Molecular identification of Enterocytozoon bieneusi and Encephalitozoon spp. in immunodeficient patients in Ahvaz, Southwest of Iran

Microsporidia are often considered as an opportunistic infection in patients with impaired immune systems such
as transplant recipients and patients with acquired immune deficiency syndrome (AIDS). Due to the increasing
prevalence of parasitic infections and immunodeficiency diseases; the aim of the study is to evaluate molecular
identification of Enterocytozoon bieneusi and Encephalitozoon spp. in immunodeficient patients in Ahvaz,
southwest of Iran. At first, 310 stool samples were collected from patients with immunodeficiency. The
specimens were stained by modified trichrome (weber) and were examined microscopically. The extracted DNA
samples were evaluated by multiplex/nested PCR method. The products of multiplex/nested PCR were explored
by RFLP method using the restriction enzyme of Mnl1. Of 310, 93 samples were suspected positive for
microsporidia by the staining. Also, of 310, 88 samples were positive by the multiplex/nested-PCR test that 62
samples were positive for E. bieneusi as well as 26 were detected as Encephalitozoon species that including 3 E.
cuniculi, 19 E. intestinalis and 4 E. hellem. Of 62 E. bieneusi, 45, 16 and 1 were detected as genotype D, M and
WL11, respectively. Also, Of 3 E. cuniculi, 1 and 2 cases were identified as genotype I and II, respectively. All E.
hellem samples were included genotype 1A. Our findings revealed a relatively high prevalence of microsporidia
species in immunodeficient patients. The highest risk of this infection is at individuals with impaired immune
systems that it can be life-threatening in people with immune system dysfunction. It is essential that the high-risk
people should be receiving the information about the risk of direct contact with infected individuals and animals