Molecular Phylodiagnosis of Enterocytozoon bieneusi and Encephalitozoon intestinalis in Children with Cancer: Microsporidia in Malignancies as an Emerging Opportunistic Infection

• Published in: Acta parasitologica Vol. 64; no. 1; pp. 103 - 111
• Main Authors: Ghoyounchi, Roghayeh, Mahami-Oskouei, Mahmoud, Rezamand, Azim, Spotin, Adel, Aminisani, Nayyereh, Nami, Sanam, Pirestani, Majid, Berahmat, Reza, Madadi, Solmaz
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-03-2019; Springer Nature B.V
• Subjects: Animal Systematics/Taxonomy/Biogeography; Biomedical and Life Sciences; Biomedicine; Cancer; Chemotherapy; Child; Children; Deoxyribonucleic acid; Diagnostic systems; DNA; DNA, Fungal - chemistry; DNA, Fungal - isolation & purification; Ecology; Encephalitozoon - classification; Encephalitozoon - genetics; Encephalitozoon - isolation & purification; Encephalitozoon intestinalis; Encephalitozoonosis - epidemiology; Encephalitozoonosis - microbiology; Encephalitozoonosis - pathology; Enterocytozoon bieneusi; Feces - microbiology; Genotype; Genotypes; Genotyping; Humans; Immunocompromised hosts; Infections; Intestine; Iran; Medical Microbiology; Microbiology; Microsporidia; Microsporidiosis; Neoplasms - complications; Opportunist infection; Opportunistic Infections - epidemiology; Opportunistic Infections - microbiology; Opportunistic Infections - pathology; Original Paper; Parasitology; Pathogenicity; Pathogens; Phylogenetics; Phylogeny; Polymerase Chain Reaction; Prevalence; Sequence Analysis, DNA; Staining; Iran; Children; Iran; PCR; Cancer; Encephalitozoon intestinalis; Enterocytozoon bieneusi
• ISSN: 1230-2821; 1896-1851
• DOI: 10.2478/s11686-018-00012-w

Background 
Microsporidia may cause infection in both immunocompromised and immunocompetent populations. The best strategy to control microsporidiosis is obtaining thorough knowledge of its outbreak and pathogenicity.
Purpose 
Because of the lack of precise estimation of microsporidia prevalence among Iranian children with cancer, the current study aimed at evaluating the rate of intestinal microsporidia in children undergoing chemotherapy.
Methods
 Patients with cancer undergoing chemotherapy in a children’s hospital in Northwestern Iran were studied; 132 stool samples were collected and stained by the Weber and Ryan-blue modified trichrome staining techniques. The extracted DNA samples were evaluated by the nested polymerase chain reaction (PCR) method. All positive isolates were sequenced for genotyping and phylogenetic analysis.
Results
A total of 17 (12.8%) samples were microscopically positive for microsporidia infection, whereas only 14 (10.6%) cases were positive based on nested PCR results. In the positive samples detected with nested PCR, the frequency of
Enterocytozoon bieneusi
and
Encephalitozoon intestinalis
infections was 71.4% (
n
 = 10) and 28.6% (
n
 = 4), respectively. After sequencing and phylogenetic analysis, the genotype of
E. bieneusi
was type D and the sequences of the isolated species were similar to those of the registered ones.
Conclusion
E. bieneusi
is a major contributor to microsporidiosis in young immunocompromised patients in Iran. Microsporidia species are well-detected when confirmatory techniques such as molecular methods are in agreement with staining. So, to ensure this, a suggestion has been made to introduce a certain diagnostic test for microsporidiosis.