title: Encephalitozoon cuniculi infection among immunocompromised and immunocompetent humans in Egypt.
abstract: BACKGROUND
  Encephalitozoon cuniculi infects a wide range of homoeothermic animals, including man. Complications due to this microsporidian have been reported only in immunocompromised patients. Reports on E. cuniculi in immunocompetent humans are lacking, most probably, because it is not linked to any clinical manifestations in such hosts. The present work was carried out with the aim of studying, for the first time in Egypt, the prevalence of E. cuniculi infection of urinary tract among non-HIV immunocompromised patients and immunocompetent individuals. It tested also the influence of some factors on the risk of infection.
  
  
  METHODS
  Blood and urine samples were collected from 88 persons (44 non-HIV immunocompromised patients and 44 subjects as immunocompetent control group). IFAT serological assay and Weber's green modified trichrome stain (MTS) urine smears were carried out. Molecular study by PCR was also performed to detect DNA of E. cuniculi in urine samples. A full history sheet was fulfilled for each subject to test the suspected risk factors.
  
  
  RESULTS
  The IFAT examination confirmed the presence of antibodies against E. cuniculi in 44.3% of the human subjects. The seroprevalence of E. cuniculi was significantly higher in the immunocompromised patients compared with the immunocompetent individuals (77.3% versus 11.4%). Compared with IFAT (the gold standard), the sensitivity and specificity of Weber's green MTS smears were 69.23% and 89.80%. By using PCR, no positive cases were detected among human subjects.
  
  
  CONCLUSIONS
  A high prevalence of E. cuniculi infection in the studied individuals was noted. Although infection was found in some immunocompetent individuals, the immune status of the host remains the corner stone for occurrence of the infection.
authors.affiliation: Parasitology Department, Faculty of Veterinary Medicine, Alexandria University, Egypt.
authors.forename: Somaia Saif
authors.initials: SS
authors.lastname: Abu-Akkada
authors.affiliation: Medical Parasitology Department, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Eman Dorry Hussein
authors.initials: ED
authors.lastname: El Kerdany
authors.affiliation: Medical Parasitology Department, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Rasha Fadly
authors.initials: RF
authors.lastname: Mady
authors.affiliation: Medical Parasitology Department, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Radwa Galal
authors.initials: RG
authors.lastname: Diab
authors.affiliation: Clinical Oncology Department, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Gehan Abd Elatti
authors.initials: GA
authors.lastname: Khedr
authors.affiliation: Parasitology Department, Faculty of Veterinary Medicine, Alexandria University, Egypt.
authors.forename: Karam Imam
authors.initials: KI
authors.lastname: Ashmawy
authors.affiliation: Parasitology Department, Medical Research Institute, Alexandria University, Egypt.
authors.forename: Wael Mohamed
authors.initials: WM
authors.lastname: Lotfy
keywords: Man; Microsporidia; Opportunistic; Protozoa
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