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Cyclospora cayetanensis: Portrait of an Intriguing and Enigmatic Protistan Parasite
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Annunziata Giangaspero, Robin B. Gasser
Although concerns about water contamination by Cyclospora mainly regard drinking water, it must be said that any type of contaminated water can allow the diffusion and maintenance of cyclosporiasis in an area. Peru appears to have the highest prevalence of Cyclospora in wastewater (up to 64%) [101], but while this may be expected in an endemic country, the surprising oocysts-positivity of wastewater in the USA [102] and of treated water in Europe (Italy) [57] is related to the kind of water treatment plants and possible treatment failure.
Protozoa
Published in Loretta A. Cormier, Pauline E. Jolly, The Primate Zoonoses, 2017
Loretta A. Cormier, Pauline E. Jolly
Cyclospora cayetanensis is an intestinal parasite that is spread by ingesting food or water that has been contaminated with feces (CDC 2013). It has a worldwide distribution but is most common in developing areas (Suh et al. 2015). C. cayetanensis is a common cause of traveler’s diarrhea, but it has become a concern as an emerging disease due to several large-scale food-borne outbreaks in the late 1990s in the United States and Canada (Shields and Olson 2003). C. cayetanensis infection is sometimes asymptomatic, but common symptoms are watery diarrhea, vomiting, headache, fever, and other flu-like-symptoms (CDC 2013). It is also of concern because it has been associated with more serious sequelae including Guillain-Barré syndrome, reactive arthritis syndrome, and cholecystitis (Shields and Olson 2003).
Antiparasitic Drugs
Published in Thomas T. Yoshikawa, Shobita Rajagopalan, Antibiotic Therapy for Geriatric Patients, 2005
Cyclospora, a recently recognized coccidian protozoan parasite, has been reported to cause diarrheal illness, often prolonged, in the United States and other countries (26). TMP-SMX is effective in treating diarrheal disease caused by cyclospora (27). In immunocompetent patients, treatment with a combination of 160 mg of trimethoprim and 800 mg of sulfamethoxazole (i.e., a double-strength tablet) twice daily for 7 days ended diarrheal illness and led to clearance of the parasites (28). In patients infected with the human immunodeficiency virus, treatment with one double-strength tablet of TMP-SMX four times a day for 10 days leads to a rapid resolution of diarrhea (29). Symptomatic cyclosporiasis may recur in the following weeks, but it can be prevented by the administration of TMP-SMX three times weekly.
Acute bacterial skin and skin structure infections in pediatric patients: potential role of dalbavancin
Published in Expert Review of Anti-infective Therapy, 2023
Lorenzo Volpicelli, Mario Venditti, Alessandra Oliva
Cotrimoxazole is a 1:5 combination of two agents blocking sequential steps of bacterial nucleic acid biosynthesis: trimethoprim, a pyrimidine analog, and the sulfonamide sulfamethoxazole. Administration may be either orally or intravenously, and the spectrum is wide, including specific pathogens like Nocardia, Pneumocystis, and Cyclospora and common syndromes like urinary tract infections and gastroenteritis. In a systematic review of studies concerning cotrimoxazole prescription for SSTIs, children represented most of the overall population and, although meta-analysis was not performable due to heterogeneity, the results supported the efficacy of this drug both for streptococcal and staphylococcal etiologies [26]. However, from 2005 to 2017, an increasing rate of resistance to cotrimoxazole was described in MRSA isolates, from 2% to 13% [23].
Treatment of cryptosporidiosis: nitazoxanide yes, but we can do better
Published in Expert Review of Anti-infective Therapy, 2023
Maria A. Caravedo, A. Clinton White
The recommended treatments for all other apicomplexan parasites (including malaria, toxoplasmosis, Cyclospora, and Cystoisospora) involve combinations of antiparasitic drugs. In vitro studies have demonstrated synergistic effects of combination therapy for Cryptosporidium [48] There is only limited data on combination antiparasitic drugs in human cryptosporidiosis. Smith et al. prospectively studied the combination of Paromomycin and Azithromycin for cryptosporidiosis in AIDS patients with CD4 counts <100, finding a clinical improvement and a significant reduction in oocyte excretion at 12 weeks [49]. Observational studies suggest that the combination of nitazoxanide and azithromycin might be more effective than either drug alone in transplant recipients. Double, or triple coverage with a combination of the above medications in transplanted and AIDS have been suggested as alternative treatments in refractory cases [2,3] Most recently, Tomczak et al. reported a case of a renal transplant patient with chronic diarrhea that resolved with reduced immunosuppression and 3-drug combination therapy with nitazoxanide, azithromycin, and rifaximin [2] However, there is still no controlled trial data on combination therapy in cryptosporidiosis.
Structure-activity relationships of Toxoplasma gondii cytochrome bc 1 inhibitors
Published in Expert Opinion on Drug Discovery, 2022
P. Holland Alday, Aaron Nilsen, J. Stone Doggett
Cytochrome (cyt) bc1 has proven to be a tractable drug target for the majority of veterinary and human apicomplexan pathogens. In addition to T. gondii, cyt bc1 inhibitors have been found to be effective across orders of the phylum Apicomplexa: Haemosporida, Plasmodia spp.; the Piroplasmida, Babesia spp., and Theileria equii; and the Eucoccidiorida, Sarcocystis neurona, Eimeria spp., Neospora caninum, and Besnoitia besnoiti [5–10]. Cryptosporidium, the human gastrointestinal parasite, is a notable exception. It lacks a mitochondrion with genes for enzymes of oxidative phosphorylation, including cyt b and instead contains mitochondrion-related organelles [11]. On the other hand, the human gastrointestinal parasites Cyclospora cayetanensis and Cystoisospora belli encode cyt b in their mitochondrial genomes, although cyt bc1 inhibitors have not been thoroughly evaluated for these diseases.