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Applied and Environmental Microbiology, August 2003, p. 4662-4669, Vol. 69, No. 8
0099-2240/03/$08.00+0 DOI: 10.1128/AEM.69.8.4662-4669.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Department of Environmental Analysis and Design, School of Social Ecology, University of California, Irvine, California 92697-7070
Received 20 December 2002/ Accepted 27 May 2003
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Microscopic detection methods take advantage of the oocyst's autofluorescence under UV light (31). Under a 365-nm dichromatic filter, C. cayetanensis oocysts autofluoresce dark blue, and under a 450- to 490-nm dichromatic filter, they autofluoresce mint green (31). While a trained microscopist can easily examine a few low-volume samples, examination of a large numbers of stool, food, and environmental samples is difficult and tedious.
Thus, molecular-analysis-based methods have been explored because of the potential for automation and high throughput. Ribosomal DNA is the most abundant constituent of nucleic acids within eukaryotes (45), and the 18S small-subunit ribosomal DNA (18S ssrDNA) contains highly conserved regions punctuated by sequences of hypervariability, making it an attractive region on which to focus. The first PCR method for clinical diagnosis, developed by Relman et al. (33), targeted this region. The outer primers, CYCF1E and CYCR2B, are Eukarya specific; the inner primers, CYCF3E and CYCR4B, were designed to specifically target C. cayetanensis. When it was noted that the inner primers would also amplify some Eimeria species, a restriction fragment length polymorphism (RFLP) method that uses the restriction enzyme MnlI was developed by Jinneman et al. (20) to distinguish C. cayetanensis from Eimeria spp. This nested-PCR-RFLP protocol is commonly used to detect this organism in stool (10, 30), foodstuffs (21, 26), and environmental waters (39; J. M. Shields and B. H. Olson, Abstr. Gen. Meet. Am. Soc. Microbiol., abstr. Q-92, 1999).
An important issue likely to be troublesome for environmental microbiologists is the presence of genetically similar microorganisms in environmental waters (Shields and Olson, Proc. Am. Water Works Assoc. 2000 Water Qual. Technol. Conf.) and soils. Of the 17 known Cyclospora species, sequence data are available for only 4: C. cayetanensis, C. cercopitheci, C. colobi, and C. papionis (11). These four species show a high degree of homology in the inner (CYCF3E and CYCR4B) PCR product (37). While there are differences in the sequences of this region, none of these occur within MnlI sites; therefore, these four Cyclospora species appear identical by PCR-RFLP analysis.
During a monitoring study of the Santa Ana River (SAR) in California, we detected a number of samples that were PCR (33)-RFLP (20) positive for C. cayetanensis but were unable to confirm these microscopically because of heavy debris and large concentrated volumes (5 to 8 ml of packed pellet for highly turbid waters). When other Cyclospora species sequences became available (11), we reexamined the 18S ssrDNA regions of the four available Cyclospora species sequences. We identified a hypervariable region and designed a nested-primer PCR-RFLP protocol that does not need microscopic confirmation. This protocol will be useful to microbiologists working with environmental samples and foodstuffs that come into contact with water and soil. Here, we describe the protocol and the results we obtained.
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Flocculation.
The flocculation method used to concentrate the samples was that of Vesey et al. (43). Resultant pellets from environmental water samples were divided into three aliquots. One was stored in digestion buffer (6) and kept at -80°C for long-term storage. The other two were kept at 4°C, one in digestion buffer for genomic DNA extraction and the other in 2.5% potassium dichromate for microscopic analysis.
Genomic DNA extraction methods. (i) Digestion and extraction of genomic DNA from environmental samples.
The protocol described by daSilva et al. (6) for the detection of microsporidial species in stools was modified. The amounts of digestion buffer and silanized glass beads were adjusted on the basis of the size and nature of the pellet as follows. A 2:1 ratio of digestion buffer to packed pellet was generally used, although more buffer was added if the pellet was difficult to resuspend. An equal weight-to-volume ratio (milligrams per milliliter) of glass beads was used. In the case of packed pellets with a volume of less than 100 µl, a minimum of 300 µl of digestion buffer and 50 mg of glass beads was used.
After pellet digestion and overnight incubation, the samples were centrifuged at 14,000 x g for 1 min to remove debris. Phenol-chloroform was used to remove proteins. The resultant aqueous layer was precipitated with ethanol-NH4 acetate and washed with cold 70% ethanol. Samples were resuspended in 100 µl of sterile double-distilled water (ddH2O). Chelex 100 was added at a concentration of 5%, and the samples were boiled for 2 to 3 min. After centrifugation, the supernatants were transferred to sterile microcentrifuge tubes.
The samples were further purified by passage through a Pharmacia ion-exchange spin column (Amersham Pharmacia Biotech and Science, Piscataway, N.J.) in accordance with the manufacturer's instructions. The samples were resuspended in 100 µl of sterile ddH2O and kept either at -20°C until PCR analysis or at -80°C for long-term storage.
(ii) Seeding of samples for minimum detection limit with primers CYCAO1, CYCAI2, and CYCAR1.
Pellets from flocculated water were divided into 300-mg fractions, 200 µl of phosphate-buffered saline was added to each, and the samples were autoclaved for 20 min to destroy the DNA of organisms present in the samples. The samples were stored in tightly sealed microcentrifuge tubes at 4°C until seeding and DNA extraction. Approximately 1,500 sporulated C. cayetanensis oocysts from Guatemala and Nepal (courtesy of Michael Arrowood of the Parasitic Diseases Division, Centers for Disease Control and Prevention, and Alan Lindquist of the Division of Parasitology, Environmental Protection Agency, respectively) were seeded into each autoclaved environmental sample. Unseeded autoclaved samples were also used to ensure that autoclaving had destroyed the genomic DNA.
(iii) Digestion and extraction of genomic DNA for minimum detection analysis of primers CYCAO1, CYCAI2, and CYCAR1.
The FastDNA kit for soils (Bio 101, Inc., Vista, Calif.) was used to extract and purify genomic DNA from the seeded sediment, as well as from autoclaved unseeded control samples. The manufacturer's instructions were followed, with certain modifications. After agitation in a bead beater, the crude DNA lysate was briefly centrifuged (
6,000 x g for 30 s), the supernatant was removed, and more buffer and detergent were added to the pellet. This was repeated for a total of four cycles; the final centrifugation was at 14,000 x g for 5 min. The crude lysates were pooled, and crude DNA was precipitated overnight in 5 M ammonium acetate (0.1 volume) and ethanol (2.2 volumes) at -20°C. The crude DNA samples were then centrifuged (20 min at 14,000 x g), and the resultant pellet was washed with 70% cold ethanol, air dried, and then resuspended in 500 µl of phosphate buffer for further purification.
PCR methods. (i) PCR with primers CYCF1E, CYCR2B, CYCF3E, and CYCR4B.
The PCR primers and cycling protocol used were those described by Relman et al. (33), with the addition of HotStart (Perkin-Elmer, Boston, Mass.) and the inclusion of 100 µg of nonfat dry milk to prevent PCR inhibition during amplification of the outer fragment.
(ii) Design of new primers CYCAO1, CYCAI2, and CYCAR1.
Nested primers were designed with the 18S ssrDNA sequences from Cyclospora and Eimeria species found in the National Center for Biotechnology Information GenBank database. Sequences were aligned with CLUSTAL W version 1.8.1 (40). The sequences of the outer fragment primers were 5'-ATAACGAACGAGACCTTAGCCT (CYCAO1) and 5'-AAGGATGCAAAAGTCGTAACAC (CYCAR1). The inner fragment primers were CYCAI2 (5'-CAGGTCTGGGTAATCTTTTGAG-3') (forward primer) and CYCAR1 (reverse primer).
(iii) Theoretical determination of new-primer (CYCAO1, CYCAI2, and CYCAR1) specificity.
The new primers were compared to those species identified during a BLAST inquiry (1). The 18S ssrDNA sequences of 31 species of Eimeria (11 complete and 20 partial), Isospora robini (complete), and the four Cyclospora species (complete) were examined. Tables 1, 2, and 3 list the species identified and examined (along with their GenBank accession numbers). These tables include the sequence where the inner primer may bind, the Tm (midpoint temperature in degrees Celsius) calculated as described by Rychlik and Rhoads (34) [Tm = 64.9 + (yG + zC - 16.4)/(wA + xT + yG + zC)], the resultant amplicon size in base pairs (when the complete 18S ssrDNA sequence is available), the predicted AluI fragments, and other pertinent information.
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TABLE 1. Species amplified with primers CYCAI2 and CYCAR1
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(v) Cloning of positive-control plasmid and isolated PCR fragments.
The outer fragment, with primers CYCAO1 and CYCAR1 (444 bp), and PCR amplicons (310 and 257 bp) were cloned into 3,015-bp plasmids with p-GEM-T Easy-Vector (Promega, Madison, Wis.) in accordance with the manufacturer's instructions. Ligation reaction products were transformed with heat shock into competent Escherichia coli DH5
cells. Blue-and-white screening was done with Luria-Bertani agar medium supplemented with 100 µg of ampicillin per ml, 0.5 mM IPTG (isopropyl-ß-D-thiogalactopyranoside), and 80 µg of X-Gal (5-bromo-4-chloro-3-indolyl-ß-D-galactopyranoside) per ml. Plasmid DNA from individual white colonies was extracted (Qiagen spin kit; Qiagen) from overnight cultures and then screened by PCR and digestion with the appropriate restriction enzyme.
Analysis of PCR amplicons. (i) Visualization of PCR amplicons.
PCR products (10 µl) were visualized on 1.75% agarose gels supplemented with 0.5 µg of ethidium bromide per ml at constant current in Tris-borate-EDTA buffer. Three molecular size markers were used: 25- and 50-bp ladders (Promega) and DNA weight marker VIII (a mixture of pUCBM21 DNA cleaved with HpaII and pUCBM21 DNA cleaved with DraI and HindIII; Boehringer Mannheim, Indianapolis, Ind.).
(ii) Separation of fragments by denaturing high-performance liquid chromatography.
Because of the probability of multiple similar-size but dissimilar-sequence products, amplicons from PCR (primers CYCAI2 and CYCAR1) were separated by denaturing high-performance liquid chromatography (Wave System, Transgenomic, San Jose, Calif.). PCR products were separated by a 46 to 39% gradient of buffers A (0.1 M triethylammonium acetate [pH 7.0]) and B (0.1 M triethylammonium acetate [pH 7.0], 25% acetonitrile) at 60°C. The collected fractions were amplified and cloned for sequencing.
(iii) Sequencing and alignment of PCR products.
All sequencing was by Davis Sequencing (Davis, Calif.) with an ABI 377 automated sequencer with m13 (-21) as the forward sequencing primer for all cloned PCR fragments. Sequences were aligned with CLUSTAL W, version 1.8.1 (40). Accurate pairwise alignments were unweighted with IUB/Bestfit with a gap open penalty of 100 and a gap extra penalty of 10.
RFLP methods. (i) Confirmation of PCR products (CYCF3E and CYCR4B) by RFLP with MnlI.
The positive PCR products from the second reaction (10 µl) were digested as described by Jinneman et al. (20). Fragments were separated on a 4% NuSieve agarose gel (BioWhittaker Molecular Applications, Rockland, Maine) at constant current in Tris-borate-EDTA buffer for approximately 1.5 h. The agarose gels, containing ethidium bromide (0.5 µg/ml), were photographed under UV light with a gel documentation system (UVP ImageStore 5000; Ultra-Violet Products Ltd., Cambridge, United Kingdom).
(ii) Confirmation of PCR products (CYCAI2 and CYCAR1) by RFLP with AluI.
The positive PCR products from the second reaction (10 µl) were digested with 1 U of AluI (New England Biolabs) at 37°C for 2 h. Fragments were separated, visualized, and photographed as described above.
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FIG. 1. RFLP analysis with MnlI (20) of PCR (primers CYCF3E and CYCR4B 33)-positive samples. Lanes: M, 25-bp ladder; 0, sterile ddH2O control; 1, SDC sample collected on 21 April 1998; 2 and 3, SARHB samples collected on 5 June 1998; 4 and 5, SARVB samples collected on 28 August 1998; 6, SARYL sample collected on 28 September 1998. "Uncut" identifies undigested PCR products.
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FIG. 2. MnlI-digested cloned isolates from PCR (primers CYCF3E and CYCR4B 33)-RFLP (with MnlI 20)-positive samples (lanes 1 to 10). The isolates in lanes 1 to 4 were collected from the SARVB on 28 August 1998, and those in lanes 5 to 10 were collected from the SARYL on 28 September 1998. Lane M is a 50-bp ladder, and lane 0 is a PCR blank.
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FIG. 3. CLUSTAL W (version 1.8.1) (40) multiple-sequence alignment of PCR (33)-RFLP (20)-positive environmental samples from the SAR. Shading indicates sequence differences, underlining indicates MnlI sites, and arrows indicate primer locations and directions. The numbers in sequence labels are the cloned isolate numbers, and the numbers in parentheses correspond to the lane numbers in Fig. 2.
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TABLE 2. Eimeria species that may be amplified with primers CYCAI2 and CYCAR1
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TABLE 3. Eimeria species that may be amplified with primers CYCAI2 and CYCAR1a
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FIG. 4. Lanes: M, DNA molecular weight marker VIII; B, unused; 1 and 2, seeded environmental samples; 1, 0.75 oocyst (1.04 ng of DNA); 2, 7.5 oocysts (10.35 ng of DNA); 3, unseeded environmental sample inoculated with 260.5 pg of positive-control plasmid; 4, the same sample with no added positive-control plasmid.
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FIG. 5. RFLP analysis with AluI of PCR (primers CYCAI2 and CYCAR1) amplicons from selected environmental samples. Lanes: M, DNA molecular weight marker VIII; +, C. cayetanensis oocysts with clear bands at 98, 88, and 50 bp and a faint band at 15 bp; 1, sample collected from the SDC on 21 April 1998; 2 to 5, individual water samples collected from the SARVB on 28 August 1998; 6 and 7, individual water samples collected from the SARYL on 28 September 1998. The term "Uncut" identifies amplicons that do not contain AluI sites.
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FIG. 6. CLUSTAL W (version 1.8.1) (40) multiple-sequence alignment of Cyclospora species and environmental samples positive by PCR with primers CYCAI2 and CYCAR1. SARVB B is from lane 2, and SARYL D is from lane 7, Fig. 5. Shading indicates sequence differences, underlining indicates AluI sites, and arrows indicate primer locations and directions.
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While the protocol using PCR with primers CYCF3E and CYCR4B (33) and RFLP with MnlI (20) is clearly able to identify C. cayetanensis oocysts in stool samples, it must be combined with microscopic confirmation to produce reliable results for environmental samples. Our newly designed primers and RFLP differentiate C. cayetanensis from Eimeria and other Cyclospora species, thus allowing researchers and public health laboratories to confidently identify C. cayetanensis in water and soil samples without microscopic confirmation, saving them time and resources.
Most of the cases of cyclosporiasis that have occurred in the United States and Canada have been linked to imported food (18); however, there have been sporadic reports of C. cayetanensis infection in the United States where no food source or history of international travel was implicated (17, 29, 46). Laboratory surveys of stool samples (collected during nonoutbreak periods), conducted in the United States and United Kingdom between 1992 and 1995, suggested that the prevalence in the general populations was <0.5% (18). Nevertheless, C. cayetanensis infection in developed countries has been viewed as linked either to travel or to foods imported from developing countries (37). However, a foodborne outbreak in southwestern Germany in December 2000 (8) suggested that C. cayetanensis may be present in the environmental waters and/or soils of European countries. The sources of this outbreak were epidemiologically traced to butterhead lettuce from southern France, mixed lettuce and leafy herbs from southern Italy, and chives from a greenhouse in Germany. While the implicated lettuce and herbs were no longer available for microscopic or molecular analysis, the relative risk associated with the consumption of these foods and illness was 5.0 (confidence interval = 1.4 < relative risk < 204 [P = 0.0045]).
The initial source of contamination of the German outbreak is still unknown. Possibilities include the soil, use of contaminated water for irrigation and pesticide dilution, and the poor sanitary facilities available to seasonal field workers (8). This outbreak clearly illustrates the potential for C. cayetanensis to become endemic in developed countries. As this potential increases, the need for methods, such as the one described in this paper, that both distinguish among Cyclospora species and differentiate Cyclospora from other coccidian genera becomes increasingly important as these organisms can be found in environmental waters used for irrigation and pesticide dilution.
This work was supported in part by grants from the California Center for Water and Wildlands and the National Water Research Institute (Fountain Valley, Calif.).
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