Berahmat Reza, Mahami-Oskouei Mahmoud, Rezamand Azim, Spotin Adel, Aminisani Nayyereh, Ghoyounchi Roghayeh, Madadi Solmaz
Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Parasitol Res. 2017 Sep;116(9):2507-2515. doi: 10.1007/s00436-017-5560-5. Epub 2017 Jul 20.
Cryptosporidiosis is a relatively uncommon disease in healthy individuals but could be potentially worrisome in immunocompromised patients. This study aimed to evaluate Cryptosporidium infection in children with cancer undergoing chemotherapy. A case-control study was conducted in 132 children with cancer undergoing chemotherapy and 132 non-cancer controls. The modified Ziehl-Neelsen (MZN) staining and polymerase chain reaction methods were used for the detection of Cryptosporidium parasite. All positive isolates were sequenced for phylogenetic analysis. Statistical analysis was performed using the SPSS version 16 and Fisher exact test. The rate of cryptosporidiosis in children with cancer undergoing chemotherapy was 3.8%, which was higher than that of the control group. Other intestinal parasites detected in patients with cancer included Giardia lamblia (3%), Entamoeba coli (1.5%), and Chilomastix mesnili (0.8%). In the control group, only two (1.5%) cases were positive for G. lamblia. No significant difference was observed between the gender, age, residency, contact with domestic animals, stool appearance, neutropenia, chemotherapy period, and type of malignancy with regard to cryptosporidiosis. Phylogenetic analysis revealed that Cryptosporidium parvum isolates in this study relied on a branch that represents similar sequences from Iran and other countries. Although the rate of Cryptosporidium infection was relatively higher in children with cancer undergoing chemotherapy compared to the control group, any statistically significant difference has not been found between them. These findings should not be contrary to the need for healthcare to prevent opportunistic parasitic infections in malignant and immunocompromised patients.
隐孢子虫病在健康个体中相对不常见，但在免疫功能低下的患者中可能令人担忧。本研究旨在评估接受化疗的癌症患儿中的隐孢子虫感染情况。对132名接受化疗的癌症患儿和132名非癌症对照者进行了病例对照研究。采用改良齐-尼（MZN）染色和聚合酶链反应方法检测隐孢子虫寄生虫。对所有阳性分离株进行测序以进行系统发育分析。使用SPSS 16版和Fisher精确检验进行统计分析。接受化疗的癌症患儿中隐孢子虫病的发生率为3.8%，高于对照组。癌症患者中检测到的其他肠道寄生虫包括蓝氏贾第鞭毛虫（3%）、结肠内阿米巴（1.5%）和梅氏唇鞭毛虫（0.8%）。在对照组中，仅两例（1.5%）蓝氏贾第鞭毛虫检测呈阳性。在性别、年龄、居住地、与家畜接触情况、粪便外观、中性粒细胞减少、化疗期以及恶性肿瘤类型方面，隐孢子虫病未观察到显著差异。系统发育分析表明，本研究中的微小隐孢子虫分离株依赖于一个代表来自伊朗和其他国家相似序列的分支。尽管与对照组相比，接受化疗的癌症患儿中隐孢子虫感染率相对较高，但未发现两者之间有任何统计学显著差异。这些发现不应与医疗保健预防恶性和免疫功能低下患者机会性寄生虫感染的需求相悖。
