Cyclospora cayetanensis and Cyclosporiasis

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Food Microbiology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 21542

Special Issue Editors

Department of Health and Human Services, Food and Drug Administration, Center for Food Safety and Nutrition (CFSAN), Office of Applied Research and Safety Assessment (OARSA), Division of Virulence Assessment, Laurel, MD 20708, USA
Interests: parasites; foodborne; waterborne; protozoa; Cyclospora; Toxoplasma
Special Issues, Collections and Topics in MDPI journals
Environmental Microbial and Food Safety Laboratory, USDA ARS, BARC, Beltsville, MD, USA
Interests: zoonotic protozoan parasites; food safety
Special Issues, Collections and Topics in MDPI journals
Department of Health and Human Services, Food and Drug Administration, Center for Food Safety and Nutrition (CFSAN), Office of Applied Research and Safety Assessment (OARSA), Division of Virulence Assessment, Laurel, MD 20708, USA
Interests: Cyclospora cayetanensis; Caenorhabditis elegans
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cyclospora cayetanensis is an emerging and important cause of foodborne outbreaks of enteric disease in many developed countries, which are mostly associated with the consumption of contaminated fresh produce. Infection by C. cayetanensis is remarkably seasonal worldwide, although it varies by geographical regions. The most susceptible populations are children, foreigners, and immunocompromised patients in endemic countries, while in industrialized countries, C. cayetanensis affects people of any age. There are no animal models, and/or in vivo and in vitro culture systems to facilitate C. cayetanensis research, and many of the epidemiological aspects of this parasitic disease remain unknown. In addition, there is an urgent need for an effective genotyping method for source tracking in outbreak investigations. The aim of this Special Issue is to provide a comprehensive, up-to-date overview of the current knowledge on C. cayetanensis and cyclosporiasis, including general biology, molecular biology, diagnosis, epidemiology, outbreaks, clinical disease, treatment, control, and prevention. We welcome research articles, reviews, and short communications related to these topics.

Dr. Sonia Almeria
Dr. Monica Santin
Dr. Hediye Nese Cinar
Guest Editors

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Keywords

  • Cyclospora cayetanensis
  • life cycle
  • biology
  • epidemiology
  • endemic areas
  • outbreaks
  • clinical symptoms
  • diagnosis
  • control

Published Papers (9 papers)

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Editorial

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3 pages, 157 KiB  
Editorial
Editorial for the Special Issue Cyclospora cayetanensis and Cyclosporiasis
Microorganisms 2024, 12(2), 281; https://doi.org/10.3390/microorganisms12020281 - 29 Jan 2024
Viewed by 431
Abstract
Cyclosporiasis is a foodborne diarrheal illness caused by the parasite Cyclospora cayetanensis [...] Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)

Research

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12 pages, 4909 KiB  
Article
Development of a Molecular Marker Based on the Mitochondrial Genome for Detection of Cyclospora cayetanensis in Food and Water Samples
Microorganisms 2022, 10(9), 1762; https://doi.org/10.3390/microorganisms10091762 - 31 Aug 2022
Cited by 7 | Viewed by 1635
Abstract
Cyclospora cayetanensis is a coccidian parasite that causes diarrheal illness outbreaks worldwide. The development of new laboratory methods for detection of C. cayetanensis is of critical importance because of the high potential for environmental samples to be contaminated with a myriad of microorganisms, [...] Read more.
Cyclospora cayetanensis is a coccidian parasite that causes diarrheal illness outbreaks worldwide. The development of new laboratory methods for detection of C. cayetanensis is of critical importance because of the high potential for environmental samples to be contaminated with a myriad of microorganisms, adversely impacting the specificity when testing samples from various sources using a single molecular assay. In this study, a new sequencing-based method was designed targeting a specific fragment of C. cayetanensis cytochrome oxidase gene and developed as a complementary method to the TaqMan qPCR present in the U.S. FDA BAM Chapter 19b and Chapter 19c. The comparative results between the new PCR protocol and the qPCR for detection of C. cayetanensis in food and water samples provided similar results in both matrices with the same seeding level. The target region and primers in the protocol discussed in this study contain sufficient Cyclospora-specific sequence fidelity as observed by sequence comparison with other Eimeriidae species. The sequence of the PCR product appears to represent a robust target for identifying C. cayetanensis on samples from different sources. Such a sensitive method for detection of C. cayetanensis would add to the target repertoire of qPCR-based screening strategies for food and water samples. Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)
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10 pages, 694 KiB  
Article
The Clinical Features and Immunological Signature of Cyclospora cayetanensis Co-Infection among People Living with HIV in Ghana
Microorganisms 2022, 10(7), 1407; https://doi.org/10.3390/microorganisms10071407 - 13 Jul 2022
Cited by 1 | Viewed by 1274
Abstract
Background: There is a paucity of information on the contemporary burden, disease patterns, and immunological profile of people living with HIV who are co-infected with C. cayetanensis in the post-antiretroviral therapy era. Methods: For this cross-sectional study, stool samples of 640 HIV-positive and [...] Read more.
Background: There is a paucity of information on the contemporary burden, disease patterns, and immunological profile of people living with HIV who are co-infected with C. cayetanensis in the post-antiretroviral therapy era. Methods: For this cross-sectional study, stool samples of 640 HIV-positive and 83 HIV-negative individuals in Ghana were tested for C. cayetanensis. Additionally, sociodemographic parameters, clinical symptoms, medical drug intake, and immunological parameters were assessed. Results: The prevalence of C. cayetanensis was 8.75% (n = 56) in HIV-positive and 1.20% (n = 1) in HIV-negative participants (p = 0.015). Within the group of HIV-positive participants, the prevalence reached 13.6% in patients with CD4+ T cell counts below 200 cells/µl. Frequencies of the clinical manifestations of weight loss and diarrheal disease were significantly higher in patients with C. cayetanensis compared to those without co-infection (36.36% vs. 22.59%, p = 0.034 and 20.00% vs. 4.90%, p < 0.001, respectively). The expression of markers of immune activation and exhaustion of T lymphocyte sub-populations was significantly elevated in patients colonized with C. cayetanensis. Conclusions: In the modern post-combined antiretroviral therapy (cART) era, the acquisition of C. cayetanensis among PLWH in Ghana is driven largely by the immunosuppression profile characterized by high expression of markers of immune activation and immune exhaustion. Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)
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13 pages, 260 KiB  
Article
Verification and Use of the US-FDA BAM 19b Method for Detection of Cyclospora cayetanensis in a Survey of Fresh Produce by CFIA Laboratory
Microorganisms 2022, 10(3), 559; https://doi.org/10.3390/microorganisms10030559 - 04 Mar 2022
Cited by 5 | Viewed by 1747
Abstract
To facilitate the harmonized surveillance and investigation of cyclosporiasis outbreaks in the US and Canada, we adapted and verified the US-FDA’s BAM 19b method and employed it in a national produce survey. Performance was verified by spiking 200, 10, 5 or 0 C. [...] Read more.
To facilitate the harmonized surveillance and investigation of cyclosporiasis outbreaks in the US and Canada, we adapted and verified the US-FDA’s BAM 19b method and employed it in a national produce survey. Performance was verified by spiking 200, 10, 5 or 0 C. cayetanensis oocysts onto berries (50 ± 5 g, n = 85) and 200, 10 or 0 oocysts onto green onions (25 ± 3 g, n = 24) and leafy greens (25 ± 1 g, n = 120) and testing these samples by the BAM method on Bio-Rad CFX96. Method robustness was assessed by aging (0 or 7 days) and freezing the produce and washes prior to testing, then implementing the method for the surveillance testing of 1759 imported leafy green, herb and berry samples. Diagnostic sensitivity was 100/44% and 93/30% for berries and leafy greens spiked with 200/10 oocysts, respectively. The diagnostic and analytical specificity were 100% for all matrices and related parasites tested. The proportion positive was unaffected (p = 0.22) by age or condition of produce (7d, fresh, frozen) or wash concentrate (3d, fresh, frozen); however, the Cq values were higher (p = 0.009) for raspberries aged 7d (37.46 ± 0.29) compared to fresh (35.36 ± 0.29). C. cayetanensis was detected in berries (two), herbs (two) and leafy greens (one), representing 0.28% of the tested survey samples. These results independently verified the reported performance characteristics and robustness of the BAM method for the detection of C. cayetanensis in a variety of matrices, including under adverse sample conditions, using a unique detection platform and demonstrating its routine diagnostic use in our Canadian Food Inspection Agency (CFIA) laboratory. Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)
7 pages, 271 KiB  
Communication
Seasonal Differences in Cyclospora cayetanensis Prevalence in Colombian Indigenous People
Microorganisms 2021, 9(3), 627; https://doi.org/10.3390/microorganisms9030627 - 18 Mar 2021
Cited by 12 | Viewed by 1792
Abstract
Fecal-orally transmitted cyclosporiasis is frequent in remote resource-limited settings in Central and South America with poor hygiene conditions. In this study, we aimed at assessing seasonal effects on the epidemiology of colonization or infection with C. cayetanensis in Colombian indigenous people living under [...] Read more.
Fecal-orally transmitted cyclosporiasis is frequent in remote resource-limited settings in Central and South America with poor hygiene conditions. In this study, we aimed at assessing seasonal effects on the epidemiology of colonization or infection with C. cayetanensis in Colombian indigenous people living under very restricted conditions. In the rainy season between July and November and in the dry season between January and April, stool samples from indigenous people with and without gastrointestinal symptoms were collected and screened for C. cayetanensis applying in-house real-time polymerase chain reaction (PCR). In the rainy season and in the dry season, positive PCR results were observed for 11.8% (16/136) and 5.1% (15/292), respectively, with cycle threshold (Ct) values of 30.6 (±3.4) and 34.4 (±1.6), respectively. Despite higher parasite loads in the rainy season, fewer individuals (2/16, 12.5%) reported gastrointestinal symptoms compared to the dry season (6/15, 40%). In conclusion, considerable prevalence of C. cayetanensis in Colombian indigenous people persists in the dry season. Low proportions of gastrointestinal symptoms along with higher parasite loads make colonization likely rather than infection. Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)

Review

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12 pages, 2152 KiB  
Review
Life Cycle and Transmission of Cyclospora cayetanensis: Knowns and Unknowns
Microorganisms 2022, 10(1), 118; https://doi.org/10.3390/microorganisms10010118 - 06 Jan 2022
Cited by 6 | Viewed by 3909
Abstract
Although infections with Cyclospora cayetanensis are prevalent worldwide, many aspects of this parasite’s life cycle and transmission remain unknown. Humans are the only known hosts of this parasite. Existing information on its endogenous development has been derived from histological examination of only a [...] Read more.
Although infections with Cyclospora cayetanensis are prevalent worldwide, many aspects of this parasite’s life cycle and transmission remain unknown. Humans are the only known hosts of this parasite. Existing information on its endogenous development has been derived from histological examination of only a few biopsy specimens. Its asexual and sexual stages occur in biliary-intestinal epithelium. In histological sections, its stages are less than 10 μm, making definitive identification difficult. Asexual (schizonts) and sexual (gamonts) are located in epithelial cells. Male microgamonts have two flagella; female macrogametes contain wall-forming bodies. Oocysts are excreted in feces unsporulated. Sporulation occurs in the environment, but there are many unanswered questions concerning dissemination and survival of C. cayetanensis oocysts. Biologically and phylogenetically, C. cayetanensis closely resembles Eimeria spp. that parastize chickens; among them, E. acervulina most closely resembles C. cayetanensis in size. Here, we review known and unknown aspects of its life cycle and transmission and discuss the appropriateness of surrogates best capable of hastening progress in understanding its biology and developing mitigating strategies. Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)
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13 pages, 27352 KiB  
Review
Cyclosporiasis—Updates on Clinical Presentation, Pathology, Clinical Diagnosis, and Treatment
Microorganisms 2021, 9(9), 1863; https://doi.org/10.3390/microorganisms9091863 - 02 Sep 2021
Cited by 17 | Viewed by 6185
Abstract
Cyclospora cayetanensis is an intestinal coccidian parasite transmitted to humans through the consumption of oocysts in fecally contaminated food and water. Infection is found worldwide and is highly endemic in tropical and subtropical regions with poor sanitation. Disease in developed countries is usually [...] Read more.
Cyclospora cayetanensis is an intestinal coccidian parasite transmitted to humans through the consumption of oocysts in fecally contaminated food and water. Infection is found worldwide and is highly endemic in tropical and subtropical regions with poor sanitation. Disease in developed countries is usually observed in travelers and in seasonal outbreaks associated with imported produce from endemic areas. Recently, summertime outbreaks in the United States have also been linked to locally grown produce. Cyclosporiasis causes a diarrheal illness which may be severe in infants, the elderly, and immunocompromised individuals. The increased adoption of highly sensitive molecular diagnostic tests, including commercially available multiplex panels for gastrointestinal pathogens, has facilitated the detection of infection and likely contributed to the increased reports of cases in developed countries. This manuscript reviews important aspects of the biology, epidemiology, and clinical manifestations of C. cayetanensis and provides an in-depth discussion of current laboratory diagnostic methods. Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)
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Other

25 pages, 431 KiB  
Perspective
Cyclospora cayetanensis: A Perspective (2020–2023) with Emphasis on Epidemiology and Detection Methods
Microorganisms 2023, 11(9), 2171; https://doi.org/10.3390/microorganisms11092171 - 28 Aug 2023
Cited by 1 | Viewed by 1431
Abstract
Cyclospora cayetanensis infections are prevalent worldwide, and the parasite has become a major public health and food safety concern. Although important efforts have been dedicated to advance toward preventing and reducing incidences of cyclosporiasis, there are still several knowledge gaps that hamper the [...] Read more.
Cyclospora cayetanensis infections are prevalent worldwide, and the parasite has become a major public health and food safety concern. Although important efforts have been dedicated to advance toward preventing and reducing incidences of cyclosporiasis, there are still several knowledge gaps that hamper the implementation of effective measures to prevent the contamination of produce and water with Cyclospora oocysts. Some of these data gaps can be attributed to the fact that access to oocysts is a limiting factor in C. cayetanensis research. There are no animal models or in vivo or in vitro culture systems to propagate the oocysts needed to facilitate C. cayetanensis research. Thus, researchers must rely upon limited supplies of oocysts obtained from naturally infected human patients considerably restricting what can be learnt about this parasite. Despite the limited supply of C. cayetanensis oocysts, several important advances have happened in the past 3 years. Great progress has been made in the Cyclospora field in the areas of molecular characterization of strains and species, generation of genomes, and development of novel detection methods. This comprehensive perspective summarizes research published from 2020 to 2023 and evaluates what we have learnt and identifies those aspects in which further research is needed. Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)
15 pages, 1012 KiB  
Perspective
Hastening Progress in Cyclospora Requires Studying Eimeria Surrogates
Microorganisms 2022, 10(10), 1977; https://doi.org/10.3390/microorganisms10101977 - 06 Oct 2022
Cited by 3 | Viewed by 1690
Abstract
Cyclospora cayetanensis is an enigmatic human parasite that sickens thousands of people worldwide. The scarcity of research material and lack of any animal model or cell culture system slows research, denying the produce industry, epidemiologists, and regulatory agencies of tools that might aid [...] Read more.
Cyclospora cayetanensis is an enigmatic human parasite that sickens thousands of people worldwide. The scarcity of research material and lack of any animal model or cell culture system slows research, denying the produce industry, epidemiologists, and regulatory agencies of tools that might aid diagnosis, risk assessment, and risk abatement. Fortunately, related species offer a strong foundation when used as surrogates to study parasites of this type. Species of Eimeria lend themselves especially well as surrogates for C. cayetanensis. Those Eimeria that infect poultry can be produced in abundance, share many biological features with Cyclospora, pose no risk to the health of researchers, and can be studied in their natural hosts. Here, we overview the actual and potential uses of such surrogates to advance understanding of C. cayetanensis biology, diagnostics, control, and genomics, focusing on opportunities to improve prevention, surveillance, risk assessment, and risk reduction. Studying Eimeria surrogates accelerates progress, closing important research gaps and refining promising tools for producers and food safety regulators to monitor and ameliorate the food safety risks imposed by this emerging, enigmatic parasite. Full article
(This article belongs to the Special Issue Cyclospora cayetanensis and Cyclosporiasis)
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