Necrotic enteritis due to simultaneous infection with Isospora suis and clostridia in newborn piglets and its prevention by early treatment with toltrazuril

The effect of an injectable toltrazuril - gleptoferron (Forceris®) on Cystoisospora suis oocyst excretion and growth of neonatal piglets pre- and post-weaning

In this study the efficacy of an intramuscular formulation of toltrazuril combined with gleptoferron for the control of porcine cystoisosporosis caused by Cystoisospora suis was investigated. The study was carried out on three Belgian farms with a confirmed history of C. suis infections. As none of the farms implemented a standardized toltrazuril treatment regimen for their piglets, the presence of resistant C. suis strains seems improbable. In total 90 litters, representing 1249 piglets, were included in the study and randomly allocated to either the treatment or control group. Piglets in the treatment group received a single intramuscular injection, containing 45 mg toltrazuril and 200 mg gleptoferron, between 1 and 3 days of age. Piglets in the control group received a single injection with only 200 mg gleptoferron. The effect of treatment on oocyst excretion, expressed in oocysts per gram of feces (OPG), average daily weight gain (ADG) and mortality was determined both pre- and post-weaning. A significant decrease in OPG as well as a decrease in the number of litters (pre-weaning) and pens (post-weaning) that tested positive for cystoisosporosis, was observed in the treated animals compared to the controls. Furthermore, treatment resulted in an increased ADG during the period from day 1 to day 21 (p-value: 0.03881). There was no significant difference in mortality observed between the treatment group to the control group (p-value: 0.2167). To our knowledge, this is the first report on the effect of toltrazuril on oocyst excretion after weaning. This finding highlights the potential long-term benefits of the treatment beyond the initial administration.

Characterization of changes in the intestinal microbiome following combination therapy with zinc preparation and conventional treatment for children with rotavirus enteritis

Background

Rotavirus (RV) is one of the most common pathogens causing diarrhea in infants and young children worldwide. Routinely, antiviral therapy, intestinal mucosa protection, and fluid supplementation are used in clinic, however this is not efficacious in some severe cases. Zinc supplementation has previously been shown to improve resolution of symptoms from infectious diarrhea.

Methods

In this study differences in response rate, duration of hyperthermia, vomiting, and diarrhea, and the persistence time of cough and lung rales in groups were compared. 16SrDNA gene sequencing technology was used to analyze and compare changes in the intestinal microflora of children with RV enteritis who received the conventional treatment with or without the zinc preparation. In addition, the correlations between the differential bacterial species and the related inflammatory factors were determined.

Results

Conventional therapy combined with the zinc preparation significantly shortened the duration of hyperthermia, vomiting, and diarrhea compared with the conventional treatment alone. In addition, the time to symptom relief showed that the absorption time of cough and lung rales was significantly shorter in the combination treatment group than that in the conventional treatment group in the children with pneumonia. Further, compared with the conventional treatment, the combined treatment significantly increased the diversity and abundances of florae as compared with the conventional treatment. This combination therapy containing zinc preparation markedly increased the abundances of Faecalibacterium, Bacteroidales, Ruminoccoccoccus, and Lachnospiraceae at the genus level. The LEfSe analysis suggested that Clostridiumbolteae were most significantly altered after the combination therapy. In addition, a correlation analysis revealed significantly negative correlations between the inflammatory factors especially IL-6, TNF-a, CRP and some intestinal florae such as Bacteroides, Faecalibacterium, Blautia, Parabacteroides, Subdoligranulum, and Flavonifractor.

Conclusion

Compared with the conventional therapy alone, the combined therapy with the zinc preparation significantly improves symptoms caused by RV. The combination therapy containing the zinc preparation significantly increases the diversity and abundances of some beneficial groups of bacteria. Further, The presence of these groups was further negatively correlated with relevant inflammatory factors. More importantly, this combination therapy containing the zinc preparation provides a reference for the clinical management of children with RV enteritis.

Cystoisospora suis in Portugal: an observational study of prevalence, management, and risk factors

BACKGROUND

Neonatal coccidiosis is a common and important disease of suckling piglets in modern farming caused by Cystoisospora suis. Prevalence rates are high, namely, in Portugal, although no recent data are available. The metaphylactic administration of a single dose of toltrazuril and hygienic measures are the backbone of control strategies on positive farms. However, several studies have shown that these programs are not always effective, underlining the need to revise the risk factors and control strategies currently applied. The present study evaluated C. suis prevalence on Portuguese farms and assessed the risk factors associated with facilities and farm rearing practices.

RESULTS

From the 27 tested farms, 23 were positive to Cystoisopora suis (85.2%). In total, 258 litters were sampled (accounting for 516 samples-2 samples per litter), with an average of 59.7% of positive litters per positive farm. Faecal pools from litters, in which liquid faeces predominated had a higher probability of containing oocysts than litter pools with mainly solid (Odds Ratio: 9.87; p < 0.0001) or pasty faeces (OR: 7.05; p = 0.001), and samples obtained from younger animals had higher oocyst counts (coefficient: - 0.0720; 95% CI - 0.125; - 0.019). No significant effect of toltrazuril administration was observed on the positivity rate, and none of the tested farms used disinfectants with official claims against parasites and known anticoccidial effects (e.g., cresol-based products).

CONCLUSIONS

The C. suis prevalence on Portuguese swine farms appears to be similar to the prevalence found in other European countries. Repeated sampling of the same litter and the use of autofluorescence microscopy after a modified Ritchie technique seems to have increased sensitivity and consequently the detection rate of positive litters. Finally, despite the common use of oral toltrazuril, C. suis control programs appear to not always be effective (based on the detection of oocysts in faecal samples), suggesting the need to revise the control strategies applied in the field, including management factors and choices of disinfectant products.

Clostridial diarrheas in piglets: A review

Clostridium perfringens type C and Clostridioides difficile are the main enteric clostridial pathogens of swine and are both responsible for neonatal diarrhea in this species. The role of Clostridum perfringes type A is under discussion. History, clinical signs, gross lesions and histological findings are the basis for a presumptive diagnosis of C. perfringens type C or C. difficile infection. Confirmation is based upon detection of beta toxin of C. perfringens type C or toxin A/B of C. difficile, respectively, in intestinal contents or feces. Isolation of C. perfringens type C and/or C. difficile is highly suggestive of infection by these microorganisms but it is not enough to confirm a diagnosis as they may be found in the intestine of some healthy individuals. Diagnosis of C. perfringens type A-associated diarrhea is more challenging because the diagnostic criteria have not been well defined and the specific role of alpha toxin (encoded by all strains of this microorganism) and beta 2 toxin (produced by some type A strains) is not clear. The goal of this paper is to describe the main clostridial enteric diseases of piglets, including etiology, epidemiology, pathogenesis, clinical signs, pathology and diagnosis.

Protective Effects of Lactobacillus plantarum Lac16 on Clostridium perfringens Infection-Associated Injury in IPEC-J2 Cells

Clostridium perfringens (C. perfringens) causes intestinal injury through overgrowth and the secretion of multiple toxins, leading to diarrhea and necrotic enteritis in animals, including pigs, chickens, and sheep. This study aimed to investigate the protective effects of Lactobacillus plantarum (L. plantarum) Lac16 on C. perfringens infection-associated injury in intestinal porcine epithelial cell line (IPEC-J2). The results showed that L. plantarum Lac16 significantly inhibited the growth of C. perfringens, which was accompanied by a decrease in pH levels. In addition, L. plantarum Lac16 significantly elevated the mRNA expression levels of host defense peptides (HDPs) in IPEC-J2 cells, decreased the adhesion of C. perfringens to IPEC-J2 cells, and attenuated C. perfringens-induced cellular cytotoxicity and intestinal barrier damage. Furthermore, L. plantarum Lac16 significantly suppressed C. perfringens-induced gene expressions of proinflammatory cytokines and pattern recognition receptors (PRRs) in IPEC-J2 cells. Moreover, L. plantarum Lac16 preincubation effectively inhibited the phosphorylation of p65 caused by C. perfringens infection. Collectively, probiotic L. plantarum Lac16 exerts protective effects against C. perfringens infection-associated injury in IPEC-J2 cells.

Absorption and Distribution of Toltrazuril and Toltrazuril Sulfone in Plasma, Intestinal Tissues and Content of Piglets after Oral or Intramuscular Administration

Piglet coccidiosis due to Cystoisospora suis is a major cause of diarrhea and poor growth worldwide. It can effectively be controlled by application of toltrazuril (TZ), and oral formulations have been licensed for many years. Recently, the first parenteral formulation containing TZ in combination with iron (gleptoferron) was registered in the EU for the prevention of coccidiosis and iron deficiency anemia, conditions in suckling piglets requiring routine preventive measures. This study evaluated the absorption and distribution of TZ and its main metabolite, toltrazuril sulfone (TZ-SO₂), in blood and intestinal tissues after single oral (20 mg/kg) or single intramuscular (45 mg/piglet) application of TZ. Fifty-six piglets were randomly allocated to the two treatment groups. Animals were sacrificed 1-, 5-, 13-, and 24-days post-treatment and TZ and TZ-SO₂ levels were determined in blood, jejunal tissue, ileal tissue, and mixed jejunal and ileal content (IC) by high performance liquid chromatography (HPLC). Intramuscular application resulted in significantly higher and more sustained concentrations of both compounds in plasma, intestinal tissue, and IC. Higher concentrations after oral dosing were only observed one day after application of TZ in jejunum and IC. Toltrazuril was quickly metabolized to TZ-SO₂ with maximum concentrations on day 13 for both applications. Remarkably, TZ and TZ-SO₂ accumulated in the jejunum, the primary predilection site of C. suis, independently of the administration route, which is key to their antiparasitic effect.

Piglet coccidiosis in Belgium and the Netherlands: Prevalence, management and potential risk factors

Piglet coccidiosis caused by Cystoisospora suis is one of the most important causes of diarrhea in suckling piglets. The parasite has a fast development and multiplies quickly and effectively under the conditions of a farrowing unit. Control measures include cleaning and disinfection and anticoccidial treatment. In Europe, toltrazuril-based products are authorized for this purpose and are applied to piglets on affected farms in the first week of life. To observe the effect of treatment and disinfection on the control of piglet coccidiosis in the field, 23 farms (11 from Belgium, 12 from the Netherlands, mean number of sows = 1413) were sampled twice by litter in the second and third week of life and fecal scores and the presence of C. suis oocysts were determined. A questionnaire was used to collect data on farm sizes, management and hygiene measures as well as treatment (product, dose and piglet age). Thirteen farms regularly treated with toltrazuril (treatment age: 1-6 days, mean 4.3 days) and 19 applied disinfection. Parasite excretion was documented on 60.9% and diarrhea on 78.3% of farms and in 34.3%/15.7% of the litters. Only 2.4% of the litters showed both, so subclinical infection appeared to be common. No significant differences between farms that did not treat against coccidiosis and farms that applied toltrazuril was observed with regard to C. suis oocysts shedding and/or diarrhea. However, in litters that were treated within the first three days of life, oocyst excretion was significantly less often observed than in litters with later treatment (p = 0.033). No significant effect of disinfection could be shown, but most farms applied disinfectants that have no proven effect against coccidia (oxygen-releasing agents or glutaraldehyde + ammonia) while the only farm that used chlorocresols (which are effective against coccidia) did not show oocyst shedding. Current control measures thus appear to be insufficient on most of the examined farms. It is therefore recommended to treat piglets timely and to apply effective disinfectants to reduce C. suis infections. Furthermore, regular evaluation of sustained efficacy of all implemented measures are necessary.

Shifts in the Fecal Microbial Community of Cystoisospora suis Infected Piglets in Response to Toltrazuril

The protozoan parasite Cystoisospora suis causes diarrhea and reduced weight gain in suckling piglets. Infections occur in the first days of life; it is transient but can lead to dysbiosis, exacerbating disease and increasing mortality. Cystoisosporosis is effectively controlled by toltrazuril treatment; however, alterations of the gut microbial composition upon infection and treatment have not been investigated. This study evaluated the development of fecal microbiota of C. suis infected piglets in response to treatment with toltrazuril. Thirty-eight conventional piglets were infected with C. suis on the first day of life (dol 1). Twenty-six of them received either parenteral or oral toltrazuril 2 days later. Fecal samples were collected pre- and post-weaning (dol 1-15 and 31-38) for microbiota analysis using 16S rRNA amplicon sequencing and during dol 5-18 to determine fecal consistency and parasite excretion. All control animals shed parasites at least once and the majority developed diarrhea, while toltrazuril-treated piglets did not excrete parasites and only had low levels of diarrhea. Age-related shifts in the fecal microbiota composition and increase in diversity and species richness were seen until after weaning. Parasite infection disrupted bacterial maturation 2 weeks after infection. Irrespective of the route of administration, fecal communities of piglets in the treated groups clustered separately and were more diverse compared to that of control piglets during the acute phase of infection on dol 11. Control piglet feces showed higher levels of Fusobacteriaceae and Veillonellaceae, while Ruminococcaceae, Lachnospiraceae, S24-7, Clostridiaceae, and Erysipelotrichaceae were more abundant in feces of treated piglets on dol 11. Thereafter, treatment-related effects on the microbial communities were small and mainly detectable on dol 34 (5 days post-weaning), potentially indicating that the oral toltrazuril treatment might have had long-term effects on host physiological responses post-weaning. Irrespective of the administration route, toltrazuril prevented C. suis-related dysbiosis and maintained species richness and diversity on dol 11. In addition to cystoisosporosis prevention, toltrazuril seems to contribute to the stabilization of the gut microbial development during the suckling phase and thus may reduce the need for antibiotics to control infections with secondary bacterial enteropathogens in C. suis-infected suckling piglets.

Cystoisospora suis Control in Europe Is Not Always Effective

After introduction of the anticoccidial toltrazuril for the metaphylactic treatment of suckling piglet coccidiosis, only few field evaluations on the effect of treatment against the causative agent, Cystoisospora suis, were performed. In 2018, a field study was conducted to detect the presence of the parasite on pig farms in four different European countries, and to evaluate management parameters possibly associated with infection and disease. A total of 49 farms from Austria, the Czech Republic, Germany and Spain were included. Repeated pooled fecal samples from 603 litters were taken in the 2nd and 3rd week of life. Samples were examined by autofluorescence for the presence of C. suis, and fecal consistency was scored. For each farm a questionnaire was provided to document management and treatment history. Feces scored as diarrhoeic were not significantly more often positive for C. suis than non-diarrhoeic feces but samples from litters with previously reported occurrence of diarrhea were significantly more often positive (p = 0.000). Pasty feces were significantly more often positive than those of other consistency (p = 0.005). Overall, 71.4% of the farms and 50.1% of the litters were positive for C. suis at least once. The prevalence on the farms reached up to 100%. Diarrhea was seen in samples from 53.1% of the farms (9.6% of the litters). Cystoisospora suis was diagnosed on 80.8% of the farms with vs. 60.8% of those without diarrhea. Toltrazuril was applied on 30 farms, and of these 53.3% had diarrhoeic samples and 66.7% were positive for C. suis vs. 19 farms that did not use toltrazuril with 52.6% diarrhoeic and 79.0% C. suis positive samples (p > 0.05). Only on two farms a disinfectant with activity against coccidia was used, and C. suis was not detected there. Current control of C. suis appears to be insufficient on the majority of the examined farms. These findings highlight the importance of correct application of medication, and an effective hygiene management. To maintain effective parasite control, efficacy monitoring of the control measures should be implemented.

Parasite infections in a social carnivore: Evidence of their fitness consequences and factors modulating infection load

There are substantial individual differences in parasite composition and infection load in wildlife populations. Few studies have investigated the factors shaping this heterogeneity in large wild mammals or the impact of parasite infections on Darwinian fitness, particularly in juveniles. A host's parasite composition and infection load can be shaped by factors that determine contact with infective parasite stages and those that determine the host's resistance to infection, such as abiotic and social environmental factors, and age. Host-parasite interactions and synergies between coinfecting parasites may also be important. We test predictions derived from these different processes to investigate factors shaping infection loads (fecal egg/oocyte load) of two energetically costly gastrointestinal parasites: the hookworm Ancylostoma and the intracellular Cystoisospora, in juvenile spotted hyenas (Crocuta crocuta) in the Serengeti National Park, in Tanzania. We also assess whether parasite infections curtail survival to adulthood and longevity. Ancylostoma and Cystoisospora infection loads declined as the number of adult clan members increased, a result consistent with an encounter-reduction effect whereby adults reduced encounters between juveniles and infective larvae, but were not affected by the number of juveniles in a clan. Infection loads decreased with age, possibly because active immune responses to infection improved with age. Differences in parasite load between clans possibly indicate variation in abiotic environmental factors between clan den sites. The survival of juveniles (<365 days old) to adulthood decreased with Ancylostoma load, increased with age, and was modulated by maternal social status. High-ranking individuals with low Ancylostoma loads had a higher survivorship during the first 4 years of life than high-ranking individuals with high Ancylostoma loads. These findings suggest that high infection loads with energetically costly parasites such as hookworms during early life can have negative fitness consequences.

Effect of Clostridium perfringens type C on TLR4/MyD88/NF-κB signaling pathway in piglet small intestines

Clostridium perfringens (C. perfringens), a Gram-positive bacterium, is one of the main causing piglet diarrhea, which leads serious economic loss in the world swine industries. Generally, the innate immune response plays a critical role in host defense against pathogen invasion. TLR4, a member of the TLR (Toll-like receptor) family, has been considered to implicate in the host immune responses and induce secretion of inflammatory cytokines during bacterial infection. However, little is clear about the effects of TLR4 and key signaling genes in the process of piglet inflammatory and immune responses after C. perfringens infection. This study aims to explore the effect of C. perfringens type C infection on the key mRNAs of TLR4/MyD88/NF-κB signaling pathways during the process of piglet diarrhea. In this study, the expressions of TLR4 and other key mRNAs in the TLR4/MyD88/NF-κB signaling pathways were quantified in piglet ileum and jejunum tissues among IR (intestinal resistance), IS (intestinal susceptibility) and IC (intestinal control) groups by qPCR and Western blot methods, the concentrations of pro-inflammatory cytokines in intestinal tissues and serum immunoglobulins were also tested by ELISA kits. Results showed that compared to IC group, expressions of ileum TLR4 and TNF-α was significantly increased in the IS and IR groups, specially TBK1 gene; the expressions of ileum TLR2, TRAF6, MyD88 and IL-8 mRNAs was significantly up-regulated in the IS group, the expressions of TLR9, NF-κB, IL-6, IFN-γ and MAPK1 genes were not significant differences among the IR, IS and IC groups. Meanwhile, the protein levels of TLR4, HMGB1 and NF-κB were higher in the IS and IR groups. The levels of jejunum IFN-γ and IL-6, ileum IL-6 and IL-12 were risen in the IR group. Serum immunoglobulin IgA and IgG in the IR and IS groups reached a peak on the 72 h and 48 h post infection, respectively. These findings suggest that C. perfringens type C infection induces host immune responses involving in the TLR4/MyD88/NF-κB signaling pathways in ileum than in jejunum, which may provide valuable information for innate immune mechanisms involved in regulation of piglet diarrhea caused by C. perfringens type C infection.

Efficacy of injectable toltrazuril-iron combination product and oral toltrazuril against early experimental infection of suckling piglets with Cystoisospora suis

BACKGROUND

Toltrazuril is frequently administered for the metaphylactic control of piglet cystoisosporosis. In a previous study, the efficacy of parenteral toltrazuril (45 mg/piglet, Group Forceris®) applied on the 2nd day of life (dol), and of oral toltrazuril (20 mg/kg of body weight, Group Baycox®) applied on the 4th dol was evaluated in an experimental model with Cystoisospora suis infection on the 3rd dol (late infection, LI). In a follow-up study, efficacy and safety were evaluated against infections with C. suis on the 1st dol (early infection, EI). Parameters included oocyst excretion and faecal consistency, body weight development, bacteriological examinations and animal health.

RESULTS

All control piglets (n = 12) shed oocysts and had diarrhoea, while parasite excretion was completely suppressed in both treatment groups (n = 13 each) and diarrhoea was reduced to a single animal (Forceris® group), resulting in significant differences for these parameters between the treated groups and the controls without significant differences among the treatment groups. No treatment-related adverse events were noted. Body weight gain was reduced in the control group during the acute phase of infection, resulting in significantly lower body weight on the 15th dol. Sows and piglets shed high numbers of Escherichia coli. Clostridium perfringens type A was only detected in low amounts in pooled litter samples. In comparison to the LI study oocyst shedding was more intense in the control animals in EI, while diarrhea was more frequent in LI. In both infection models a high efficacy of toltrazuril in the control of parasitological and clinical outcomes of experimental C. suis infection could be demonstrated. Since in the LI study high numbers of Cl. perfringens type A were detected, it is hypothesized that colonization with these opportunistic pathogens has synergistic effects with C. suis and may explain variable clinical outcomes in untreated animals as well as the sporadic occurrence of diarrhea in toltrazuril-treated piglets.

CONCLUSIONS

Parenteral and oral toltrazuril administered on the 2nd or 4th dol is safe and effective against experimental infections with C. suis on the 1st to 3rd dol. The clinical outcome of experimental infections seems influenced by bacterial coinfections.

Efficacy of an injectable toltrazuril - gleptoferron (Forceris®) to control coccidiosis (Cystoisospora suis) in comparison with iron supplemented piglets without anticoccidial treatment

The efficacy and safety of an injectable combination product containing toltrazuril and gleptoferron (Forceris® - CEVA) for the control of coccidiosis due to Cystoisospora suis was investigated in neonatal piglets. The study was carried out on five European commercial pig farms in France, Germany and Spain and 122 litters consisting of 1508 piglets were selected and randomly allocated to one of two treatment groups. The first group received a single intramuscular injection per piglet of the test product, containing 45 mg toltrazuril and 200 mg iron and this was compared with a control group, which was administered a single intramuscular treatment of iron at 200 mg per piglet only. Body weights, faecal scores and oocysts counts, recorded as oocysts per gram of faeces, (OPG) were observed for 21 days. Only 1138 piglets were actually exposed to coccidiosis and data sets of these animals were selected for statistical analysis. The efficacy of the test product in the control of coccidiosis was shown in higher body weight gains, a lower percentage of animals with diarrhoea, fewer samples with positive oocysts counts as well as a lower excretion peak and a reduced area under the curve of OPG from study day (SD) 4 - SD 21. The combination product of toltrazuril and gleptoferron provided an effective alternative approach to current conventional separate treatment for the prevention of iron deficiency anaemia and coccidiosis in neonatal piglets. It reduced the numbers of potentially stressful interventions and work time.

Microsatellite Analysis of Geographically Close Isolates of Cystoisospora suis

Microsatellites are short repetitive DNA sequences of 2–6 repeats interspersed in the genome that display a rapid mutation rate and consequently show high variation between individuals or populations. They have been used to characterize population diversity and structure and the level of variation between different isolates of a number of different organisms, including apicomplexan protozoa. Currently nothing is known about the genetic variability and population structure of Cystoisospora suis (Apicomplexa: Coccidia), the causative agent of piglet coccidiosis, and we made use of the recently available genome of C. suis (strain Wien-I) to amplify microsatellite regions (ca. 300–550 bp) and evaluate the applicability of fluorescence-labeled primers to investigate amplicon length variation at high resolution using capillary electrophoresis (CE). Two phenotypically characterized isolates (Wien-I, toltrazuril susceptible; Holl 1 toltrazuril resistant) and six field isolates from Europe were compared by conventional PCR followed by agar-gel electrophoresis, Sanger sequencing, and CE (fluorescence labeling and fragment length analysis) to evaluate the applicability of the method. Four primer pairs could be identified that amplified bands of the expected size and were labeled for CE analysis. High resolution CE for size determination of PCR amplicons proved to be a reliable and simple method. It revealed high diversity of the analyzed strains, with marked differences even between two strains from neighboring swine farms. In follow-up studies, adaptation of the PCR assay to multiplexing and amplification of small DNA quantities will provide a cost-effective tool to analyse field strains to reveal geographic diversity that could be mapped to phenotypic traits.

Rotavirus and Cystoisospora suis in piglets during the suckling and early post weaning period, in systems with solid floors and age segregated rearing

Background

Piglet diarrhoea is considered a worldwide problem resulting in animal welfare problems and financial losses for pig farmers. Porcine rotavirus and the coccidian parasite Cystoisospora suis (C. suis) are considered two important pathogens associated with diarrhoea in piglets during the suckling and early post weaning periods. To obtain an overview on the prevalence of porcine rotavirus and C. suis in piglet producing herds with solid floors and age segregated rearing, faecal sampling of 791 litters in 81 farms was performed.

Results

For porcine rotavirus, faecal samples were analysed using a sandwich ELISA. The overall prevalence of rotavirus in the examined herds was 11.4 ± 17.7% at 2 weeks, 56.8 ± 30.7% at 4 weeks and 71.1 ± 29.1% at 6 weeks of age and the accumulated prevalence was 49, 97 and 100%. To detect C. suis, faecal samples were analysed using sedimentation. The overall prevalence of C. suis in the examined herds was 11.9 ± 15.1% at 2 weeks of age, 10.7 ± 16.7% at 4 weeks and 8.7 ± 15.3% at 6 weeks of age and the accumulated prevalence was 56, 76 and 85%. The number of empty days between farrowing batches did influence the shedding of rotavirus at 2 weeks of age but not later. Regarding C. suis, no difference in prevalence was correlated to the number of days between consecutive farrowing batches.

Conclusions

Our study confirmed that rotavirus should be regarded as an ubiquitous virus that can be expected to be present in almost every pig herd in Sweden. The study also demonstrated that the number of infected litters increased from birth to 6 weeks of age. Secondly, it showed that C. suis frequently occurred in pig herds and that the number of infected litters was rather stable from two to 6 weeks of age. Consequently, both rotavirus and C. suis may play a role in intestinal disturbances in piglets during the suckling and post weaning periods despite age segregated rearing, at least in systems with solid floors. However, as this study was carried out in herds without reported problems with diarrhoea or poor weight gain, the role of these pathogens should not be overestimated.

Treatment With Probiotic Bacteria Does Not Diminish the Impact of a Cystoisospora suis Challenge in Suckling Piglets

Colonization of newborn piglets with beneficial and ubiquitous microorganisms in combination with colostral passive immunity is the prerequisite for development of immunity and gut maturation. In this study living strains of Clostridium perfringens type A (CpA) and non-pathogenic Escherichia (E.) coli strains harvested from healthy piglets were administered to piglets prior to first colostrum intake in order to prevent disease caused by pathogenic variants of the same bacterial species by competitive exclusion. In addition, it was investigated whether these potential beneficial colonizers were able to prevent harmful effects of infection with Cystoisospora (C.) suis as a primary invasive pathogen. In a first trial, half of the piglets from four litters were treated with a bacterial cocktail consisting of two E. coli and four CpA strains immediately after birth on two consecutive days, while the other half of the litters served as control group. In a second trial, piglets were treated following the protocol of the first trial, and additionally all piglets were infected 4 h after the end of littering with ~1,000 sporulated oocysts of a C. suis laboratory strain. General health, body weight development, fecal consistency and, in the second trial, oocyst excretion were monitored from birth until weaning. No adverse effects of the cocktail on the health status were observed. Treated piglets of the first trial showed a higher average daily weight gain until weaning. In the second trial, no significant differences were found with respect to average daily weight gain, fecal consistency, amount, and duration of oocyst excretion assessed in daily samples. In treatment group 51.1% and in the control group 38.5% of the fecal samples were positive for oocysts in autofluorescence. The average duration of oocyst excretion was longer in treatment group (7.7 days) than in control group (5.6 days). Application of bacterial cocktail could not effectively minimize disease symptoms caused by C. suis. There was a trend toward an increase in severity of disease symptoms in treated pigs, suggesting that the synergism between CpA and C. suis was independent of the bacterial strains, but is exclusively dominated by the pathogenic effect of C. suis.

Comparison of an injectable toltrazuril-gleptoferron (Forceris®) and an oral toltrazuril (Baycox®) + injectable iron dextran for the control of experimentally induced piglet cystoisosporosis

BACKGROUND

Cystoisospora suis causes diarrhoeal disease and reduced weight gain in suckling piglets, and a toltrazuril-based oral suspension is available for treatment. Recently a combinatorial product with toltrazuril plus iron has been developed for parenteral application. In this study we compared the efficacy of the injectable product with the oral suspension against experimentally induced piglet cystoisosporosis.

METHODS

In a randomised controlled study, three groups of piglets (n = 10-13) were treated either with a fixed dose of 45 mg toltrazuril + 200 mg gleptoferron i.m. per piglet (Forceris®) on the second day of life (study day 2; SD 2) or with 20 mg toltrazuril/kg body weight as an oral suspension (Baycox® 5%) on SD 4 or left untreated (Control group). The Baycox® and the Control group received 200 mg of iron dextran/piglet on SD 2. All piglets were infected with 1000 sporulated C. suis oocysts on SD 3. Faecal samples were taken daily from SD 7 to SD 20 to determine faecal consistency, oocyst shedding and other diarrhoeal pathogens. Body weight was recorded on SD 1 and then weekly until SD 29. Animals were observed daily for general health and after treatment for possible adverse events.

RESULTS

In the Control group all animals shed oocysts for 3.1 days on average and all animals showed diarrhoea for an average of five days. Excretion peaked on SD 9 (max. 48,618 oocysts per gram of faeces). Treatment with Forceris® completely suppressed oocyst excretion. In the Baycox® group, low levels of excretion could be detected. Diarrhoea was reduced to single piglets in the treated groups. Body weight development was reduced in the Control group compared to the treated groups. Enteropathogenic bacteria (Escherichia coli, Clostridium perfringens) could be detected. All parameters related to oocyst excretion, faecal consistency and weight gain were significantly improved in the treated groups compared to the Control group without significant differences between the treated groups. Both products were safe to use.

CONCLUSIONS

Treatment with both the injectable (Forceris®) and the oral (Baycox®) formulation of toltrazuril in the prepatent period were safe and highly effective against experimental infection with C. suis in newborn piglets.

W A A V P guideline for evaluating the efficacy of anticoccidials in mammals (pigs, dogs, cattle, sheep)

This guideline is intended as an aid in the design, implementation and interpretation of studies for the assessment of drug efficacy against Eimeria in cattle and sheep, Cystoisospora in pigs and dogs, and Cryptosporidium in cattle. It deals with the most important aspects of how to conduct both experimental and field studies for dose determination, dose confirmation and assessment of field effectiveness. Also, guidance on the selection of animals, diagnostic techniques, statistical evaluation and methods for the preparation, maintenance and use of parasites is provided. The specific management conditions that may influence the course of natural infections and consequently determine treatment schemes are mentioned and suggestions for best practice in sampling and evaluation of data prior to conducting of efficacy studies are given. The guideline is also intended to assist investigators in carrying out specific studies, provide relevant information for registration authorities involved in the decision-making process, assist in the approval of anticoccidial drugs in the target species, and facilitate the world-wide adoption of standard procedures. Although currently not implemented, issues of drug resistance testing and alternative methods for drug testing are also discussed as future issues in drug testing against mammalian coccidia.

Clinical cystoisosporosis associated to porcine cytomegalovirus (PCMV, Suid herpesvirus 2) infection in fattening pigs

Cystoisospora (syn. Isospora) suis is the causative agent of neonatal porcine coccidiosis and one of the main causes of diarrhoea in suckling piglets worldwide. Infection with porcine cytomegalovirus (PCMV, Suid herpesvirus 2) causes inclusion body rhinitis in pigs. In a Swiss pig herd (n = 2 boars, 7 sows, 2 gilts, 18 finishing pigs, 30 fattening pigs, 54 suckling piglets), an outbreak of PCMV infection with high morbidity in all age categories, characterized by fever, anorexia, reduced general condition, respiratory signs and increased piglet mortality, was diagnosed by histopathology and molecular methods. Five fattening pigs (age ~ 17 weeks) additionally showed diarrhoea, not typical for PCMV infections, and one fattener had to be euthanized due to poor condition. Histopathologically, severe fibrinopurulent jejunoileitis with extensive atrophy and fusion of intestinal villi, loss of goblet cells and crypt abscesses associated to C. suis infection were present. In the liver, herpesvirus intranuclear inclusion bodies were observed and PCMV was confirmed by PCR/sequencing. No further infectious causes of diarrhoea (i.e. Rotavirus A; TGEV; PEDV; PCV-2; enterotoxigenic Escherichia coli or Lawsonia intracellularis) were detected in the euthanized fattener. Coproscopically, C. suis oocysts were identified in the faeces from further fatteners with diarrhoea. While C. suis usually produces disease only in suckling piglets, its association with severe intestinal lesions and diarrhoea in ~ 17-week-old fatteners was surprising. It is supposed that the underlying PCMV infection might have contributed to the presentation of clinical cystoisosporosis in fattening pigs. The interaction mechanisms between these two pathogens are unknown.

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A Porcine Cytomegalovirus (PCMV) outbreak was diagnosed in a Swiss pig herd

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Cystoisospora suis caused diarrhoea in 17 week-old fattening pigs co-infected with PCMV

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PCMV infection may produce immunosuppression in pigs

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PCMV may have contributed to presentation of clinical cystoisosporosis in fattening pigs

Experimentally confirmed toltrazuril resistance in a field isolate of Cystoisospora suis

Background

Constant treatment regimens with toltrazuril against Cystoisospora suis infection in piglets are being applied in the intensive production systems for the last two decades, but the possibility of resistance development has not been addressed so far despite limited availability of treatment alternatives. Recently, a pig producer in The Netherlands who routinely used toltrazuril complained about diarrhea in suckling piglets in the absence of bacterial and viral pathogens, and oocysts of C. suis could be isolated from feces of affected litters.

Methods

Piglets from two litters were infected with a field isolate of C. suis, Holland-I, and treated with 0 (Holl-Ctrl), 20 (Holl-20) or 30 (Holl-30) mg/kg of body weight (BW) of toltrazuril (Baycox®). The efficacy of toltrazuril was measured by assessment of oocyst excretion, fecal consistency and BW gain. A separate litter was infected with a toltrazuril-susceptible strain of C. suis, Wien-I, and treated with 0 (Wien-Ctrl) or 20 (Wien-20) mg/kg BW of toltrazuril for comparison.

Results

Treatment with the recommended (20 mg/kg) dose of toltrazuril completely suppressed oocyst shedding and diarrhea in group Wien-20. The prevalence of oocyst excretion was 100% in the groups infected with Holland-I and 80% in the group Wien-Ctrl. Most days with diarrhea were observed in group Holl-20 with an average of 6.40%, followed by 5.71% in Wien-Ctrl, while in Holl-Ctrl and Holl-30 diarrhea was only seen in 1.79% of the samples (n = 14/piglet). Oocyst excretion, fecal consistency and BW gain did not differ significantly among groups infected with Holland-I, indicating loss of efficacy to toltrazuril.

Conclusion

Experimental infections and treatment confirmed toltrazuril resistance against the field isolate even at increased dosage. Such isolates are a potential threat to pig production as no other effective and economically sustainable alternative treatment is currently available. In the absence of a standardized protocol for resistance testing in C. suis, regular parasitological examination and, if possible, experimental confirmation should be considered to evaluate the extent and consequences of toltrazuril resistance.

Electronic supplementary material

The online version of this article (doi:10.1186/s13071-017-2257-7) contains supplementary material, which is available to authorized users.

Vaccination against parasites - status quo and the way forward

Although vaccination against various pathogens is integral to health management of swine, vaccines against parasites have not yet been commercialized for the use in pigs. The incentive to develop and commercialize anti-parasitic vaccines in swine are twofold; on the one hand parasitic diseases which are economically important, such as ascarosis and neonatal coccidiosis, could be controlled in a sustainable manner; on the other hand, the transmission of zoonotic parasites, such as Toxoplasma gondii or Cysticercus cellulosae, could be effectively interrupted. Although experimental research indicates that vaccination against a number of porcine parasites is feasible, development and commercialization of potential vaccines so far has been very slow, as our knowledge on the host-parasite interplay in porcine parasitic infections is still very limited. In the light of growing concerns regarding consumer health and antiparasitic drug resistance, however, it is timely to re-direct R&D efforts to the development of biological control options.

Prevalence and factors associated with the occurrence of bacterial enteropathogens in suckling piglets in farrow-to-finish herds

The aim of the study was to determine both environmental and infectious factors, influencing occurrence of bacterial enteropathogens in suckling piglets. For this purpose, a cross-sectional study in 70 Polish farrow-to-finish pig herds was performed. In each herd, presence of selected intestinal pathogens (Escherichia coli, Clostridium perfringens and Salmonella species) in faeces of suckling piglets were determined using bacteriological and PCR methods. Using logistic regression models, risk factors for enterotoxigenic E coli with fimbriae F4 (ETEC-F4) and C perfringens type A were established. Prevalence of bacterial enteropathogens in investigated herds was as follows (on herd and sample level): ETEC-F4 30.0 per cent and 9.3 per cent, respectively, C perfringens type A 91.4 per cent and 58.3 per cent, C perfringens type C 1.4 per cent and 0.3 per cent, Salmonella species 2.9 per cent and 0.5 per cent. The occurrence of ETEC-F4 was associated with presence of diarrhoea in piglets and vulval discharge in sows. Vulval discharge in sows, not slatted floor in farrowing pen and lack of coccidiosis prevention were determined as risk factors for C perfringens type A. The results obtained in the study revealed the high prevalence of enteropathogenic bacteria in pig herds and indicate management and organisation of production as factors having the greatest impact on the incidence of bacterial enteropathogens in piglets before weaning.

First report of molecular identification of Cystoisospora suis in piglets with lethal diarrhea in Japan

Cystoisospora suis is a pathogen that causes diarrhea in pigs and can lead to serious disease. Species identification, especially by histopathological examination, is often difficult because of morphologically similar parasites such as Eimeria species. In this study, we used histopathological, bacteriological, virological, and parasitological methods to identify the cause of the disease in two piglets with severe diarrhea. Villous atrophy, diffuse necrosis, and flattening of mucosal epithelial cells were found in the ilea of examined piglets, and coccidian parasites were found in the cytoplasm of the epithelial cells. In some merozoites in the meronts, the presence of two nuclei indicated type 1 merozoites, characteristic of C. suis. According to Cystoisospora-specific PCR targeting the rRNA internal transcribed spacer 1 (ITS1) gene, the sequences of the products were 98.5% similar to those of C. suis. Escherichia coli (O149 serogroup) exhibiting a virulence factor profile (LT, STb, and EAST1 as toxins and F4 as a colonization factor) was detected in one piglet. No other bacteria or significant enteric viruses were found. Co-infection with C. suis and E. coli could imply aggravation of the disease, although further study is needed to assess the pathogenicity of this interaction. This study is the first to clarify by molecular analysis the sequences of C. suis detected in piglets in Japan.

Case-control study of pathogens involved in piglet diarrhea

Background

Diarrhea in piglets directly affects commercial swine production. The disease results from the interaction of pathogens with the host immune system and is also affected by management procedures. Several pathogenic agents such as Campylobacter spp., Clostridium perfringens, Escherichia coli, Salmonella spp., group A rotavirus (RV-A), coronaviruses (transmissible gastroenteritis virus; porcine epidemic diarrhea virus), as well as nematode and protozoan parasites, can be associated with disease cases.

Results

All bacterial, viral, protozoan, and parasitic agents here investigated, with the exception of Salmonella spp. as well as both coronaviruses, were detected in varying proportions in piglet fecal samples, and positive animals were equally distributed between case and control groups. A statistically significant difference between case and control groups was found only for Cystoisospora suis (p = 0.034) and Eimeria spp. (p = 0.047). When co-infections were evaluated, a statistically significant difference was found only for C. perfringens β2 and C. suis (p = 0.014).

Conclusions

The presence of pathogens in piglets alone does not determine the occurrence of diarrhea episodes. Thus, the indiscriminate use of antibiotic and anthelminthic medication should be re-evaluated. This study also reinforces the importance of laboratory diagnosis and correct interpretation of results as well as the relevance of control and prophylactic measures.

Cystoisospora suis - A Model of Mammalian Cystoisosporosis

Cystoisospora suis is a coccidian species that typically affects suckling piglets. Infections occur by oral uptake of oocysts and are characterized by non-hemorrhagic transient diarrhea, resulting in poor weight gain. Apparently, primary immune responses to C. suis cannot readily be mounted by neonates, which contributes to the establishment and rapid development of the parasite, while in older pigs age-resistance prevents disease development. However, the presence of extraintestinal stages, although not unequivocally demonstrated, is suspected to enable parasite persistence together with the induction and maintenance of immune response in older pigs, which in turn may facilitate the transfer of C. suis-specific factors from sow to offspring. It is assumed that neonates are particularly prone to clinical disease because infections with C. suis interfere with the establishment of the gut microbiome. Clostridia have been especially inferred to profit from the altered intestinal environment during parasite infection. New tools, particularly in the area of genomics, might illustrate the interactions between C. suis and its host and pave the way for the development of new control methods not only for porcine cystoisosporosis but also for other mammalian Cystoisospora infections. The first reference genome for C. suis is under way and will be a fertile ground to discover new drugs and vaccines. At the same time, the establishment and refinement of an in vivo model and an in vitro culture system, supporting the complete life cycle of C. suis, will underpin the functional characterization of the parasite and shed light on its biology and control.

Superinfection of sows with Cystoisospora suis ante partum leads to a milder course of cystoisosporosis in suckling piglets

Cystoisospora (syn. Isospora) suis is a leading cause of diarrheal disease in neonatal piglets. To address the possibility of maternal immunization against C. suis infection six non-naïve pregnant sows were superinfected with 100,000 oocysts 2 weeks ante partum and compared to non-superinfected animals. Their piglets were infected with 1000 oocysts on the third day of life. Clinical and parasitological parameters as well as antibody titers in colostrum/milk and blood of sows and in the blood of piglets were evaluated by IFAT against sporozoites and merozoites from 2 weeks ante partum until the 35th day after birth. For IFAT two different invasive stages of C. suis were used to find possible differences between the immune response against the initially infectious stages (sporozoites) and later occurring asexual developmental stages (merozoites), which might be responsible for persisting/extraintestinal infections. IFN-γ production of PBMC and piglet splenocytes was determined by ELISPOT. Maternal superinfection resulted in increased titers of IgA, IgM and IgG in colostrum and milk as well as in the blood of sows and their piglets. Oocyst shedding and diarrhea were observed in the offspring of both groups, but piglets of superinfected sows showed significantly reduced oocyst shedding and less diarrhea. This protective effect was correlated with increased titers of antibodies, especially IgA, in colostrum, milk and blood serum of sows and piglets, and with the reactivity of splenocytes to parasite antigen. Superinfection of sows ante partum could partially protect piglets against the clinical outcome of experimental infection. Both colostrum and milk contain maternal protective substances as the effect of protection was highly correlated with antibody titers during the first 2 weeks of life. IgA in different substrates may serve as a marker for the level of protection against clinical cystoisosporosis.

Which factors influence the outcome of experimental infection with Cystoisospora suis?

For reliable predictions of clinical and parasitological outcome of experimental infections with parasites, different models must be evaluated for possible influences of infection time point, infection dose and host-specific parameters such as breed or litter size. To address these issues for Cystoisospora (syn. Isospora) suis, the causative agent of porcine neonatal coccidiosis, 181 piglets from 90 litters (hybrid crosses of different breeds) were included in a retrospective study to evaluate differences in time point and dose of infection in four different experimental models ((1) 1,500 oocysts on the 4th day of life, d.o.l.; (2) 1,000 oocysts, 4th d.o.l.; (3) 1,000 oocysts, 1st d.o.l.; (4) 5,000 oocysts, 4th d.o.l.). The target variables body weight gain, faecal consistency and oocyst excretion were evaluated during the acute phase of infection (5-10 days post infection), and the influences of the dependent variables breed or litter size were estimated. Despite differences in the time course of excretion and faecal consistency, neither the average amount of excretion nor the average faecal consistency differed among models, breeds or litters of different size. High individual variability was seen in all four models as described earlier for higher infection doses. When infections on the 1st vs. 4th day of life were compared, no differences in averages could be found, in contrast to previous observations on the influence of age. Other, not yet defined, variables appear to have a greater impact on the outcome of infection than doses and time points in the tested range, despite the reliable outcome of infection with high excretion rates and signs of clinical disease.

Isospora suis in an epithelial cell culture system - an in vitro model for sexual development in coccidia

Coccidian parasites are of major importance in animal production, public health and food safety. The most frequently used representative in basic research on this group is Toxoplasma gondii. Although this parasite is well investigated there is no adequate in vitro model for its sexual development available and knowledge on this important life cycle phase is therefore scarce. The use of Isosporasuis, a sister taxon to T. gondii and the causative agent of piglet coccidiosis, could provide a solution for this. In the present study an in vitro model for neonatal porcine coccidiosis in cells representative for the in vivo situation in the piglet gut was developed and evaluated. The parasite development was investigated by light and transmission electron microscopy and optimum culture conditions were evaluated. Intestinal porcine epithelial cells (IPEC-J2) adequately representing the natural host cells supported the development of all endogenous life cycle stages of I. suis, including gametocytes and oocysts. A concentration of 5% fetal calf serum in the culture medium led to highest gametocyte densities on day 12 post infection. Low infection doses (≤1 sporozoite for 100 host cells) were best for oocyst and gametocyte development. The presented system can also be used for immunostaining with established antibodies developed against T. gondii (in our case, anti-TgIMC3 antibodies directed against the inner membrane complex 3). The complete life cycle of I. suis in a cell line representing the natural host cell type and species provides a unique model among coccidian parasites and can be used to address a wide range of topics, especially with regard to the sexual development of coccidia.