First survey of Enterocytozoon bieneusi and dominant genotype Peru6 among ethnic minority groups in southwestern China’s Yunnan Province and assessment of risk factors

Abstract

Background Enterocytozoon bieneusi is the most common microsporidian species causing diarrhea and other intestinal disorders in humans and animals. Like other infectious diseases, microsporidiosis usually disproportionately affects poor populations. In China, some ethnic minority areas remain poor. Currently, no information of E . bieneusi infection is available in minority populations. The present aims were to understand occurrence and genetic characterizations of E . bieneusi in ethnic minority groups from a poverty-stricken ethnic township in Yunnan Province, and to assess risk factors for E . bieneusi infection. Methodology/Principal findings 289 fecal specimens were collected from Yao people (one specimen each) with and without diarrhea, in Yunnan Province. E . bieneusi was identified and genotyped by PCR and sequence analysis of the ITS region of the rRNA gene. An average prevalence of 8.30% (24/289) was observed and four genotypes were identified—genotype Peru6 (n = 21) and three novel genotypes (one each). Genotype Peru6 was detected in two family members in each of three families. In a phylogenetic analysis, all of four genotypes fell into group 1 with zoonotic potential. The people owning individual pit toilets had a statistically higher prevalence of E . bieneusi (16.67%, 12/72) than those using public pit toilets (6.06%, 12/198). Conclusions/Significance This is the first report on occurrence and genetic characteristics of E . bieneusi in ethnic minority groups in China. Genotype Peru6 was found in humans in China for the first time and showed dominance in Yao people. The same genotype was found in some family members and all the genotypes fell into group 1, suggesting the possibility of anthroponotic and zoonotic transmissions. The majority (83.33%, 20/24) of E . bieneusi positive individuals did not present diarrhea. In any case, it is important to recognize their existence and the importance that asymptomatic individuals to E . bieneusi may have from an epidemiological point of view, as transmitters of this pathogen. The analysis of risk factors provides scientific evidence for the development of effective strategies for prevention and control of E . bieneusi infection.

Unusual dominant genotype NIA1 of Enterocytozoon bieneusi in children in Southern Xinjiang, China

“…In 2011, the first report emerged of E. bieneusi infecting humans in Jilin, China [6], with 22.5% (9/40) of children with diarrheal disease testing positive for this pathogen. Over the last decade, the prevalence and genotype distribution of E. bieneusi in humans in China have been reported by several studies [6][7][8][9][10][11][12][13][14][15]. The study participants had widely variable characteristics (children with or without diarrhea, HIV-positive or -negative individuals, and other immunocompromised patients) [6][7][8][9][10][11][12][13][14][15] and the studies were conducted in diverse geographical locations (Jilin, Heilongjiang, Guangxi, Henan, Shanghai, Hubei, Chongqing, and Yunnan).…”

Genotype identification and phylogenetic analysis ofEnterocytozoon bieneusiin farmed black goats (Capra hircus) from China’s Hainan Province

“…All the studies on E. bieneusi in goats found at least one zoonotic genotype (BEB6, Peru6, EbpA and EbpC) with a high prevalence, except for the study from Anhui Province. Interestingly, Peru6 and EbpC were commonly found in humans from Yunnan and Heilongjiang Provinces; they were also found in animals including pigs, minks and birds [5,7,15,27,29]. Zoonotic genotype BEB6 was found in a child from Shanghai City, and it seems more common in herbivore animals in China, including deer, sheep, goats, cattle and horses [30].…”

“…Sequence analysis of the ribosomal internal transcribed spacer (ITS) region is the standard method for the detection and identification of E. bieneusi genotypes [19]. To date, more than 500 genotypes have been identified, of which 130 have been found in humans [7,13,15,26]. The known genotypes of E. bieneusi were divided into 11 phylogenetic groups (Groups 1-11) by phylogenetic analysis.…”

Prevalence, genetic diversity and implications for public health of Enterocytozoon bieneusi in various rodents from Hainan Province, China

“…These genotypes were grouped into 11 genetically isolated clusters by phylogenetic analysis [5]. Group 1 is the largest group containing more than 300 genotypes, including 87.6% (132/142) human-pathogenic genotypes [5,10]; 85.7% (42/49) zoonotic genotypes also belong to this group [5,9]. In Group 2, up to 100 genotypes are considered to be adapted to ruminants; however, contrary to previous reports, a broader host range was indicated for some genotypes, such as genotypes I, J, BEB6, BEB4 and CHN3 that are also commonly found in humans, enhancing their importance for public health [5].…”