AUTHOR=Zhang Tiemin , Ren Guangxu , Zhou Huanhuan , Qiang Yu , Li Jiaqi , Zhang Yun , Li Tingting , Zhou Yunfei , Wang Yuan , Lai Xiuyi , Lei Shen , Tan Feng , Liu Rui , Li Wenting , He Jing , Zhao Wei , Zhu Chuanlong , Lu Gang 

TITLE=Molecular prevalence and genetic diversity analysis of Enterocytozoon bieneusi in humans in Hainan Province, China: High diversity and unique endemic genetic characteristics

JOURNAL=Frontiers in Public Health

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1007130

DOI=10.3389/fpubh.2022.1007130

ISSN=2296-2565

ABSTRACT=<p><italic>Enterocytozoon bieneusi</italic> is a zoonotic pathogen commonly found in humans and animals all over the world. Here, we investigated the occurrence and genotype constitute of <italic>E. bieneusi</italic> among the individuals from Haikou city of Hainan, China. A total of 1,264 fecal samples of humans were collected, including 628 samples from patients with diarrhea (325 adults and 303 children) and 636 samples from the asymptomatic population (383 college students and 253 kindergarten children). <italic>E. bieneusi</italic> was detected using nested polymerase chain reaction (PCR) amplification of the internal transcribed spacer (ITS) region. A phylogenetic tree was constructed using a neighbor-joining tree construction method. The overall prevalence of <italic>E. bieneusi</italic> was 3.7% (47/1,264), while it was 5.6% in the patients with diarrhea (5.8% in adults and 5.3% in children) and 1.9% in the asymptomatic population (2.9% in college students and 0.4% in kindergarten children). The prevalence of <italic>E. bieneusi</italic> in humans with diarrhea was significantly higher than that in the asymptomatic population (χ<sup>2</sup> = 36.9; <italic>P</italic> &lt; 0.05). A total of 28 genotypes were identified, including ten known genotypes: CHG2 (<italic>n</italic> = 3), CHG3 (<italic>n</italic> = 5), CHG5 (<italic>n</italic> = 10), CM21 (<italic>n</italic> = 1), EbpA (<italic>n</italic> = 1), EbpC (<italic>n</italic> = 1), PigEBITS4 (<italic>n</italic> = 1), PigEBITS7 (<italic>n</italic> = 1), SHR1 (<italic>n</italic> = 4), Type IV (<italic>n</italic> = 2), and 18 novel genotypes (HNH-1 to HNH-18; one each). All these genotypes were categorized into three groups, including group 1 (<italic>n</italic> = 6), group 2 (<italic>n</italic> = 14), and group 13 (<italic>n</italic> = 8). This was the first study on the identification of <italic>E. bieneusi</italic> among humans in Hainan, China. The correlation between <italic>E. bieneusi</italic> infection and diarrhea was observed. The high diversity and distinctive distribution of <italic>E. bieneusi</italic> genotypes found in this study reflected the unique epidemic genetic characteristics of <italic>E. bieneusi</italic> in humans living in Hainan.</p>