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Cryptosporidium hominis IbA12G3: First report of a rare sub-genotype in Spain
Cryptosporidium hominis IbA12G3: primera descripción de un subgenotipo infrecuente en España
Rosario Millána, Pamela C. Kösterb, Isabel Fuentesb, David Carmenab,
Corresponding author
dacarmena@isciii.es

Corresponding author.
a Microbiology and Clinical Parasitology Service, University Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
b Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Madrid, Spain
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Phylogenetic tree illustrating the evolutionary relationship of the IbA12G3 sequence generated in the present study &#40;represented by a red filled circle&#41; to other <span class="elsevierStyleItalic">C&#46; hominis</span> family Ib sequences previously identified in Spain and other countries at the <span class="elsevierStyleItalic">GP60</span> locus inferred by a neighbour-joining analysis&#46; Red empty circles represent all human &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; and non-human &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41; primate IbA12G3 sequences reported globally to date&#46; Black filled circles indicate reference sequences from GenBank<span class="elsevierStyleSup">&#174;</span>&#46; Bootstrapping values over 50&#37; from 1&#46;000 replicates are shown at the branch points&#46; The evolutionary distances were computed using the Tamura 3-parameter method&#46; The rate variation among sites was modelled with a gamma distribution &#40;shape parameter<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46; <span class="elsevierStyleItalic">C&#46; parvum</span> was used as outgroup taxa&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Members of the genus <span class="elsevierStyleItalic">Cryptosporidium</span> are major contributors to the burden of diarrhoeal disease globally&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> Cryptosporidiosis primarily affect children in resource-poor settings with unsafe drinking water and inadequate sanitary facilities&#44; but also represents a significant health concern in developed nations&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleItalic">Cryptosporidium hominis</span> and <span class="elsevierStyleItalic">Cryptosporidium parvum</span>&#44; particularly the former&#44; are the two major causative species of human cryptosporidiosis&#46; To date&#44; at least nine subtype families &#40;Ia&#44; Ib&#44; Id&#44; Ie&#44; If&#44; Ig&#44; Ih&#44; Ii&#44; Ik&#41; have been identified within <span class="elsevierStyleItalic">C&#46; hominis</span> by sequence analysis of the 60-kDa glycoprotein &#40;<span class="elsevierStyleItalic">gp60</span>&#41; gene&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> Among them&#44; Ia &#40;1&#46;7&#37;&#41;&#44; Ib &#40;92&#46;2&#37;&#41;&#44; Id &#40;5&#46;1&#37;&#41;&#44; and Ie &#40;0&#46;9&#37;&#41; were the subtype families found &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>529&#41; in the four largest molecular epidemiological surveys conducted so far in Spain&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">4&#8211;7</span></a> In these studies&#44; all the Ib samples &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>152&#41; molecularly characterized at the sub-genotype level were assigned to IbA10G2&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In December 2017 an 18-month-old male infant complaining of gastrointestinal symptoms including altered intestinal transit&#44; distended abdomen&#44; cramps&#44; and acute&#44; non-bloody watery diarrhoea associated to weigh loss &#40;below 25th percentile&#41; and anaemia &#40;serum iron&#58; 24<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;dL&#41; was admitted to the outpatient clinic of the University Hospital Puerta de Hierro Majadahonda &#40;Madrid&#41; for routine coproparasitological examination&#46; The patient had a normal immune status&#44; no contact with pet animals&#44; and no relevant record of recent travelling abroad&#44; although his father reported travelling to Romania during the same period&#46; A single&#44; concentrated stool sample tested positive for the presence of <span class="elsevierStyleItalic">Cryptosporidium</span> oocysts by a rapid immunochomatographic test &#40;Cer Test Biotec S&#46;L&#46;&#44; Zaragoza&#44; Spain&#41; and by microscopic examination of a fresh faecal smear stained with the modified Ziehl&#8211;Neelsen method&#46; As part of an ongoing research project&#44; a new&#44; fresh aliquot of the faecal material was sent to the National Centre for Microbiology at Majadahonda &#40;Madrid&#41; for genotyping analyses&#46; Total DNA was extracted and purified using the QIAamp<span class="elsevierStyleSup">&#174;</span> DNA stool mini test kit &#40;Qiagen&#44; Hilden&#44; Germany&#41;&#46; Molecular characterization of the sample was achieved by PCR amplification of the <span class="elsevierStyleItalic">gp60</span> marker&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> Amplicons of the expected size &#40;&#8764;870<span class="elsevierStyleHsp" style=""></span>bp&#41; were directly submitted for sequencing&#46; Subsequent sequence analyses confirmed the presence of <span class="elsevierStyleItalic">C&#46; hominis</span> 1bA12G3&#44; a sub-genotype not previously identified in Spain&#46; A representative nucleotide sequence of the sub-genotype obtained was submitted to the GenBank<span class="elsevierStyleSup">&#174;</span> public repository under the accession number MH161561&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Remarkably&#44; a search using the BLAST tool of the National Centre for Biotechnology Information &#40;NCBI&#41; revealed that only six additional IbA12G3 sequences have been previously deposited in GenBank<span class="elsevierStyleSup">&#174;</span>&#46; This particular <span class="elsevierStyleItalic">C&#46; hominis</span> sub-genotype was initially described in a human specimen from UK in 2010&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> Further molecular research conducted in the Sonora state &#40;Mexico&#41; allowed the identification of IbA12G3 in four children attending hospital settings&#44; three of them presenting with gastrointestinal and&#47;or nutritional disorders and the remaining one asymptomatic at the moment of diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Finally&#44; IbA12G3 has also been reported in seven rhesus macaques &#40;<span class="elsevierStyleItalic">Macaca mulatta</span>&#41; housed on monkey farms in China&#44; a finding that may be indicative of potential zoonotic transmission&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the phylogenetic relationships among the IbA12G3 sequences generated in the present study and those reported in the surveys mentioned above&#46; Appropriated reference sequences and representative sequences of the most frequent <span class="elsevierStyleItalic">C&#46; hominis</span> family subtypes circulating in Spanish human populations were retrieved from NCBI and included in the analysis for comparative purposes&#46; As expected&#44; sequences belonging to the family subtype Ib grouped together in a well-defined cluster&#46; Within this group&#44; the IbA12G3 sequence of non-human primate origin was placed into an independent &#40;but closely related&#41; clade&#44; very likely reflecting differences in host adaptation and specificity&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In summary&#44; we show here the first description in Spain of a <span class="elsevierStyleItalic">C&#46; hominis</span> human infection by IbA12G3&#44; a very rare sub-genotype only reported before in clinical specimens in UK and Mexico&#46; A host-adapted IbA12G3 variant has been previously identified infecting non-human primates in China&#44; raising doubts about its actual zoonotic potential&#46; Although the origin of the infection in our paediatric case could not be elucidated&#44; we cannot rule out the possibility that this <span class="elsevierStyleItalic">C&#46; hominis</span> sub-genotype is naturally circulating in Spain at low frequency rates&#46; This study clearly demonstrates that molecular surveillance of human cryptosporidiosis is key in determining the occurrence or emergence of novel genotypes of the parasite of uncertain pathogenicity and virulence&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">This study was funded by the <span class="elsevierStyleGrantSponsor" id="gs1">Health Institute Carlos III &#40;ISCIII&#41;&#44; Ministry of Economy and Competitiveness</span> under project MPY 1350&#47;16&#46;</p></span></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Phylogenetic tree illustrating the evolutionary relationship of the IbA12G3 sequence generated in the present study &#40;represented by a red filled circle&#41; to other <span class="elsevierStyleItalic">C&#46; hominis</span> family Ib sequences previously identified in Spain and other countries at the <span class="elsevierStyleItalic">GP60</span> locus inferred by a neighbour-joining analysis&#46; Red empty circles represent all human &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; and non-human &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41; primate IbA12G3 sequences reported globally to date&#46; Black filled circles indicate reference sequences from GenBank<span class="elsevierStyleSup">&#174;</span>&#46; Bootstrapping values over 50&#37; from 1&#46;000 replicates are shown at the branch points&#46; The evolutionary distances were computed using the Tamura 3-parameter method&#46; The rate variation among sites was modelled with a gamma distribution &#40;shape parameter<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46; <span class="elsevierStyleItalic">C&#46; parvum</span> was used as outgroup taxa&#46;</p>"
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Article information
ISSN: 2529993X
Original language: English
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