The apicomplexan intestinal parasites of the genus Cryptosporidium take a major toll on human and animal health and are frequent causes of waterborne outbreaks. Several species and genotypes can infect humans, including Cryptosporidium viatorum, which, to date, has only been found in humans. Molecular characterization of Cryptosporidium spp., critical to epidemiological analyses, is commonly based on gp60 gene analysis, which appears to require bespoke species-or group-specific PCR primers due to extensive genetic diversity across the genus. In this study, we amplified, sequenced, and characterized the gp60 gene of C. viatorum for the first time. Moreover, we developed and validated a gp60 typing assay for this species and applied it to 27 isolates originating from Asia, Africa, and Central America. A single subtype family, XVa, was identified containing multiple alleles.
Cryptosporidium is one of the leading causes of infant and childhood morbidity (1). Nearly 20 species and genotypes of Cryptosporidium have been isolated from human stool (2). While Cryptosporidium parvum and Cryptosporidium hominis account for the majority of human cases of cryptosporidiosis, many other species and genotypes, most of which are acknowledged as zoonotic, appear to occur sporadically or rarely in outbreaks all over the world (3-7). The availability of relevant, precise, and robust typing tools is therefore critical to outbreak investigation, surveillance, and control of the parasite.Molecular characterization of Cryptosporidium based on gp60 gene data has proved to have high epidemiological relevance (8).To date, the resolution of the gp60 locus has enabled a subtle classification of species and genotypes into subtype families, which in turn can be differentiated at the subtype level. However, the high resolution and genetic variability existing in the gp60 locus also entails a challenge in terms of developing primers applicable to the many species and genotypes of Cryptosporidium (4, 9-11). The primers commonly used for gp60 subtyping of C. parvum and C. hominis (12) do not reliably amplify many other Cryptosporidium species. For example, new primers have been published for Cryptosporidium meleagridis (9) and Cryptosporidium ubiquitum (11). Similarly, the C. parvum/C. hominis primers do not apply to C. viatorum (4, 10), one of the panoply of Cryptosporidium species infecting humans and first described in 2012 (10); the 10 cases identified in the United Kingdom at that point all had a history of recent return from traveling to the Indian subcontinent. Later, C. viatorum was identified in patients in Nigeria (13) and Ethiopia (14) and in Swedish patients who had travelled to Kenya or Guatemala (4, 5).The aims of the present study were, first, to amplify, sequence, and characterize the gp60 gene of C. viatorum, and second, to develop, validate, and apply primers appropriate for gp60 typing of C. viatorum, thus complementing the panel of Cryptosporidium gp60 primers and contributing to C. viatorum gp60 data useful for epidemiologica...