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Gunasekera S, Thierry B, King B, Monis P, Carr JM, Chopra A, Watson M, O’Dea M, Cheah E, Ram R, Clode PL, Hijjawi N, Ryan U. Microphysiological gut-on-chip enables extended in vitro development of Cryptosporidium hominis. Front Cell Infect Microbiol 2025; 15:1564806. [PMID: 40343058 PMCID: PMC12058726 DOI: 10.3389/fcimb.2025.1564806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2025] [Accepted: 03/17/2025] [Indexed: 05/11/2025] Open
Abstract
Introduction Cryptosporidium hominis is the dominant Cryptosporidium species infecting humans, but most advances in developing robust in vitro culturing platforms for Cryptosporidium have utilised C. parvum. Consequently, there is relatively little available information specific to the biology and life cycle of C. hominis. The present study utilised a pumpless and tubeless gut-on-chip to generate a physiologically relevant in vitro environment by applying a constant fluid shear stress of 0.02 dyn cm-2 to HCT-8 cells. Methods Gut-on-chips were fabricated using standard soft lithography. C. hominis oocysts isolated from human pathology samples were used to infect the human ileocecal colorectal adenocarcinoma (HCT-8) cell line under a constant fluid shear stress of 0.02 dyn cm-2. Parasite growth was assessed using a C. hominis-specific quantitative PCR, a Cryptosporidium genus-specific immunofluorescence assay, and scanning electron microscopy. Differences in the HCT-8 transcriptome with and without fluid shear stress, and the host-parasite interaction, were both assessed using bulk transcriptomics. Results Transcriptomic analysis of the HCT-8 cell line cultured within the gut-on-chip demonstrated a metabolic shift towards oxidative phosphorylation when compared to the same cell line cultured under static conditions. Extended C. hominis (subtype IdA15G1) cultures were sustained for up to 10 days within the gut-on-chip as shown by a C. hominis-specific qPCR and a Cryptosporidium genus-specific immunofluorescence assay, which demonstrated ~30-fold amplification in the gut-on-chip over the duration of the experiment. Scanning electron microscopy of infected monolayers identified trophozoites, meronts, merozoites, macrogamonts, microgamonts, and possible gamont-like stages at 48 h post-infection. The potential role of gamonts in the Cryptosporidium life cycle remains unclear and warrants further investigation. Transcriptomes of HCT-8 cells infected with C hominis revealed upregulation of biological processes associated with cell cycle regulation and cell signalling in C. hominis-infected cells under fluid shear stress compared to static culture. Conclusions These data demonstrate that bioengineered gut-on-chip models support extended C. hominis growth and can be used to interrogate responses of host cells to infection. Owing to its relative simplicity, the pumpless and tubeless gut-on-chip can be accessible to most laboratories with established HCT-8 infection models for Cryptosporidium culture.
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Affiliation(s)
- Samantha Gunasekera
- Harry Butler Institute, College of Environmental and Life Sciences, Murdoch University, Murdoch, WA, Australia
| | - Benjamin Thierry
- Future Industries Institute, University of South Australia, Adelaide, SA, Australia
| | - Brendon King
- Australian Water Quality Centre, South Australian Water Corporation, Adelaide, SA, Australia
| | - Paul Monis
- Australian Water Quality Centre, South Australian Water Corporation, Adelaide, SA, Australia
| | - Jillian M. Carr
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Abha Chopra
- Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
| | - Mark Watson
- Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
| | - Mark O’Dea
- Harry Butler Institute, College of Environmental and Life Sciences, Murdoch University, Murdoch, WA, Australia
| | - Edward Cheah
- Future Industries Institute, University of South Australia, Adelaide, SA, Australia
| | - Ramesh Ram
- Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
| | - Peta L. Clode
- Centre for Microscopy, Characterisation, and Analysis and School of Biological Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Nawal Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Una Ryan
- Harry Butler Institute, College of Environmental and Life Sciences, Murdoch University, Murdoch, WA, Australia
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Huang W, He W, Huang Y, Tang Y, Chen M, Sun L, Yang Z, Hou T, Liu H, Chen H, Wang T, Li N, Guo Y, Xiao L, Feng Y. Multicopy subtelomeric genes underlie animal infectivity of divergent Cryptosporidium hominis subtypes. Nat Commun 2024; 15:10774. [PMID: 39737947 PMCID: PMC11685829 DOI: 10.1038/s41467-024-54995-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 11/27/2024] [Indexed: 01/01/2025] Open
Abstract
The anthroponotic Cryptosporidium hominis differs from the zoonotic C. parvum in its lack of infectivity to animals, but several divergent subtypes have recently been found in nonhuman primates and equines. Here, we sequence 17 animal C. hominis isolates and generate a new IbA12G3 genome at the chromosome level. Comparative analysis with 222 human isolates shows significant genetic divergence of the animal isolates, with genetic recombination among them. They have additional subtelomeric insulinase and MEDLE genes. In interferon-γ knockout mice, three monkey isolates show differences in infectivity and induce higher and longer oocyst shedding than a reference C. parvum isolate. Deletion of the MEDLE genes significantly reduces the growth and pathogenicity of a virulent strain in mice. Co-infection of two fluorescence-tagged C. hominis subtypes produces bicolored oocysts, supporting the conclusion that mixed subtype infections can lead to genetic recombination. These data provide insight into potential determinants of host infectivity in Cryptosporidium, and a convenient animal model for biological studies of C. hominis.
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Affiliation(s)
- Wanyi Huang
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Wei He
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Yue Huang
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Yongping Tang
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Ming Chen
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Lianbei Sun
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Zuwei Yang
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Tianyi Hou
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Huimin Liu
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Haoyu Chen
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Tianpeng Wang
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Na Li
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Yaqiong Guo
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China.
| | - Lihua Xiao
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China.
| | - Yaoyu Feng
- State Key Laboratory for Animal Disease Control and Prevention, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China.
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3
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Jiang Y, Yuan Z, Wang Y, Zhang J, Shen Y, Cao J. Wastewater-based intestinal protozoa monitoring in Shanghai, China. Microbiol Spectr 2024; 12:e0403223. [PMID: 39315819 PMCID: PMC11540151 DOI: 10.1128/spectrum.04032-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 07/19/2024] [Indexed: 09/25/2024] Open
Abstract
Intestinal protozoa Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi have been implicated in serious waterborne outbreaks worldwide. Wastewater-based epidemiology (WBE) is a promising approach for evaluating the disease prevalence in a catchment population in that it monitors the contamination level of the intestinal pathogens in wastewater. We collected 48 urban wastewater samples (24 from influents and 24 from effluents) from the Yangpu Wastewater Treatment Plant (YPWTP) in Shanghai, China. We identified Cryptosporidium spp., G. duodenalis, and E. bieneusi by nested polymerase chain reaction (PCR) amplification. Cryptosporidium hominis and subtype IdA14 were identified in two samples by analyzing the sequences of small subunit ribosomal RNA (SSU rRNA) and 60-kDa glycoprotein (gp60) genes, respectively. The G. duodenalis sub-assemblage AII (n = 8) and assemblage C (n = 4) in 12 samples were determined by analyzing triosephosphate isomerase (tpi) gene sequences. The E. bieneusi genotype A was identified in one sample by analyzing the sequence of the internal transcribed spacer (ITS) region of the rRNA gene. These findings suggest that improving wastewater treatment and monitoring the virility of pathogens in effluents is critical. We observed similar prevalence and genotypes/subtypes of the three intestinal protozoa in our wastewater samples as those reported in previous studies, providing evidence that WBE can be used as an effective epidemic management tool.IMPORTANCECryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are common intestinal protozoa causing diarrhea. The infective oocysts, cysts, and spores released in feces can survive in different environments, including multiple types of water bodies. Humans can acquire these intestinal protozoan infections via the fecal-oral route as in waterborne transmission. Wastewater-based epidemiology can rapidly and reliably detect and monitor the emergence and spread of waterborne diseases. We detected Cryptosporidium spp., G. duodenalis, and E. bieneusi in a wastewater treatment plant in Shanghai, China, reflecting the occurrence and genetic characterizations of the three intestinal pathogens from community members served by the wastewater treatment plant.
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Affiliation(s)
- Yanyan Jiang
- National Key
Laboratory of Intelligent Tracking and Forecasting for Infectious
Diseases, National Institute of Parasitic Diseases at Chinese Center for
Disease Control and Prevention, Chinese Center for Tropical Diseases
Research, NHC Key Laboratory of Parasite and Vector Biology, WHO
Collaborating Centre for Tropical
Diseases, Shanghai,
China
| | - Zhongying Yuan
- National Key
Laboratory of Intelligent Tracking and Forecasting for Infectious
Diseases, National Institute of Parasitic Diseases at Chinese Center for
Disease Control and Prevention, Chinese Center for Tropical Diseases
Research, NHC Key Laboratory of Parasite and Vector Biology, WHO
Collaborating Centre for Tropical
Diseases, Shanghai,
China
| | - Yaxue Wang
- National Key
Laboratory of Intelligent Tracking and Forecasting for Infectious
Diseases, National Institute of Parasitic Diseases at Chinese Center for
Disease Control and Prevention, Chinese Center for Tropical Diseases
Research, NHC Key Laboratory of Parasite and Vector Biology, WHO
Collaborating Centre for Tropical
Diseases, Shanghai,
China
| | - Jing Zhang
- National Key
Laboratory of Intelligent Tracking and Forecasting for Infectious
Diseases, National Institute of Parasitic Diseases at Chinese Center for
Disease Control and Prevention, Chinese Center for Tropical Diseases
Research, NHC Key Laboratory of Parasite and Vector Biology, WHO
Collaborating Centre for Tropical
Diseases, Shanghai,
China
| | - Yujuan Shen
- National Key
Laboratory of Intelligent Tracking and Forecasting for Infectious
Diseases, National Institute of Parasitic Diseases at Chinese Center for
Disease Control and Prevention, Chinese Center for Tropical Diseases
Research, NHC Key Laboratory of Parasite and Vector Biology, WHO
Collaborating Centre for Tropical
Diseases, Shanghai,
China
| | - Jianping Cao
- National Key
Laboratory of Intelligent Tracking and Forecasting for Infectious
Diseases, National Institute of Parasitic Diseases at Chinese Center for
Disease Control and Prevention, Chinese Center for Tropical Diseases
Research, NHC Key Laboratory of Parasite and Vector Biology, WHO
Collaborating Centre for Tropical
Diseases, Shanghai,
China
- School of Global
Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao
Tong University School of Medicine,
Shanghai, China
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4
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Attaway C, Mathison BA, Misra A. No longer stuck in the past: new advances in artificial intelligence and molecular assays for parasitology screening and diagnosis. Curr Opin Infect Dis 2024; 37:357-366. [PMID: 39133581 DOI: 10.1097/qco.0000000000001041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
PURPOSE OF REVIEW Emerging technologies are revolutionizing parasitology diagnostics and challenging traditional methods reliant on microscopic analysis or serological confirmation, which are known for their limitations in sensitivity and specificity. This article sheds light on the transformative potential of artificial intelligence and molecular assays in the field, promising more accurate and efficient detection methods. RECENT FINDINGS Artificial intelligence has emerged as a promising tool for blood and stool parasite review, when paired with comprehensive databases and expert oversight result in heightened specificity and sensitivity of diagnoses while also increasing efficiency. Significant strides have been made in nucleic acid testing for multiplex panels for enteric pathogen. Both multiplex and single target panels for Plasmodium , Babesia , filaria, and kinetoplastids have been developed and garnered regulatory approval, notably for blood donor screening in the United States. Additional technologies such as MALDI-TOF, metagenomics, flow cytometry, and CRISPR-Cas are under investigation for their diagnostic utility and are currently in the preliminary stages of research and feasibility assessment. SUMMARY Recent implementation of artificial intelligence and digital microscopy has enabled swift smear screening and diagnosis, although widespread implementation remains limited. Simultaneously, molecular assays - both targeted and multiplex panels are promising and have demonstrated promise in numerous studies with some assays securing regulatory approval recently. Additional technologies are under investigation for their diagnostic utility and are compelling avenues for future proof-of-concept diagnostics.
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Affiliation(s)
| | - Blaine A Mathison
- Scientist III, Institute for Clinical and Experimental Pathology, ARUP Laboratories, Department of Pathology, University of Utah, Salt Lake City, Utah, USA
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5
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Knox MA, Biggs PJ, Garcia-R JC, Hayman DTS. Quantifying Replication Slippage Error in Cryptosporidium Metabarcoding Studies. J Infect Dis 2024; 230:e144-e148. [PMID: 39052741 PMCID: PMC11272095 DOI: 10.1093/infdis/jiae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/08/2024] [Accepted: 02/06/2024] [Indexed: 02/10/2024] Open
Abstract
Genetic variation in Cryptosporidium, a common protozoan gut parasite in humans, is often based on marker genes containing trinucleotide repeats, which differentiate subtypes and track outbreaks. However, repeat regions have high replication slippage rates, making it difficult to discern biological diversity from error. Here, we synthesized Cryptosporidium DNA in clonal plasmid vectors, amplified them in different mock community ratios, and sequenced them using next-generation sequencing to determine the rate of replication slippage with dada2. Our results indicate that slippage rates increase with the length of the repeat region and can contribute to error rates of up to 20%.
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Affiliation(s)
| | - Patrick J Biggs
- School of Veterinary Science
- School of Natural Sciences, Massey University, Palmerston North, Manawatu-Wanganui, New Zealand
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6
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Egan S, Barbosa AD, Feng Y, Xiao L, Ryan U. Critters and contamination: Zoonotic protozoans in urban rodents and water quality. WATER RESEARCH 2024; 251:121165. [PMID: 38290188 DOI: 10.1016/j.watres.2024.121165] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
Rodents represent the single largest group within mammals and host a diverse array of zoonotic pathogens. Urbanisation impacts wild mammals, including rodents, leading to habitat loss but also providing new resources. Urban-adapted (synanthropic) rodents, such as the brown rat (R. norvegicus), black rat (R. rattus), and house mouse (Mus musculus), have long successfully adapted to living close to humans and are known carriers of zoonotic pathogens. Two important enteric, zoonotic protozoan parasites, carried by rodents, include Cryptosporidium and Giardia. Their environmental stages (oocysts/cysts), released in faeces, can contaminate surface and wastewaters, are resistant to common drinking water disinfectants and can cause water-borne related gastritis outbreaks. At least 48 species of Cryptosporidium have been described, with C. hominis and C. parvum responsible for the majority of human infections, while Giardia duodenalis assemblages A and B are the main human-infectious assemblages. Molecular characterisation is crucial to assess the public health risk linked to rodent-related water contamination due to morphological overlap between species. This review explores the global molecular diversity of these parasites in rodents, with a focus on evaluating the zoonotic risk from contamination of water and wasterwater with Cryptosporidium and Giardia oocysts/cysts from synanthropic rodents. Analysis indicates that while zoonotic Cryptosporidium and Giardia are prevalent in farmed and pet rodents, host-specific Cryptosporidium and Giardia species dominate in urban adapted rodents, and therefore the risks posed by these rodents in the transmission of zoonotic Cryptosporidium and Giardia are relatively low. Many knowledge gaps remain however, and therefore understanding the intricate dynamics of these parasites in rodent populations is essential for managing their impact on human health and water quality. This knowledge can inform strategies to reduce disease transmission and ensure safe drinking water in urban and peri‑urban areas.
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Affiliation(s)
- Siobhon Egan
- Harry Butler Institute, Vector- and Water-Borne Pathogen Research Group, Murdoch University, Murdoch, Western Australia 6150, Australia.
| | - Amanda D Barbosa
- Harry Butler Institute, Vector- and Water-Borne Pathogen Research Group, Murdoch University, Murdoch, Western Australia 6150, Australia; CAPES Foundation, Ministry of Education of Brazil, Brasilia, DF 70040-020, Brazil
| | - Yaoyu Feng
- Guangdong Laboratory for Lingnan Modern Agriculture, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China
| | - Lihua Xiao
- Guangdong Laboratory for Lingnan Modern Agriculture, Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China
| | - Una Ryan
- Harry Butler Institute, Vector- and Water-Borne Pathogen Research Group, Murdoch University, Murdoch, Western Australia 6150, Australia
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Schoeps A, Röbl K, Walter N, Neute A, Walter B, Freudenau I, Jurke A, Klier C, Heinmüller P, Saeed S, Metz J, Wilking H, Zanger P. Increased number of cryptosporidiosis cases with travel history to Croatia might be related to swimming pools, Germany, 2023. Euro Surveill 2024; 29:2300699. [PMID: 38179624 PMCID: PMC10905659 DOI: 10.2807/1560-7917.es.2024.29.1.2300699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/03/2024] [Indexed: 01/06/2024] Open
Abstract
In August and September 2023, an unusually high number of cryptosporidiosis cases identified by routine German surveillance had travelled to Croatia (n = 23). Nine cases had stayed in the same camping resort and seven further cases had stayed at other camping sites within 15 km. Based on our standardised questionnaires, the most likely source of infection was swimming pools (93%). Further environmental investigations on site might reveal potential common sources of contamination that could be targeted by control measures.
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Affiliation(s)
- Anja Schoeps
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- These authors contributed equally to this work and share first authorship
- Federal State Agency for Consumer and Health Protection Rhineland-Palatinate, Koblenz, Germany
| | - Klara Röbl
- These authors contributed equally to this work and share first authorship
- Postgraduate Training for Applied Epidemiology (PAE), Department of Infectious Disease Epidemiology, Robert Koch Institute, Germany
| | - Nicole Walter
- District Public Health Authority Rhein-Pfalz-Kreis, Ludwigshafen, Germany
| | - Andrea Neute
- Landesamt für Arbeitsschutz, Verbraucherschutz und Gesundheit (LAVG), Potsdam, Germany
| | - Bernadette Walter
- Postgraduate Training for Applied Epidemiology (PAE), Department of Infectious Disease Epidemiology, Robert Koch Institute, Germany
- Department for Health Protection, Infection Control and Epidemiology, State Health Office, Ministry of Social Affairs, Health and Integration Baden-Württemberg, Stuttgart, Germany
| | - Inga Freudenau
- Landeszentrum Gesundheit Nordrhein-Westfalen, Fachgruppe Infektionsepidemiologie, Bochum, Germany
| | - Annette Jurke
- Landeszentrum Gesundheit Nordrhein-Westfalen, Fachgruppe Infektionsepidemiologie, Bochum, Germany
| | - Christiane Klier
- Niedersächsisches Landesgesundheitsamt, Abt. 2: Infektionsepidemiologie, Hannover, Germany
| | - Petra Heinmüller
- Hessisches Landesamt für Gesundheit und Pflege (HLfGP), Abteilung 2 Gesundheits- und Infektionsschutz, Dillenburg, Germany
| | - Syamend Saeed
- Postgraduate Training for Applied Epidemiology (PAE), Department of Infectious Disease Epidemiology, Robert Koch Institute, Germany
- Hessisches Landesamt für Gesundheit und Pflege (HLfGP), Abteilung 2 Gesundheits- und Infektionsschutz, Dillenburg, Germany
| | - Jasmin Metz
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, München, Germany
- Postgraduate Training for Applied Epidemiology (PAE), Department of Infectious Disease Epidemiology, Robert Koch Institute, Germany
| | - Hendrik Wilking
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Germany
| | - Philipp Zanger
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Federal State Agency for Consumer and Health Protection Rhineland-Palatinate, Koblenz, Germany
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Bourli P, Eslahi AV, Tzoraki O, Karanis P. Waterborne transmission of protozoan parasites: a review of worldwide outbreaks - an update 2017-2022. JOURNAL OF WATER AND HEALTH 2023; 21:1421-1447. [PMID: 37902200 PMCID: wh_2023_094 DOI: 10.2166/wh.2023.094] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
The current study presents a comprehensive review of worldwide waterborne parasitic protozoan outbreaks reported between 2017 and 2022. In total, 416 outbreaks were attributed to the waterborne transmission of parasitic protozoa. Cryptosporidium accounted for 77.4% (322) of outbreaks, while Giardia was identified as the etiological agent in 17.1% (71). Toxoplasma gondii and Naegleria fowleri were the primary causes in 1.4% (6) and 1% (4) of outbreaks, respectively. Blastocystis hominis, Cyclospora cayetanensis, and Dientamoeba fragilis were independently identified in 0.72% (3) of outbreaks. Moreover, Acanthamoeba spp., Entamoeba histolytica, Vittaforma corneae, and Enterocytozoon bieneusi were independently the causal agents in 0.24% (1) of the total outbreaks. The majority of the outbreaks (195, 47%) were reported in North America. The suspected sources for 313 (75.2%) waterborne parasitic outbreaks were recreational water and/or swimming pools, accounting for 92% of the total Cryptosporidium outbreaks. Furthermore, 25.3% of the outbreaks caused by Giardia were associated with recreational water and/or swimming pools. Developing countries are most likely to be impacted by such outbreaks due to the lack of reliable monitoring strategies and water treatment processes. There is still a need for international surveillance and reporting systems concerning both waterborne diseases and water contamination with parasitic protozoa.
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Affiliation(s)
- Pavlina Bourli
- School of the Environment, Department of Marine Sciences, University of the Aegean, University Hill, Mytilene, Lesvos 81100, Greece E-mail:
| | - Aida Vafae Eslahi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ourania Tzoraki
- School of the Environment, Department of Marine Sciences, University of the Aegean, University Hill, Mytilene, Lesvos 81100, Greece
| | - Panagiotis Karanis
- Medical Faculty and University Hospital, University of Cologne, Cologne, Germany; Medical School, Department of Basic and Clinical Sciences, Anatomy Centre, University of Nicosia, Nicosia, Cyprus
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Wang T, Wei Z, Zhang Y, Zhang Q, Zhang L, Yu F, Qi M, Zhao W. Molecular detection and genetic characterization of Cryptosporidium in kindergarten children in Southern Xinjiang, China. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 103:105339. [PMID: 35840104 DOI: 10.1016/j.meegid.2022.105339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/06/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
Cryptosporidium is a common cause of diarrhea in children globally. However, there is limited information on the prevalence and genetic characteristics of Cryptosporidium in children in Xinjiang, China. This study aimed to assess the genetic characteristics and epidemiological status of Cryptosporidium in kindergarten children in Southern Xinjiang, China. A total of 609 fecal samples were collected from kindergartners aged 2-6 years from 11 counties in Southern Xinjiang, China. We used nested PCR amplification of the partial SSU rDNA gene to screen samples for Cryptosporidium spp. Isolates containing Cryptosporidium parvum and C. hominis were further subtyped for a gene encoding a 60-kDa glycoprotein (gp60). We used MEGA7 to construct a phylogenetic tree to study the genetic relationship between the gp60 subtypes of these two species via the Maximum Likelihood method based on the Tamura-Nei model. Only 1.3% (8/609) of asymptomatic children were confirmed to be infected with Cryptosporidium, with a 2.0% (6/299) infection rate in boys and 0.6% (2/310) infection rate in girls. Three Cryptosporidium species were identified including C. felis (37.5%; 3/8), C. hominis (37.5%; 3/8), and C. parvum (25.0%; 2/8). Three C. hominis subtypes (IbA9G3, IdA14, and IfA12G1) and two C. parvum subtypes (IIdA14G1 and IIdA15G1) were also found. This study is the first to identify the presence of Cryptosporidium in kindergarten children in Southern Xinjiang, China. The presence of zoonotic C. parvum subtypes IIdA14G1 and IIdA15G1 indicates the possible cross-species transmission of Cryptosporidium between children and animals.
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Affiliation(s)
- Tian Wang
- College of Animal Science and Technology, Tarim University, Alar, Xinjiang 843300, PR China
| | - Zilin Wei
- College of Animal Science and Technology, Tarim University, Alar, Xinjiang 843300, PR China
| | - Ying Zhang
- College of Animal Science and Technology, Tarim University, Alar, Xinjiang 843300, PR China
| | - Qiyuan Zhang
- College of Animal Science and Technology, Tarim University, Alar, Xinjiang 843300, PR China
| | - Longxian Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan 450046, China
| | - Fuchang Yu
- College of Animal Science and Technology, Tarim University, Alar, Xinjiang 843300, PR China
| | - Meng Qi
- College of Animal Science and Technology, Tarim University, Alar, Xinjiang 843300, PR China.
| | - Wei Zhao
- Department of Parasitology, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China.
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Evaluation of Next-Generation Sequencing Applied to Cryptosporidium parvum and Cryptosporidium hominis Epidemiological Study. Pathogens 2022; 11:pathogens11080938. [PMID: 36015058 PMCID: PMC9414878 DOI: 10.3390/pathogens11080938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/26/2022] Open
Abstract
Background. Nowadays, most of the C. parvum and C. hominis epidemiological studies are based on gp60 gene subtyping using the Sanger sequencing (SgS) method. Unfortunately, SgS presents the limitation of being unable to detect mixed infections. Next-Generation Sequencing (NGS) seems to be an interesting solution to overcome SgS limits. Thus, the aim of our study was to (i) evaluate the reliability of NGS as a molecular typing tool for cryptosporidiosis, (ii) investigate the genetic diversity of the parasite and the frequency of mixed infections, (iii) assess NGS usefulness in Cryptosporidium sp. outbreak investigations, and (iv) assess an interpretation threshold of sequencing data. Methods. 108 DNA extracts from positive samples were sequenced by NGS. Among them, two samples were used to validate the reliability of the subtyping obtained by NGS and its capacity to detect DNA mixtures. In parallel, 106 samples from French outbreaks were used to expose NGS to epidemic samples. Results. NGS proved suitable for Cryptosporidium sp. subtyping at the gp60 gene locus, bringing more genetic information compared to SgS, especially by working on many samples simultaneously and detecting more diversity. Conclusions. This study confirms the usefulness of NGS applied to C. hominis and C. parvum epidemiological studies, especially aimed at detecting minority variants.
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Ryan U, Hill K, Deere D. Review of generic screening level assumptions for quantitative microbial risk assessment (QMRA) for estimating public health risks from Australian drinking water sources contaminated with Cryptosporidium by recreational activities. WATER RESEARCH 2022; 220:118659. [PMID: 35635918 DOI: 10.1016/j.watres.2022.118659] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/26/2022] [Accepted: 05/21/2022] [Indexed: 06/15/2023]
Abstract
As urban communities continue to grow, demand for recreational access (including swimming) in drinking water sources have increased, yet relatively little is understood about the public health implications this poses for drinking water consumers. Preventative risk-based approaches to catchment management, informed by quantitative microbial risk assessment (QMRA), requires accurate input data to effectively model risks. A sound understanding of the knowledge gaps is also important to comprehend levels of uncertainty and help prioritise research needs. Cryptosporidium is one of the most important causes of waterborne outbreaks of gastroenteritis globally due to its resistance to chlorine. This review was undertaken by Water Research Australia to provide the most up-to-date information on current Cryptosporidium epidemiological data and underlying assumptions for exposure assessment, dose response and risk assessment for generic components of QMRA for Cryptosporidium and highlights priorities for common research. Key interim recommendations and guidelines for numerical values for relatively simple screening level QMRA modelling are provided to help support prospective studies of risks to drinking water consumers from Cryptosporidium due to body-contact recreation in source water. The review does not cover site-specific considerations, such as the levels of activity in the source water, the influence of dilution and inactivation in reservoirs, or water treatment. Although the focus is Australia, the recommendations and numerical values developed in this review, and the highlighted research priorities, are broadly applicable across all drinking source water sources that allow recreational activities.
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Affiliation(s)
- U Ryan
- Harry Butler Institute, Murdoch University, 90 South Street, Perth, Australia.
| | - Kelly Hill
- Water Research Australia, 250 Victoria Square, Adelaide, South Australia, Australia
| | - Dan Deere
- Water Futures, Sydney, Australia and Water Research Australia, Australia
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Ryan U, Zahedi A, Feng Y, Xiao L. An Update on Zoonotic Cryptosporidium Species and Genotypes in Humans. Animals (Basel) 2021; 11:3307. [PMID: 34828043 PMCID: PMC8614385 DOI: 10.3390/ani11113307] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022] Open
Abstract
The enteric parasite, Cryptosporidium is a major cause of diarrhoeal illness in humans and animals worldwide. No effective therapeutics or vaccines are available and therefore control is dependent on understanding transmission dynamics. The development of molecular detection and typing tools has resulted in the identification of a large number of cryptic species and genotypes and facilitated our understanding of their potential for zoonotic transmission. Of the 44 recognised Cryptosporidium species and >120 genotypes, 19 species, and four genotypes have been reported in humans with C. hominis, C. parvum, C. meleagridis, C. canis and C. felis being the most prevalent. The development of typing tools that are still lacking some zoonotic species and genotypes and more extensive molecular epidemiological studies in countries where the potential for transmission is highest are required to further our understanding of this important zoonotic pathogen. Similarly, whole-genome sequencing (WGS) and amplicon next-generation sequencing (NGS) are important for more accurately tracking transmission and understanding the mechanisms behind host specificity.
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Affiliation(s)
- Una Ryan
- Harry Butler Institute, Murdoch University, Perth, WA 6152, Australia;
| | - Alireza Zahedi
- Harry Butler Institute, Murdoch University, Perth, WA 6152, Australia;
| | - Yaoyu Feng
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China; (Y.F.); (L.X.)
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou 510642, China
| | - Lihua Xiao
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China; (Y.F.); (L.X.)
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou 510642, China
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Ryan UM, Feng Y, Fayer R, Xiao L. Taxonomy and molecular epidemiology of Cryptosporidium and Giardia - a 50 year perspective (1971-2021). Int J Parasitol 2021; 51:1099-1119. [PMID: 34715087 DOI: 10.1016/j.ijpara.2021.08.007] [Citation(s) in RCA: 194] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 12/11/2022]
Abstract
The protozoan parasites Cryptosporidium and Giardia are significant causes of diarrhoea worldwide and are responsible for numerous waterborne and foodborne outbreaks of diseases. Over the last 50 years, the development of improved detection and typing tools has facilitated the expanding range of named species. Currently at least 44 Cryptosporidium spp. and >120 genotypes, and nine Giardia spp., are recognised. Many of these Cryptosporidium genotypes will likely be described as species in the future. The phylogenetic placement of Cryptosporidium at the genus level is still unclear and further research is required to better understand its evolutionary origins. Zoonotic transmission has long been known to play an important role in the epidemiology of cryptosporidiosis and giardiasis, and the development and application of next generation sequencing tools is providing evidence for this. Comparative whole genome sequencing is also providing key information on the genetic mechanisms for host specificity and human infectivity, and will enable One Health management of these zoonotic parasites in the future.
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Affiliation(s)
- Una M Ryan
- Harry Butler Institute, Murdoch University, Perth, Western Australia, Australia.
| | - Yaoyu Feng
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, Guangdong, China
| | - Ronald Fayer
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, 10300 Baltimore Avenue, BARC-East, Building 173, Beltsville, MD 20705, USA
| | - Lihua Xiao
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, Guangdong, China
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Karim MR, Li J, Rume FI, Sumon SMR, Selim ASM, Hoda N, Zhang L. Occurrence and molecular characterization of Cryptosporidium spp. and Giardia duodenalis among captive mammals in the Bangladesh National Zoo. Parasitol Int 2021; 84:102414. [PMID: 34182122 DOI: 10.1016/j.parint.2021.102414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/09/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
Cryptosporidium and Giardia are protozoan parasites capable of causing gastrointestinal illness in humans and animals. The purpose of this research was to determine the occurrence, genetic characteristics, and zoonotic potential of Cryptosporidium spp. and Giardia duodenalis in captive mammals at the Bangladesh National Zoo. A total of 200 fresh fecal samples from 32 mammalian species were collected and examined for Cryptosporidium spp. using nested polymerase chain reaction (PCR) targeting the small subunit (SSU) rRNA gene and G. duodenalis targeting the β-giardin (bg), glutamate dehydrogenase (gdh), and triosephosphate isomerase (tpi) genes. The overall infection rates of Cryptosporidium and G. duodenalis among captive mammals in the zoo were 3.5% (7/200) and 5.5% (11/200), respectively. Five species/genotypes of Cryptosporidium (C. hominis, C. andersoni, C. muris, C. felis, and Cryptosporidium deer genotype) were identified. C. hominis was subtyped as IbA12G3 by sequence analysis of the glycoprotein 60 (gp60) gene. Multilocus genotyping of G. duodenalis revealed assemblages A, B, and D. Mixed infections of assemblages B and D and A and B were found in an Asiatic jackal and a Nilgiri langur, respectively. To our knowledge, this is the first report on the occurrence and genetic identity of the two parasites among zoo animals in Bangladesh. The results suggest that zoonotic Cryptosporidium spp. and G. duodenalis are maintained in and transmitted between captive mammals. Therefore, washing, cleaning, and disinfection measures should be implemented to reduce the spread of Cryptosporidium and G. duodenalis infections.
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Affiliation(s)
- Md Robiul Karim
- Faculty of Veterinary Medicine and Animal Science, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur 1706, Bangladesh
| | - Junqiang Li
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China.
| | - Farzana Islam Rume
- Department of Microbiology and Public Health, Patuakhali Science and Technology University, Barishal 8210, Bangladesh
| | - Sm Mostafizur Rahaman Sumon
- Faculty of Veterinary Medicine and Animal Science, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur 1706, Bangladesh
| | - Abu Sadeque Md Selim
- Faculty of Veterinary Medicine and Animal Science, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur 1706, Bangladesh
| | - Nazmul Hoda
- Bangladesh National Zoo, Mirpur, Dhaka 1216, Bangladesh
| | - Longxian Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China.
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