Prevalence and Phylogenetic Analysis of Microsporidium Enterocytozoon bieneusi in Diarrheal Patients

Abstract

Enterocytozoon bieneusi can cause severe diarrhea in children and adults. However, in China, there are scant studies on E. bieneusi in diarrheal children and adults, with the exception of prevalence and genotyping data in a small number of cities including Hubei, Shanghai, and Heilongjiang. In this study, 196 fecal samples (n = 132 in Chongqing, n = 44 in Shandong, n = 20 in Hubei) were collected, including 91 from children and 105 from adults. Through microscopic examination, 19 positive samples (11 from children and 8 from adults) were detected. Using PCR examination, the internal transcriptional spacer (ITS) region was utilized by nested PCR to detect and characterize E. bieneusi. Twenty positive samples were detected, including 14 from children (≤11 years of age) and 6 from adults. According to the sequence analysis of ITS data, one known zoonotic (D) and seven novel (CQH5-11) genotypes were identified. This is the first molecular epidemiological study of E. bieneusi in diarrheal patients in different regions of China. Therefore, this study can provide useful information for the molecular epidemiology and control of E. bieneusi infection in humans in the future.

Enterocytozoon bieneusi in patients with diarrhea and in animals in the northeastern Chinese city of Yichun: genotyping and assessment of potential zoonotic transmission

“…In China, although human epidemiological studies of E. bieneusi have been carried out in several populations (0.2%-22.5%), only two studies explored the relationship between E. bieneusi infection and ages. Children were observed to have higher prevalences of E. bieneusi than adults (Chongqing: 14.1% versus 7.4%; Shandong: 18.5% versus 0; Shanghai: 13.6% versus 13.3%) [24,53]. However, similar to our study, there was no statistical difference in prevalence between children and adults.…”

“…To date, human infection cases with genotypes D and Type IV have been reported in at least 21 and 14 countries, respectively [21]. In China, genotypes D and Type IV have been identified in humans from six and four provinces, respectively [12,36,53]. The two genotypes also have an extensive host range of animals, and they have been found in numerous mammal species and bird species worldwide [21].…”

“…To date, epidemiological studies of E. bieneusi have been carried out in humans in 10 provinces, municipalities and autonomous regions. More than 7000 people have been involved in investigational studies of E. bieneusi [12,18,36,52,53]. Prevalences varied by different populations: 0.2%-22.5% for diarrheal children; 4.2%-7.5% for children without gastrointestinal diseases; 1.2% for children with different disease backgrounds; 5.0%-13.2% for diarrheal adults; 6.5%-8.1% for non-diarrheal adults; 5.7%-11.6% for HIV-positive patients; 4.3% for HIV-negative patients; 1.3% for cancer patients [8,18,24,25,36,45,46,48,[51][52][53][54][55].…”

“…More than 7000 people have been involved in investigational studies of E. bieneusi [12,18,36,52,53]. Prevalences varied by different populations: 0.2%-22.5% for diarrheal children; 4.2%-7.5% for children without gastrointestinal diseases; 1.2% for children with different disease backgrounds; 5.0%-13.2% for diarrheal adults; 6.5%-8.1% for non-diarrheal adults; 5.7%-11.6% for HIV-positive patients; 4.3% for HIV-negative patients; 1.3% for cancer patients [8,18,24,25,36,45,46,48,[51][52][53][54][55]. A total of 66 ITS genotypes were identified out of 280 E. bieneusi-positive specimens: 54 in group 1, nine in group 2, and three in group 5.…”

Molecular prevalence and genetic diversity analysis of Enterocytozoon bieneusi in humans in Hainan Province, China: High diversity and unique endemic genetic characteristics

“…Since its first report on humans in China in 2011, a total of 14 epidemiological studies on the prevalence of E. bieneusi have been performed in ten provinces/municipalities of China, including Xinjiang, Yunnan, Shanghai, Henan, Heilongjiang, Jilin, Chongqing, Shandong, Guangxi, and Hubei Provinces ( 13 – 16 ). The highest prevalence was 22.5% in Changchun ( 17 ) and the lowest prevalence was 0.2% in Wuhan ( 18 ).…”