AUTHOR=Zhang Weizhe , Ren Guangxu , Zhao Wei , Yang Ziyin , Shen Yujuan , Sun Yihua , Liu Aiqin , Cao Jianping 

TITLE=Genotyping of Enterocytozoon bieneusi and Subtyping of Blastocystis in Cancer Patients: Relationship to Diarrhea and Assessment of Zoonotic Transmission

JOURNAL=Frontiers in Microbiology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2017.01835

DOI=10.3389/fmicb.2017.01835

ISSN=1664-302X

ABSTRACT=<p><italic>Enterocytozoon bieneusi</italic> (<italic>E. bieneusi</italic>) and <italic>Blastocystis</italic> are common pathogens responsible for diarrhea in humans, especially in immunocompromised individuals. The number of cancer patients has been increasing and diarrhea is a common clinical symptom in the treatment of cancers. To understand the prevalences and genotypes/subtypes of <italic>E. bieneusi</italic> and <italic>Blastocystis</italic> in cancer patients in China, to track the infection sources, and to explore the relationships between <italic>E. bieneusi</italic> and <italic>Blastocystis</italic> infections and diarrhea, 381 fecal specimens were collected from cancer patients. Each of them was analyzed for the presence of <italic>E. bieneusi</italic> and <italic>Blastocystis</italic> by PCR amplifying and sequencing the ITS region of the rRNA gene and the barcode region of the SSU rRNA gene, respectively. 1.3 and 7.1% of cancer patients were positive for <italic>E. bieneusi</italic> and <italic>Blastocystis</italic>, respectively. No statistical differences were observed in the infection rates between the groups by age, gender, and residence. <italic>E. bieneusi</italic> and <italic>Blastocystis</italic> were both significantly more common in cancer patients with diarrhea, and significant relationship of <italic>Blastocystis</italic> to diarrhea was found in chemotherapy group. Two <italic>E. bieneusi</italic> genotypes (D and a novel one named as HLJ-CP1) and two <italic>Blastocystis</italic> subtypes (ST1 and ST3) were identified with three novel ST1 sequences. This is the first report of occurrence and molecular characterizations of <italic>E. bieneusi</italic> and <italic>Blastocystis</italic> in cancer patients in China. <italic>E. bieneusi</italic> genotype D and <italic>Blastocystis</italic> ST1 and ST3 have been identified in humans and animals while one novel <italic>E. bieneusi</italic> genotype falling into zoonotic group 1, implying a potential of zoonotic transmission.</p>