title: Species-specific identification of microsporidia in stool and intestinal biopsy specimens by the polymerase chain reaction.
abstract: In view of the increasing number of cases of human microsporidiosis, simple and rapid methods for clear identification of microsporidian parasites to the species level are required. In the present study, the polymerase chain reaction (PCR) was used for species-specific detection of Encephalitozoon cuniculi. Encephalitozoon hellem, Encephalitozoon (Septata) intestinalis, and Enterocytozoon bieneusi in both tissue and stool. Using stool specimens and intestinal biopsies of patients infected with Enterocytozoon bieneusi (n = 9), Encephalitozoon spp. (n = 2), and Encephalitozoon intestinalis (n = 1) as well as stool spiked with spores of Encephalitozoon cuniculi and Encephalitozoon hellem and tissue cultures of Encephalitozoon cuniculi and Encephalitozoon hellem, three procedures were developed to produce PCR-ready DNA directly from the samples. Specific detection of microsporidian pathogens was achieved in the first PCR. The subsequent nested PCR permitted species determination and verified the first PCR products. Without exception, the PCR assay confirmed electron microscopic detection of Enterocytozoon bieneusi and Encephalitozoon intestinalis in stool specimens and their corresponding biopsies and in spiked stool samples and tissue cultures infected with Encephalitozoon cuniculi and Encephalitozoon hellem. Moreover, identification of Encephalitozoon spp. could be specified as Encephalitozoon intestinalis. Whereas standard methods such as light and transmission electron microscopy may lack sensitivity or require more time and special equipment, the PCR procedure described facilitates species-specific identification of microsporidian parasites in stool, biopsies, and, probably, other samples in about five hours.
authors.affiliation: Section of Parasitology, Bernard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: N P
authors.initials: NP
authors.lastname: Kock
authors.forename: H
authors.initials: H
authors.lastname: Petersen
authors.forename: T
authors.initials: T
authors.lastname: Fenner
authors.forename: I
authors.initials: I
authors.lastname: Sobottka
authors.forename: C
authors.initials: C
authors.lastname: Schmetz
authors.forename: P
authors.initials: P
authors.lastname: Deplazes
authors.forename: N J
authors.initials: NJ
authors.lastname: Pieniazek
authors.forename: H
authors.initials: H
authors.lastname: Albrecht
authors.forename: J
authors.initials: J
authors.lastname: Schottelius
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000469:parasitology; D000818:Animals; D001483:Base Sequence; D001707:Biopsy, Needle; D002648:Child; D016054:DNA, Protozoan / Q000032:analysis*; D004587:Electrophoresis, Agar Gel; D005243:Feces / Q000469:parasitology*; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D000882:Haplorhini; D006801:Humans; D007422:Intestines / Q000469:parasitology* / Q000473:pathology; D008297:Male; D016816:Microsporida / Q000145:classification* / Q000302:isolation & purification; D016881:Microsporidiosis / Q000175:diagnosis*; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D013045:Species Specificity
chemical_list: D016054:DNA, Protozoan