is a lack of national surveillance for acute gastroenteritis, and limited data exists regarding the prevalence of pathogens causing diarrhea. The one-year study aims to investigate the epidemiology of common gastrointestinal pathogens and compare our findings with causative agents of diarrhea reported by our study collaborative centers. Methods A multicenter, cross-sectional study was conducted over a one-year period. A total of 271 samples were obtained from outpatients and inpatients presenting with symptoms of acute gastroenteritis at various healthcare facilities. The samples were then analyzed using Allplex gastrointestinal assay that identifies a panel of enteric pathogens. Results Overall, enteropathogens were detected in 71% of the enrolled cases, 46% of those were identified in patients as single and 54% as mixed infections. Bacteria were observed in 48%, parasites in 12% and viruses in 11%. Bacterial infections were the most prevalent in all age groups. Enteroaggregative E. coli (26.5%), Enterotoxigenic E. coli (23.2%) and Enteropathogenic E. coli (20.3%) were the most frequently identified followed by Blastocystis hominis (15.5%) and Rotavirus (7.7%). Highest hospitalization rate occurred with rotavirus (63%), Enterotoxigenic E. coli (50%), Blastocystis hominis (45%) and Enteropathogenic E. coli (43%). Enteric pathogens were prevalent during summer, fall and winter seasons. Conclusions The adoption of multiplex real-time PCR assays in the diagnosis of gastrointestinal infections has identified gaps and improved the rates of detection for multiple pathogens. Our findings highlight the importance of conducting comprehensive surveillance to monitor enteric infections. The implementation of a syndromic testing panel can therefore provide healthcare professionals with timely and accurate information for more effective treatment and public health interventions.

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Section: Resultsmentioning

confidence: 99%

Enhancing enteric pathogen detection: implementation and impact of multiplex PCR for improved diagnosis and surveillance

Mohtar,

Mallah,

Mardirossian

et al. 2024

BMC Infect Dis

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“…Different studies investigated the prevalence of protozoan pathogens in immunocompromised patients since most protozoan intestinal parasites can cause opportunistic infections, defined as "serious, usually progressive infections by a microorganism that has limited or no pathogenic capacity under ordinary circumstances, but which has been able to cause serious disease as a result of the predisposing effect of another disease or of its treatment" [63], in immunocompromised persons [10,20,36,49,50,[64][65][66][67][68][69][70][71][72][73].…”

Section: Parasitic Protozoans In Patients Immunocompromised or With P...mentioning

confidence: 99%

Protozoan Infections Acquired from Food or Drinking Water: An Update

Rossi,

Amadoro,

Santonicola

et al. 2024

Preprint

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This review summarizes the most recent developments of research on protozoan parasite infections ac-quired through food and drinking water and is aimed at gathering updated knowledge on the risk factors, illnesses caused, and measures for prevention. Reports included dated from 2019 to the present and regarded recent outbreaks and cases of severe infec-tions, prevalence in different population segments and food handlers, and occurrence in food and drinking water. Cryptosporidium spp., Entamoeba histolytica, Giardia intestinalis, Trypanosoma cruzi and Toxoplasma gondii were the microorganisms most frequently involved in large outbreaks and/or severe infections, while Cyclospora cayetanensis was most frequently involved in single case reports. Cystoisospora belli was implied in severe infections in immunocompromised patients, while Blastocystis homi-nis, Sarcocystis spp., Dientamoeba fragilis, Endolimax nana and Pentatrichomonas hominis appeared to be less relevant for number of symptomatic infections and pathogenic potential. A progressive improvement in surveillance of protozoan infections and infection sources was highlighted, especially in developed countries. The apparent increase in cases was concomitant with the implementa-tion of reporting systems and the application of molecular diagnostic methods that represent valuable in-struments for establishing epidemiological links and preventing or limiting outbreaks. The pathogenic role and sources of infection should be better elucidated for some species.

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“…It has also been hypothesized that coccidia infections, including cyclosporiasis, could be environmental triggers for celiac disease [ 116 ]. Most reported clinical cases of cyclosporiasis in the past three years involved immunocompromised persons, such as HIV-positive, transplant recipients, or cancer patients [ 15 , 114 , 117 , 118 , 119 , 120 ]. A clinical case in an immunocompetent person was also reported [ 17 ].…”

Section: Pathogenesis Symptoms and Treatmentmentioning

confidence: 99%

“…To our knowledge, no new treatments have been used in humans in recent years. In recent clinical cases, patients were treated with trimethoprim/sulfamethoxazole [ 117 , 119 ]. The clinical cases included a patient with severe combined pulmonary Nocardia bacteremia with cyclosporiasis and a previous history of heart transplant in India [ 117 ] and an immunocompromised patient with large B cell lymphoma in Northern Spain [ 119 ].…”

Section: Pathogenesis Symptoms and Treatmentmentioning

confidence: 99%

“…In recent clinical cases, patients were treated with trimethoprim/sulfamethoxazole [ 117 , 119 ]. The clinical cases included a patient with severe combined pulmonary Nocardia bacteremia with cyclosporiasis and a previous history of heart transplant in India [ 117 ] and an immunocompromised patient with large B cell lymphoma in Northern Spain [ 119 ]. Cotrimoxazole was successful in the treatment of an immunocompromised patient, who had previously undergone a renal allograft transplant and had a history of several coinfections (tuberculosis, cytomegalovirus, severe acute respiratory syndrome coronavirus 2, and hepatitis C) [ 120 ].…”

Section: Pathogenesis Symptoms and Treatmentmentioning

confidence: 99%

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Cyclospora cayetanensis: A Perspective (2020–2023) with Emphasis on Epidemiology and Detection Methods

Almeria,

Chacin-Bonilla,

Maloney

et al. 2023

Microorganisms

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Cyclospora cayetanensis infections are prevalent worldwide, and the parasite has become a major public health and food safety concern. Although important efforts have been dedicated to advance toward preventing and reducing incidences of cyclosporiasis, there are still several knowledge gaps that hamper the implementation of effective measures to prevent the contamination of produce and water with Cyclospora oocysts. Some of these data gaps can be attributed to the fact that access to oocysts is a limiting factor in C. cayetanensis research. There are no animal models or in vivo or in vitro culture systems to propagate the oocysts needed to facilitate C. cayetanensis research. Thus, researchers must rely upon limited supplies of oocysts obtained from naturally infected human patients considerably restricting what can be learnt about this parasite. Despite the limited supply of C. cayetanensis oocysts, several important advances have happened in the past 3 years. Great progress has been made in the Cyclospora field in the areas of molecular characterization of strains and species, generation of genomes, and development of novel detection methods. This comprehensive perspective summarizes research published from 2020 to 2023 and evaluates what we have learnt and identifies those aspects in which further research is needed.

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A case of severe diarrhoea caused by Cyclospora cayetanensis in an immunocompromised patient in northern Spain

Cited by 6 publications

References 11 publications

Enhancing enteric pathogen detection: implementation and impact of multiplex PCR for improved diagnosis and surveillance

Enhancing enteric pathogen detection: implementation and impact of multiplex PCR for improved diagnosis and surveillance

Protozoan Infections Acquired from Food or Drinking Water: An Update

Cyclospora cayetanensis: A Perspective (2020–2023) with Emphasis on Epidemiology and Detection Methods

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