Genetic Diversity of Cryptosporidium Causing Infections from Diarrheic Cases in Egypt and Co-infections with Other Intestinal Protozoan Parasites

Abstract

Cryptosporidiosis is endemic worldwide; the highest rates are found in low- and middle-income countries. Cryptosporidium is transmitted via the fecal–oral route. Cryptosporidium spp. are important parasites in the small intestines of humans and animals. Cryptosporidiosis is a significant cause of diarrhea among humans in Egypt; however, data on Cryptosporidium genotypes in symptomatic patients from Egypt is scarce. The purpose of the current study was to identify the prevalence and various genotypes of Cryptosporidium species that circulate among diarrheal children in Egypt. A total of 185 stool samples from diarrheic children at the Hospital of Abu El Rish, Cairo were collected and examined using the modified acid-fast (AF) stain. Cryptosporidium-positive samples were conducted to multilocus genotyping using three genetic markers (COWP, Hsp90, and SSU rRNA) in various n-PCR-RFLP reactions. Co-infections with the other intestinal protozoa were detected using the direct wet mount as well as formol-ether concentration procedures. Of the 185 diarrheic subjects, 50 were confirmed positive for intestinal parasites (27.0%), including 18 that tested positive for Cryptosporidium either microscopically or molecularly. The other detected protozoa were Blastocystis hominis (24.0%), Giardia intestinalis (22.0%), and Entamoeba histolytica (18.0%). Two Cryptosporidium species were identified; Cryptosporidium hominis was the predominant species (83.33%) followed by Cryptosporidium parvum (16.66%). This study updates the status of cryptosporidiosis between children in Egypt and highlights the urgent need for establishing effective control strategies against this ubiquitous protozoon.