Investigation of Cryptosporidium spp. inImmunosuppressive and Immunocompetent Cases withDiarrhea by Microscopic, Serological and MolecularMethods

Abstract

Objective: In this study, our aim was to compare the diagnostic methods with each other and show the

presence of Cryptosporidium oocysts by using molecular, serological and microscopic methods in stool

samples which were collected from immunosuppressive and immunocompetent patients with diarrhea

Methods: Total 172 stool samples were collected from 80 immunosuppressive patients and 92

immunocompetent patients (between 0-94 years) with diarrhea. These stool samples were obtained from the

different clinics of Ataturk University, Yakutiye Research Hospital between January 2014 and July 2014.

Patient group composed of 49 persons between 0-14 years and 123 persons between 15-94 years. On the

other hand, 141 patients were using tap water while 41 of them were using well water. Modified acid-fast

staining, ELISA and DFA techniques were applied to detect the Cryptosporidium parasite positivity. Nested

PCR method was performed to the samples which were detected positive with one of the above methods.

Results: The positivity was detected in 5.8%, 4.1% and 3.5% by ELISA, DFA technique and Modified acidfast staining method, respectively. Cryptosporidium DNA was detected in only 1.2% by PCR method. The

rates of positivity were 6.3% and 5.4% in immunosuppressive and immunocompetent patients, respectively.

The positivity was detected in 10.2% and 4.1% in 0-14 age group and 15-94 age group patients, respectively.

On the other hand, 4.3% and 12.9% positivity rates were detected in tap water and well water users

respectively.

Conclusion: Our study pointed out that the investigation of Cryptosporidium oocysts as diarrhea agents in

especially immunosuppressive patients, individuals in childhood and well water users may be useful. Because

cryptosporidiosis is a common disease in children and immunosuppressive individuals. Additionally, we

think that ELISA method can be preferred to other methods in terms of high sensitivity and ease of

application.

Key words: Cryptosporidium, DFA, ELISA, immunosuppressive, immunocompetent, modified acid-fast staining, PCR