[Carriers and excretors of protozoa]

Causative agents of intestinal infections in humans are about 10 pathogenic or facultative pathogenic species of protozoa of which Giardia lamblia, Entamoeba histolytica, Cryptosporidium parvum and Enterozytozoon bieneusi are discussed. G. lamblia from humans is morphologically indistinguishable from Giardia isolates originating from several species of domestic and wild mammals. Swiss Giardia isolates of human, sheep, cattle and dog origin could be transmitted to Giardia-free rodents and were rather homogenous in biochemical parameters. These data support the hypothesis that zoonotic transmission of Giardia may occur. Routine faecal examinations in Zürich in 1991 revealed 3.61% of Giardia excretors among 5017 examined patients. Of the same group of persons 3.95% excreted E. histolytica. At present it is anticipated that the species E. histolytica consists of invasive and non-invasive strains which can be differentiated by isoenzyme electrophoresis. The confirmation of this assumption could deeply influence the opinion about medical and epidemiological significance of Entamoeba infections. Cryptosporidium parvum is an important cause of diarrhea in HIV-infected patients. Person-to-person, zonnotic and waterborne transmission may play a role. A short review of new data on Enterozytozoon bieneusi and other microsporidia is presented. E. bieneusi appears to be an important causative agent of diarrhea in HIV-infected persons.