Correlation Between Diarrhea Severity and Oocyst Count via Quantitative PCR or Fluorescence Microscopy in Experimental Cryptosporidiosis in Calves

Darwin J. Operario Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia; Department of Population Medicine and Diagnostic Science, College of Veterinary Medicine, Cornell University, Ithaca, New York

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Lauren S. Bristol Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia; Department of Population Medicine and Diagnostic Science, College of Veterinary Medicine, Cornell University, Ithaca, New York

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Janice Liotta Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia; Department of Population Medicine and Diagnostic Science, College of Veterinary Medicine, Cornell University, Ithaca, New York

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Daryl V. Nydam Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia; Department of Population Medicine and Diagnostic Science, College of Veterinary Medicine, Cornell University, Ithaca, New York

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Eric R. Houpt Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia; Department of Population Medicine and Diagnostic Science, College of Veterinary Medicine, Cornell University, Ithaca, New York

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Cryptosporidium is an important diarrhea-associated pathogen, however the correlation between parasite burden and diarrhea severity remains unclear. We studied this relationship in 10 experimentally infected calves using immunofluorescence microscopy and real-time polymerase chain reaction (qPCR) (N = 124 fecal samples). The qPCR data were corrected for extraction/amplification efficiency and gene copy number to generate parasite counts. The qPCR and microscopic oocyst quantities exhibited significant correlation (R2 = 0.33, P < 0.05), however qPCR had increased sensitivity. Upon comparison with diarrhea severity scores (from 0 to 3), a PCR-based count of ≥ 2.6 × 105 parasites or an immunofluorescence microscopy count of ≥ 4.5 × 104 oocysts were discriminatory predictors of moderate-to-severe diarrhea (versus no-to-mild diarrhea), with accuracies and predictive values of 72–82%. In summary, a quantitative approach for Cryptosporidium can refine predictive power for diarrhea and appears useful for distinguishing clinical cryptosporidiosis versus subclinical infection.

Author Notes

* Address correspondence to Darwin J. Operario, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, P.O. Box 801340, 345 Crispell Drive, Charlottesville, VA 22908. E-mail: do2s@eservices.virginia.edu

Authors' addresses: Darwin J. Operario and Eric R. Houpt, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, E-mails: do2s@virginia.edu and erh6k@virginia.edu. Lauren S. Bristol, Janice Liotta, and Daryl V. Nydam, Department of Population Medicine and Diagnostic Science, College of Veterinary Medicine, Cornell University, Ithaca, NY, E-mails: lls92@cornell.edu, jll55@cornell.edu, and dvn2@cornell.edu.

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