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Occurrence of intestinal microsporidia in immunodeficient patients in Poland
Małgorzata Bednarska1, Anna Bajer1, Edward Siński1
1Department of Parasitology, Institute of Zoology, Faculty of Biology, University of Warsaw, Poland.
Abstract:
Microsporidial infections may be asymptomatic in immunocompetent hosts, but can be severe and disseminated in HIV/AIDS patients, children, the elderly, or in immunocompromised individuals, including those with primary or medically-induced immunodeficiencies. 209 faecal samples were collected from 80 clinical patients, with or without abdominal symptoms, and tested for the presence of the parasites. Microsporidia were found in 10 of the 80 patients (12.5%) using trichrom staining of faecal smears and/or PCR. Encephalitozoon intestinalis and 1 unidentified species were identified in 2 of the 32 children with primary immunodeficiencies (6%), presenting with diarrhoea, including one co-infection with Cryptosporidium meleagridis. In the group of patients with medically-induced immunosuppression (transplant recipients), 8 of the 48 patients (17%) were tested positive for microsporidia. Thus, these pathogens should be taken into account when the other etiological agents cannot be found in diarrheic patients with PIDs or undergoing immunosuppressive treatment before or after transplantation. This article presents the results of the first epidemiological study on the occurrence and prevalence of microsporidia in patients with primary and secondary immunodeficiency in Poland.
Insights
Microsporidia infections were detected in 12.5% of immunocompromised patients in Poland. These opportunistic pathogens, including Encephalitozoon intestinalis, are significant in primary immunodeficiencies and transplant recipients with diarrhea.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Immunology
Background:
- Microsporidia cause opportunistic infections, particularly severe in immunocompromised individuals like HIV/AIDS patients, children, elderly, and those with primary or medically-induced immunodeficiencies.
- These infections can be asymptomatic in healthy hosts but pose significant risks to vulnerable populations.
Purpose of the Study:
- To investigate the prevalence and occurrence of microsporidia in patients with primary and secondary immunodeficiencies in Poland.
- To identify specific microsporidia species and assess their association with clinical symptoms in immunocompromised patients.
Main Methods:
- Collected 209 fecal samples from 80 clinical patients with or without abdominal symptoms.
- Utilized trichrome staining of fecal smears and Polymerase Chain Reaction (PCR) for microsporidia detection.
- Identified species including Encephalitozoon intestinalis and one unidentified species.
Main Results:
- Microsporidia were identified in 10 out of 80 patients (12.5%).
- In children with primary immunodeficiencies (n=32), 2 (6%) were positive, one with a co-infection of Cryptosporidium meleagridis.
- In transplant recipients (medically-induced immunosuppression, n=48), 8 (17%) tested positive for microsporidia.
Conclusions:
- Microsporidia are important etiological agents to consider in diarrheic patients with primary immunodeficiencies or those undergoing immunosuppressive therapy.
- This study provides the first epidemiological data on microsporidia prevalence in immunocompromised patients in Poland.
- Early consideration of microsporidia is crucial for accurate diagnosis and management in at-risk patient groups.
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