Prevalence and Genetic Characterization of Cryptosporidium and Microsporidia Infecting Hematological Malignancy Patients
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ORIGINAL PAPER
Prevalence and Genetic Characterization of Cryptosporidium and Microsporidia Infecting Hematological Malignancy Patients Ujjala Ghoshal1 · Sonali K. Kalra1,2 · Nidhi Tejan1 · Prabhat Ranjan1 · Asmita Dey1 · Soniya Nityanand3 Received: 17 August 2020 / Accepted: 23 October 2020 © Witold Stefański Institute of Parasitology, Polish Academy of Sciences 2020
Abstract Purpose To evaluate the prevalence of Cryptosporidium and Microsporidia, associated risk factors and species identification in patients with haematological malignancies (HM). Methods A total of 148 consecutive patients with HM and 101 healthy subjects were evaluated for Cryptosporidium and Microsporidia using modified Kinyoun and modified Trichrome staining. Clinical, demographic and laboratory parameters were studied. The species of Cryptosporidium and Microsporidia were studied using PCR–RFLP. Results Of 148 HM patients initially screened, 47 were excluded from the final analysis due to inadequate clinical records. Patients with HM [n = 101, 63 (62.4%) male] more often had Cryptosporidium than healthy subjects [n = 101, 65 (74.4%) male] [3/101 (3%) vs. 0/101 (0%), p = 0.02]. Two of 101 (2%) HM patients and none of the healthy subjects had Microsporidia (p = 0.155). Diarrhea was more prevalent in HM patients with Cryptosporidium than those without [3, 100% vs. 39/96, 40.62%; p = 0.04). Both patients infected with Microsporidia presented with persistent diarrhea and fever. Cryptosporidium hominis was identified in all the three HM patients. Enterocytozoon bieneusi was identified in one HM patient infected with Microsporidia, which was classified as genotype Ind2. Conclusion Cryptosporidium and Microsporidia may infect HM patients leading to overwhelming diarrhea. The commonest species of Cryptosporidium and Microsporidia found to infect HM patients are C. hominis and E. bieneusi. Keywords Cryptosporidiosis · Intestinal microsporidiosis · Diarrhea · Malignancy
Introduction Cryptosporidium and Microsporidia are intracellular pathogens, which are known to cause severe watery diarrhea among immunocompromised individuals like those infected with human immunodeficiency virus (HIV) and transplant recipients [1–3]. Patients with malignancies are immune-compromised due to the disease or therapeutic * Ujjala Ghoshal [email protected] 1
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili road, Lucknow, UP 226014, India
2
Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, PO Sultanpur, Distt., Solan, HP 173229, India
3
Department of Haematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili road, Lucknow, UP 226014, India
agents/procedures administered to them. However, limited studies have been conducted to determine the occurrence of Cryptosporidium and Microsporidia among them [4–9]. Hematological malignancies (HM) are cancers of blood or bone marrow and include leukemias and lymphomas.
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