Chapter 142 : Cryptosporidium

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spp. are important zoonotic pathogens, causing enterocolitis and diarrhea in children and immunocompromised persons. In developing countries, cryptosporidiosis is one of the most important causes of moderate to severe diarrhea and diarrhea-associated death. In industrialized nations, spp. are well recognized waterborne, foodborne, and zoonotic pathogens, having caused many outbreaks of human illness. In the United States, the number of annual reported cases of cryptosporidiosis has increased more than 2-fold in recent years. In this chapter, various laboratory techniques for the detection and diagnosis of spp. and the most recent progress in taxonomy and the molecular epidemiology and treatment of cryptosporidiosis are reviewed.

Citation: Xiao L, Cama V. 2015. Cryptosporidium, p 2435-2447. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch142
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Life cycle of spp. Sporulated oocysts, containing four sporozoites, are excreted by the infected host through feces and possibly other routes such as respiratory secretions ( ). Transmission of spp. in humans occurs mainly through contact with infected persons (for and ) or animals (for mostly) and consumption of contaminated water and food ( ). Following ingestion (and possibly inhalation) by a suitable host ( ), excystation (a) occurs. The sporozoites are released and parasitize epithelial cells (b, c) of the gastrointestinal tract or other tissues such as the respiratory tract. In these cells, the parasites undergo asexual multiplication (schizogony or merogony) (d to f) and then sexual multiplication (gametogony), producing microgamonts (male) (g) and macrogamonts (female) (h). Upon fertilization of the macrogamonts by the microgametes (i), oocysts (j, k) develop that sporulate in the infected host. Two different types of oocysts are produced, the thick-walled oocyst (j), which is commonly excreted from the host; and the thin-walled oocyst (k), which is primarily involved in autoinfection. Oocysts are infective upon excretion, thus permitting direct and immediate fecal-oral transmission. Courtesy of DPDx (http://www.cdc.gov/dpdx/). doi:10.1128/9781555817381.ch142.f1

Citation: Xiao L, Cama V. 2015. Cryptosporidium, p 2435-2447. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch142
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Image of FIGURE 2

Oocysts of (4 to 6 μm) (A), (6 to 8 μm) (B), (8 to 10 μm) (C), and (20 to 30 μm by 10 to 20 μm) (D) stained by the modified Ziehl-Neelsen acid-fast stain. doi:10.1128/9781555817381.ch142.f2

Citation: Xiao L, Cama V. 2015. Cryptosporidium, p 2435-2447. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch142
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Image of FIGURE 3

oocysts (4 to 6 μm) and cyst (11 to 14 μm by 7 to 10 μm) under immunofluorescence microscopy. doi:10.1128/9781555817381.ch142.f3

Citation: Xiao L, Cama V. 2015. Cryptosporidium, p 2435-2447. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch142
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Some commercial diagnostic assays for the detection of oocysts, antigens, or DNA

Citation: Xiao L, Cama V. 2015. Cryptosporidium, p 2435-2447. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch142

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