Microsporidial infections due to Encephalitozoon intestinalis in non-HIV-infected patients with chronic diarrhoea

• Published in: Epidemiology and infection Vol. 140; no. 10; pp. 1773 - 1779
• Main Authors: YAKOOB, J., ABBAS, Z., BEG, M. ASIM, JAFRI, W., NAZ, S., KHALID, A., KHAN, R.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-10-2012
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Hepatocellular - complications; Chronic infection; Diarrhea; Diarrhea - epidemiology; Diarrhea - microbiology; DNA, Fungal - genetics; Drinking water; Encephalitozoon; Encephalitozoon - isolation & purification; Encephalitozoonosis - epidemiology; Encephalitozoonosis - microbiology; Enterocytozoon - isolation & purification; Feces - microbiology; Female; Fundamental and applied biological sciences. Psychology; Gastroenteritis; Hepatitis C; Hepatocellular carcinoma; HIV; Human immunodeficiency virus; Human viral diseases; Humans; Immunocompetence; Infections; Infectious diseases; Liver cancer; Liver diseases; Liver Neoplasms - complications; Male; Medical sciences; Microbiology; Microscopy; Microsporidia; Middle Aged; Parasites; Polymerase Chain Reaction; Product category rules; Spores; Staining and Labeling; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; United States > US; modified trichrome staining; Encephalitozoon intestinalis; PCR; Chronic diarrhoea; Immunopathology; Diarrhea; AIDS; Immune deficiency; Microsporidia; Epidemiology; Fungi; Infection; Chronic; Viral disease; Digestive diseases; Intestinal disease
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268811002639

We determined the prevalence of microsporidia Enterocytozoon (Ent.) bieneusi and Encephalitozoon (E.) intestinalis infection in patients with chronic diarrhoea and hepatocellular carcinoma (HCC). A total of 330 stool samples were examined from 171 (52%) patients with chronic diarrhoea, 18 (5%) with HCC while 141 (43%) were controls. Stool microscopy, polymerase chain reaction (PCR) with species-specific primers for Ent. bieneusi and E. intestinalis and sequencing were carried out. Microsporidia were found by trichrome staining in 11/330 (3%) and E. intestinalis by PCR in 13/330 (4%) while Ent. bieneusi was not detected. PCR for E. intestinalis was positive in 8/171 (5%) stool samples from patients with chronic diarrhoea, 2/141 (1·4%) samples from healthy controls and in 3/18 (17%) samples from patients with HCC. In the chronic diarrhoea group, E. intestinalis was positive in 4/171 (2·3%) (P=0·69) stool samples compared to 2/18 (11%) (P=0·06) in the HCC group and 2/141 (1·4%) from healthy controls. E. intestinalis infection was significantly associated with chronic diarrhoea and HCC in these patients who were negative for HIV. Stool examination with trichrome or species-specific PCR for microsporidia may help establish the cause of chronic diarrhoea.