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PubMed1999

An oligonucleotide-ligation assay for the differentiation between Cyclospora and Eimeria spp. polymerase chain reaction amplification products.

An oligonucleotide-ligation assay (OLA) was developed and compared to a restriction fragment length polymorphism (RFLP) test for distinguishing between 294-bp polymerase chain reaction (PCR) amplification products of the 18S rRNA gene from Cyclospora and Eimeria spp. The PCR/OLA correctly distinguished between three Cyclospora, three E. tenella, and one E. mitis strains and the ratio of positive to negative spectrophotometric absorbance (A490) values for each strain ranged from 4.086 to 15.280 (median 9.5). PCR/OLA provides a rapid, reliable, spectrophotometric alternative to PCR/RFLP.

Animals↗
PubMed1996

Understanding intestinal spore-forming protozoa: cryptosporidia, microsporidia, isospora, and cyclospora.

OBJECTIVES: To summarize recent information about the "new" gastrointestinal protozoal pathogens (cryptosporidia, microsporidia, isospora, and cyclospora) and to help practicing clinicians integrate this information into their clinical databases by emphasizing the similarities among these organisms. DATA SOURCES: Relevant English-language articles published between 1988 and 1995 were identified through a MEDLINE search done using the names of the intestinal spore-forming protozoa. Articles cited in the bibliographies of these and other articles were searched manually. STUDY SELECTION: Studies that contained information on the history, taxonomy, life cycle, epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of the pathogens were reviewed. DATA EXTRACTION: Cryptosporidium parvum, Isospora belli, Cyclospora cayetanensis, Enterocytozoon bieneusi, and Septata intestinalis are intestinal spore-forming protozoa that cause intracellular infections, predominantly in the epithelial cells of the intestine. They are transmitted either by stool from person to person or through contaminated water or food by an infectious particle called a spore or oocyst. Asymptomatic infections occur; the most common symptom of infection is diarrhea. Infections have been associated with intestinal inflammation, disordered architecture (such as villus blunting), and abnormal function (for example, malabsorption). Mild to moderate, self-limited diarrhea is common in healthy persons, but patients with immune dysfunction can have severe intestinal injury and prolonged diarrhea. Diagnosis is made by a microscopic examination of the stool and the use of appropriate staining techniques. Effective antibiotic treatment for prolonged infection in immunocompromised patients is available for most of these infections. CONCLUSIONS: The intestinal spore-forming protozoa are four frequently identified gastrointestinal pathogens that have important similarities in epidemiology, disease pathogenesis, clinical manifestations, diagnosis, and treatment.

Animals↗
PubMedDate not supplied

Waterborne transmission of Cryptosporidium, Cyclospora and Giardia.

Waterborne transmission of Cryptosporidium, Cyclospora, and Giardia has been associated with numerous recent outbreaks of diarrheal disease. Epidemiologic evidence shows that many community-acquired infections originate from public water sources. Drinking water, even when chlorinated and filtered, has been implicated in several outbreaks. Cryptosporidium and Cyclospora are resistant to chlorine. Giardia cysts are not killed immediately by chlorine and are less susceptible than most other organisms. Swimming pools and other recreational waters have also been implicated as transmission sources. All 3 organisms pose a challenge to the water industry, as they are difficult to detect in water when small numbers of cysts or oocysts are present. Small numbers of these organisms can cause disease; therefore, the clinical laboratory must be vigilant in screening, identifying, and reporting outbreaks of illness due to these protozoa.

Animals↗
PubMed2000

Cyclospora infections in England and Wales: 1993 to 1998.

The coccidian protozoon Cyclospora cayetanensis is a treatable cause of prolonged, watery diarrhoea in humans. Microbiology laboratories in England and Wales often restrict testing to those who have recently travelled abroad. Only 44 to 66 laboratory reports of C. cayetanensis are made in England and Wales each year and a large proportion are found to have visited developing countries. Large foodborne outbreaks of infection have arisen in North America among people who have not travelled abroad but no such outbreaks have been identified in the United Kingdom. Public health laboratories in England and Wales were surveyed in 1998 to investigate their procedures for identifying C. cayetanensis. Sixty-eight per cent actively looked for the protozoon, but only half used a recommended method of direct microscopy of formol ether concentrates. National external quality assurance results for all participating UK laboratories were reviewed to assess laboratory proficiency in identification. C. cayetanensis was correctly identified in a wet preparation by 58% of laboratories, the lowest rate for specimens containing a single parasite species. Cyclosporiasis could be acquired in the UK from imported food, but current laboratory procedures might fail to identify it. Ascertainment must improve and awareness needs to be raised among food handlers, public and environmental health workers, laboratory staff, and general practitioners. We recommend that laboratories test all patients with watery diarrhoea for > 1 week for cyclospora, use formol ether concentration and microscopy with a calibrated eyepiece graticule, and confirm diagnoses with the help of a reference laboratory.

Animals↗
PubMed1995

Cyclospora in AIDS patients: not always an agent of diarrhoic syndrome.

The present study reports the clinical features of two AIDS patients infected by Cyclospora. According to our observations, Cyclospora in AIDS can be responsible both for gastroenteritis and for asymptomatic infections with spontaneous rapid clearance. In addition, and undiagnosed circulation of this agent in Italy could be hypothesized: neither patient had a past history of foreign travel. These are the first two cases in AIDS described in Italy.

AIDS-Related Opportunistic Infections↗
PubMed1995

[New parasitic diseases in man: infections caused by Microsporida and Cyclospora species].

The non-taxonomic term microsporidia relates to a group of organisms belonging to the order Microsporida of the phylum Microspora. Microsporidia are obligate intracellular spore-forming protozoa and have no metabolically active stages outside the host cell. Their host range is extensive and includes most invertebrates and all 5 classes of vertebrates. More than 100 microsporidial genera and almost 1000 species have now been identified. 5 genera (Enterocytozoon, Encephalitozoon, Septata, Pleistophora and Nosema) and unclassified microsporidia have been associated with human disease. Only 10 cases of microsporidiosis have been described among persons not infected with HIV. In contrast, microsporidia have gained increasing attention as important opportunistic pathogens in the evolving pandemic of HIV infection. Diagnosis depends on morphological demonstration of the organisms themselves. The potential sources and modes of transmission of human microsporidial infections are uncertain. The clinical manifestations of microsporidiosis are diverse and include intestinal, pulmonary, ocular, muscular, and renal disease. Preliminary observations of the possible utility of albendazole for infections due to Septata intestinalis and Encephalitozoon sp. have been reported. The success of therapy for intestinal Enterocytozoon bieneusi infection has been limited. Cyclospora sp. are recently described protozoa capable of causing diarrhea in immunocompetent and immunodeficient patients. Groups at risk for infection are children in the developing world, travellers and HIV-infected patients. Diagnosis depends on light-microscopic detection of oocysts in stool smears stained with acid-fast stains. Diarrhea is usually self-limiting. Diarrhea, however, may often last weeks to months, causing significant morbidity. Cotrimoxazole appears to be the drug of choice for treatment of Cyclospora infection.

Adult↗
PubMed1996

Outbreaks of Cyclospora cayetanensis infection--United States, 1996.

Cyclospora cayetanensis (previously termed cyanobacterium-like body) is a recently characterized coccidian parasite; the first known cases of infection in humans were diagnosed in 1977. Before 1996, only three outbreaks of Cyclospora infection had been reported in the United States. This report describes the preliminary findings of an ongoing outbreak investigation by the South Carolina Department of Health and Environmental Control (SCDHEC) and summarizes the findings from investigations in other states.

Animals↗
PubMedDate not supplied

[Cyclospora in 2 Mexican children].

We report two patients, one symptomatic and another asymptomatic, infected with Cyclospora an enteropathogen recently described. The symptoms were: abdominal pain, hiporexia, vomit, bruxism, watery diarrhea 3 or 4 times in a day but self-limiting after 24 to 72 hours. In both children there were unsporulated oocysts with a diameter of 8.44 +/- 0.146 microns detected in feces concentrated by Faust's technique; the confirmation was achieved with a Ziehl-Neelsen stain and the observation of sporulated oocysts (two sporocysts per oocyst). In Mexico, Cyclospora is perhaps overlooked or it is mistaken with oocysts of Cryptosporidium.

Animals↗
PubMed1995

[The first report in Cuba of human intestinal infection by Cyclospora cayetanensis, Ortega, 1993].

The human intestinal infection by Cyclospora cayetanensis, is reported for the first time in Cuba, Ortega, 1993. This coccidian parasite was being identified since several years in humans presenting with diarrhea, as a blue-green Alga, a similar body to cyanobacteria, or similar to a great coccidia. However, it was identified for the first time a genus of Cyclospora, in 1993, and the taxonomic description of the human species as C. cayetanensis is very recent. This paper reports on a child presenting with an acute diarrheal picture in which no other causative agent was found, and describes the morphological characteristics of this rounded organism which measures between 7.7 and 10 micras of diameter and results positive to Ziehl-Neelsen staining. This is a warning for all physicians and biomedical staff in charge of making the laboratory diagnosis of acute diarrheal diseases.

Acute Disease↗
PubMed2003

Cyclospora cayetanensis and other intestinal parasites associated with diarrhea in a rural area of Jordan.

Cryptosporidium spp. and Cyclospora cayetanensis have emerged as important causes of epidemic and endemic diarrhea in immunocompetent and immunocompromised hosts. The exact modes of transmission in certain rural areas are still unclear. Reports of water-borne and food-borne outbreaks suggest that fecally contaminated water or food acts as a vehicle of transmission. Two hundred stool samples of patients with gastroenteritis from four health centers in a rural area of Jordan were examined using formalin-ethyl acetate concentration, wet preparation, and modified acid-fast staining methods. Oocysts of C. cayetanensis and Cryptosporidium spp. were found in 6% and 8% of the samples respectively, mainly those of children. Parasites such as Entamoeba histolytica, Giardia lamblia, and other enteropathogens were also observed. The results reflect the seasonality of natural cyclosporiasis and cryptosporidiosis, being higher in the spring. The risk factors that were found by the Fisher test to be significant and might be associated with illness are the source of drinking water, contact with animals, and eating unwashed vegetables ( p<0.028, p<0.0005, p<0.00005 respectively).

Adolescent↗
PubMed2003

Evaluation of lacto-phenol cotton blue (LPCB) for detection of Cryptosporidium, Cyclospora and Isospora in the wet mount preparation of stool.

Lacto-phenol cotton blue (LPCB) was found to be a useful stain for detection of Cyclospora and Isospora oocysts in direct wet mounts of stool. LPCB stained these parasites blue, and differentiated their internal structures clearly, thereby facilitating detection and accurate identification of these parasites. However, the LPCB staining was not found useful in the identification of Cryptosporidium. The LPCB wet mount is recommended for use in the laboratories where acid-fast staining is not performed routinely, such as in a peripheral laboratory or in a rural health centre in the developing countries.

Animals↗
PubMed2003

Detection of Cyclospora cayetanensis using a quantitative real-time PCR assay.

Cyclospora cayetanensis, a coccidian parasite, with a fecal-oral life cycle, has become recognized worldwide as an emerging human pathogen. Clinical manifestations include prolonged gastroenteritis. While most cases of infection with C. cayetanensis in the United States have been associated with foodborne transmission, waterborne transmission has also been implicated. We report on the development and application of a real-time, quantitative polymerase chain reaction assay for the detection of C. cayetanensis oocysts, which is the first reported use of this technique for this organism. Both a species-specific primer set and dual fluorescent-labeled C. cayetanensis hybridization probe were designed using the inherent genetic uniqueness of the 18S ribosomal gene sequence of C. cayetanensis. The real-time polymerase chain reaction assay has been optimized to specifically detect the DNA from as few as 1 oocyst of C. cayetanensis per 5 microl reaction volume.

Animals↗
PubMed2003

Cyclospora cayetanensis infection in Lagos, Nigeria.

Although reports of Cyclospora infection continue to increase globally, few cases have been reported from the African continent. We present 11 cases of cyclosporiasis detected from stool samples submitted to seven major hospital laboratories in Lagos, Nigeria between March 1999 and April 2000.

Adult↗
PubMed2003

Detection of Cyclospora cayetanensis in travellers returning from the tropics and subtropics using microscopy and real-time PCR.

We examined 100 stool specimens of returning travellers with diarrhoea for the presence of Cyclospora cayetanensis using fluorescence microscopy and real-time PCR. C. cayetanensis was found in four cases with microscopy and PCR. One additional sample was positive only by PCR, and could be confirmed by microscopic examination of several additional slides. C. cayetanensis was the most frequent parasitic cause of diarrhoea after Giardia duodenalis.

Animals↗
PubMed2001

Histologic proof of acalculous cholecystitis due to Cyclospora cayetanensis.

It is suspected that Cyclospora cayetanensis can infect the biliary tract in persons with human immunodeficiency virus infection, but histologic proof has never been published. We report a case of acalculous cholecystitis in a person with acquired immunodeficiency syndrome who required cholecystectomy and demonstrated C. cayetanensis in the gallbladder epithelium.

AIDS-Related Opportunistic Infections↗
PubMed2001

Viability of Giardia intestinalis cysts and viability and sporulation state of Cyclospora cayetanensis oocysts determined by electrorotation.

Electrorotation is a noninvasive technique that is capable of detecting changes in the morphology and physicochemical properties of microorganisms. Electrorotation studies are reported for two intestinal parasites, Giardia intestinalis and Cyclospora cayetanensis. It is concluded that viable and nonviable G. intestinalis cysts can be differentiated by this technique, and support for this conclusion was obtained using a fluorogenic vital dye assay and morphological indicators. The viability of C. cayetanensis oocysts (for which no vital dye assay is currently available) can also be determined by electrorotation, as can their sporulation state. Modeling of the electrorotational response of these organisms was used to determine their dielectric properties and to gain an insight into the changes occurring within them. Electrorotation offers a new, simple, and rapid method for determining the viability of parasites in potable water and food products and as such has important healthcare implications.

Animals↗
PubMed2001

Cyclospora cayetanensis in three populations at risk in Guatemala.

In 1996 and 1997, outbreaks of Cyclospora cayetanensis in North America were linked to Guatemalan raspberries. From April 1999 to April 2000, we undertook a survey for C. cayetanensis in raspberry farm workers, malnourished children, and human immunodeficiency virus and AIDS patients in Guatemala. Stool samples were analyzed using ethylacetate-formalin concentration, wet preparation, modified acid-fast staining method, and epifluorescence. Oocysts were found in 1.5% of the subjects, none of whom were raspberry farm workers.

AIDS-Related Opportunistic Infections↗