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Prevalence and Molecular Characterization of Cryptosporidium Species in Patients With Hematologic Malignancies in
Rahmat Solgi1, Seyed Mohammad Mousavi2, Sadaf Saeedi1
1Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran, bums.ac.ir.
Introduction:
Cryptosporidium is a leading protozoan cause of diarrheal disease globally, posing a significant threat to immunocompromised individuals, including patients with hematologic malignancies. This study was aimed at finding out how common Cryptosporidium is, what species and genotypes are present, and what risk factors are linked to patients with leukemia and lymphoma in Birjand, South Khorasan. This region has not had this information available before.
Methods:
In this cross-sectional study conducted in 2023, stool samples were collected from 55 patients with confirmed hematologic cancers at Iranmehr Hospital, Birjand. Samples were examined using microscopy (modified Ziehl-Neelsen stain), and all were subsequently analyzed using a nested PCR assay targeting the gp60 gene for species and subtype identification. Demographic and risk factor data were collected and analyzed for association with infection using Fisher's exact test.
Results:
The overall prevalence of cryptosporidiosis was 3.6% (two out of 55 cases). One case was found in a patient with leukemia (one out of 34; 2.9%), and another in a patient with lymphoma (one out of 21; 4.8%). The difference in prevalence between these groups was not statistically significant. Molecular analysis identified all isolates as Cryptosporidium parvum. Sequencing revealed two zoonotic subtypes: IIaA in the lymphoma patient and IIdA in the leukemia patient. A statistically significant association was found between infection and contact with animals (p = 0.004) and having a high-risk occupation (p = 0.03).
Conclusion:
As the first report in our study area, we identified a 3.6% prevalence of cryptosporidiosis among patients with hematologic malignancies in Birjand, with zoonotic C. parvum subtypes as the sole etiological agents. The results emphasize the significant role of zoonotic transmission in this population and indicate a critical need for tailored preventive counseling to mitigate exposure risks associated with potential animal reservoirs for these vulnerable patients.
Insights
Cryptosporidiosis affects 3.6% of hematologic cancer patients in Birjand, primarily caused by zoonotic Cryptosporidium parvum. Animal contact and high-risk jobs are significant risk factors for infection in these vulnerable individuals.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Oncology
Background:
- Cryptosporidium is a major cause of diarrheal disease globally.
- Immunocompromised individuals, such as those with hematologic malignancies, are at high risk.
- Limited data exists on Cryptosporidium prevalence and genotypes in this patient group in Birjand, Iran.
Purpose of the Study:
- To determine the prevalence of Cryptosporidium infection in patients with leukemia and lymphoma in Birjand.
- To identify the species and genotypes of Cryptosporidium in these patients.
- To investigate risk factors associated with Cryptosporidium infection in this population.
Main Methods:
- A cross-sectional study involving 55 patients with hematologic cancers.
- Stool sample analysis using microscopy (modified Ziehl-Neelsen stain) and nested PCR targeting the gp60 gene.
- Demographic and risk factor data collection with statistical analysis using Fisher's exact test.
Main Results:
- Overall prevalence of cryptosporidiosis was 3.6% (2/55 patients).
- All identified isolates were Cryptosporidium parvum, with zoonotic subtypes IIaA and IIdA.
- Significant associations found between infection and animal contact (p=0.004) and high-risk occupation (p=0.03).
Conclusions:
- This study reports a 3.6% prevalence of cryptosporidiosis in Birjand patients with hematologic malignancies.
- Zoonotic C. parvum subtypes are the primary cause, highlighting the role of animal transmission.
- Preventive counseling is crucial for vulnerable patients to reduce exposure risks from animal reservoirs.
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