Molecular Prevalence and Genotypes of Cryptosporidium parvum and Giardia duodenalis in Patients with Acute Diarrhea in Korea, 2013-2016

다국어 초록 (Multilingual Abstract)

Cryptosporidium parvum and Giardia duodenalis are the main diarrhea-causing parasitic pathogens; however, their prevalence in Korea is unknown. Here, we conducted a survey to determine the prevalence and genotype distribution of these 2 pathogens causing acute diarrhea in 8,571 patients hospitalized in 17 Regional Institute of Health Environment sites in Korea, during 2013-2016. C. parvum and G. duodenalis were detected and genotyped by nested PCR, and the isolate were molecularly characterized by sequencing the glycoprotein 60 (Gp60) and β-giardin genes, respectively. The overall prevalence of C. parvum and G. duodenalis was 0.37% (n=32) and 0.55% (n=47), respectively, and both pathogens were more prevalent in children under 9 years old. Molecular epidemiological analysis showed that the C. parvum isolates belonged to the IIa family and were subtyped as IIaA13G2R1, IIaA14G2R1, IIaA15G2R1, and IIaA18G3R1. Analysis of the β-giardin gene fragment from G. duodenalis showed that all positive strains belong to assemblage A. This is the first report on the molecular epidemiology and subtyping of C. parvum and G. duodenalis in such a large number of diarrheal patients in Korea. These results highlight the need for continuous monitoring of these zoonotic pathogens and provide a basis for implementing control and prevention strategies. Further, the results might be useful for epidemiological investigation of the source of outbreak.

참고문헌 (Reference)

1 Feng Y, "Zoonotic potential and molecular epidemiology of Giardia species and giardiasis" 24 : 110-140, 2011

2 Baldursson S, "Waterborne transmission of protozoan parasites : review of worldwide outbreaks-an update 2004-2010" 45 : 6603-6614, 2011

3 Efstratiou A, "Waterborne transmission of protozoan parasites : Review of worldwide outbreaks-An update 2011-2016" 114 : 14-22, 2017

4 Cacciò SM, "Unravelling Cryptosporidium and Giardia epidemiology" 21 : 430-437, 2005

5 Sulaiman IM, "Unique endemicity of cryptosporidiosis in children in Kuwait" 43 : 2805-2809, 2005

6 Gherasim A, "Two geographically separated food-borne outbreaks in Sweden linked by an unusual Cryptosporidium parvum subtype, October 2010" 17 : 20318-, 2012

7 Cheun HI, "The first outbreak of giardiasis with drinking water in Korea" 4 : 89-92, 2013

8 심서보, "Simultaneous Molecular Detection of Cryptosporidium and Cyclospora from Raw Vegetables in Korea" 대한기생충학ㆍ열대의학회 55 (55): 137-142, 2017

9 Seguí R, "Prevalence of intestinal parasites, with emphasis on the molecular epidemiology of Giardia duodenalis and Blsstocystis sp., in the Paranaguá Bay, Brazil; a community survey" 11 : 490-, 2018

10 Gashout A, "Pattern of intestinal parasites among hospital patients at Tripoli Central Hospital, Libya" 1 : 13-15, 2017

11 Huey CS, "Multilocus genotyping of Giardia duodenalis in Malaysia" 17 : 269-276, 2013

12 Sánchez A, "Molecular epidemiology of Giardia, blastocystis, and Cryptosporidium among indigenous children from the Colombian Amazon basin" 8 : 248-, 2017

13 Hong SH, "Molecular characterization of Giardia duodenalis and Cryptosporidium parvum in fecal samples of individuals in Mongolia" 90 : 4-47, 2014

14 Moore CE, "Molecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian children" 10 : e0004822-, 2016

15 Kumar S, "MEGA : a biologist-centric software for evolutionary analysis of DNA and protein sequences" 9 : 299-306, 2008

16 전형일, "Infection Status of Hospitalized Diarrheal Patients with Gastrointestinal Protozoa, Bacteria, and Viruses in the Republic of Korea" 대한기생충학ㆍ열대의학회 48 (48): 113-120, 2010

17 Matsubayashi M, "Identification of genotypes of Giardia intestinalis isolates from a human and calf in Japan" 67 : 337-340, 2005

18 Homan WL, "Human giardiasis : genotype linked differences in clinical symptomatology" 31 : 822-826, 2001

19 Yoder JS, "Giardiasis surveillance-United States, 2006-2008" 59 : 15-25, 2010

20 Hogan JN, "Giardia in mountain gorillas(Gorilla beringei beringei), forest buffalo(Syncerus caffer), and domestic cattle in Volcanoes National Park, Rwanda" 50 : 21-30, 2014

21 Heyworth MF, "Giardia duodenalis genetic assemblages and hosts" 23 : 13-, 2016

22 Feng Y, "Genetic diversity and population structure of Cryptosporidium" 34 : 997-1011, 2018

23 Wang T, "First survey of Cryptosporidium, Giardia and Enterocytozoon in diarrhoeic children from Wuhan, China" 51 : 127-131, 2017

24 Sockett PN, "Enteric and foodborne disease in children : A review of the influence of food-and environment-related risk factors" 6 : 203-209, 2001

25 유재란, "Comparative Sensitivity of PCR Primer Sets for Detection of Cryptosporidium parvum" 대한기생충학ㆍ열대의학회 47 (47): 293-297, 2009

26 Chalmers RM, "Analysis of the Cryptosporidium spp. and gp60 subtypes linked to human outbreaks of cryptosporidiosis in England and Wales, 2009 to 2017" 12 : 95-, 2019

27 Eun Joo Cho, "A Waterborne Outbreak and Detection of Cryptosporidium Oocysts in Drinking Water of an Older High-Rise Apartment Complex in Seoul" 대한기생충학ㆍ열대의학회 51 (51): 461-466, 2013

28 허정원, "A Survey of Intestinal Protozoan Infections among Gastroenteritis Patients during a 3-Year Period (2004-2006) in Gyeonggi-do (Province), South Korea" 대한기생충학ㆍ열대의학회 47 (47): 303-305, 2009

29 이목영, "A Survey of Cryptosporidium Oocysts in Water Supplies during a 10-Year Period (2000-2009) in Seoul" 대한기생충학ㆍ열대의학회 48 (48): 219-224, 2010