Treatment of Urticaria caused by severe cryptosporidiosis in a 17-month-old child - a case report

BACKGROUND

Cryptosporidium is an intracellular protozoan that causes gastrointestinal symptoms in humans and animals. In immunocompromised patients and children under 5 years of age, the infection is severe and can be life-threatening due to severe diarrhea.

CASE PRESENTATION

We report a case of urticaria associated with Cryptosporidium in a 17-month-old female Iranian child. The patient had moderate diarrhea (> 3 loose, watery stools but not more than 10 diarrhea stools in a day), weight loss, and acute urticarial (rash clears completely within 6 weeks). Since the child's father worked in livestock farming, the parasite may have been transferred from the cow or calve to the house and the child. Several Cryptosporidium oocysts were detected in the modified acid-fast staining of the child's stool sample. The patient was successfully treated with nitazoxanide (100 mg twice daily) and became negative for parasites three days after treatment and one week after discharge from the hospital. The child was observed to produce < 3 loose stools in the previous 24 h after 1-week post-treatment and after 6 months of follow-up.

CONCLUSION

A number of parasites are associated with urticaria, but to our knowledge, there is no information on Cryptosporidium-induced urticaria. Therefore, our result may be evidence for the role of this parasite in the development of urticaria if other causes such as food allergies, autoimmune diseases and etc. don't role in urticaria.

First case report of hospital staff infestation with cat flea (Ctenocephalides felis) in Iran

Background

Cat fleas (Ctenocephalides felis) are the most common ectoparasites of domestic cats and dogs worldwide. They can parasitize humans in many regions of the globe. Hospital infestation with fleas has not been reported in Iran, and the number of reported cases in the world is very low.

Case presentation

Here we report and describe a hospital infestation with cat fleas in a number of health-care service personnel and nurses, which led to the development of skin lesions and severe itching.

Conclusion

Diagnosing the parasite, removing it, and good health and medical management lead to satisfactory outcomes.

Association with sagittal alignment and osteoporosis-related fractures in outpatient women with osteoporosis

The baseline sagittal vertical axis (SVA) and pelvic tilt (PT) are independent risk factors of osteoporosis-related fractures in women with osteoporosis. We clarified the SVA and PT to predict the incidence of osteoporosis-related fractures.

PURPOSE

Sagittal alignment with osteoporosis women deteriorates with advancing age and sagittal alignment may indicate osteoporosis-related fractures in the future. However, whether the sagittal alignment predicts future osteoporosis-related fracture in patients with osteoporosis has not been clarified. We aimed to investigate the association between sagittal alignment and future osteoporosis-related fractures.

METHODS

This was a retrospective cohort study. Of the 313 participants (mean follow-up period, 2.9 years), 236 were included in the analysis. At baseline, we measured bone mineral density (BMD) of the lumbar spine and the femoral neck, sagittal vertical axis (SVA), thoracic kyphosis, pelvic incidence minus lumbar lordosis, sacral slope, pelvic tilt (PT), geriatric locomotive function scale (GLFS), two-step value, and stand-up test. The information on medications and the duration of treatment were reviewed from the medical records. Additionally, participants reported their history of falls at baseline. Multiple logistic regression analysis was used to determine the association of future osteoporosis-related fracture, and adjusted Odds ratios (OR) and 95% confidence interval (CI) were calculated with all predictors as covariates. All continuous variables were calculated using standardized OR (sOR).

RESULTS

Osteoporosis-related fractures occurred in 33 of 313 participants (10.5%). Multiple logistic regression analysis showed that a history of falls (OR =4.092, 95% CI: 1.029-16.265, p =0.045), SVA (sOR =4.228, 95% CI: 2.118-8.439, p <0.001), and PT (sOR =2.497, 95% CI: 1.087-5.733, p =0.031) were independent risk factors for future osteoporosis-related fractures.

CONCLUSIONS

This study revealed the SVA and PT to predict osteoporosis-related fractures.

TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION

UMIN000036516 (April 1, 2019).

Immunology and Genetic of Leishmania infantum: The Role of Endonuclease G in the Apoptosis

Leishmania infantum is the causative agent of infantile visceral leishmaniasis (VL) in the Mediterranean region. Despite developing protective responses, the disease progresses due to many of factors. These include the action of suppressive cytokines, exhaustion of specific T cells, loss of lymphoid tissue, and defective humoral response. Genetic changes that occur inside the genome of alienated or parasite cells, along with immune responses, play an important role in controlling or progressing the disease. Proapoptotic proteins such as Smac/DIABLO, EndoG, AIF (apoptosis-inducing factor), and cytochrome C are effective in apoptosis. EndoG is a mitochondrion-specific nuclease that translocates to the nucleus during apoptosis. Once released from mitochondria, endoG cleaves chromatin DNA into nucleosomal fragments independently of caspases. Therefore, endoG represents a caspase-independent apoptotic pathway initiated from the mitochondria. A comprehensive understanding of the immune and genetic events that occur during VL is very important for designing immunotherapy strategies and developing effective vaccines for disease prevention. In this review which explained the immunological responses and also the important factors that can contribute to parasite apoptosis and are used in subsequent studies as a target for the preparation of drugs or recombinant vaccines against parasites are briefly reviewed.

Analysis of the cox1 gene in Echinococcus granulosus from sheep in northeast Iran using PCR high-resolution melting (qPCR-HRM) curve analysis

Echinococcus granulosus, the etiologic agent of echinococcosis, is one of the most important zoonotic helminthes worldwide. Knowledge of E. granulosus species and genotypes has important implications for epidemiology, control, and prevention of diseases as well as future vaccine and drug designs. There are many molecular methods developed to define genotypes of E. granulosus, among them high resolution melting (HRM) analysis, as a new approach, is a single step and closed tube method. It is appropriate for fast screening of large number of isolates. This technique is an accurate, user friendly, cost-effective, fast and simple method, which does not need post-PCR processes. Between March and lst august 2016, of 726 sheep examined in abattoirs in Razavi Khorasan province, Northeast Iran, 109 harboured cystic echincoccosis lesions (liver samples= 65 and lung samples= 44) which were collected for analysis. Total genomic DNA was extracted from each sample and amplified for the presence of polymorphism in the mitochondrial cox1 gene of Echinococcus granulosus using a high resolution melting curve (HRM) method. A total of 109 hydatid cyst samples analyzed by PCR high-resolution melting (qPCR-HRM) curve of the cox1 gene, all isolates were identified as G1 genotype (sheep strain). G1 is the predominant genotype in sheep in northeast of Iran. The high incidence of the G1 genotype (known to be the predominant E. granulosus genotype infecting humans globally) in sheep has considerable implications for hydatid disease control programs in this area.

A wide diversity of zoonotic intestinal parasites in domestic and stray dogs in rural areas of Kermanshah province, Iran

Dogs can act as reservoirs, carriers, and transmitters of several zoonotic intestinal parasites that can cause serious health problems for humans. The aim of this study was to determine the prevalence of intestinal parasites in dogs in Kermanshah Province, west of Iran. Faecal samples were collected from domestic and stray dogs from 30 rural areas of Kermanshah province from August 2014 to April 2015 and were analyzed by formalin-ether sedimentation, sucrose otation technique and the modied Ziehl-Neelsen method. Out of 301 dogs examined, 230 (76.4%) were infected with at least one parasite. The incidence on the different types of intestinal parasitic species recovered from domestic and stray dogs are as follows: Toxocara leonina (20.8% and 27.6%), T. canis (7.5% and 9.4%), Taenia spp. (9.2% and 9.4%), hookworm spp. (18.3% and 33.7%), Capillaria spp. (0.8 and 1.7%), Dicrocoelium dendriticum (0.8% and 3.3%), Fasciola spp. (0.8% and 2.2%), Acanthocephal spp. (3.3% and 5.5%), Trichuris vulpis (0.8% and 1.7%), Dipylidium caninum (4.2% and 3.3%), Physaloptera spp. (6.7% and 6.6%), Cryptosporidium spp.(21.7% and 25.4%), Eimeria spp. (35.0% and 34.3%), Giardia spp. (6.7% and 12.7%), Cystoisospora spp. (7.5% and 5.5%), Blastocystis spp. (18.3% and 20.4%) and Sarcocystis spp. (6.7% and 7.2%), respectively. Signicant difference in infection rates was observed between domestic and stray dogs (P>0.05). Hookworm and Eimeria spp. were the most common intestinal helminth and protozoa detected with 83 (27.6%) out of 301 and 104 (34.6%), out of 301, respectively. There was no significant difference in prevalence and distribution of intestinal parasites between male and female dogs (P>0.05). The wide range of zoonotic parasites indicated that people residing in rural areas in Kermanshah province are at risk of exposure to these pathogens. In this respect, appropriate implementation of control programs by public health authorities and veterinarians should be taken into account.

Seroepidemiology of Toxoplasma gondii infection in pregnant women in west Iran: determined by ELISA and PCR analysis

Congenital toxoplasmosis can lead to severe damage for the fetus and newborn. Considering that the seroepidemiology of Toxoplasma infection in the pregnant women is poorly studied in west of Iran, the main objective of this study was to estimate the seroprevalence and potential risk factors for congenital toxoplasmosis in Delfan, Iran. In this cross-sectional study, the serum samples obtained from pregnant women who were referred to health centers for routine monitoring of the pregnancy. Totally, 264 sera were screened for IgG and IgM anti-T. gondii antibodies by enzyme linked immunosorbent assay method. All women with IgM anti-T. gondii positive checked by RT-PCR and confirmed. In addition, structured questionnaires were used to obtain information on risk factors for T. gondii infection. Anti-Toxoplasma IgG and IgM were positive in 66 (25 %) and 15 (5.7 %) respectively. Seropositive subjects were more frequently seen in those with >30 years old compared to younger women (<25 years old) (p < 0.001). No significant relationship was found between the seroprevalence of T. gondii infection and level of education, and gestational age (p > 0.05), while there was statistical difference between the infection with cat exposure, consumption of raw/undercooked meat, eating raw or uncooked eggs, consumption of unwashed vegetables and drinking unpasteurized milk (p < 0.001). In the present study, it was found that T. gondii infection was present among pregnant women in west of Iran. Therefore, it is suggested to provide health education for preventing primary infection during pregnancy and subsequently congenital toxoplasmosis in the pregnant women.

The prevalence of tuberculosis among Iranian elderly patients admitted to the infectious ward of hospital: A systematic review and meta-analysis

AIMS AND OBJECTIVES

Age increasing is caused physiological changes in the human body, such as reducing the power of the immune system. Weakened immune systems are more susceptible to bacterial infections like tuberculosis. So, this present study was performed for evaluating the prevalence of tuberculosis among Iranian elderly patients admitted to the infectious ward of a hospital.

METHODS

This systematic review and meta-analysis study has been done based on PRISMA guidelines. A comprehensive search was conducted in Iranian and International databases included: Magiran, Iranmedex, IranDoc, SID, Medlib, Scopus, PubMed, Science Direct, Cochrane, Web of Science, Springer, Wiley Online Library as well as the Google Scholar search engine in the period 1990-2016 by two independent researchers using the Mesh keywords. All of the reviewed studies that had inclusion criterion were been evaluated. The diagnosis of tuberculosis were considered results of physical examination, PPD (Purified Protein Derivative) test, Blood tests, Imaging tests and sputum test. The data were analyzed by using random effects model with the software Stata-Ver.11.1.

RESULTS

Five studies with a total number of 2,956 elderly patients were included. The prevalence of tuberculosis among Iranian elderly patients admitted to the infectious ward of the hospital was estimated to be 15% (95%CI: 1-30). The relationship between prevalence of tuberculosis with a year of study was not statistically significant (P=0.371).

CONCLUSION

This will be the first systematic review of tuberculosis prevalence among elderly patients admitted to the infectious ward in Iran. This study showed a high prevalence of Tuberculosis and it is recommended considering tuberculosis as a differential diagnosis in elderly patients with infectious symptoms.

Prevalence and clinical features of Cryptosporidium infection in hemodialysis patients

AIM

This cross-sectional study aims to assess the prevalence of Cryptosporidium in hemodialysis patients compared with healthy individuals in central Iran from August 2014 to January 2015.

BACKGROUND

Cryptosporidiosis is a major cause of acute and persistent diarrhea with significant morbidity and mortality in immunocompromised patients such as those undergoing renal dialysis.

METHODS

Three stool samples were collected from 330 hemodialysis patients and 150 healthy individuals on 3 consecutive days. The samples were screened for Cryptosporidium infection using formalin-ether sedimentation and modified Ziehl-Neelsen staining. Demographic variables as well as risk factors were recorded.

RESULTS

Out of 330 dialysis patients and 150 healthy individuals, 10 (3%) and 1 (0.7%) were infected with Cryptosporidium, respectively. We found statistically significant differences between infection and place of residency, hygiene status, education level, diarrhea, and abdominal pain in the two groups (p<0.05). On the other hand, there was no relationship between infection and sex, contact with domestic animals, fever, vomiting, nausea, flatulence, anorexia, duration of dialysis and underlying disorders in the two groups. Also, there was a statistically significant difference between age and infection in hemodialysis patients (p=0.003). A higher infection rate was observed in patients under 20 years of age.

CONCLUSION

Risk factors for Cryptosporidium infection must be controlled. We strongly recommended that stool samples from such patients, especially those with severe or prolonged diarrhea, should be examined with modified Ziehl-Neelsen staining for appropriate and timely treatment.

PCR-RFLP diagnosis and characterization of Leishmania species causing human cutaneous leishmaniasis and evaluation of treatment times with glucantime in these patients

Antimony compounds are first line treatments for cutaneous leishmaniasis. The prognosis of the disease varies depending on the type of medicine and species. We aimed to determine the species responsible for cutaneous leishmaniasis in patients referred to Skin Diseases and Leishmaniasis Research Center in Isfahan and Bam Health Center (Kerman) in order to follow and assess the complete healing of the lesions. A total of 40 skin lesions samples were collected from patients with cutaneous leishmaniasis (CL) form January 2014 to 2015. Dermal scrapings were analyzed by examination of Giemsa-stained smears. Parasites were cultured and isolated in NNN and RPMI 1640 medium and DNA was extracted. We used PCR-RFLP assays of ITS1 genes for direct identification of Leishmania species. Treatment process was assessed after a treatment period with glucantime and healing of the studied cases was followed up. All the samples from Isfahan and Bam regions were L. major and L. tropica species respectively. In patients infected with L. major and L. tropica treated with glucantime, the shortest healing period was 40 days in 5(25%) and 60 days in 3(15.8%) patients, respectively and the longest healing period was 100 days in 1 (5%) and 160 days in 1 (5.3%) patient, respectively. The mean complete healing periods in patients with L. tropica and L. major were 100 and 58 days, respectively (P<0.001). Average recovery period for people with dry cutaneous leishmaniasis is longer than average recovery period for people with wet cutaeous leishmaniasis.

SEROPREVALENCE OF TOXOPLASMA GONDII INFECTION AMONG PATIENTS ADMITTED TO AL-ZAHRA HOSPITAL, ISFAHAN, IRAN

BACKGROUND

Toxoplasma gondii (T. gondii) infection is one of the most common parasitic infections among humans and other warm-blooded animals worldwide. The aim of this study was to evaluate toxoplasmosis status in patients admitted to Al-Zahra hospital, Isfahan, Iran.

METHODS

This cross-sectional study was conducted from October 2012 to January 2015. During this period, 716 patients referred to AI-Zahra hospital in Isfahan city, Iran, were studied to investigate the IgG and IgM antibodies against T. gondii using ELISA kit. The data were analysed by Chi-square and Fisher's exact tests. In addition, the relation of data with age and sex were also examined.

RESULTS

Among 716 patients, 21 patients (2.9%) had positive IgM and 288 patients (40.2%) had positive IgG titer against T. gondii. Data analysis by Chi-square and Fisher's exact tests revealed that there was no significant relationship between IgG titer and age (p > 0.05). Additionally, there was no relationship between IgM titer and age (p > 0.05). The data showed that there was no relationship between IgG and IgM antibody titer and sex (p > 0.05).

CONCLUSION

The prevalence of toxoplasmosis in Isfahan inhabitants seems fairly high but it can be concluded that the rate of seropositive patient is moderate comparing to other regions of country. Accordingly, the authors propose that all sensitive patients have to be tested for T. gondii antibody in order to prevent the consequences of disease.

In vitro and in vivo anthelmintic activity of seed extract of Coriandrum sativum compared to Niclosamid against Hymenolepis nana infection

Phytotherapy can be an alternative for the control of gastrointestinal parasites in human and animals. Coriander (Coriandrum sativum L.) is a medicinal plant which grown as a spice crop all over the world. The seeds of this plant have been used to treat parasitic disease, indigestion, diabetes, rheumatism and pain in the joints. This study was carried out to compare the efficacy of Niclosamid and alcoholic seed extract of C. sativum on Hymenolepis nana infection, in vivo and vitro. For in vivo study, Balb/c mice were used, to compare the efficacy of 50 mg/kg body weight (B.W) of Niclosamid with different doses of alcoholic extracts of C. sativum (250, 500, and 750 mg/kg B.W). It was found that the efficacy of Niclosamid had reached 100 % after 11 days post treatment, while the efficacy of 500 and 750 mg/kg B.W of C. sativum reached to 100 % after 15 days after treatment. For in vitro study, special nutrient broth media was used. It was found that the addition of 1000 mg/ml of Niclosamid had paralyzed and killed worms within 5 min, while C. sativum killed them within 30 min. Our results showed that extract of C. sativum has good effect against H. nana and could be use in traditional medicine for treatment of parasitic disease.

Prevalence of hydatidosis in slaughtered animals in Iran

OBJECTIVE

Hydatid cyst or cystic echincoccosis (CE) is an important medical and veterinary problem in the world, especially in Iran. Domestic intermediate hosts are a major reservoir for the disease in humans. The aim of this study was to determine the prevalence of hydatid cysts in slaughtered animals in Isfahan, central part of Iran.

METHODS

In this cross-sectional study performed from 10 May 2009 to 10 May 2010, a total of 196,325 animals (89,651 sheep, 93,050 goats, 9,112 cattle and 4,512 calves) were inspected macroscopically for hydatid cysts.

RESULTS

Prevalence rate of CE in sheep, goats, cattle and calf was 16.4%, 3.1%, 6.5% and 8.2%, respectively. In all cases, the prevalence in female cattle and sheep was more than in males (P < 0.001). There are significant seasonal pattern for hydatidosis only in sheep (P < 0.001) and the highest prevalence of cysts was seen in autumn and winter seasons. The fertility of cysts in the liver of sheep (77%) was higher than in lungs (47.9%), but was higher in lungs in cattle (44%). Most condemnation cases were seen in lung of sheep (27.1%).

CONCLUSION

It appears that sheep are the most important intermediate hosts for E. granolusus in this area.

First report of birds infection by intestinal parasites in Khorramabad, west Iran

Parasitic infections in birds are omnipresent, even when they occur in low amounts, may result in subclinical diseases. There aren't any studies, based on Iranian data, investigating the prevalence of intestinal parasitic infections in some birds' species. We conducted a cross-sectional study between December 2011 and December 2012. The fecal samples were taken from 451 birds including hen, turkey, sparrow, pigeon and decorative birds. The samples screened for intestinal parasitic infections using direct smear, formalin-ether concentration technique, modified Ziehl-Neelsen staining, Culture in RPMI 1640 medium, sporulation with potassium dichromate and Trichrome and Giemsa staining. Out of 451 birds' species, 157 (34.8 %), were infected with one or more type of intestinal parasites. We identified two nematode, two cestoda species and five protozoan parasites species. No trematodes were found in the samples studied. The parasites identified among birds involved Raillietina spp. (4.2 %) and Eimeria spp. (7.1 %) were the most common helminthes and protozoa respectively. From total of birds study, 12 (2.7 %) and 6 (1.3 %) have two and three mixed infections respectively. Intestinal parasitic infections are common in birds in west Iran. The future studies are needed in order to determine to which extent the infections influence mortality and performance of the birds.

Prevalence of liver fluke infections in slaughtered animals in Lorestan, Iran

Fasciola spp. and Dicrocoelium dendriticum as liver flukes, contaminate ruminants and other mammalian extensively and cause major diseases of livestock that create considerable economic losses. This retrospective study has been done to evaluate contamination rate of slaughtered animals with fasciolosis and dicrocoeliosis at Lorestan abattoirs. In this survey, prevalence rate of fasciolosis and dicrocoeliosis in slaughtered animals in a 3-year period (2010-2013) has been analyzed. A total of 356,605 livestock including 265,692 sheep and 90,913 goats were slaughtered in the 3-year period and overall 39,613 (11.1 %) livers were condemned. Fascioliasis and dicrocoeliosis were responsible for 6.3 and 4.8 % of total liver condemnations in this period, respectively. Fasciola spp. and D. dendriticum infection in sheep (7.1 and 5.6 %, respectively) were considerably higher than goats (3.9 and 2.6 %, respectively). The annual prevalence rates showed a significant decline in the fasciolosis and dicrocoeliosis infection in goats (p < 0.001). Data showed significant seasonal pattern for distomatosis in sheep and goats (p < 0.001). Liver condemnations due to fasciolosis were prevalent in sheep and goats slaughtered during spring and autumn, respectively, whereas dicrocoeliosis were common in spring season for both sheep and goats. This survey provides baseline data for the future monitoring of these potentially important parasitic infections in the region.

Seroprevalence of toxoplasmosis in mentally retarded patients in Iranian rehabilitation centers

Toxoplasma gondii is one of the most common causes of latent infections in humans and animals. Although T. gondii infection is widely prevalent in the world, most acquired cases of the disease are asymptomatic. The important aspect of this parasitic infection is the probable danger of congenital transmission and its severe effects on the fetus. There have been many reports about the prevalence of anti-T. gondii antibody among different groups of people in Iran; however the epidemiological data in mentally retarded patients are rare. The present study was conducted on 158 mentally retarded persons (94 males, 64 females) in the rehabilitation centers of Khoramabad from autumn 2012 to winter 2013. The overall prevalence of anti-T. gondii antibody was 30.4 % (48 cases). There were no significant difference between sex and toxoplasmosis (p > 0.05). However, there were no statistically significant difference between age and toxoplasmosis, nevertheless the prevalence of toxoplasmosis in the patients less than 10-years-old had significantly the lowest rate. The highest infection rates were found in the two age groups of 10-19 and ≥30 years old. Our results showed that the prevalence of toxoplasmosis in the mentally retarded persons in the rehabilitation centers of Khorramabad was similar to the prevalence in pregnant women in this city. Therefore, the disease does not cause additional danger to this group of women.

Importance of cystic echinococcosis in slaughtered herbivores from Iran

Cystic echinococcosis (CE) or hydatidosis is well-known as one of the zoonotic diseases in world-wide including Iran. Hydatidosis was considered as a disease that causes severe reduction in meat wool and milk in livestock animals which all of them indicating its importance. Thus, present study was designed to evaluated prevalence of CE in slaughtered animals from Delfan region in Lorestan province of Iran. The samples 6,885 animals were considered based on type of species in a slaughter from Lorestan province. The study performed from 3 April 2009 to 3 April 2012 and inspection carried out from 4,101 cattle, 2,150 sheep and 634 goat. The liver and lungs examined based on CE and showed the highest prevalence in cattle (25.7 %) and the lowest 3.8 % in goat, likewise, CE was more in the lung than to liver. There was significant difference between species of animals and infected organ (P < 0.001). The highest prevalence was seen in winter (32.8 % for cattle, 8.1 % for goat) while, it was 15.7 % for sheep in summer (P = 0.04). Overall these data indicate the necessity of disease control strategy for reduction of CE.

Intestinal parasitic infections in renal transplant recipients

The impact of intestinal parasitic infection in renal transplant recipients requires careful consideration in the developing world. However, there have been very few studies addressing this issue in Iran. This study was conducted to determine the prevalence of intestinal parasitic infections in renal transplant recipients in Iran. Stool specimens from renal transplant recipients and control groups were obtained between June 2006 and January 2007. The samples screened for intestinal parasitic infections using direct smear, formalin-ether sedimentation, Sheather's flotation and modified Ziehl-Neelsen staining methods. Out of 150 renal transplant recipients, 33.3% (50), and out of 225 control group, 20% (45) were infected with one or more type of intestinal parasites. The parasites detected among patients included Entamoeba coli (10.6%), Endolimax nana (8.7%), Giardia lamblia (7.4%), Blastocystis spp. (4.7%), Iodamoeba butschlii (0.7%), Chilomastix mesnili (0.7%) and Ascaris lumbricoides (0.7%). Multiple infections were more common among renal transplant recipients group (p < 0.05). This study highlights the importance of testing for intestinal parasites among Iranian renal transplant recipients. Routine examinations of stool samples for parasites would significantly benefit the renal transplant recipients by contributing to reduce severe infections.

Prevalence of Cryptosporidium infection in cattle in Isfahan, Iran

Cryptosporidium are commonly identified as intestinal pathogens in humans and animals. Fecal samples from 480 cattle randomly selected from 30 regions in Isfahan, Iran, were examined to investigate the prevalence of Cryptosporidium infection. Cryptosporidium oocysts were identified by using sheather's concentration and the Ziehl-Neelsen modified staining technique in 30 of 480 cattle ranging from less than 6 mo of age to older than 1 yr of age. Infected animals were found in 86.6% (26/30) of regions investigated. Overall prevalence of infection was 6.25%, but higher in cattle less than 6 mo of age (10.8%) and this was statistically significant (P<0.05). Both sexes of cattle were infected with Cryptosporidium parasites, but prevalences were higher in diarrheic (56.7%) than in non-diarrheic (39%) cattle. Cryptosporidium appears to be prevalent in cattle in Isfahan.

[The identification of Cryptosporidium species (protozoa) in Ifsahan, Iran by PCR-RFLP analysis of the 18S rRNA gene]

Cryptosporidium is an important protozoan that cause diarrheal illness in humans and animals. Different species of Cryptosporidium have been reported and it is believed that species characteristics are an important factor to be considered in strategic planning for control. We therefore analyzed oocysts from human and animal isolates of Cryptosporidium by PCR-RFLP to determine strain variation in Isfahan. In total, 642 human fecal samples from children under five years of age, immunocompromised patients, and high risk persons and 480 randomly selected rectal specimens of cows and calves in Isfahan were examined. Microscopic examination showed that 4.7% (30/642) of human samples and 6.2% (30/480) of animal samples were infected with Cryptosporidium. After identification of the samples infected with the parasite, oocysts were purified and their DNA was extracted. We used PCR-RFLP analysis of a 1750-bp region of 18S rRNA gene to identify Cryptosporidium species. The human samples were infected with Cryptosporidium parvum II, C. muris, C. wrairi, and a new genotype of Cryptosporidium (GenBank accession numbers: DQ520951). The cattle samples were identified as C. parvum II, C. muris, C. wrairi, C. serpentis, C. baileyi, and a new genotype of Cryptosporidium (GenBank accession numbers: DQ520952). Also we found a new genotype infecting both human and cattle samples (GenBank accession numbers: DQ520950). In addition to demonstrating the widespread occurrence of most species of Cryptosporidium, C. parvum, we also observed extensive polymorphism within species. Furthermore, the occurrence of the same species of parasite in both animal and human samples shows the importance of the animal-human cycle.

Blastocystis hominis and the evaluation of efficacy of metronidazole and trimethoprim/sulfamethoxazole

Blastocystis hominis is commonly found in the intestinal tract of humans. Although the pathogenicity of this unicellular parasite is controversial, anti-protozoan agents are usually administered to infected individuals. At present, the first choice of chemotherapeutic agent is Metronidazole as described in the literature. In this study, we evaluated the effects of metronidazole and Trimethoprim/Sulfamethoxazole (TMP/SMX) on persons infected with B.hominis. A total of 104 subjects infected with B. hominis were admitted to the laboratory from 2002 to 2003. All individuals were non-immunocompromised and subjects were monitored for 1 year after treatment. All stool samples were microscopically examined after staining with iodine and by culturing in an egg slant medium. Of the 104 infected individuals (52+/-16 years of age, M:F=60:44) with B. hominis infection, 28 were discharging large numbers of parasites before treatment. Of 28 severely infected individuals, 12 were treated with metronidazole/250-750 mg at a regimen of 3 x/day/10 days and 4 of the 12 were eradicated. Nine individuals were treated with TMP/SMX/1 tab at a regimen of 3 x/day/10 days and 2 of the 9 were eradicated. For severe B. hominis infections, it appears that metronidazole and TMP/SMX are effective in some individuals, but not all.