Infection by Cryptosporidium parvum in renal patients submitted to renal transplant or hemodialysis

Chieffi, Pedro Paulo; Sens, Yvoty Alves dos Santos; Paschoalotti, Maria Aparecida; Miorin, Luiz Antonio; Silva, Hélio Gomes C.; Jabur, Pedro

doi:10.1590/s0037-86821998000400001

Cited by 42 publications

(44 citation statements)

References 23 publications

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“…The results showed frequencies of C. parvum infection of 34.8, 25, and 17.4% for the transplant recipients, the patients undergoing hemodialysis, and the control group, respectively. Statistical analysis showed no significant differences among the three groups (26). Contrary to this view was a study from Turkey which examined 115 fecal specimens from 69 renal transplant recipients and 42 fecal specimens from 42 control patients (97).…”

Section: Cryptosporidiosis In Patients Following Solid-organ Transplamentioning

confidence: 88%

Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Hunter

Nichols²

2002

Clin Microbiol Rev

480

352

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SUMMARY Cryptosporidium spp. are a major cause of diarrheal disease in both immunocompetent and immunodeficient individuals. They also cause waterborne disease in both the United States and United Kingdom. Studies on the mechanisms of immunity to cryptosporidiosis indicate the importance of the T-cell response. The spectrum and severity of disease in immunocompromised individuals with cryptosporidiosis reflect this importance since the most severe disease is seen in individuals with defects in the T-cell response. The most commonly studied group is that of patients with AIDS. These patients suffer from more severe and prolonged gastrointestinal disease that can be fatal; in addition, body systems other than the gastrointestinal tract may be affected. The widespread use of antiretroviral therapy does appear to be having a beneficial effect on recovery from cryptosporidiosis and on the frequency of infection in human immunodeficiency virus-positive patients. Other diseases that are associated with increased risk of severe cryptosporidiosis, such as primary immunodeficiencies, most notably severe combined immunodeficiency syndrome, are also predominantly associated with T-cell defects. Of the remaining groups, children with acute leukemia seem to be most at risk from cryptosporidiosis. There is less evidence of severe complications in patients with other malignant diseases or in those receiving immunosuppressive chemotherapy.

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Section: Cryptosporidiosis In Patients Following Solid-organ Transplamentioning

confidence: 88%

Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Hunter

Nichols²

2002

Clin Microbiol Rev

480

352

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“…Studies determining the prevalence of enteroparasitosis in CRF patients on dialysis are scarce and have shown high infection rates, mainly by protozoa 2,8,24,31,34 . The impact of this parasitosis on the health of immunocompetent individuals is already known, and there may be impairment of the nutritional and immune condition culminating in an increased risk of bacterial, viral, and fungal co-infections 35 .…”

Section: Discussionmentioning

confidence: 99%

“…Studies determining the prevalence of enteroparasites in chronic renal failure patients have shown rates ranging from 11% to 34% 2,8,34 . A study comparing 86 patients on hemodialysis and 146 healthy individuals found significant differences in the prevalence of enteroparasites between both groups (45.1% X 26.7% -p = 0.0318), and a greater ratio of polyparasitism in patients on dialysis (9.2% vs. 0.9% -p = 0.0019) 19 .…”

Section: Discussionmentioning

confidence: 99%

“…Intestinal parasitosis, especially that caused by Cryptosporidium spp and Blastocystis hominis, has also been reported as a clinically important infection not only in immunocompromised patients but also in hemodialysis and renal transplant patients, with the prevalence data in these groups ranging from 15-25% and 20-35% respectively 2,8,24,31,34 . Such infections can cause uremic symptoms in patients to be aggravated, which as well as compromising their quality of life play an important role in the progress of those patients who will undergo kidney transplants.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Intestinal Parasitism and Associated Symptomatology Among Hemodialysis Patients

Gil

Barros

Macedo

et al. 2013

Rev. Inst. Med. trop. S. Paulo

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SUMMARYIntestinal parasites are an important cause of morbidity and mortality. Immunocompromised individuals may develop more severe forms of these infections. Taking into account the immunity impairment in patients suffering from chronic renal failure (CRF), we will determine the prevalence and associated symptoms of intestinal parasites in these patients. Controls without CRF were used for comparison. Stool samples were collected and processed for microscopic identification of parasites using the Formalin-ether concentration method. For Cryptosporidium diagnosis, the ELISA technique was used. One hundred and ten fecal samples from hemodialysis patients were analyzed, as well as 86 from a community group used as control group. A result of 51.6% of intestinal parasites was observed in hemodialysis patients and 61.6% in the control group. Cryptosporidium and Blastocystis were the most common infections in patients with CRF (26.4% and 24.5%, respectively). Blastocystis was the most common infection in the control group (41.9%), however no individual was found positive for Cryptosporidium. Among the CRF patients, 73.6% were symptomatic, 54.3% of these tested positive for at least one parasite, in contrast to 44.8% in asymptomatic patients (p = 0.38). The most common symptoms in this group were flatulence (36.4%), asthenia (30.0%) and weight loss (30.0%). In the control group, 91.9% were symptomatic, 60.8% of these tested positive for at least one parasite, in contrast to 71.4% in asymptomatic patients (p = 0.703). A significant difference between the two groups was observed with regard to symptoms, with bloating, postprandial fullness, and abdominal pain being more frequent in the control group than in the hemodialysis group (all p < 0.05). Comparing symptomatic with asymptomatic, there was no association in either group between symptoms or the prevalence of parasitic infection, nor with the type of parasite or with multiple parasitic infections. Patients with chronic renal failure are frequent targets for renal transplantation, which as well as the inherent immunological impairment of the disease itself, results in immunosuppression by medication. For this reason, carriers of intestinal parasites with pathogenic potential can develop serious clinical complications influencing the success of transplantation. This fact, coupled with the high prevalence of intestinal parasites and the dissociation between symptoms and infection in CRF patients, suggests that the stool test should be incorporated in routine propedeutics. Furthermore, preventive measures for the acquisition of parasites through the fecal-oral contamination route should be introduced.

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“…En pacientes sometidos a trasplantes, C. parvum ocasiona diarrea 39, infecciones asintomáticas u oligosintomáticas 40 . Se ha aislado en 34,8 y 18,8% de los pacientes receptores de trasplante renal en Brasil 41 y Turquía 42 , respectivamente. El único paciente que recibiera un trasplante renal de este estudio presentó diarrea por C. parvum; su criptosporidiosis pudiera corresponder a una reinfección o al empeoramiento de una infección leve debido al uso prolongado de fármacos inmunosupresores, como se ha observado en experimentos con animales [43][44] ; o bien a una infección actual.…”

Section: Discussionunclassified

Especies de Cryptosporidum en pacientes inmunodeficientes e inmunocompetentes de Valparaíso: Estudio descriptivo

et al. 2012

Rev. chil. infectol.

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Objective: Genetical characterization of human Cryptosporidium isolates to determine species diversity. Patients and Methods: A cross-sectional study in Valparaiso, Chile, was performed. A total of 458 patients participated in the study: 259 immunodefi cient (HIV, cancer, renal transplant hyper-IgM syndrome, HIV and unintended pregnancy) and 178 immunocompetent individuals provided stool samples and 21 patients bile samples. Results: We obtained 29 (6.3%) positive samples. 25 (9.7%) derived from immunodefi cient patients: 18 (7.3%) from HIV patients and 7 from patients with other immunodefi ciencies. The remaining 4 (2.2%) samples originated from immunocompetent individuals. Cryptosporidium genotyping was performed by nested polymerase chain reaction (PCR) and restriction fragments length polymorphism and/or PCR followed by sequencing of the SSU rRNA from oocysts in stool samples. 4 species were identifi ed: C. parvum, C. hominis, C. muris, and C. meleagridis. In immunodefi cient patients, 16 C. parvum, 8 C. hominis, and 1 C. muris strain were identifi ed. In immunocompetent participants, 3 C. hominis and 1 C. meleagridis isolate were found. Conclusion: The results indicate that zoonotic and anthroponotic transmission occurs and that C. parvum is the predominant species in our study population. Cryptosporidium species of zoonotic transmission accounted for 62% of the human infections detected in this study.Key words: Cryptosporidium parvum, C. hominis, C. meleagridis, C. muris, inmunocompetent, immunodefi cient, descriptive study.Palabras clave: Cryptosporidium parvum, C. hominis, C. meleagridis, C. muris, inmunocompetente, inmunodefi ciente, estudio descriptivo. IntroducciónC ryptosporidium spp son protozoos del phylum Apicomplexa, ubicuos en el ambiente, que ocasionan infección aguda y autolimitada. Del punto de vista clínico, las personas inmunocompetentes pueden ser asintomáticas o manifestar cuadros de diarrea que tienden a ser graves y persistentes, con un alto grado de morbilidad y mortalidad en los infectados inmunodefi cientes.Las especies de Cryptosporidium se han reportado en una amplia variedad de vertebrados 1 . A partir de ellos puede infectarse el hombre por diversos mecanismos de transmisión: contacto directo con personas (antroponótico) o animales (zoonótico) infectados, ingestión de alimentos y agua contaminada 2 . Existe evidencia de al menos 25 especies y 61 genotipos en diversos hospederos y con amplia distribución geográfi ca 1,3 . Las especies del parásito se han validado sobre la base de la morfología de los ooquistes, la biología del desarrollo, la especifi cidad del hospedero, el sitio de la infección, la histopatología y las diferencias genéticas establecidas mediante la biología molecular. También se utiliza el depósito en un museo de una muestra del parásito, como lo establece el Código Internacional para Nomenclatura Zoológica (ICZN por su sigla en inglés) 3,4 . Los análisis genéticos revelan que al menos ocho especies ( C. hominis, C. parvum, C. meleagridis, C. felis, C. canis, C...

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Infection by Cryptosporidium parvum in renal patients submitted to renal transplant or hemodialysis

Abstract: The frequency of infection by

Cited by 42 publications

References 23 publications

Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Prevalence of Intestinal Parasitism and Associated Symptomatology Among Hemodialysis Patients

Especies de Cryptosporidum en pacientes inmunodeficientes e inmunocompetentes de Valparaíso: Estudio descriptivo

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