Chapter 138 : , , and

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The (), , and are intestinal coccidia of humans, and oocysts of these coccidia are found in the feces of humans, and diagnosis is based ultimately on demonstrating oocysts ( or ) or sporocysts (Sarcocystis) in human stool samples. is in the family Eimeriidae, while and are in the family Sarcocystidae. The oocysts are -like and contain two sporocysts, each with four sporozoites. In areas of endemicity, there is an increased risk of infection with contact with soil and water. Most of the produce items implicated as transmitting are consumed raw, which does not lend itself to prevention by thermal means. species infecting mammals other than humans may also be present in water samples or on produce, and proofs of specificity are needed for these tests designed to look at environmental sources of and to detect oocysts on produce. Nitazoxanide has been evaluated for activity against , and in these studies, its efficacy for the treatment of cyclosporiasis was about 70%. Both and are usually identified by stool examination and are rarely misidentified in human feces. Computer report notes can indicate that trimethoprim-sulfamethoxazole is the drug of choice for treatment of these parasites. PCR can be used for the identification of organisms but is not commercially available and should be indicated as an experimental test.

Citation: Lindsay D, Upton S, Weiss L. 2011. , , and , p 2172-2179. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch138

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Image of FIGURE 1

Line drawings of unsporulated and sporulated oocysts of (A and B) and (C and D) and a sporulated oocyst (E) and sporocyst (F) of a species, all from humans. Bar, 10 μm.

Citation: Lindsay D, Upton S, Weiss L. 2011. , , and , p 2172-2179. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch138
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Image of FIGURE 2

Modified Kinyoun's acid-fast-stained smears demonstrating an oocyst with a sporont (A), an oocyst with two sporoblasts (B), and a oocyst with a sporont (C).

Citation: Lindsay D, Upton S, Weiss L. 2011. , , and , p 2172-2179. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch138
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Image of FIGURE 3

Toludine blue-stained 1-μm section demonstrating several unizoite cysts of . Note the thick wall that surrounds each single zoite.

Citation: Lindsay D, Upton S, Weiss L. 2011. , , and , p 2172-2179. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch138
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1. Alfano-Sobsey, E. M.,, M. L. Eberhard,, J. R. Seed,, D. J. Weber,, K. Y. Won,, E. K. Nace,, and C. L. Moe. 2004. Human challenge pilot study with Cyclospora cayetanensis. Emerg. Infect. Dis. 10:726728.
2. Arness, M. K.,, J. D. Brown,, J. P. Dubey,, R. C. Neafie,, and D. E. Granstrom. 1999. An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism. Am. J. Trop. Med. Hyg. 61:548553.
3. Atambay, M.,, M. R. Bayraktar,, U. Kayabas,, S. Yilmaz,, and Y. Bayindir. 2007. A rare diarrheic parasite in a liver transplant patient: Isospora belli. Transplant. Proc. 39:16931695.
4. Beaver, P. C.,, K. Gadgil,, and P. Morera. 1979. Sarcocystis in man: a review and report of five cases. Am. J. Trop. Med. Hyg. 28:819844.
5. Benator, D. A.,, A. L. French,, L. M. Beaudet,, C. S. Levy,, and J. M. Orenstein. 1994. Isospora belli infection associated with acalculous cholecystitis in a patient with AIDS. Ann. Int. Med. 121:663664.
6. Bendall, R. P.,, S. Lucas,, A. Moody,, G. Tovey,, and P. L. Chiodini. 1993. Diarrhoea associated with cyanobacterium- like bodies: a new coccidian enteritis of man. Lancet 341:590592.
7. Bialek R.,, N. Binder, 2002. Comparison of autofluorescence and iodine staining for detection of Isospora belli in feces. Am. J. Trop. Med. Hyg. 67:304305.
8. Bialek, R.,, D. Overkamp,, I. Rettig,, and J. Knobloch. 2001. Case report: nitazoxanide treatment failure in chronic isosporiasis. Am. J. Trop. Med. Hyg. 65:9495.
9. Brandborg, L. L.,, S. B. Goldberg,, and W. C. Breidenbach. 1970. Human coccidiosis—a possible cause of malabsorption: the life cycle in small-bowel mucosal biopsies as a diagnostic feature. N. Engl. J. Med. 283:13061313.
10. Bunyaratvej, S.,, and P. Unpunyo. 1992. Combined Sarcocystis and gram-positive bacterial infections. A possible cause of segmental enterocolitis in Thailand. J. Med. Assoc. Thai. 75:S38S44.
11. Bunyaratvej, S.,, P. Bunyawongwiroj,, and P. Nitiyanant. 1982. Human intestinal sarcosporidiosis: report of six cases. Am. J. Trop. Med. Hyg. 31:3641.
12. Certad, G.,, A. Arenas-Pinto,, L. Pocaterra,, G. Ferrara,, J. Castro,, A. Bello,, and L. Nunez. 2003. Isosporiasis in Venezuelan adults infected with human immunodeficiency virus: clinical characterization. Am. J. Trop. Med. Hyg. 69:217222.
13. Chacín-Bonilla, L. 2008. Transmission of Cyclospora cayetanensis infection: a review focusing on soil-borne cyclosporiasis. Trans. R. Soc. Trop. Med. Hyg. 102:215216.
14. Clarke, S. C.,, and M. McIntyre. 1997. An attempt to demonstrate a serological immune response in patients infected with Cyclospora cayetanensis. Br. J. Biomed. Sci. 54:7374.
15. de Gorgolas, M.,, J. Fortes,, and M. L. Fernandez Guerrero. 2001. Cyclospora cayetanensis cholecystitis in a patient with AIDS. Ann. Intern. Med. 134:166.
16. de Otazu, R. D.,, L. Garcia-Nieto,, E. Izaguirre-Gondra,, E. Mayayo,, S. Ciani,, and F. F. Nogales. 2004. Endometrial coccidiosis. J. Clin. Pathol. 57:11041105.
17. Diaz, E.,, J. Mondragon,, E. Ramirez,, and R. Bernal. 2003. Epidemiology and control of intestinal parasites with nitazoxanide in children in Mexico. Am. J. Trop. Med. Hyg. 69:384385.
18. Dixon, B. R.,, J. M. Bussey,, L. J. Parrington,, and M. Parenteau. 2005. Detection of Cyclospora cayetanensis oocysts in human fecal specimens by flow cytometry. J. Clin. Microbiol. 43:23752379.
19. Dodds, S. E.,, and R. Elsdon-Dew. 1955. Further observations on human coccidiosis in Natal. S. Afr. J. Lab. Clin. Med. 1:104109.
20. Doumbo, O.,, J. F. Rossignol,, E. Pichard,, H. A. Traore,, T. M. Dembele,, M. Diakite,, F. Traore,, and D. A. Diallo. 1997. Nitazoxanide in the treatment of cryptosporidial diarrhea and other intestinal parasitic infections associated with acquired immunodeficiency syndrome in tropical Africa. Am. J. Trop. Med. Hyg. 56:637639.
21. Dowd, S. E.,, D. John,, J. Eliopolus,, C. P. Gerba,, J. Naranjo,, R. Klein,, B. Lopez,, M. de Mejia,, C. E. Mendoza,, and I. L. Pepper. 2003. Confirmed detection of Cyclospora cayetanensis, Encephalitozoon intestinalis and Cryptosporidium parvum in water used for drinking. J. Water Health 1:117123.
22. Dubey, J. P.,, A. W. Kotula,, A. Sharar,, C. D. Andrews,, and D. S. Lindsay. 1990. Effect of high temperature on infectivity of Toxoplasma gondii tissue cysts in pork. J. Parasitol. 76:201204.
23. Eberhard, M. L.,, N. J. Pieniazek,, and M. J. Arrowood. 1997. Laboratory diagnosis of Cyclospora infections. Arch. Pathol. Lab. Med. 121:792797.
24. Eberhard, M. L.,, Y. R. Ortega,, D. E. Hanes,, E. K. Nace,, R. Q. Do,, M. G. Robl,, K. Y. Won,, C. Gavidia,, N. L. Sass,, K. Mansfield,, A. Gozalo,, J. Griffiths,, R. Gilman,, C. R. Sterling,, and M. J. Arrowood. 2000. Attempts to establish experimental Cyclospora cayetanensis infection in laboratory animals. J. Parasitol. 86:577582.
25. El Naggar, H. H.,, A. E. Handousa,, E. M. El Hamshary,, and A. M. El Shazly. 1999. Evaluation of five stains in diagnosing human intestinal coccidiosis. J. Egypt. Soc. Parasitol. 29:883891.
26. Elsdon-Dew, R. 1953. Isospora natalensis (sp. nov.) in man. J. Trop. Med. Hyg. 56:149150.
27. Fayer, R. 2004. Sarcocystis spp. in humans. Clin. Microbiol. Rev. 17:894902.
28. Ferreira, L. F.,, S. G. Coutinho,, C. A. Argento,, and J. R. da Silva. 1962. Experimental human coccidial enteritis by Isospora belli Wenyon, 1923. A study based on the infection of 5 volunteers. Hospital (Rio de Janeiro) 62:795804.
29. Fox, L. M.,, and L. D. Saravolatz. 2005. Nitazoxanide: a new thiazolide antiparasitic agent. Clin. Infect. Dis. 40:11731180.
30. French, A. L.,, L. M. Beaudet,, D. A. Benator,, C. S. Levy,, M. Kass,, and J. M. Orenstein. 1995. Cholecystectomy in patients with AIDS: clinicopathologic correlations in 107 cases. Clin. Infect. Dis. 21:852858.
31. Garcia, L. S.,, and D. A. Bruckner. 1997. Diagnostic Medical Parasitology, 3rd ed., p. 593607, 937. ASM Press, Washington, DC.
32. González, L. M.,, N. Villalobos,, E. Montero,, J. Morales,, R. A. Sanz,, A. Muro,, L. J. Harrison,, R. M. Parkhouse,, and T. Gárate. 2006. Differential molecular identification of Taeniid spp. and Sarcocystis spp. cysts isolated from infected pigs and cattle. Vet. Parasitol. 142:95101.
33. Goodman, M. L.,, and E. Maher. 1966. Four uncommon infections in Hodgkin's disease. JAMA 198:1129.
34. Greenberg, S. J.,, M. P. Davey,, W. S. Zierdt,, and T. A. Waldmann. 1988. Isospora belli infection in patients with human T-cell leukemia virus type I-associated adult T-cell leukemia. Am. J. Med. 85:435438.
35. Hallak, A.,, I. Yust,, Y. Ratan,, and U. Adar. 1982. Malabsorption syndrome, coccidiosis, combined immune deficiency, and fulminant lymphoproliferative disease. Arch. Intern. Med. 142:196197.
36. Herwaldt, B. L. 2000. Cyclospora cayetanensis: a review, focusing on the outbreaks of cyclosporiasis in the 1990s. Clin. Infect. Dis. 31:10401057.
37. Jinneman, K. C.,, J. H. Wetherington,, W. E. Hill,, A. M. Adams,, J. M. Johnson,, B. J. Tenge,, N. L. Dang,, R. L. Manger,, and M. M. Wekell. 1998. Template preparation for PCR and RFLP of amplification products for the detection and identification of Cyclospora sp. and Eimeria spp. oocysts directly from raspberries. J. Food Prot. 61:14971503.
38. Jongwutiwes, S.,, C. Putaporntip,, M. Charoenkorn,, T. Iwasaki,, and T. Endo. 2007. Morphologic and molecular characterization of Isospora belli oocysts from patients in Thailand. Am. J. Trop. Med. Hyg. 77:107112.
39. Karanis, P.,, C. Kourenti,, and H. Smith. 2007. Waterborne transmission of protozoan parasites: a worldwide review of outbreaks and lessons learnt. J. Water Health 5:138.
40. Kimura, K.,, S. Kumar Rai,, K. Takemasa,, Y. Ishibashi,, M. Kawabata,, M. Belosevic,, and S. Uga. 2004. Comparison of three microscopic techniques for diagnosis of Cyclospora cayetanensis. FEMS Microbiol Lett. 238:263266.
41. Koru, O.,, R. E. Araz,, Y. A. Yilmaz,, S. Ergüven,, M. Yenicesu,, B. Pektas,, and M. Tanyüksel. 2007. Case report: Isospora belli infection in a renal transplant recipient. Turkiye Parazitol. Derg. 31:98100.
42. Lalonde, L. F.,, and A. A. Gajadhar. 2008. Highly sensitive and specific PCR assay for reliable detection of Cyclospora cayetanensis oocysts. Appl. Environ. Microbiol. 74:43544358.
43. Limson-Pobre, R. N.,, S. Merrick,, D. Gruen,, and R. Soave. 1995. Use of diclazuril for the treatment of isosporiasis in patients with AIDS. Clin. Infect. Dis. 20:201202.
44. Lindquist, H. D.,, J. W. Bennett,, J. D. Hester,, M. W. Ware,, J. P. Dubey,, and W. V. Everson. 2003. Autofluorescence of Toxoplasma gondii and related coccidian oocysts. J. Parasitol. 89:865867.
45. Lindsay, D. S.,, J. P. Dubey,, M. A. Toivio-Kinnucan,, J. F. Michiels,, and B. L. Blagburn. 1997. Examination of extraintestinal tissue cysts of Isospora belli. J. Parasitol. 83:620625.
46. Lindsay, D. S.,, D. Holliman,, G. J. Flick,, D. G. Goodwin,, S. M. Mitchell,, and J. P. Dubey. 2008. Effects of high pressure processing on Toxoplasma gondii oocysts on raspberries. J. Parasitol. 94:757758.
47. Madico, G.,, J. McDonald,, R. H. Gilman,, L. Cabrera,, and C. R. Sterling. 1997. Epidemiology and treatment of Cyclospora cayetanensis infection in Peruvian children. Clin. Infect. Dis. 24:977981.
48. Matsubayashi, H.,, and T. Nozawa. 1948. Experimental infection of Isospora hominis in man. Am. J. Trop. Med. 28:633637.
49. Mehlhorn, H.,, and A. O. Heydorn. 1979. Electron microscopical study on gamogony of Sarcocystis suihominis in human tissue cultures. Z. Parasitenkd. 58:97113.
50. Mehrotra, R.,, D. Bisht,, P. A. Singh,, S. C. Gupta,, and R. K. Gupta. 1996. Diagnosis of human Sarcocystis infection from biopsies of the skeletal muscle. Pathology 28:281282.
51. Michiels, J. F.,, P. Hofman,, E. Bernard,, M. C. St. Paul,, C. Boissy,, V. Mondain,, Y. LeFichoux,, and R. Loubiere. 1994. Intestinal and extraintestinal Isospora belli infection in an AIDS patient. Pathol. Res. Pract. 190:10891093.
52. Mirdha, B. R.,, S. K. Kabra,, and J. C. Samantray. 2002. Isosporiasis in children. Indian Pediatr. 39:941944.
53. Mughal, T. I.,, and M. Y. Khan. 1991. Isospora belli diarrhea as a presenting feature of AIDS. Saudi Med. J. 12:433434.
54. Muller, A.,, R. Bialek,, G. Fatkenheuer,, B. Salzberger,, V. Diehl,, and C. Franzen. 2000. Detection of Isospora belli by polymerase chain reaction using primers based on smallsubunit ribosomal RNA sequences. Eur. J. Clin. Microbiol. Infect. Dis. 19:631634.
55. Oliveira-Silva, M. B.,, E. Lages-Silva,, D. V. Resende,, A. Prata,, L. E. Ramirez,, and J. K. Frenkel. 2006. Cystoisospora belli: in vitro multiplication in mammalian cells. Exp. Parasitol. 114:189192.
56. Ortega, Y.,, R. Nagle,, R. H. Gilman,, J. Watanabe,, J. Miyagui,, H. Quispe,, P. Kanagusuku,, C. Roxas,, and C. R. Sterling. 1997. Pathologic and clinical findings in patients with cyclosporiasis and a description of intracellular parasite life-cycle stages. J. Infect. Dis. 176:15841589.
57. Pape, J. W.,, R.-I. Verdier,, M. Boncy,, J. Boncy,, and W. D. Johnson. 1994. Cyclospora infection in adults infected with HIV. Clinical manifestations, treatment, and prophylaxis. Ann. Intern. Med. 121:654657.
58. Pape, J. W.,, R. I. Verdier,, and W. D. Johnson, Jr. 1989. Treatment and prophylaxis of Isospora belli infections in patients with the acquired immunodeficiency syndrome. New Engl. J. Med. 320:10441047.
59. Parija, S. C.,, M. R. Shivaprakash,, and S. R. Jayakeerthi. 2003. Evaluation of lacto-phenol cotton blue (LPCB) for detection of Cryptosporidium, Cyclospora and Isospora in the wet mount preparation of stool. Acta Trop. 85:349354.
60. Pathmanathan, R.,, and K. P. Kan. 1992. Three cases of human Sarcocystis infection with a review of human muscular sarcocystosis in Malaysia. Trop. Geogr. Med. 44:102108.
61. Relman, D. A.,, T. M. Schmidt,, A. Gajadhar,, M. Sogin,, J. Cross,, K. Yoder,, O. Sethabutr,, and P. Echeverria. 1996. Molecular phylogenetic analysis of Cyclospora, the human intestinal pathogen, suggests that it is closely related to Eimeria species. J. Infect. Dis. 73:440445.
62. Resiere, D.,, J. M. Vantelon,, P. Bouree,, E. Chachaty,, G. Nitenberg,, and F. Blot. 2003. Isospora belli infection in a patient with non-Hodgkin's lymphoma. Clin. Microbiol. Infect. 9:10651067.
63. Romero Cabello, R.,, L. R. Guerrero,, M. R. Munoz Garcia,, and A. Geyne Cruz. 1997. Nitazoxanide for the treatment of intestinal protozoan and helminthic infections in Mexico. Trans. R. Soc. Trop. Med. Hyg. 91:701703.
64. Sifuentes-Osornio, J.,, G. Porras-Cortes,, R. P. Bendall,, F. Morales-Villarreal,, G. Reyes-Teran,, and G. M. Ruiz- Palacios. 1995. Cyclospora cayetanensis infection in patients with and without AIDS: biliary disease as another clinical manifestation. Clin. Infect. Dis. 21:10921097.
65. Siripanth, C.,, B. Punpoowong,, P. Amarapal,, and N. Thima. 2004. Development of Isospora belli in Hct-8, Hep-2, human fibroblast, BEK and Vero culture cells. Southeast Asian J. Trop. Med. Public Health 35:796800.
66. Smith, H. V.,, C. A. Paton,, M. M. A. Mtambo,, and R. W. A. Girdwood. 1997. Sporulation of Cyclospora sp. oocysts. Appl. Environ. Microbiol. 63:16311632.
67. Sun, T.,, C. F. Ilardi,, D. Asnis,, A. R. Bresciani,, S. Goldenberg,, B. Roberts,, and S. Teichberg. 1996. Light and electron microscopic identification of Cyclospora species in the small intestine. Evidence of the presence of asexual life cycle in human host. Am. J. Clin. Pathol. 105:216220.
68. ten Hove, R. J.,, L. van Lieshout,, E. A. Brienen,, M. A. Perez,, and J. J. Verweij. 2008. Real-time polymerase chain reaction for detection of Isospora belli in stool samples. Diagn. Microbiol. Infect. Dis. 61:280283.
69. Trier, J. S.,, P. C. Moxey,, E. M. Schimmel,, and E. Robles. 1974. Chronic intestinal coccidiosis in man: intestinal morphology and response to treatment. Gastroenterology 66:923935.
70. Van den Enden, E.,, M. Praet,, R. Joos,, A. Van Gompel,, and P. Gigasse. 1995. Eosinophilic myositis resulting from sarcocystosis. J. Trop. Med. Hyg. 98:273276.
71. Vangeel, L.,, K. Houf,, K. Chiers,, J. Vercruysse,, K. D'Herde,, and R. Ducatelle. 2007. Molecular-based identification of Sarcocystis hominis in Belgian minced beef. J. Food Prot. 70:15231526.
72. Varea, M.,, A. Clavel,, O. Doiz,, F. J. Castillo,, M. C. Rubio,, and R. Gomez-Lus. 1998. Fuchsin fluorescence and autofluorescence in Cryptosporidium, Isospora and Cyclospora oocysts. Int. J. Parasitol. 28:18811883.
73. Varma, M.,, J. D. Hester,, F. W. Schaefer III,, M. W. Ware,, and H. D. Lindquist. 2003. Detection of Cyclospora cayetanensis using a quantitative real-time PCR assay. J. Microbiol. Methods 53:2736.
74. Velásquez, J. N.,, S. Carnevale,, M. Mariano,, L. H. Kuo,, A. Caballero,, A. Chertcoff,, C. Ibáñez,, and J. P. Bozzini. 2001. Isosporosis and unizoite tissue cysts in patients with acquired immunodeficiency syndrome. Hum. Pathol. 32:500505.
75. Verdier, R. I.,, D. W. Fitzgerald,, D. W. Johnson,, and J. W. Pape. 2000. Trimethoprim-sulfamethoxazole compared with ciprofloxacin for treatment and prophylaxis of Isospora belli and Cyclospora cayetanensis infection in HIV-infected patients—a randomized, controlled trial. Ann. Intern. Med. 132:885888.
76. Visvesvara, G. S.,, H. Moura,, E. Kovacs-Nace,, S. Wallace,, and M. L. Eberhard. 1997. Uniform staining of Cyclospora oocysts in fecal smears by a modified safranin technique with microwave heating. J. Clin. Microbiol. 35:730733.
77. Wang, K. X.,, C. P. Li,, J. Wang,, and Y. Tian. 2002. Cyclospora cayetanensis in Anhui, China. World J. Gastroenterol. 8:11441148.
78. Weiss, L. M.,, D. C. Perlman,, J. Sherman,, H. Tanowitz,, and M. Wittner. 1988. Isospora belli infection: treatment with pyrimethamine. Ann. Intern. Med. 109:474475.
79. Westerman, E. L.,, and R. P. Christensen. 1979. Chronic Isospora belli infection treated with co-trimoxazole. Ann. Intern. Med. 91:413414.
80. Yang, Z. Q.,, Q. Q. Li,, Y. X. Zuo,, X. W. Chen,, Y. J. Chen,, L. Nie,, C. G. Wei,, J. S. Zen,, S. W. Attwood,, X. Z. Zhang,, and Y. P. Zhang. 2002. Characterization of Sarcocystis species in domestic animals using a PCR-RFLP analysis of variation in the 18S rRNA gene: a cost-effective and simple technique for routine species identification. Exp. Parasitol. 102:212217.
81. Yazar, S.,, B. Tokgöz,, O. Yaman,, and I. Sahin. 2006. Isospora belli infection in a patient with a renal transplant. Turkiye Parazitol. Derg. 30:2224.
82. Zar, F. A.,, E. El-Bayoumi,, and M. M. Yungbluth. 2001. Histologic proof of acalculous cholecystitis due to Cyclospora cayetanensis. Clin. Infect. Dis. 33:E140E141.


Generic image for table

Structural data for and coccidial oocysts and sporocysts found in the feces of humans

Data have been rounded to the nearest micrometer.

Citation: Lindsay D, Upton S, Weiss L. 2011. , , and , p 2172-2179. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch138

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