AUTHOR=Wang Yuanfei , Li Na , Guo Yaqiong , Wang Lin , Wang Rui , Feng Yaoyu , Xiao Lihua 

TITLE=Persistent Occurrence of Cryptosporidium hominis and Giardia duodenalis Subtypes in a Welfare Institute

JOURNAL=Frontiers in Microbiology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.02830

DOI=10.3389/fmicb.2018.02830

ISSN=1664-302X

ABSTRACT=<p>Few data are available on the transmission dynamics of intestinal protozoa in children in welfare institutes. In this study, fecal specimens were collected from 396 children in a welfare institute in Shanghai, China during December 2011 (207 specimens), June 2012 (78 specimens), and September 2013 (111 specimens), and examined for <italic>Cryptosporidium</italic> spp., <italic>Giardia duodenalis</italic>, and <italic>Enterocytozoon bieneusi</italic> by PCR analysis of the small subunit rRNA, triosephosphate isomerase, and internal transcribed spacer genes, respectively. The <italic>Cryptosporidium hominis</italic> and <italic>G. duodenalis</italic> assemblage A identified were further subtyped by multilocus sequence typing. Altogether, <italic>Cryptosporidium</italic> was detected in 39 (9.8%) children, with infection rates of 11.6% (24/207), 9.0% (7/78), and 7.2% (8/111) in December 2011, June 2012, and September 2013, respectively. Infection rates were higher in children of 0–12 months (20.4% compared to 0–7.3% in other age groups, <italic>P</italic> = 0.0001) and those with diarrhea (17.9% compared to 7.7% in those with no diarrhea, <italic>P</italic> = 0.006). In contrast, <italic>G. duodenalis</italic> was detected in 161/396 (40.7%), with infection rates of 48.3% (100/207), 35.9% (28/78), and 29.7% (33/111) in December 2011, June 2012, and September 2013, respectively. There were no significant gender- or diarrhea-associated differences, but the <italic>G. duodenalis</italic> infection rate in children of 13–24 months (50%) was significantly higher than in the age groups of 0–12 months and &gt; 48 months (29.8–36.5%, <italic>P</italic> = 0.021). Co-infection of <italic>Cryptosporidium</italic> and <italic>G. duodenalis</italic> was seen in 19 (4.8%) children, but no <italic>E. bieneusi</italic> infection was detected in this study. All <italic>Cryptosporidium</italic>-positive specimens belonged to the subtype IaA14R4 of <italic>C. hominis</italic>, while all <italic>G. duodenalis</italic>-positive specimens belonged to sub-assemblage AII. Both were the same subtypes in a previous outbreak of cryptosporidiosis and giardiasis in a hospital ward hosting children from the welfare institute. Results of the study indicate that there was a persistent occurrence of limited <italic>C. hominis</italic> and <italic>G. duodenalis</italic> subtypes in the small enclosed community, with differences in age distribution and association with diarrhea occurrence between cryptosporidiosis and giardiasis.</p>