First survey of Enterocytozoon bieneusi and dominant genotype Peru6 among ethnic minority groups in southwestern China's Yunnan Province and assessment of risk factors

Baiyan Gong; Yaming Yang; Xiaohua Liu; Jianping Cao; Meng Xu; Ning Xu; Fengkun Yang; Fangwei Wu; Benfu Li; Aiqin Liu; Yujuan Shen

doi:10.1371/journal.pntd.0007356

First survey of Enterocytozoon bieneusi and dominant genotype Peru6 among ethnic minority groups in southwestern China's Yunnan Province and assessment of risk factors

PLoS Negl Trop Dis. 2019 May 23;13(5):e0007356. doi: 10.1371/journal.pntd.0007356. eCollection 2019 May.

Authors

Baiyan Gong¹, Yaming Yang², Xiaohua Liu¹, Jianping Cao³, Meng Xu³, Ning Xu³, Fengkun Yang¹, Fangwei Wu², Benfu Li², Aiqin Liu¹, Yujuan Shen³

Affiliations

¹ Department of Parasitology, Harbin Medical University, Harbin, China.
² Department of Helminth, Yunnan Institute of Parasitic Diseases, Puer, China.
³ National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, MOH; Shanghai, China.

Abstract

Background: Enterocytozoon bieneusi is the most common microsporidian species causing diarrhea and other intestinal disorders in humans and animals. Like other infectious diseases, microsporidiosis usually disproportionately affects poor populations. In China, some ethnic minority areas remain poor. Currently, no information of E. bieneusi infection is available in minority populations. The present aims were to understand occurrence and genetic characterizations of E. bieneusi in ethnic minority groups from a poverty-stricken ethnic township in Yunnan Province, and to assess risk factors for E. bieneusi infection.

Methodology/principal findings: 289 fecal specimens were collected from Yao people (one specimen each) with and without diarrhea, in Yunnan Province. E. bieneusi was identified and genotyped by PCR and sequence analysis of the ITS region of the rRNA gene. An average prevalence of 8.30% (24/289) was observed and four genotypes were identified-genotype Peru6 (n = 21) and three novel genotypes (one each). Genotype Peru6 was detected in two family members in each of three families. In a phylogenetic analysis, all of four genotypes fell into group 1 with zoonotic potential. The people owning individual pit toilets had a statistically higher prevalence of E. bieneusi (16.67%, 12/72) than those using public pit toilets (6.06%, 12/198).

Conclusions/significance: This is the first report on occurrence and genetic characteristics of E. bieneusi in ethnic minority groups in China. Genotype Peru6 was found in humans in China for the first time and showed dominance in Yao people. The same genotype was found in some family members and all the genotypes fell into group 1, suggesting the possibility of anthroponotic and zoonotic transmissions. The majority (83.33%, 20/24) of E. bieneusi positive individuals did not present diarrhea. In any case, it is important to recognize their existence and the importance that asymptomatic individuals to E. bieneusi may have from an epidemiological point of view, as transmitters of this pathogen. The analysis of risk factors provides scientific evidence for the development of effective strategies for prevention and control of E. bieneusi infection.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
China / epidemiology
China / ethnology
Enterocytozoon / classification
Enterocytozoon / genetics*
Enterocytozoon / isolation & purification*
Ethnicity
Female
Genetic Variation
Humans
Male
Microsporidiosis / epidemiology
Microsporidiosis / ethnology
Microsporidiosis / microbiology*
Middle Aged
Minority Groups
Phylogeny
Polymerase Chain Reaction
Risk Factors
Young Adult

Grants and funding

This work was supported by the National Science and Technology Major Program of China (No. 2018ZX10713001 to YS), the National Key Research and Development of China (No. 2016YFC1201900 to JC) and the Scientific Research Project of Health Department Heilongjiang Province (No. 2011-202 to FY). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.