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Ávalos G, Caballero-Gómez J, Matas-Méndez P, Castro-Scholten S, Jiménez-Martín D, Köster PC, Santín M, Bailo B, Cano-Terriza D, González-Barrio D, Mateo M, García-Bocanegra I, Dashti A, Nájera F, Carmena D. Detection and genotyping of zoonotic microsporidia in the endangered Iberian lynx (Lynx pardinus). Med Mycol 2024; 62:myae027. [PMID: 38499442 DOI: 10.1093/mmy/myae027] [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: 02/12/2024] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 03/20/2024] Open
Abstract
Microsporidia is a diverse group of obligate, intracellular, and spore-forming parasites that infect a wide range of animals. Among them, Enterocytozoon bieneusi and Encephalitozoon spp. are the most frequently reported species in humans. Limited information is available about the presence and molecular diversity of microsporidian species in the endangered Iberian lynx (Lynx pardinus). Presence of Enterocytozoon bieneusi and Encephalitozoon spp. was investigated by molecular methods in wild and captive Iberian lynxes from Spain. Overall, E. bieneusi was detected in 3.2% (8/251) of the animals examined. None of the samples tested were positive for Encephalitozoon spp. Four known (D, EbfelA, PigEBITS7, and Type IV) and a novel (named as LynxSpEb1) E. bieneusi genotypes were identified. All the genotypes found belonged to the zoonotic Group 1 of E. bieneusi. This study provides the first genotyping data of E. bieneusi in Iberian lynx in Spain. Our result indicate that the Iberian lynx does not seem to play a relevant role in the epidemiology of Encephalitozoon spp., and that this endangered felid is likely acting as spillover host rather than a true reservoir of E. bieneusi. Additional studies should be conducted to assess the impact of this parasite in the health status of the endangered Iberian lynx.
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Affiliation(s)
- Gabriel Ávalos
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain
| | - Javier Caballero-Gómez
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM), University of Córdoba, Córdoba, Spain
- Infectious Diseases Unit, Maimonides Institute for Biomedical Research (IMIBIC), University Hospital Reina Sofía, University of Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII - CIBER Infectious Diseases, Health Institute Carlos III, Madrid, Spain
| | - Pablo Matas-Méndez
- Faculty of Veterinary, Alfonso X El Sabio University (UAX), Villanueva de la Cañada, Madrid, Spain
| | - Sabrina Castro-Scholten
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM), University of Córdoba, Córdoba, Spain
| | - Débora Jiménez-Martín
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM), University of Córdoba, Córdoba, Spain
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain
- Women for Africa Foundation, Madrid, Spain
| | - Mónica Santín
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - Begoña Bailo
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain
| | - David Cano-Terriza
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM), University of Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII - CIBER Infectious Diseases, Health Institute Carlos III, Madrid, Spain
| | - David González-Barrio
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain
| | - Marta Mateo
- Department of Microbiology and Parasitology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - Ignacio García-Bocanegra
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM), University of Córdoba, Córdoba, Spain
- CIBERINFEC, ISCIII - CIBER Infectious Diseases, Health Institute Carlos III, Madrid, Spain
| | - Alejandro Dashti
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain
| | - Fernando Nájera
- Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - David Carmena
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain
- CIBERINFEC, ISCIII - CIBER Infectious Diseases, Health Institute Carlos III, Madrid, Spain
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Carrera A, Navas I, María-Mojica P, García-Fernández AJ. Greater predisposition to second generation anticoagulant rodenticide exposure in red foxes (Vulpes vulpes) weakened by suspected infectious disease. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 907:167780. [PMID: 37865245 DOI: 10.1016/j.scitotenv.2023.167780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/23/2023]
Abstract
Anticoagulant rodenticide (AR) exposure in wild carnivores is a current and global concern due to continuous and widespread use worldwide. We studied the prevalence of ARs in liver samples of 25 red foxes (Vulpes vulpes), 3 European badgers (Meles meles) and 2 genets (Genneta genneta) from Alicante (Spanish Levante region) obtained in 2021 and 2022. In addition to trauma, poisoning by pesticides is the most frequent cause of death in wild carnivores in this region. The present research aims to explain a possible association between the fact of suffering from an infectious disease and the increase in ARs concentrations in the affected animals. Both first- and second-generation ARs were analysed by HPLC/MS/TOF in liver samples. Apart from the cause of death, the influence of other variables such as age, sex and body weight were also assessed on AR liver concentrations. Potential health risks for individuals and populations in the study area have also been studied. Our research detected higher AR concentrations in the group of red foxes clinically diagnosed with infectious disease compared to the group of apparently healthy red foxes, mostly killed by trauma. Furthermore, our results lead us to suggest that red fox could be considered a good sentinel species for the risk of exposure to ARs in other wild mammals. All the livers analysed contained ARs and the most detected compounds in red fox were difenacoum, bromadiolone, brodifacoum, present in all the samples analysed, and flocoumafen (in 96 %). Additionally, 53 % of the animals had at least one second generation anticoagulant rodenticide (SGAR) above the threshold value reported as triggering adverse health effects (200 ng/g). Regarding this, the level of risk in red fox in this area might be classified as high and worrying. Moreover, we suggest that individuals and populations with weakened health due to other diseases (for example, infectious or parasitic diseases) might be more prone to high exposure to anticoagulant rodenticides and, very probably, would be more sensitive to suffering serious effects at lower doses of ARs.
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Affiliation(s)
- Alberto Carrera
- Servicio de Toxicología y Veterinaria Forense, Faculty of Veterinary Medicine, Campus de Espinardo, Universidad de Murcia, Murcia, Spain
| | - Isabel Navas
- Servicio de Toxicología y Veterinaria Forense, Faculty of Veterinary Medicine, Campus de Espinardo, Universidad de Murcia, Murcia, Spain; Toxicology and Risk Assessment Group, IMIB-Arrixaca, Campus de Ciencias de la Salud El Palmar, Universidad de Murcia, Spain.
| | - Pedro María-Mojica
- Servicio de Toxicología y Veterinaria Forense, Faculty of Veterinary Medicine, Campus de Espinardo, Universidad de Murcia, Murcia, Spain; Centro de Recuperación de Fauna Santa Faz (Alicante), VAERSA-Servicio de Vida Silvestre, Generalitat Valenciana, Spain
| | - Antonio J García-Fernández
- Servicio de Toxicología y Veterinaria Forense, Faculty of Veterinary Medicine, Campus de Espinardo, Universidad de Murcia, Murcia, Spain; Toxicology and Risk Assessment Group, IMIB-Arrixaca, Campus de Ciencias de la Salud El Palmar, Universidad de Murcia, Spain
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Moratal S, Magnet A, Izquierdo F, del Águila C, López-Ramon J, Dea-Ayuela MA. Microsporidia in Commercially Harvested Marine Fish: A Potential Health Risk for Consumers. Animals (Basel) 2023; 13:2673. [PMID: 37627464 PMCID: PMC10451485 DOI: 10.3390/ani13162673] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Microsporidia are widely spread obligate intracellular fungal pathogens from vertebrate and invertebrate organisms, mainly transmitted by contaminated food and water. This study aims to detect the presence of major human-pathogenic microsporidia, i.e., Enterocytozoon bieneusi, Encephalitozoon intestinalis, Encephalitozoon hellem, and Encephalitozoon cuniculi, in the gastrointestinal tract of commercially harvested marine fish from Mediterranean coast of the Comunidad Valenciana, Eastern Spain. A total of 251 fish, 138 farmed fish and 113 wild fish from commercial fishing were tested by SYBR Green real-time PCR, enabling the simultaneous detection of the four targeted species. E. intestinalis/hellem was found in 1.45% of farmed fish and 7.96% of wild fish, while Enterocytozoonidae was detected in 2.90% and 18.58% of farmed and wild fish, respectively. E. cuniculi was not detected in any of the analyzed specimens. To the authors' knowledge, this is the first report of E. intestinalis/hellem in fish, particularly in marine fish. Although the role of fish in these species' epidemiology remains unknown, this finding points out a potential public health risk linked to fish consumption. Further studies are necessary to characterize these microsporidia in fish hosts better and to elucidate their epidemiological role.
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Affiliation(s)
- Samantha Moratal
- Servicio de Análisis, Investigación y Gestión de Animales Silvestres (SAIGAS), Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, C/Tirant lo Blanc, Alfara del Patriarca, 46115 Valencia, Spain (J.L.-R.)
| | - Angela Magnet
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Fernando Izquierdo
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Carmen del Águila
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Jordi López-Ramon
- Servicio de Análisis, Investigación y Gestión de Animales Silvestres (SAIGAS), Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, C/Tirant lo Blanc, Alfara del Patriarca, 46115 Valencia, Spain (J.L.-R.)
- Wildlife Ecology & Health Group (WE&H), Veterinary Faculty, Universitat Autònoma de Barcelona (UAB), Travessera dels Turons, Bellaterra, 08193 Barcelona, Spain
| | - María Auxiliadora Dea-Ayuela
- Departamento Farmacia, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, C/Ramón y Cajal, Alfara del Patriarca, 46115 Valencia, Spain
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Baz-González E, Abreu-Acosta N, Foronda P. High Prevalence of Microsporidia in the North African Hedgehog ( Atelerix algirus) in the Canary Islands, Spain. Animals (Basel) 2023; 13:1756. [PMID: 37889680 PMCID: PMC10251962 DOI: 10.3390/ani13111756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 10/29/2023] Open
Abstract
Microsporidia are unicellular eukaryotic obligate intracellular parasites with a wide range of hosts reported worldwide; however, little is known about the epidemiological data on microsporidia infection in animals from the Canary Islands. Since data on microsporidia infection in hedgehog species are scarce, the aim of this study was to analyze the presence and identity of microsporidia in a group of North African hedgehogs (Atelerix algirus) using microscopic and molecular methods. From December 2020 to September 2021, a total of 36 fecal samples were collected from naturally deceased hedgehogs from Tenerife and Gran Canaria. All samples showed spore-compatible structures (100%; 36/36) under microscopic analysis, of which 61.1% (22/36) were amplified via the nested-polymerase chain reaction (PCR) targeting the partial sequence of the 16S rRNA gene, the internal transcribed spacer (ITS) region, and the partial sequence of the 5.8S rRNA gene. After Sanger sequencing and ITS analysis, Enterocytozoon bieneusi was detected in 47.2% (17/36) of the samples, identifying two novel genotypes (AAE1 and AAE2), followed by the detection of an undetermined species in 8.3% (3/36) and Encephalitozoon cuniculi genotype I in 5.6% (2/36) of the samples. This study constitutes the first report of microsporidia species in Atelerix algirus worldwide, highlighting the high prevalence of zoonotic species.
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Affiliation(s)
- Edgar Baz-González
- Department Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna (ULL), Avda. Astrofísico F. Sánchez s/n, 38203 San Cristóbal de La Laguna, Tenerife, Canary Islands, Spain;
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), Avda. Astrofísico F. Sánchez s/n, 38203 San Cristóbal de La Laguna, Tenerife, Canary Islands, Spain;
- Programa de Doctorado en Ciencias Médicas y Farmacéuticas, Desarrollo y Calidad de Vida, Universidad de La Laguna (ULL), Avda. Astrofísico F. Sánchez s/n, 38203 San Cristóbal de La Laguna, Tenerife, Canary Islands, Spain
| | - Néstor Abreu-Acosta
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), Avda. Astrofísico F. Sánchez s/n, 38203 San Cristóbal de La Laguna, Tenerife, Canary Islands, Spain;
- Nertalab S.L.U., 38001 Santa Cruz de Tenerife, Tenerife, Canary Islands, Spain
| | - Pilar Foronda
- Department Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna (ULL), Avda. Astrofísico F. Sánchez s/n, 38203 San Cristóbal de La Laguna, Tenerife, Canary Islands, Spain;
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), Avda. Astrofísico F. Sánchez s/n, 38203 San Cristóbal de La Laguna, Tenerife, Canary Islands, Spain;
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Rego L, Castro‐Scholten S, Cano C, Jiménez‐Martín D, Köster PC, Caballero‐Gómez J, Bailo B, Dashti A, Hernández‐Castro C, Cano‐Terriza D, Vioque F, Maloney JG, Santín M, García‐Bocanegra I, Carmena D, González‐Barrio D. Iberian wild leporidae as hosts of zoonotic enteroparasites in Mediterranean ecosystems of Southern Spain. Zoonoses Public Health 2022; 70:223-237. [PMID: 36533513 DOI: 10.1111/zph.13018] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
Wild lagomorphs including rabbits and hares can act as natural carriers or reservoirs of bacterial and parasitic zoonotic diseases. However, little is known on the epidemiology and potential public health significance of intestinal eukaryotes in wild leporids. We examined faecal samples from European wild rabbits (Oryctolagus cuniculus, n = 438) and Iberian hares (Lepus granatensis, n = 111) collected in the Autonomous Region of Andalusia in southern Spain during 2012-2021. We searched for the presence of DNA from the main intestinal protist and microsporidial pathogens of veterinary and public health concerns using molecular methods (PCR followed by Sanger and next-generation sequencing). Giardia duodenalis was the most prevalent species found (27.8%, 153/550; 95% CI: 24.1-31.8), followed by Cryptosporidium spp. (1.3%, 7/550; 95% CI: 0.5-2.6), Blastocystis sp. (1.1%, 6/550; 95% CI: 0.4-2.4) and Encephalitozoon intestinalis (0.2%, 1/550; 95% CI: 0.0-10.1). All samples tested negative for Enterocytozoon bieneusi. Sequence analyses revealed the presence of sub-assemblage BIV (n = 1) within G. duodenalis, and Cryptosporidium cuniculus (n = 6) and Cryptosporidium andersoni (n = 1) within Cryptosporidium. The presence of ruminant-adapted C. andersoni is indicative of a potential cross-species transmission event, although a spurious infection (mechanical carriage) cannot be ruled out. Samples assigned to C. cuniculus belonged to the gp60 subtype families Va (n = 3) and Vb (n = 2). The six Blastocystis-positive samples were identified as ST2 (n = 3) and ST1 + ST2 (n = 3). Our molecular results suggest that wild rabbits and hares were primarily infected by leporid-adapted species of eukaryotic pathogens. However, the occasional findings of zoonotic G. duodenalis sub-assemblage BIV, Blastocystis sp. ST1 and ST2, and Encephalitozoon intestinalis could be of public health relevance.
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Affiliation(s)
- Laura Rego
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
| | - Sabrina Castro‐Scholten
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM) University of Córdoba Córdoba Spain
| | - Carmen Cano
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
| | - Débora Jiménez‐Martín
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM) University of Córdoba Córdoba Spain
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
| | - Javier Caballero‐Gómez
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM) University of Córdoba Córdoba Spain
- Infectious Diseases Unit, Maimonides Institute for Biomedical Research (IMIBIC) University Hospital Reina Sofía, University of Córdoba Córdoba Spain
- CIBERINFEC, ISCIII – CIBER Infectious Diseases, Health Institute Carlos III Madrid Spain
| | - Begoña Bailo
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
| | - Alejandro Dashti
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
| | - Carolina Hernández‐Castro
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies University of Antioquia Medellín Colombia
| | - David Cano‐Terriza
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM) University of Córdoba Córdoba Spain
- CIBERINFEC, ISCIII – CIBER Infectious Diseases, Health Institute Carlos III Madrid Spain
| | - Fátima Vioque
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
| | - Jenny G. Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture Beltsville Maryland USA
| | - Mónica Santín
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture Beltsville Maryland USA
| | - Ignacio García‐Bocanegra
- Department of Animal Health, Animal Health and Zoonosis Research Group (GISAZ), UIC Zoonoses and Emerging Diseases (ENZOEM) University of Córdoba Córdoba Spain
- CIBERINFEC, ISCIII – CIBER Infectious Diseases, Health Institute Carlos III Madrid Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
- CIBERINFEC, ISCIII – CIBER Infectious Diseases, Health Institute Carlos III Madrid Spain
| | - David González‐Barrio
- Parasitology Reference and Research Laboratory National Centre for Microbiology Madrid Spain
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Baz-González E, Martin-Carrillo N, García-Livia K, Abreu-Acosta N, Foronda P. Molecular Detection of Microsporidia in Rabbits ( Oryctolagus cuniculus) in Tenerife, Canary Islands, Spain. BIOLOGY 2022; 11:biology11121796. [PMID: 36552305 PMCID: PMC9775083 DOI: 10.3390/biology11121796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Enterocytozoon bieneusi and Encephalitozoon spp. are microsporidia with zoonotic potential that have been identified in humans, as well as in a large group of wild and domestic animals. Several wildlife species have been studied as reservoirs of zoonotic microsporidia in mainland Spain, including the European rabbit (Oryctolagus cuniculus). Due to a lack of data on microsporidia infection in wildlife on the Canary Islands, the aim of this work was to analyze the prevalence and identify the species of microsporidia in rabbits in Tenerife. Between 2015 and 2017, a total of 50 fecal samples were collected from rabbits in eight municipalities of Tenerife, Canary Islands, Spain. Seven of the fifty samples (14%) were amplified using nested polymerase chain reaction (PCR) targeting the partial sequence of the 16S rRNA gene, the internal transcribed spacer (ITS) region, and the partial sequence of the 5.8S rRNA gene. Sanger sequencing reveals the presence of Encephalitozoon cuniculi genotype I in two samples (4%), and undescribed microsporidia species in five samples (10%). This study constitutes the first molecular detection and genotyping of E. cuniculi in rabbits in Spain.
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Affiliation(s)
- Edgar Baz-González
- Department Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
| | - Natalia Martin-Carrillo
- Department Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
| | - Katherine García-Livia
- Department Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
| | - Néstor Abreu-Acosta
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
- Nertalab S.L., 38008 Santa Cruz de Tenerife, Spain
| | - Pilar Foronda
- Department Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38203 San Cristóbal de La Laguna, Spain
- Correspondence:
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