OBJECTIVE: In recent years new infectious diseases, i.e. emerging or re-emerging diseases, have been coming to the forefront. Currently, microsporidia, considered to be a major cause of emerging and opportunistic infections particularly in immunocompromised individuals, are also included in this group. Therefore, the aim of our study was to map the prevalence of Encephalitozoon intestinalis and Enterocytozoon bieneusi infection in a group of patients and to compare it with the occurrence of specific antigens in immunocompetent people. METHODS: Detection of spores of both pathogens in faecal samples was performed by an immunofluorescence test using species-specific monoclonal antibodies. RESULTS: Positivity to E. intestinalis in 91 examined immunosuppressed patients reached 33% (30/91), while only 4.3% (3/70) of the control group samples were found to be positive (relative risk 7.7, p < 0.001). In case of E. bieneusi 14.3% (13/91) of immunocompromised patients were positive, as were 5.7% (4/70) of people from the control group (relative risk 2.5, p = 0.095). CONCLUSION: In case of development of any opportunistic infection, the infection is detected and removed in most cases at an early stage. The incidence of clinically manifested microsporidiosis in patients with immunodeficiency is rare as they are under constant medical supervision. However, we must not forget about opportunistic infections, and in case of any non-specific symptoms it is necessary to exclude or confirm the diagnosis for immediate treatment.
- MeSH
- Encephalitozoon izolace a purifikace MeSH
- encephalitozoonóza diagnóza epidemiologie MeSH
- Enterocytozoon izolace a purifikace MeSH
- feces mikrobiologie MeSH
- imunokompromitovaný pacient * MeSH
- lidé MeSH
- mikrosporidióza diagnóza epidemiologie MeSH
- oportunní infekce diagnóza mikrobiologie MeSH
- plošný screening * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
A 23-year-old, HIV-negative woman who had undergone a hematopoietic stem cell transplantation was admitted to the hospital with respiratory failure and symptoms of bronchiolitis obliterans. A chest computed tomography scan revealed diffuse ground-glass opacification and fibrous plugs. Due to worsening respiratory failure despite treatment, ventilation was provided through a tracheostomy tube. Molecular examination of bronchoalveolar lavage and urine revealed Enterocytozoon bieneusi infection. After treatment with albendazole the patient gradually improved, but the pathogen was not eradicated and reappeared on follow-up examination. E. bieneusi belongs to the most clinically important microsporidial species infecting humans, mostly those who are immunocompromised. This fungus tends to infect enterocytes of the intestine, and there are limited studies concerning its extraintestinal location. This is the first report of a case of disseminated respiratory and urinary E. bieneusi infection in a transplant recipient.
- MeSH
- albendazol terapeutické užití MeSH
- bronchoalveolární laváž MeSH
- Enterocytozoon účinky léků izolace a purifikace MeSH
- HIV infekce MeSH
- imunokompromitovaný pacient účinky léků MeSH
- infekce močového ústrojí diagnóza farmakoterapie MeSH
- levofloxacin terapeutické užití MeSH
- lidé MeSH
- mikrosporidióza diagnóza farmakoterapie MeSH
- mladý dospělý MeSH
- rizikové faktory MeSH
- transplantace hematopoetických kmenových buněk * MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Microsporidia are obligate intracellular parasitic protozoa infecting the wide variety of hosts and are commonly known as a cause of chronic diarrhea particularly in immunocompromised individuals. Molecular-based tests have high sensitivity and specificity in disease diagnosis. However, these tests' performance relies on the isolation of DNA in a good concentration. The standard procedures of commercial DNA extraction kits are usually insufficient for this purpose due to the tough walls of spores. This study aimed to test the significance of pretreatments by glass beads and freeze-thawing processes in DNA isolation from microsporidia spores. The parasite was cultured in growing Vero cells and seven serial dilutions were prepared from the collected spores. DNA purification was performed according to different tissue kits and stool kit procedures with and without any pretreatment. Concentration of isolated DNA samples were evaluated by real-time PCR. As a result of this study, the detectable amount of spores is minimum 10 spores in each 100 μ! sample according to the different tissue kits' standard protocols. However, according to the DNA stool mini kit, the detectable amount of spores was found to be 1,000 spores/100 μl of stool sample when pretreated with both the freeze-thawing and glass beads methods.In conclusion, the current study demonstrated that further pretreatments are an essential process for DNA extraction from the stool specimens in order to avoid possible false negativity in the diagnosis of microsporidiosis.
- MeSH
- Cercopithecus aethiops MeSH
- DNA fungální izolace a purifikace MeSH
- Enterocytozoon genetika MeSH
- feces parazitologie MeSH
- kvantitativní polymerázová řetězová reakce MeSH
- Microsporidia genetika MeSH
- mikrosporidióza diagnóza mikrobiologie MeSH
- molekulární biologie přístrojové vybavení metody MeSH
- reagenční diagnostické soupravy * MeSH
- senzitivita a specificita MeSH
- spory hub izolace a purifikace MeSH
- Vero buňky MeSH
- zmrazování MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
BACKGROUND: Microsporidia (Fungi) have been repeatedly identified as the cause of opportunistic infections predominantly in immunodeficient individuals such as AIDS patients. However, the global epidemiology of human microsporidiosis is poorly understood and the ability of microsporidia to survive and multiply in immunocompetent hosts remains unsolved. AIMS: To determine the presence of latent microsporidia infections in apparently healthy humans in the Czech Republic, the authors tested sera, urine and stool originating from fifteen persons within a three month period examined on a weekly basis. METHODS: Sera, stool and urine samples originating from fifteen HIV-negative people at risk with occupational exposure to animals, aged 22-56 years, living in the Czech Republic were tested by indirect immunofluorescence assay (IFA) for the presence of specific anti-microsporidial antibodies, standard Calcofluor M2R staining for the detection of microsporidian spores in all urine sediments and stool smears and molecular methods for the microsporidial species determination. RESULTS: Specific anti-microsporidial antibodies were detected in fourteen individuals, asymptomatic Encephalitozoon spp. infection was found in thirteen and E. bieneusi infection was detected in seven of those examined. While E. hellem 1A and E. cuniculi II were the major causative agents identified, seven different genotypes of E. bieneusi were recorded. CONCLUSIONS: These findings clearly show that exposure to microsporidia is common and chronic microsporidiosis is not linked to any clinical manifestation in healthy population. Moreover, our results indicate much higher incidence of microsporidial infections among an apparently healthy population than previously reported. These results open the question about the potential risk of reactivation of latent microsporidiosis in cases of immunosupression causing life-threatening disease.
- MeSH
- asymptomatické nemoci epidemiologie MeSH
- barvení a značení metody MeSH
- dospělí MeSH
- Encephalitozoon cytologie imunologie izolace a purifikace MeSH
- feces mikrobiologie MeSH
- fluorescenční protilátková technika nepřímá MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- mikroskopie MeSH
- mikrosporidióza diagnóza epidemiologie mikrobiologie MeSH
- moč mikrobiologie MeSH
- mykologie metody MeSH
- protilátky fungální krev MeSH
- sérum mikrobiologie MeSH
- spory hub cytologie izolace a purifikace MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Souhrn: Superficiální kožní mykózy jsou velmi častá onemocnění. Řadu z nich může úspěšně diagnostikovat a léčit praktický lékař, jiné je lepší přenechat k vyřešení odborníkovi – dermatovenerologovi. Článek podává přehled o možnosti léčení keratomykóz, epidermofycií a trichofycií léky, jejichž preskripce není omezena na dermatovenerologickou odbornost.
- MeSH
- antifungální látky terapeutické užití MeSH
- dermatomykózy diagnóza farmakoterapie MeSH
- lidé MeSH
- mikrosporidióza diagnóza farmakoterapie MeSH
- onychomykóza diagnóza farmakoterapie MeSH
- tinea capitis diagnóza farmakoterapie MeSH
- tinea pedis diagnóza farmakoterapie MeSH
- tinea diagnóza farmakoterapie MeSH
- Check Tag
- lidé MeSH
- MeSH
- amébiáza diagnóza epidemiologie terapie MeSH
- balantidióza diagnóza epidemiologie terapie MeSH
- blastocystóza diagnóza epidemiologie terapie MeSH
- cyklosporóza diagnóza epidemiologie terapie MeSH
- giardiáza diagnóza epidemiologie terapie MeSH
- izosporóza diagnóza epidemiologie terapie MeSH
- kryptosporidióza diagnóza epidemiologie terapie MeSH
- lidé MeSH
- mikrosporidióza diagnóza epidemiologie terapie MeSH
- protozoální infekce klasifikace MeSH
- průjem etiologie MeSH
- Check Tag
- lidé MeSH
- MeSH
- biopsie MeSH
- finanční podpora výzkumu jako téma MeSH
- lidé MeSH
- Microsporidia patogenita MeSH
- mikrosporidióza diagnóza MeSH
- myozitida diagnóza parazitologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- Culicidae parazitologie MeSH
- finanční podpora výzkumu jako téma MeSH
- genotyp MeSH
- imunoblotting MeSH
- lidé MeSH
- Microsporidia genetika izolace a purifikace parazitologie MeSH
- mikrosporidióza diagnóza MeSH
- sekvenční analýza RNA metody MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
