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The incidence of Cyclospora cayetanensis in stool samples submitted to a district general hospital
1Department of Microbiology, Wexham Park Hospital, Slough, Berkshire.
Insights
Cyclospora cayetanensis causes prolonged diarrhea, primarily in UK travelers returning from endemic regions. This study found it to be a rare cause of diarrhea in a district general hospital population.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Gastroenterology
Background:
- Cyclospora cayetanensis is an emerging waterborne protozoan parasite.
- It is recognized as a cause of prolonged diarrhoeal illness, particularly in immunocompetent individuals.
- Most cases in non-endemic regions, such as the UK, are associated with international travel.
Observation:
- This investigation aimed to determine the incidence of Cyclospora cayetanensis in stool samples at a UK district general hospital.
- A modified Ziehl-Neelsen technique was employed to screen 6151 stool samples from 5374 patients over one year.
- Oocysts were detected in 7 samples (0.1%), originating from 4 individual patients (0.07%).
Findings:
- All identified cases (4 patients) were adult travelers returning from Cyclospora cayetanensis endemic areas.
- The study indicates that Cyclospora cayetanensis is a rare cause of diarrhea within this specific UK healthcare setting.
- No cases were identified in patients without a relevant travel history to endemic regions.
Implications:
- Clinical suspicion for Cyclospora cayetanensis infection should be maintained in individuals with relevant travel history to endemic areas.
- Routine screening for Cyclospora cayetanensis in stool samples is not recommended for patients lacking such a travel history.
- This finding aids in optimizing diagnostic strategies and resource allocation for parasitic infections in non-endemic settings.
Abstract:
Cyclospora cayetanensis is the cause of a prolonged diarrhoeal syndrome. In the UK most cases are seen in travellers who have returned from countries in which the organism is endemic. The purpose of this investigation was to determine the incidence of C. cayetanensis in stool samples submitted to a district general hospital. A total of 6151 stools from 5374 different patients were screened for the presence of C. cayetanensis over a 1-year period using the modified Ziehl-Neelsen technique. Oocysts of C. cayetanensis were found in 7 stools (0.1%) from 4 patients (0.07%). All four patients were adult travellers who had visited countries in which C. cayetanensis is known to be endemic. In the population of this study, C. cayetanensis was found to be a rare cause of diarrhoea. Although C. cayetanensis infection should be considered in individuals of all ages who have lived in, or have travelled to endemic areas, there is no need to screen stool samples for the organism in those without such a travel history.