# First Detection of Cryptosporidium Canis and Occurrence of Cryptosporidium spp. in Hospitalized Patients in Romania

## TL;DR

This study reports the first detection of Cryptosporidium canis in humans in Romania and finds higher infection rates in urban areas.

## Contribution

First report of Cryptosporidium canis in humans in Romania and highlights urban residence as a significant risk factor.

## Key findings

- Cryptosporidium infection was detected in 7.42% of hospitalized patients.
- Cryptosporidium canis was identified for the first time in humans in Romania.
- Urban residence was a significant risk factor for cryptosporidiosis.

## Abstract

The study aimed to identify Cryptosporidium infection in hospitalized patients in Western Romania. Stool samples were collected from 175 patients, both male and female, aged between 2 months and 88 years, residing in urban and rural areas. The identification of Cryptosporidium was performed using a qualitative chromatographic rapid test, supplemented by the modified Ziehl–Neelsen method described by Henricksen and Pohlenz. Cryptosporidium spp. were identified through PCR analysis and Sanger sequencing. To assess potential risk factors for cryptosporidiosis, a questionnaire was administered to the study participants. Laboratory test results revealed a cryptosporidiosis occurrence of 7.42%, with a significantly higher occurrence observed in urban areas (p < 0.05). Two species were identified, C. parvum and C. canis, the latter being reported for the first time in humans in Romania. Among the assessed risk factors, only the area of residence significantly influenced the occurrence of Cryptosporidium infection. The other evaluated risk factors—age, sex, concomitant microbial infections, contact with animals, use of public transport, international travel, frequenting children’s playgrounds, and swimming pools—although potentially involved in Cryptosporidium infection, did not have a significant contribution. This study represents the first report of C. canis identified in humans in Romania. Our results indicate a high occurrence of human cryptosporidiosis in hospitalized patients, with a significantly higher rate observed in individuals residing in urban areas.