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Cryptosporidium infection in children with cancer undergoing chemotherapy: how important is the prevention of opportunistic parasitic infections in patients with malignancies?

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Abstract

Cryptosporidiosis is a relatively uncommon disease in healthy individuals but could be potentially worrisome in immunocompromised patients. This study aimed to evaluate Cryptosporidium infection in children with cancer undergoing chemotherapy. A case-control study was conducted in 132 children with cancer undergoing chemotherapy and 132 non-cancer controls. The modified Ziehl-Neelsen (MZN) staining and polymerase chain reaction methods were used for the detection of Cryptosporidium parasite. All positive isolates were sequenced for phylogenetic analysis. Statistical analysis was performed using the SPSS version 16 and Fisher exact test. The rate of cryptosporidiosis in children with cancer undergoing chemotherapy was 3.8%, which was higher than that of the control group. Other intestinal parasites detected in patients with cancer included Giardia lamblia (3%), Entamoeba coli (1.5%), and Chilomastix mesnili (0.8%). In the control group, only two (1.5%) cases were positive for G. lamblia. No significant difference was observed between the gender, age, residency, contact with domestic animals, stool appearance, neutropenia, chemotherapy period, and type of malignancy with regard to cryptosporidiosis. Phylogenetic analysis revealed that Cryptosporidium parvum isolates in this study relied on a branch that represents similar sequences from Iran and other countries. Although the rate of Cryptosporidium infection was relatively higher in children with cancer undergoing chemotherapy compared to the control group, any statistically significant difference has not been found between them. These findings should not be contrary to the need for healthcare to prevent opportunistic parasitic infections in malignant and immunocompromised patients.

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Acknowledgments

This study was financially supported by Pediatric Health Research Center, Tabriz University of Medical Sciences, Iran. This is a report of a database from the thesis of Reza Berahmat registered in Tabriz University of Medical Sciences (Thesis number: 93/2–4/19).

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Authors and Affiliations

  1. Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Reza Berahmat, Mahmoud Mahami-Oskouei & Azim Rezamand

  2. Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Reza Berahmat, Mahmoud Mahami-Oskouei, Adel Spotin, Roghayeh Ghoyounchi & Solmaz Madadi

  3. Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Azim Rezamand

  4. Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran

    Nayyereh Aminisani

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  1. Reza Berahmat
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Correspondence to Mahmoud Mahami-Oskouei.

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This study was approved by the research ethics committee of Tabriz University of Medical Sciences (Tabriz, Iran).

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Berahmat, R., Mahami-Oskouei, M., Rezamand, A. et al. Cryptosporidium infection in children with cancer undergoing chemotherapy: how important is the prevention of opportunistic parasitic infections in patients with malignancies?. Parasitol Res 116, 2507–2515 (2017). https://doi.org/10.1007/s00436-017-5560-5

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