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To the Editor —In their study of Cryptosporidium infection in children in Lima, Peru, Xiao et al. [1] report that 5 types of Cryptosporidium were identified in stool specimens and that none of the children screened were found to have antibodies against human immunodeficiency virus (HIV) type 1. Recent advances in the molecular identification of Cryptosporidium species have permitted not only the differentiation of species otherwise indistinguishable by microscopy from C. parvum but also differentiation of subtypes within the genus. It has been reported that species and subtypes other than C. parvum infect HIV-immunocompromised patients [2, 3], but there is increasing evidence that these infections are not restricted to HIV-immunocompromised hosts

From January 2000 through July 2001, we collected, confirmed, and genotyped 3100 clinical isolates of Cryptosporidium identified in patients by microscopy at local laboratories throughout England and Wales, using polymerase chain reaction (PCR) to amplify sequences of the 70-kDa heat shock protein (HSP70) [4] and PCR/restriction fragment–length polymorphism analysis to amplify and digest sequences of the Cryptosporidium oocyst wall protein (COWP) [5] and small-subunit rRNA [6] genes. A minimum data set was collected for each isolate, including clinical information about the patient from whom the isolate was obtained. Although the majority of isolates were C. parvum genotype 1 or genotype 2, we identified and confirmed by sequence analysis 21 C. meleagridis isolates from 19 patients and 2 isolates from 2 other patients that do not match currently recognized species or genotypes. None of these 23 patients were reported to have HIV or to be immunocompromised, although Campylobacter species were identified in the same stool specimens that yielded 3 of the C. meleagridis isolates. However, Campylobacter is the gastrointestinal pathogen most commonly identified in the United Kingdom, and coinfection with Cryptosporidium species has been reported in outbreak and sporadic cases, which may reflect common elements in the epidemiology and transmission of these 2 organisms [7, 8]. Isolation of C. meleagridis, C. felis and the Cryptosporidium species called the “dog type” from immunocompetent individuals has recently been reported [9, 10]. Work is also in progress to identify and characterize the 2 unusual isolates identified in our laboratory, and the epidemiology of these unusual infections is currently being explored

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