RESUMEN
This study shows a clinical case report of a kidney transplant patient who traveled from Mexico to The Netherlands and ate green vegetables in an international food restaurant. After 5 days, he started having diarrhea, nausea, colic, and a physical feeling of malaise. The patient only received symptomatic treatment after showing the characteristic symptoms of traveler's diarrhea. When he returned to Mexico, the clinical picture worsened, and he was hospitalized. Clinical analyses indicated dehydration and acute kidney injury stage II. Coproparasitoscopic study showed the presence of Cyclospora cayetanensis. Parenteral solutions, gastric mucosal protector, ciprofloxacin, and a soft diet were administrated as treatment. The patient was discharged 72 h later with an improvement of the kidney function.
Asunto(s)
Lesión Renal Aguda/diagnóstico , Cyclospora/aislamiento & purificación , Ciclosporiasis/complicaciones , Diarrea/complicaciones , Trasplante de Riñón , Lesión Renal Aguda/parasitología , Adulto , Viaje en Avión , Ciclosporiasis/parasitología , Ciclosporiasis/fisiopatología , Diarrea/parasitología , Diarrea/fisiopatología , Humanos , Masculino , México , Países Bajos , TurismoRESUMEN
In Cuba, there are few studies on cyclosporiasis. Here, we report results from 1247 stool samples from symptomatic patients that were examined by microscopy methods and positive cases confirmed by nested PCR targeting the 18S rRNA gene, followed by sequencing. Seven positive samples, all diagnosed during May-June, were confirmed by the molecular method, indicating an occurrence in this patient cohort of 0.56%.
Asunto(s)
Cyclospora/aislamiento & purificación , Ciclosporiasis/diagnóstico , Adulto , Niño , Preescolar , Cuba/epidemiología , Cyclospora/clasificación , Cyclospora/citología , Cyclospora/genética , Ciclosporiasis/epidemiología , Ciclosporiasis/parasitología , ADN Protozoario/genética , Heces/parasitología , Femenino , Humanos , Masculino , Microscopía , Persona de Mediana Edad , Filogenia , Reacción en Cadena de la Polimerasa , Prevalencia , ARN Ribosómico 18S/genética , Estaciones del Año , Análisis de Secuencia de ADN , Adulto JovenRESUMEN
Cyclospora cayetanensis is an emerging pathogen that is endemic in developing countries and responsible for many large foodborne cyclosporiasis outbreaks in North America since 1990s. Because of the lack of typing targets, the genetic diversity and population genetics of C. cayetanensis have not been investigated. In this study, we undertook a population genetic analysis of multilocus sequence typing data we recently collected from 64 C. cayetanensis specimens. Despite the extensive genetic heterogeneity in the overall C. cayetanensis population, there were significant intra- and inter-genic linkage disequilibria (LD). A disappearance of LD was observed when only multilocus genotypes were included in the population genetic analysis, indicative of an epidemic nature of C. cayetanensis. Geographical segregation-associated sub-structuring was observed between specimens from China and those from Peru and the United States. The two subpopulations had reduced LD, indicating the likely occurrence of genetic exchange among isolates in endemic areas. Further analyses of specimens from other geographical regions are necessary to fully understand the population genetics of C. cayetanensis.
Asunto(s)
Cyclospora/genética , Genética de Población , Alelos , China , Cyclospora/clasificación , Ciclosporiasis/parasitología , Variación Genética , Humanos , Tipificación de Secuencias Multilocus , Nepal , Perú , Polimorfismo Genético , España , Estados UnidosRESUMEN
BACKGROUND: Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras. METHODS: Retrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts. RESULTS: A total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036-0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r(2) = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura. CONCLUSIONS: Results suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.
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Cyclospora/aislamiento & purificación , Ciclosporiasis/epidemiología , Estaciones del Año , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Niño , Preescolar , Coinfección/epidemiología , Coinfección/parasitología , Ciclosporiasis/parasitología , Heces/parasitología , Femenino , Helmintos/aislamiento & purificación , Honduras/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
During June-August 2013, 25 US states reported 631 cyclosporiasis cases including Nebraska and Iowa where a regional investigation implicated common-source imported salad mix served in two chain restaurants. At least two common-origin growing fields were likely sources of contaminated romaine lettuce. Using producer- and distributor-provided data, we conducted a grower-specific traceforward investigation to reveal exposures of ill US residents elsewhere who reported symptom onset during 11 June-1 July 2013, the time period established in the Nebraska and Iowa investigation. Romaine lettuce shipped on 2-6 June from one of these Mexico-origin growing fields likely caused cyclosporiasis in 78 persons reporting illness onsets from 11 June to 1 July in Nebraska, Texas, and Florida. Nationwide, 97% (314/324) of persons confirmed with cyclosporiasis with symptom onset from 11 June to 1 July 2013 resided in 11 central and eastern US states receiving approximately two-thirds of romaine lettuce from this field. This grower's production practices should be investigated to determine potential sources of contamination and to develop recommendations to prevent future illnesses.
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Cyclospora/aislamiento & purificación , Ciclosporiasis/epidemiología , Brotes de Enfermedades , Parasitología de Alimentos , Lactuca/parasitología , Comercio , Ciclosporiasis/parasitología , Florida/epidemiología , Humanos , México , Nebraska/epidemiología , Restaurantes , Texas/epidemiologíaRESUMEN
Cyclospora cayetanensis, a coccidian parasite, can cause gastrointestinal illness in humans and is characterized by watery and persistent diarrhea and abdominal pain. Cyclosporiasis has been associated with traveler's diarrhea. The infection is acquired through food and waterborne transmission, particularly by consumption of contaminated fresh fruits and vegetables. In the present study, stool samples from 8,877 children were examined for ova and parasites at the Pediatric Hospital of Morelia in Michoacán, Mexico, during 2000-2009. Sixty children (0.67%) had Cyclospora in their stools. Diarrhea (45.8%), abdominal pain (39.6%), and vomiting (18.8%) were the most frequent symptoms of cases with cyclosporiasis. Most of the cases (93.3%) were observed during June-August, the rainy season. In 45 children, Cyclospora was the only parasitic pathogen detected (75%); 15 children were co-infected with commensal, pathogenic, or both groups of parasites. Our findings suggest that C. cayetanensis is endemic to Michoacán and shows characteristically temporal patterns.
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Cyclospora/aislamiento & purificación , Ciclosporiasis/epidemiología , Hospitales Pediátricos , Dolor Abdominal , Adolescente , Niño , Preescolar , Cyclospora/genética , Ciclosporiasis/parasitología , ADN Protozoario/genética , Diarrea , Heces/parasitología , Femenino , Humanos , Lactante , Masculino , México/epidemiología , Reacción en Cadena de la Polimerasa , Prevalencia , Estaciones del AñoRESUMEN
A Mexican airline pilot had clinical manifestations of illness after a five-day stay in Lima, Peru. Six months later in Mexico, he was given a diagnosis of infection with Cyclospora cayetanensis by using coproparasitoscopic serial tests. He was treated twice with nitazoxadine successfully.
Asunto(s)
Cyclospora/aislamiento & purificación , Ciclosporiasis/parasitología , Adulto , Ciclosporiasis/diagnóstico , Ciclosporiasis/tratamiento farmacológico , Diarrea/tratamiento farmacológico , Diarrea/parasitología , Heces/parasitología , Humanos , Masculino , México , Perú , Sulfametoxazol/uso terapéutico , Trimetoprim/uso terapéuticoRESUMEN
A quantitative polymerase chain reaction assay with melt curve analysis (qPCR-MCA) was applied for the detection of protozoan oocysts in 501 human fecal samples collected in Dominican Republic. Samples were subjected to qPCR using universal coccidia primers targeting 18S rDNA to detect oocysts followed by MCA to identify oocyst species based on amplicon melting temperature. Putative positive samples were also tested by conventional PCR and microscopy. Cystoisospora belli (×3), Cryptosporidium parvum (×3), Cryptosporidium hominis (×5), Cryptosporidium meleagridis (×1), Cryptosporidium canis (×1), and Cyclospora cayetanensis (×9) were detected by qPCR-MCA and confirmed by sequencing. This assay consistently detected 10 copies of the cloned target fragment and can be considered more efficient and sensitive than microscopy flotation methods for detecting multiple species of oocysts in human feces. The qPCR-MCA is a reliable protozoan oocyst screening assay for use on clinical and environmental samples in public health, food safety and veterinary programs.
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Coccidios/genética , Cryptosporidium/genética , Cyclospora/genética , ADN Protozoario/genética , Heces/parasitología , Oocistos/química , Adulto , Anciano , Anciano de 80 o más Años , Animales , Coccidios/aislamiento & purificación , Coccidiosis/diagnóstico , Coccidiosis/epidemiología , Coccidiosis/parasitología , Criptosporidiosis/diagnóstico , Criptosporidiosis/epidemiología , Criptosporidiosis/parasitología , Cryptosporidium/clasificación , Cryptosporidium/aislamiento & purificación , Cyclospora/aislamiento & purificación , Ciclosporiasis/diagnóstico , Ciclosporiasis/epidemiología , Ciclosporiasis/parasitología , Cartilla de ADN , ADN Protozoario/clasificación , República Dominicana/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Desnaturalización de Ácido Nucleico , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
We have described the development of a 2-step nested PCR protocol based on the characterization of the 70-kDa heat shock protein (HSP70) gene for rapid detection of the human-pathogenic Cyclospora cayetanensis parasite. We tested and validated these newly designed primer sets by PCR amplification followed by nucleotide sequencing of PCR-amplified HSP70 fragments belonging to 16 human C. cayetanensis isolates from 3 different endemic regions that include Nepal, Mexico, and Peru. No genetic polymorphism was observed among the isolates at the characterized regions of the HSP70 locus. This newly developed HSP70 gene-based nested PCR protocol provides another useful genetic marker for the rapid detection of C. cayetanensis in the future.
Asunto(s)
Cyclospora/genética , Ciclosporiasis/parasitología , Proteínas HSP70 de Choque Térmico/genética , Proteínas Protozoarias/genética , Secuencia de Bases , Cyclospora/química , ADN Protozoario/química , ADN Protozoario/aislamiento & purificación , Heces/parasitología , Marcadores Genéticos , Humanos , México , Datos de Secuencia Molecular , Nepal , Perú , Filogenia , Reacción en Cadena de la Polimerasa/métodos , Alineación de SecuenciaRESUMEN
INTRODUCTION: Microsporidia are intracellular micro-organisms, characterized by mature spores with chitin walls and by one extrusive polar tube through which they pour their sporoplasm to the host cells. In immunocompromised patients, Enterocytozoon bieneusi and Encephalitozoon intestinalis produce diarrhea and systemic dissemination. In Mexico there is not information about microsporidia in children with cancer. OBJECTIVE: The aim of this pilot study was to investigate the presence of microsporidia species in pediatric patients with leukemia or lymphoma. MATERIAL AND METHODS: We obtained fecal samples from thirteen patients. The samples were processed to detect microsporidia by both modified Ziehl-Neelsen and clacofluor white stains, DNA was isolated to amplify rRNA specific sequences, to identify E. bieneusi, E. intestinalis, E. cuniculi and E. hellem by DNA polymerase chain reaction (PCR). Other parasites and pathogenic bacteria were also tested. RESULTS: Based on morphologic traits 7/13 samples were found positives to microsporidia and 6/10 by PCR. Was identified E. bieneusi in three patients with leukemia and one with lymphoma, another two children with leukemia were infected with E. intestinalis. Almost all children were high-risk patients and in phase of re-induction, consolidation or with many chemotherapy treatments. All the patients with microspiridia did not present diarrhea at the moment of the sampling; however, in two children with diarrhea it was found Cyclospora cayetanensis. Also we obtained feces from five patients' mothers and microsporidia spores were identified by stain in all of them and by PCR it was diagnosed the species in three of them. CONCLUSION: It was demonstrated that the feces of patients with leukemia or lymphoma had microsporidia, therefore is necessary to know the prevalence of these microorganisms and to analyze their impact in evolution of cancer patients.
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Leucemia/epidemiología , Linfoma no Hodgkin/epidemiología , Microsporidiosis/epidemiología , Adolescente , Adulto , Niño , Preescolar , Comorbilidad , Cyclospora/aislamiento & purificación , Ciclosporiasis/epidemiología , Ciclosporiasis/parasitología , Encephalitozoon/aislamiento & purificación , Encefalitozoonosis/epidemiología , Enterocytozoon/aislamiento & purificación , Heces/microbiología , Heces/parasitología , Femenino , Humanos , Lactante , Masculino , México/epidemiología , Microsporidiosis/microbiología , Madres , Proyectos Piloto , Leucemia-Linfoma Linfoblástico de Células Precursoras B/epidemiologíaRESUMEN
Cyclospora cayetanensis is an apicomplexan protozoan that has emerged as an important pathogen causing endemic or epidemic diarrheal disease worldwide. In industrialized countries, the parasite has been recognized as the causative agent of several outbreaks of diarrheal illness mostly associated with produce imported from endemic areas. In developing countries, human cyclosporosis is widely distributed. Infection rates from 0% to 41.6% have been described in the general population. However, the epidemiology, biology, and ecology of C. cayetanensis are not fully understood. The life cycle is not completely characterized, although it appears to require a single human host to be accomplished. The role of animals as natural reservoirs of the parasite remains to be determined. Little information is available concerning the environmental distribution and vehicles of transmission of C. cayetanensis. Contaminated water, foods or soil can be vehicles of spread of the parasite. The significant uncertainties that remain in the knowledge of C. cayetanensis highlight the need for continuing research in several areas, including its basic biology and environmental distribution.
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Cyclospora/fisiología , Cyclospora/patogenicidad , Ciclosporiasis/epidemiología , Ciclosporiasis/parasitología , Ambiente , Animales , Cyclospora/crecimiento & desarrollo , Ciclosporiasis/transmisión , Diarrea/epidemiología , Diarrea/etiología , Diarrea/parasitología , Humanos , Estadios del Ciclo de VidaRESUMEN
Human infection by Cyclospora cayetanensis, namely cyclosporiasis, can cause a wide range of symptoms in immunocompetent patients, from mild to severe diarrhea. Immunocompromised patients can present with chronic diarrhea and it has been recognized as a cause of traveler's diarrhea. We report three patients who traveled from Chile to Peru, who presented upon returning with prolonged traveler's diarrhea. A literature review about cyclosporiasis is presented, with emphasis on the clinical, epidemiological, diagnostic and therapeutic aspects of this disease.
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cyclospora/aislamiento & purificación , Ciclosporiasis/parasitología , Diarrea/parasitología , Viaje , Antiinfecciosos/uso terapéutico , Ciclosporiasis/diagnóstico , Ciclosporiasis/tratamiento farmacológico , Heces/parasitología , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoRESUMEN
Human infection by Cyclospora cayetanensis, namely cyclosporiasis, can cause a wide range of symptoms in immunocompetent patients, from mild to severe diarrhea. Immunocompromised patients can present with chronic diarrhea and it has been recognized as a cause of traveler's diarrhea. We report three patients who traveled from Chile to Peru, who presented upon returning with prolonged traveler's diarrhea. A literature review about cyclosporiasis is presented, with emphasis on the clinical, epidemiological, diagnostic and therapeutic aspects of this disease.
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Cyclospora/aislamiento & purificación , Ciclosporiasis/parasitología , Diarrea/parasitología , Viaje , Adulto , Antiinfecciosos/uso terapéutico , Ciclosporiasis/diagnóstico , Ciclosporiasis/tratamiento farmacológico , Heces/parasitología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoRESUMEN
In industrialised regions, cyclosporiasis has been most often linked with either food-borne outbreaks or foreign travel. In endemic areas, risk factors associated with the infection include contaminated water or food, contact with animals, type of sanitation and contact with soil. In a community from Venezuela, a strong association was observed between environmental contact with faecal-contaminated soil and cyclosporiasis, suggesting that contact with soil may be an important mode of transmission. This paper reviews the transmission of cyclosporiasis, focusing on soil-related infection.
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Ciclosporiasis/transmisión , Suelo/parasitología , Animales , Ciclosporiasis/parasitología , Humanos , Factores de RiesgoRESUMEN
We conducted an exploratory investigation in a community in Haiti to determine the prevalence of Cyclospora cayetanensis infection and to identify potential risk factors for C. cayetanensis infection. In 2001, two cross-sectional stool surveys and a nested case-control study were conducted. In 2002, a follow-up cross-sectional stool survey was conducted among children < or =10 years of age. Stool specimens from study participants and water samples from their wells were examined for Cyclospora and other intestinal parasites. In stools, the prevalence of infection with Cyclospora in persons of all ages decreased from 12% (20 of 167 persons) in February 2001 to 1.1% (4 of 352 persons) in April 2001, a 90.8% decrease. For children < or =10 years of age, the prevalence rates were 22.5% (16 of 71 children) in February 2001, 3.0% (4 of 135 children) in April 2001, and 2.5% (2 of 81 children) in January 2002. Use of the water from the artesian well in the northern region of the community versus the one in the south was the only risk factor associated with Cyclospora infection in multivariate analyses (odds ratio, 18.5; 95% confidence interval, 2.4 to 143.1). The water sample from one of the nine wells or water sources tested (one sample per source) in January 2001, shortly before the investigation began, was positive for Cyclospora by UV fluorescence microscopy and PCR. None of the water samples from the 46 wells or water sources tested during the investigation (one sample per source per testing period, including the artesian wells) were positive for Cyclospora. Further studies are needed to assess the role of water as a possible risk factor for Cyclospora infection in Haiti and other developing countries.
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Ciclosporiasis/epidemiología , Adolescente , Adulto , Animales , Estudios de Casos y Controles , Niño , Preescolar , Estudios Transversales , Cyclospora/genética , Cyclospora/aislamiento & purificación , Ciclosporiasis/etiología , Ciclosporiasis/parasitología , Heces/parasitología , Femenino , Haití/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Factores de Riesgo , Agua/parasitología , Abastecimiento de AguaRESUMEN
The prevalence and pathogenic role of Cyclospora cayetanensis among 212 subjects (age range = two months to 70 years) in an impoverished community in Venezuela were assessed retrospectively. For identification of the coccidium, modified Ziehl-Neelsen carbolfuchsin staining of formalin-ether concentrates was used. For other pathogenic parasites, iron-hematoxylin-stained smears and formalin-ether concentrates were examined. Cyclospora infections were identified in 13 (6.1%) subjects with a high percentage of asymptomatic carriers (11 of 13, 84.6%). Only two (15.4%) infants had diarrhea and the coccidium as the single detectable pathogenic parasite. The findings suggest that Cyclospora infections are relatively common and often asymptomatic in this region.