First Cases of Microsporidiosis in Transplant Recipients in Spain and Review of the Literature

ABSTRACT Microsporidia are currently considered emerging pathogens responsible for life-threatening infections in organ transplant recipients. Here, we describe the first cases of intestinal microsporidiosis by Enterocytozoon bieneusi genotype D in two non-HIV-infected renal transplant recipients from Spain. Previously reported cases of microsporidiosis in organ transplant recipients have also been reviewed, highlighting the necessity of considering organ transplant recipients a risk group for microsporidiosis. A systematic search for these parasites is recommended in cases of persistent diarrhea and in the differential diagnosis of other syndromes, such as chronic fever of unknown etiology.

[1]  F. Derouin,et al.  Disseminated Infection with a New Genovar of Encephalitozoon cuniculi in a Renal Transplant Recipient , 2010, Journal of Clinical Microbiology.

[2]  S. Fenoy,et al.  Phylogenetic Approach to the Variability of the Microsporidian Enterocytozoon bieneusi and Its Implications for Inter- and Intrahost Transmission , 2010, Applied and Environmental Microbiology.

[3]  C. Woods,et al.  Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA1 , 2010, Emerging infectious diseases.

[4]  M. Beadsworth,et al.  Characterization of Genotypes of Enterocytozoon bieneusi in Immunosuppressed and Immunocompetent Patient Groups , 2009, The Journal of eukaryotic microbiology.

[5]  D. Boutboul,et al.  Microsporidiosis in solid organ transplant recipients: two Enterocytozoon bieneusi cases and review , 2009, Transplant infectious disease : an official journal of the Transplantation Society.

[6]  R. Fayer,et al.  Enterocytozoon bieneusi Genotype Nomenclature Based on the Internal Transcribed Spacer Sequence: A Consensus , 2009, The Journal of eukaryotic microbiology.

[7]  J. Breton,et al.  Enterocytozoon bieneusi in human and animals, focus on laboratory identification and molecular epidemiology. , 2008, Parasite.

[8]  A. Carbone,et al.  New Highly Divergent rRNA Sequence among Biodiverse Genotypes of Enterocytozoon bieneusi Strains Isolated from Humans in Gabon and Cameroon , 2007, Journal of Clinical Microbiology.

[9]  R. Fayer,et al.  Cryptosporidium, Giardia and Enterocytozoon bieneusi in cats from Bogota (Colombia) and genotyping of isolates. , 2006, Veterinary parasitology.

[10]  J. Joseph,et al.  Microsporidia keratoconjunctivitis in a corneal graft , 2006, Eye.

[11]  L. Weiss,et al.  Microsporidiosis: current status , 2006, Current opinion in infectious diseases.

[12]  Y. Suputtamongkol,et al.  Identification of Genotypes of Enterocytozoon bieneusi from Stool Samples from Human Immunodeficiency Virus-Infected Patients in Thailand , 2006, Journal of Clinical Microbiology.

[13]  J. Lorenzo-Morales,et al.  Enterocytozoon bieneusi (microsporidia) in clinical samples from immunocompetent individuals in Tenerife, Canary Islands, Spain. , 2005, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[14]  S. Adl,et al.  The New Higher Level Classification of Eukaryotes with Emphasis on the Taxonomy of Protists , 2005, The Journal of eukaryotic microbiology.

[15]  Savitri Sharma,et al.  Is Microsporidial keratitis an emerging cause of stromal keratitis? – a case series study , 2005, BMC ophthalmology.

[16]  M. Luczak,et al.  Infections caused by clostridium difficile in kidney or liver graft recipients. , 2005, Annals of transplantation.

[17]  J. Biswas,et al.  Chronic microsporidial stromal keratitis in an immunocompetent, non-contact lens wearer. , 2005, Indian journal of ophthalmology.

[18]  D. Teachey,et al.  Fatal Pulmonary Microsporidiosis Due to Encephalitozoon cuniculi Following Allogeneic Bone Marrow Transplantation for Acute Myelogenous Leukemia , 2005, Ultrastructural pathology.

[19]  W. Finkbeiner,et al.  Disseminated microsporidiosis in a pancreas/kidney transplant recipient. , 2009, Archives of pathology & laboratory medicine.

[20]  P. Brindley,et al.  Epidemiology of microsporidiosis: sources and modes of transmission. , 2004, Veterinary parasitology.

[21]  D. Teachey,et al.  Pulmonary infection with microsporidia after allogeneic bone marrow transplantation , 2004, Bone Marrow Transplantation.

[22]  R. Fayer,et al.  Molecular Characterization of Microsporidia Indicates that Wild Mammals Harbor Host-Adapted Enterocytozoon spp. as well as Human-Pathogenic Enterocytozoon bieneusi , 2003, Applied and Environmental Microbiology.

[23]  M. Rabodonirina,et al.  Microsporidiosis and Transplantation: A Retrospective Study of 23 Cases , 2003, The Journal of eukaryotic microbiology.

[24]  R. Gilman,et al.  A Molecular Biologic Study of Enterocytozoon bieneusi in HIV‐Infected Patients in Lima, Peru , 2003, The Journal of eukaryotic microbiology.

[25]  A. Gamboa-Domínguez,et al.  Disseminated encephalitozoon cuniculi infection in a Mexican kidney transplant recipient , 2003, Transplantation.

[26]  M. Mahmood,et al.  Pathologic quiz case: a 45-year-old renal transplant recipient with persistent fever. , 2003, Archives of pathology & laboratory medicine.

[27]  S. Chevret,et al.  Fumagillin treatment of intestinal microsporidiosis. , 2002, The New England journal of medicine.

[28]  H. Moura,et al.  Disseminated microsporidiosis in a renal transplant recipient , 2002, Transplant infectious disease : an official journal of the Transplantation Society.

[29]  S. Fenoy,et al.  Intestinal microsporidiosis due to Enterocytozoon bieneusi in elderly human immunodeficiency virus--negative patients from Vigo, Spain. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[30]  S. Fenoy,et al.  Intestinal microsporidiosis due to Enterocytozoon bieneusi in elderly human immunodeficiency virus--negative patients from Vigo, Spain. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[31]  R. Borrow,et al.  Genotyping of Enterocytozoon bieneusi in AIDS patients from the north west of England. , 2002, The Journal of infection.

[32]  D. Kahn,et al.  Microsporidiosis in the graft of a renal transplant recipient , 2001, Transplant International.

[33]  F. Derouin,et al.  Evidence of Different Enterocytozoon bieneusiGenotypes in Patients with and without Human Immunodeficiency Virus Infection , 2001, Journal of Clinical Microbiology.

[34]  A. Sing,et al.  Molecular Diagnosis of an Enterocytozoon bieneusiHuman Genotype C Infection in a Moderately Immunosuppressed Human Immunodeficiency Virus- Seronegative Liver-Transplant Recipient with Severe Chronic Diarrhea , 2001, Journal of Clinical Microbiology.

[35]  R. López-Vélez,et al.  In Vitro Culture, Ultrastructure, Antigenic, and Molecular Characterization of Encephalitozoon cuniculiIsolated from Urine and Sputum Samples from a Spanish Patient with AIDS , 2001, Journal of Clinical Microbiology.

[36]  M. Goetz,et al.  CHRONIC DIARRHEA AS A RESULT OF INTESTINAL MICROSPOSIDIOSIS IN A LIVER TRANSPLANT RECIPIENT , 2001, Transplantation.

[37]  J. Tran van Nhieu,et al.  A Case of Enterocytozoon bieneusi Infection in an HIV-Negative Renal Transplant Recipient , 2000, European Journal of Clinical Microbiology and Infectious Diseases.

[38]  R. López-Vélez,et al.  Microsporidiosis in travelers with diarrhea from the tropics. , 1999, Journal of travel medicine.

[39]  M. Rabodonirina,et al.  Intestinal microsporidiosis occurring in two renal transplant recipients treated with mycophenolate mofetil. , 1999, Transplantation.

[40]  R. Hobbs,et al.  Microsporidia infection in transplant patients. , 1999, Transplantation.

[41]  A. Thomschke,et al.  Strain differentiation in microsporidia. , 1998, The Tokai journal of experimental and clinical medicine.

[42]  S. Fenoy,et al.  Microsporidiosis in HIV‐Positive Children in Madrid (Spain). , 1997, The Journal of eukaryotic microbiology.

[43]  R. López-Vélez,et al.  Identification of Enterocytozoon bieneusi spores in respiratory samples from an AIDS patient with a 2-year history of intestinal microsporidiosis , 1997, Journal of clinical microbiology.

[44]  Schwartz,et al.  Detection of Septata intestinalis (Microsporidia) Cali et al. 1993 Using Polymerase Chain Reaction Primers Targeting the Small Submit Subunit Ribosomal RNA Coding Region. , 1997, Molecular diagnosis : a journal devoted to the understanding of human disease through the clinical application of molecular biology.

[45]  P. Parikh,et al.  Pulmonary microsporidial infection in a patient with CML undergoing allogeneic marrow transplant , 1997, Bone Marrow Transplantation.

[46]  P. Degirolami,et al.  Enterocytozoon bieneusi infection and diarrheal disease in patients who were not infected with human immunodeficiency virus: case report and review. , 1996, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[47]  M. Rabodonirina,et al.  Enterocytozoon bieneusi as a cause of chronic diarrhea in a heart-lung transplant recipient who was seronegative for human immunodeficiency virus. , 1996, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[48]  D. Schwartz,et al.  Sensitive PCR diagnosis of Infections by Enterocytozoon bieneusi (microsporidia) using primers based on the region coding for small-subunit rRNA , 1996, Journal of clinical microbiology.

[49]  P. Sax,et al.  Intestinal microsporidiosis occurring in a liver transplant recipient. , 1995, Transplantation.

[50]  Michael L Wilson,et al.  Polymerase chain reaction and culture confirmation of disseminated Encephalitozoon cuniculi in a patient with AIDS: successful therapy with albendazole. , 1995, The Journal of infectious diseases.

[51]  D. Schwartz,et al.  Polyclonal and monoclonal antibody and PCR-amplified small-subunit rRNA identification of a microsporidian, Encephalitozoon hellem, isolated from an AIDS patient with disseminated infection , 1994, Journal of clinical microbiology.

[52]  D. Schwartz,et al.  Human microsporidial infections , 1994, Clinical Microbiology Reviews.

[53]  R. Bryan,et al.  Microsporidial infections in immunodeficient and immunocompetent patients. , 1994, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[54]  P. Reiss,et al.  Diagnosis of intestinal and disseminated microsporidial infections in patients with HIV by a new rapid fluorescence technique. , 1993, Journal of clinical pathology.

[55]  R. Bryan,et al.  Improved light-microscopical detection of microsporidia spores in stool and duodenal aspirates. The Enteric Opportunistic Infections Working Group. , 1992, The New England journal of medicine.