Co-infection of Microsporidia with Mycobacterium tuberculosis in pulmonary patients

Abstract [Background] Co-infection of multiple pathogens into one host is a great threat to public health, for it exacerbates symptoms and leads to worse outcomes compared to single pathogen infection. Both Mycobacterium tuberculosis (Mtb) and microsporidia are wide spread pathogens world-widely. However, the co-infection of Mycobacterium tuberculosis with microsporidia has long been underestimated. [Methods] Current study recruited Mtb-positive pulmonary patients and Mtb-negative patients yet immune-suppressed due to various causes. Stool samples were collected from these two groups of individuals and the total DNAs were isolated. Quantitative PCR (qPCR) assay was used to detect the presence of microsporidia in these samples. [Results] The results showed that infection rates of microsporidia are 39.6% (23/58) in Mtb-positive group and 50% (4/8) in Mtb-negative yet immune-suppressed group. Sequencing of the positive further revealed that the infected microsporidia species include all four common human-infecting microsporidia which are Enterocytozoon bieneusi , Encephalitozoon intestinalis , Encephalitozoon cuniculi and Encephalitozoon hellem . [Conclusion] Our report is the first to investigate and compare the influences of Mtb-infection and host immune state in microsporidia infection. Our findings demonstrated that microsporidia have high co-infection incidence with Mtb, and the host immune state has profound influence on infection of microsporidia. [Trial Registration] N/A.