First joint report on the prevalence and genotyping of Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi among hospitalized children in Inner Mongolia, China

INTRODUCTION: Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are zoonotic intestinal parasitic protozoa that occur globally and can cause varying degrees of diarrhea, especially in children. In immunocompromised individuals, these protozoa may lead to persistent diarrhea and even death. Most studies worldwide have focused on the occurrence of these protozoa in animals, while few have investigated the prevalence and genotyping of these three protozoans among hospitalized children in Inner Mongolia, China. METHODS: DNA was extracted from fresh fecal samples of hospitalized children in Inner Mongolia. Nested polymerase chain reaction, genome sequencing, and sequence analysis were performed to evaluate the prevalence and genotyping of the above-mentioned three protozoa. RESULTS: Among hospitalized children in Inner Mongolia, the prevalence of Cryptosporidium spp., G. duodenalis, and E. bieneusi infections was 0.84% (1/119), 30.25% (36/119), and 21.85% (26/119), respectively. G. duodenalis and E. bieneusi, as well as Cryptosporidium spp. and G. duodenalis, have mixed infections. The prevalence of E. bieneusi and G. duodenalis was numerically higher in non-diarrheic samples (27.27%, 21/77; 33.77%, 26/77) than in diarrheic samples (11.9%, 5/42; 23.81%, 10/42), and no association was found between protozoan occurrence and diarrhea. Cryptosporidium spp. was identified as C. bovis; G. duodenalis was identified as assemblage AI (1) and assemblage E (33); and E. bieneusi was identified as genotype J (11), BEB4 (2), and new genotypes NMGC1-9, all belonging to group 2. CONCLUSIONS: To the best of our knowledge, this is the first study to jointly report prevalence and genotyping of Cryptosporidium spp., G. duodenalis, and E. bieneusi among hospitalized children in Inner Mongolia. Moreover, a mixed infection of two protozoa was detected; C. bovis and E. bieneusi were detected in hospitalized children in Inner Mongolia; a mixed infection of G. duodenalis assemblages AI and E was observed in humans; and E. bieneusi genotype J was identified as the dominant genotype in the evaluated population.