Intestinal Microsporidiosis in Iran (Kerman): Comparison in immune-compromised patients and immune competent people with diarrhea

Nooshadokht, Maryam; Sharifi, Iraj; Mohammadi, Mohammad  Ali; Pirestani, Majid; Afgar, Afgar; Mahootchi, Armina; Salari, Samira; Babaei, Zahra

doi:10.29252/cmm.3.1.30

Intestinal Microsporidiosis in Iran (Kerman): Comparison in immune-compromised patients and immune competent people with diarrhea

Authors

Maryam Nooshadokht ¹

Iraj Sharifi ²

Mohammad Ali Mohammadi ³

Majid Pirestani ⁴

Afgar Afgar ⁵

Armina Mahootchi ¹

Samira Salari ¹

Zahra Babaei ²

¹ Department of Medical Parasitology and Mycology, Kerman University of Medical Sciences, Kerman, Iran

² Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran

³ Research center for Hydatid disease in Iran, Kerman, Iran

⁴ Deptartment of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran, I. R. Iran

⁵ Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran

10.29252/cmm.3.1.30

Abstract

Background and Purpose: Gastroenteritis and the clinical profile caused by Microsporidia, an opportunistic pathogen, may be severe in immunocompromised individuals, especially in AIDS patients. Conventionally, it is necessary to detect the small infective spores in stained smears. However, due to the limitations of the microscopy-based methods, several DNA-based methods such as polymerase chain reaction (PCR) have recently been developed to enhance diagnosis sensitivity. Therefore,we sought to evaluate the rate of infection in immunocompromised patients as compared with immunocompetent patients in Kerman, Iran.
Materials and Methods: We collected stool samples of 199 human subjects (116 males and 83 females), aged 1 to 69 years old. They were divided into immunocompromised (i.e., AIDS [n=72] and cancer-positive patients [n=59]) and immunocompetent (n=68) groups. We comparatively examined the fecal materials using the microscopy and PCR methods.
Results: The overall prevalence rate of Microsporidia infection was 10.05% (20/199). Entrocytozoon bieneusi was the only species within the Microsporidia genus that was identified in 14.5% (19/131) of the immunocompromised patients and 1.47% (1/68) of the immunocompetent individuals.
Conclusion: Considering the higher prevalence rate of microsporidiosis in patients with immunodeficiency (10.03%), we suggest performing sensitive and specific techniques such as PCR for the detection of these parasites in immunocompromised patients.

Keywords

Immunocompetent individuals

Immunocompromised patients

Iran

Microsporidia