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Am J Trop Med Hyg. 2019 Jul;101(1):160-163. doi: 10.4269/ajtmh.19-0057.

The Prevalence of Cryptosporidium among Children Hospitalized because of Gastrointestinal Symptoms and the Efficiency of Diagnostic Methods for Cryptosporidium.

Author information

1
The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
2
Department of Pediatrics, Baruch Padeh Medical Center, Poriya, Israel.
3
Reference Parasitology Laboratory, Central Laboratories, Ministry of Health, Jerusalem, Israel.
4
Pediatric Gastrointestinal Unit, Baruch Padeh Medical Center, Poriya, Israel.
5
Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel.

Abstract

Cryptosporidium is a parasite that causes watery diarrhea among both children and adults. However, because many physicians do not routinely ask for Cryptosporidium diagnostic test, cryptosporidiosis prevalence is likely underestimated. The current study investigated the prevalence of cryptosporidiosis among children admitted to the hospital with gastrointestinal symptoms. Stool sample was collected from each child and subjected to routine microbiological culture. Cryptosporidium presence was tested by three different methods: real-time PCR (RT-PCR), quick antigen, and microscopic examination with acid-fast staining. Each positive specimen was further tested with BioFire FilmArray Multiplex PCR (bioMérieux SA, Marcy-l'Etoile, France) to determine that Cryptosporidium is the only pathogen in the sample. Demographic and epidemiological data were collected from the patients' medical records. Of 291 patient stool samples, nine were positive for Cryptosporidium hominis or Cryptosporidium parvum. The average age of the nine Cryptosporidium-positive cases was 2.3 years, lower than the average age of the study population (4.2 years). Of the positive cases, 66.7% were Arabs and 33.3% were Jews. The main complaint of children with Cryptosporidium was diarrhea. Regarding the laboratory methods for Cryptosporidium identification, of the positive samples, 100% (9/9) were identified by RT-PCR, 88% (8/9) were positive by antigen test, and only 67% (6/9) were positive by microscopic examination with acid-fast staining. Because of the low incidence of Cryptosporidium among patients in our facility, the prevalence of cryptosporidiosis still cannot be established. Nevertheless, among the other pathogens found in stool samples, Cryptosporidium is the second leading cause of hospitalization due to gastrointestinal disease in children in our area.

PMID:
31115293
PMCID:
PMC6609172
[Available on 2020-07-01]
DOI:
10.4269/ajtmh.19-0057

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