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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Vet. Sci.</journal-id>
<journal-title>Frontiers in Veterinary Science</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Vet. Sci.</abbrev-journal-title>
<issn pub-type="epub">2297-1769</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fvets.2022.933691</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Veterinary Science</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Molecular Detection and Genotyping of <italic>Enterocytozoon bieneusi</italic> in Pigs in Shanxi Province, North China</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Zhang</surname> <given-names>Zhen-Huan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1895257/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Qin</surname> <given-names>Rui-Lin</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Liu</surname> <given-names>Ya-Ya</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1895279/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zou</surname> <given-names>Yang</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/617090/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Mei</surname> <given-names>Jin-Jin</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1895368/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Liu</surname> <given-names>Qing</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1374721/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Gao</surname> <given-names>Wen-Wei</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1895277/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zhu</surname> <given-names>Xing-Quan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/255972/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Ren</surname> <given-names>Yu-Hong</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x0002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1895283/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Xie</surname> <given-names>Shi-Chen</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="corresp" rid="c002"><sup>&#x0002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1773214/overview"/>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>College of Veterinary Medicine, Shanxi Agricultural University</institution>, <addr-line>Jinzhong</addr-line>, <country>China</country></aff>
<aff id="aff2"><sup>2</sup><institution>Heilongjiang Key Laboratory for Zoonosis, College of Veterinary Medicine, Northeast Agricultural University</institution>, <addr-line>Harbin</addr-line>, <country>China</country></aff>
<aff id="aff3"><sup>3</sup><institution>Research Center for Parasites &#x00026; Vectors, College of Veterinary Medicine, Hunan Agricultural University</institution>, <addr-line>Changsha</addr-line>, <country>China</country></aff>
<aff id="aff4"><sup>4</sup><institution>Key Laboratory of Veterinary Public Health of Higher Education of Yunnan, College of Veterinary Medicine, Yunnan Agricultural University</institution>, <addr-line>Kunming</addr-line>, <country>China</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Simona Gabrielli, Sapienza University of Rome, Italy</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Iraj Mohammadpour, Shiraz University of Medical Sciences, Iran; Lei Deng, National University of Singapore, Singapore; Yujuan Shen, National Institute of Parasitic Diseases, China</p></fn>
<corresp id="c001">&#x0002A;Correspondence: Yu-Hong Ren <email>renyuhong1963&#x00040;163.com</email></corresp>
<corresp id="c002">Shi-Chen Xie <email>xieshichen221&#x00040;163.com</email></corresp>
<fn fn-type="other" id="fn001"><p>This article was submitted to Parasitology, a section of the journal Frontiers in Veterinary Science</p></fn></author-notes>
<pub-date pub-type="epub">
<day>15</day>
<month>07</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>9</volume>
<elocation-id>933691</elocation-id>
<history>
<date date-type="received">
<day>01</day>
<month>05</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>16</day>
<month>06</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2022 Zhang, Qin, Liu, Zou, Mei, Liu, Gao, Zhu, Ren and Xie.</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Zhang, Qin, Liu, Zou, Mei, Liu, Gao, Zhu, Ren and Xie</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<p><italic>Enterocytozoon bieneusi</italic> is a common opportunistic intestinal pathogen that can cause acute diarrhea in immunosuppressed humans and animals. Though <italic>E. bieneusi</italic> has been widely detected in pigs around the world, little is known of its prevalence and genotype distribution in pigs in Shanxi province, north China. In this study, a total of 362 fecal samples were collected from pigs in three representative counties in north, south, and central Shanxi province, China. The prevalence and genotypes of <italic>E. bieneusi</italic> were investigated by nested PCR amplification of the ribosomal internal transcribed spacer (ITS) region of the ribosomal RNA (rRNA) gene. Overall, the prevalence of <italic>E. bieneusi</italic> in pigs in Shanxi province was 54.70% (198/362). Statistical analysis showed the difference in prevalence was statistically significant between regions (&#x003C7;<sup>2</sup> = 41.94, df = 2, <italic>P</italic> &#x0003C; 0.001) and ages (&#x003C7;<sup>2</sup> = 80.37, df = 1, <italic>P</italic> &#x0003C; 0.001). In addition, 16 genotypes of <italic>E. bieneusi</italic> were identified in this study by sequence analysis of the ITS region, including 15 known genotypes (EbpC, EbpA, EbpB, pigEb4, PigEBITS5, I, Henan-I, G, WildBoar 7, SH10, EbpD, CHC5, PigSpEb1, PigSpEb2, and CHG19) and one novel genotype (designated as PigSX-1). Phylogenetic analysis revealed that 14 known genotypes and the novel genotype were clustered into Group 1, whereas genotype I belonged to Group 2. To the best of our knowledge, this is the first report on the prevalence and genotypes of <italic>E. bieneusi</italic> in pigs in Shanxi province. These findings enrich the genetic diversity of <italic>E. bieneusi</italic> and provide the baseline data for the prevention and control of <italic>E. bieneusi</italic> in pigs in the study regions.</p></abstract>
<kwd-group>
<kwd><italic>Enterocytozoon bieneusi</italic></kwd>
<kwd>pigs</kwd>
<kwd>prevalence</kwd>
<kwd>genotypes</kwd>
<kwd>Shanxi province</kwd>
</kwd-group>
<counts>
<fig-count count="1"/>
<table-count count="3"/>
<equation-count count="0"/>
<ref-count count="38"/>
<page-count count="7"/>
<word-count count="4434"/>
</counts>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="s1">
<title>Introduction</title>
<p>The phylum Microsporidia contains a large group of single-celled, obligate intracellular spore-forming parasites (more than 220 genera and 1,700 species). Of which, <italic>Enterocytozoon bieneusi</italic> is the most frequently detected species in humans (<xref ref-type="bibr" rid="B1">1</xref>). Although <italic>E. bieneusi</italic> infection in immunocompetent individuals is usually asymptomatic (<xref ref-type="bibr" rid="B2">2</xref>), acute diarrhea can occur in immunocompromised individuals, such as patients with AIDS (<xref ref-type="bibr" rid="B3">3</xref>). In addition, <italic>E. bieneusi</italic> has also been detected in a variety of mammals and birds (<xref ref-type="bibr" rid="B4">4</xref>). Humans and animals can be infected by <italic>E. bieneusi</italic> through contact with infected hosts or by ingesting spore-contaminated water or food (<xref ref-type="bibr" rid="B5">5</xref>).</p>
<p>Genotyping of <italic>E. bieneusi</italic> is based on amplification and sequencing of the ribosomal internal transcribed spacer (ITS) region of the rRNA gene, which has high single nucleotide polymorphisms (SNPs) (<xref ref-type="bibr" rid="B6">6</xref>). At present, over 500 genotypes of <italic>E. bieneusi</italic> have been identified, which are divided into 11 phylogenetic groups (<xref ref-type="bibr" rid="B5">5</xref>). Group 1 is the largest human-pathogenic group containing more than 300 genotypes (<xref ref-type="bibr" rid="B5">5</xref>). The prevalence of <italic>E. bieneusi</italic> in pigs varied, ranging from 10 to 93.70% worldwide (<xref ref-type="bibr" rid="B5">5</xref>). A number of genotypes within Group 1 identified in humans have also been found in pigs, suggesting that pigs could serve as a potential reservoir for <italic>E. bieneusi</italic> transmission to humans (<xref ref-type="bibr" rid="B5">5</xref>, <xref ref-type="bibr" rid="B7">7</xref>, <xref ref-type="bibr" rid="B8">8</xref>).</p>
<p>According to data from the National Bureau of Statistics of China, approximately 8 million pigs were produced and consumed in Shanxi province annually (<ext-link ext-link-type="uri" xlink:href="http://www.stats.gov.cn/tjsj/ndsj/2019/indexeh.htm">http://www.stats.gov.cn/tjsj/ndsj/2019/indexeh.htm</ext-link>). However, little is known about the epidemiology of <italic>E. bieneusi</italic> in pigs in Shanxi province. In this study, the prevalence and genotypes of <italic>E. bieneusi</italic> in pigs in Shanxi province were investigated by using nested PCR amplification of the ribosomal ITS region. Meanwhile, phylogenetic analysis was conducted to evaluate the zoonotic potential of the <italic>E. bieneusi</italic> isolates.</p>
</sec>
<sec sec-type="materials and methods" id="s2">
<title>Materials and Methods</title>
<sec>
<title>Collection of Samples</title>
<p>In November 2020, with the permission of the farm owners, a total of 362 fresh fecal samples were randomly collected from pigs in three farms each in Shanyin county (39&#x000B0;52&#x02032; N, 112&#x000B0;81&#x02032; E) located in northern Shanxi province, Qi county (37&#x000B0;35&#x02032; N, 112&#x000B0;33&#x02032; E) located in central Shanxi province, and Jishan county (35&#x000B0;59&#x02032; N, 110&#x000B0;97&#x02032; E) located in southern Shanxi province. Approximately, 5&#x02013;15% of samples were collected from each farm. All fecal samples were transported to the laboratory in a styrofoam box with ice packs immediately and stored at &#x02212;20&#x000B0;C until genomic DNA extraction.</p>
</sec>
<sec>
<title>DNA Extraction and PCR Amplification</title>
<p>The genomic DNA was extracted from each fecal sample (approximately 200 mg) using the E.Z.N.A.<sup>&#x000AE;</sup> Stool DNA Kit (Omega Bio-tek Inc., Norcross, GA, USA) and stored at &#x02212;20&#x000B0;C until used for subsequent PCR amplification. A nested PCR was performed to amplify the ITS region by using <italic>E. bieneusi</italic>-specific primers described in a previous study (<xref ref-type="bibr" rid="B9">9</xref>). Briefly, the reaction mixture (25 &#x003BC;l) contained 2.5 &#x003BC;l of 10&#x000D7;PCR Buffer (Mg<sup>2&#x0002B;</sup> free), 1.5 mM of MgCl<sub>2</sub>, 2 &#x003BC;l of dNTP mixture (2.5 mM each), 1.25 U of <italic>Ex</italic>-Taq polymerase (Takara, Dalian, China), 1 &#x003BC;M of each primer, 14.75 &#x003BC;l of ddH<sub>2</sub>O, and 2 &#x003BC;l of DNA template. The conditions and cycling parameters were as follows: initial denaturation at 94&#x000B0;C for 5 min, followed by 35 cycles at 94&#x000B0;C for 30 s, annealing at 55&#x000B0;C for 30 s, 72&#x000B0;C for 40 s, and a final extension at 72&#x000B0;C for 10 min. To ensure the reliability of the results, each PCR amplification included a negative control (reagent-grade water) and a positive control (DNA of the <italic>E. bieneusi</italic> BEB6 genotype from sheep). Then, secondary products were checked by using 2.5% agarose gel and visualized under UV light after staining in ethidium bromide.</p>
</sec>
<sec>
<title>Sequencing and Phylogenetic Analysis</title>
<p>All PCR products were sent to Sangon Biotech Co. Ltd (Shanghai, China) for two-directional sequencing on an ABI PRISM DNA Analyzer (Applied Biosystems, Foster City, CA, USA) using relevant internal primers for PCR amplification. The obtained sequences were aligned with the relevant sequences available in the GenBank database using Basic Local Alignment Search Tool (BLAST) and Clustal X to determine the genotypes of <italic>E. bieneusi</italic>. All samples with novel genotypes were sequenced two times to ensure the reliability of the data. The novel genotype was denominated according to the nomenclature established by Santin and Fayer (<xref ref-type="bibr" rid="B6">6</xref>). The phylogenetic tree was constructed by MEGA 7 using the Neighbor-Joining (NJ) method and Kimura 2-parameter model with 1,000 bootstraps (<xref ref-type="bibr" rid="B9">9</xref>).</p>
</sec>
<sec>
<title>Statistical Analysis</title>
<p>In this study, the software SPSS V26.0 (SPSS Inc., Chicago, IL, USA) was used to analyze the correlation between prevalence and risk factors of <italic>E. bieneusi</italic> in pigs by Chi-square (&#x003C7;<sup>2</sup>) test. Odds ratios (ORs) and their 95% confidence intervals (95%CIs) were calculated to identify risk factors. There was a significant difference in prevalence when the <italic>p</italic>-value was &#x0003C;0.05.</p>
</sec>
</sec>
<sec sec-type="results" id="s3">
<title>Results</title>
<sec>
<title>Prevalence of <italic>E. bieneusi</italic> in Pigs in Shanxi Province</title>
<p>In this study, 198 of 362 fecal samples were detected to be positive for <italic>E. bieneusi</italic>, and the prevalence of <italic>E. bieneusi</italic> in pigs in Shanxi province was 54.70% (<xref ref-type="table" rid="T1">Table 1</xref>). Statistical analysis showed that the prevalence of <italic>E. bieneusi</italic> in pigs aged &#x0003C;6 months was 71.73% (170/237), which was significantly higher than that in pigs aged more than 6 months (22.40%, 28/125) (&#x003C7;<sup>2</sup> = 80.37, df = 1, <italic>P</italic> &#x0003C; 0.001). The prevalence of <italic>E. bieneusi</italic> in Qi county (22.06%, 15/68) was significantly lower than that of Shanyin county (53.15%, 59/111) and Jishan county (67.76%, 124/183) (&#x003C7;<sup>2</sup> = 41.94, df = 2, <italic>P</italic> &#x0003C; 0.001), respectively.</p>
<table-wrap position="float" id="T1">
<label>Table 1</label>
<caption><p>Factors associated with prevalence of <italic>Enterocytozoon bieneusi</italic> in pigs in Shanxi province, China.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left"><bold>Factor</bold></th>
<th valign="top" align="left"><bold>Category</bold></th>
<th valign="top" align="center"><bold>No. tested</bold></th>
<th valign="top" align="center"><bold>No. positive</bold></th>
<th valign="top" align="center"><bold>Prevalence% (95%CI)</bold></th>
<th valign="top" align="center"><bold>OR (95%CI)</bold></th>
<th valign="top" align="center"><bold><italic>P</italic>-value</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Region</td>
<td valign="top" align="left">Jishan</td>
<td valign="top" align="center">183</td>
<td valign="top" align="center">124</td>
<td valign="top" align="center">67.76 (60.99&#x02013;74.53)</td>
<td valign="top" align="center">7.43 (3.87&#x02013;14.25)</td>
<td valign="top" align="center">&#x0003C;0.001</td>
</tr>
<tr>
<td/>
<td valign="top" align="left">Qi</td>
<td valign="top" align="center">68</td>
<td valign="top" align="center">15</td>
<td valign="top" align="center">22.06 (12.20&#x02013;31.91)</td>
<td valign="top" align="center">1</td>
<td/>
</tr>
<tr>
<td/>
<td valign="top" align="left">Shanyin</td>
<td valign="top" align="center">111</td>
<td valign="top" align="center">59</td>
<td valign="top" align="center">53.15 (43.87&#x02013;62.44)</td>
<td valign="top" align="center">4.01 (2.02&#x02013;7.94)</td>
<td/>
</tr>
<tr>
<td valign="top" align="left">Age</td>
<td valign="top" align="left">0 &#x0003C; month &#x02264; 6</td>
<td valign="top" align="center">237</td>
<td valign="top" align="center">170</td>
<td valign="top" align="center">71.73 (66.00&#x02013;77.46)</td>
<td valign="top" align="center">8.79 (5.30&#x02013;14.59)</td>
<td valign="top" align="center">&#x0003C;0.001</td>
</tr>
<tr>
<td/>
<td valign="top" align="left">6 &#x0003E; month</td>
<td valign="top" align="center">125</td>
<td valign="top" align="center">28</td>
<td valign="top" align="center">22.40 (15.09&#x02013;29.71)</td>
<td valign="top" align="center">1</td>
<td/>
</tr>
<tr>
<td valign="top" align="left">Total</td>
<td/>
<td valign="top" align="center">362</td>
<td valign="top" align="center">198</td>
<td valign="top" align="center">54.70 (49.57&#x02013;59.82)</td>
<td/>
<td/>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec>
<title>Genotype Distribution of <italic>E. bieneusi</italic> in Pigs</title>
<p>A total of 16 genotypes were identified by ITS sequence analysis, including 15 known genotypes (EbpC, EbpA, EbpB, pigEb4, PigEBITS5, I, Henan-I, G, WildBoar7, SH10, EbpD, CHC5, PigSpEb1, CHG19, and PigSpEb2) and one novel genotype (named as PigSX-1) (<xref ref-type="table" rid="T2">Table 2</xref>). Of which, EbpA (5.05%, 10/198), EbpC (34.34%, 68/198), and PigSpEb2 (22.22%, 44/198) were the predominant genotype in Qi county, Jishan county, and Shanyin county, respectively. Notably, genotype PigSpEb2 was detected in Shanyin county (55.70%, 44/79) and Jishan county (44.30%, 35/79), but not in Qi county. A comparison between the two age groups showed that PigSpEb2 was mainly distributed in young pigs (&#x0003C;6 months) (94.94%, 75/79). Almost all the genotypes identified in Jishan county were EbpC (98.55%, 68/69), which was mainly detected in young pigs (91.30%, 63/69). In addition, the novel genotype pigSX-1 (2.53%, 5/198) was only detected in pigs in Jishan county. Sequence analysis revealed that the novel genotype pigSX-1 showed a 98.71% similarity to the genotype EbpB (AF076041), with five SNPs.</p>
<table-wrap position="float" id="T2">
<label>Table 2</label>
<caption><p>Genotype distribution of <italic>Enterocytozoon bieneusi</italic> in pigs in Shanxi province, China.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left"><bold>Factor</bold></th>
<th valign="top" align="left"><bold>Category</bold></th>
<th valign="top" align="center"><bold>No. tested</bold></th>
<th valign="top" align="center"><bold>No. positive</bold></th>
<th valign="top" align="left"><bold>Genotypes (<italic>n</italic>)</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Location</td>
<td valign="top" align="left">Jishan</td>
<td valign="top" align="center">183</td>
<td valign="top" align="center">124</td>
<td valign="top" align="left">EbpC (68), PigSpEb2 (35), PigSX-1 (5), Henan-I (3), pigEb4 (3), I (3), WildBoar7 (2), PigEBITS5 (2), EbpA (1), CHG19 (1), CHC5 (1)</td>
</tr>
<tr>
<td/>
<td valign="top" align="left">Qi</td>
<td valign="top" align="center">68</td>
<td valign="top" align="center">15</td>
<td valign="top" align="left">EbpA (10), EbpB (4), EbpD (1)</td>
</tr>
<tr>
<td/>
<td valign="top" align="left">Shanyin</td>
<td valign="top" align="center">111</td>
<td valign="top" align="center">59</td>
<td valign="top" align="left">PigSpEb2 (44), EbpA (8), G (2), SH10 (2), EbpC (1), PigEBITS5 (1), PigSpEb1 (1)</td>
</tr>
<tr>
<td valign="top" align="left">Age</td>
<td valign="top" align="left">0 &#x0003C; month &#x0003C; 6</td>
<td valign="top" align="center">237</td>
<td valign="top" align="center">170</td>
<td valign="top" align="left">PigSpEb2 (75), EbpC (63), EbpA (16), PigSX-1 (5), EbpB (4), Henan-I (1), CHG19 (1), CHC5 (1), G (1), PigEBITS5 (1), PigSpEb1 (1), SH10 (1)</td>
</tr>
<tr>
<td/>
<td valign="top" align="left">month &#x0003E; 6</td>
<td valign="top" align="center">125</td>
<td valign="top" align="center">28</td>
<td valign="top" align="left">EbpC (6), PigSpEb2 (4), EbpA (3), pigEb4 (3), I (3), WildBoar7 (2), PigEBITS5 (2), Henan-I (2), EbpD (1), G (1), SH10 (1)</td>
</tr>
<tr>
<td valign="top" align="left">Total</td>
<td/>
<td valign="top" align="center">362</td>
<td valign="top" align="center">198</td>
<td valign="top" align="left">PigSpEb2 (79), EbpC (69), EbpA (19), PigSX-1 (5), EbpB (4), pigEb4 (3), PigEBITS5 (3), I (3), Henan-I (3), G (2), WildBoar7 (2), SH10 (2), EbpD (1), CHC5 (1), PigSpEb1 (1), CHG19 (1)</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec>
<title>Phylogenetic Relationship Based on ITS Locus</title>
<p>A phylogenetic tree was used to evaluate the genetic relationship of the 16 genotypes of <italic>E. bieneusi</italic> obtained in this study. The results showed that all 15 genotypes were clustered into Group 1, except for genotype I, which belonged to Group 2 (<xref ref-type="fig" rid="F1">Figure 1</xref>).</p>
<fig id="F1" position="float">
<label>Figure 1</label>
<caption><p>Phylogenetic relationships of <italic>E. bieneusi</italic> genotypes based on ITS sequences. Obtained ITS sequences in the present study were marked with black circles (&#x02022; known genotypes) and black triangle (&#x025B4; novel genotype), respectively. The bootstrap value &#x0003C;50% was hide.</p></caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fvets-09-933691-g0001.tif"/>
</fig>
</sec>
<sec>
<title>Nucleotide Sequence Accession Numbers</title>
<p>The 16 representative ITS sequences of <italic>E. bieneusi</italic> obtained in this study were deposited in the GenBank database under accession numbers <ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="OM219033-OM219048">OM219033-OM219048</ext-link>.</p>
</sec>
</sec>
<sec sec-type="discussion" id="s4">
<title>Discussion</title>
<p><italic>E. bieneusi</italic> has caused economic losses to the pig industry worldwide since it was detected in Sweden in 1996 for the first time (<xref ref-type="bibr" rid="B10">10</xref>). The results obtained in this study showed that the overall prevalence of <italic>E. bieneusi</italic> in pigs in Shanxi province was 54.70% (198/362), which was higher than that in pigs in most provinces in China (<xref ref-type="bibr" rid="B11">11</xref>&#x02013;<xref ref-type="bibr" rid="B17">17</xref>) (<xref ref-type="table" rid="T3">Table 3</xref>), Thailand (14.75%, 36/244) (<xref ref-type="bibr" rid="B18">18</xref>), Japan (33.33%, 10/30) (<xref ref-type="bibr" rid="B19">19</xref>), Spain (22.58%, 42/186) (<xref ref-type="bibr" rid="B20">20</xref>), Massachusetts, USA (31.68%, 64/202) (<xref ref-type="bibr" rid="B21">21</xref>), and Malaysia (40.67%, 183/450) (<xref ref-type="bibr" rid="B22">22</xref>). However, the prevalence of <italic>E. bieneusi</italic> in pigs in Shanxi province was lower than that in two provinces in China (<xref ref-type="bibr" rid="B23">23</xref>, <xref ref-type="bibr" rid="B24">24</xref>) (<xref ref-type="table" rid="T3">Table 3</xref>) and Brazil (59.34%, 54/91) (<xref ref-type="bibr" rid="B25">25</xref>). Regional differences in the prevalence of <italic>E. bieneusi</italic> may be related to geographical locations, sample volumes, breeding management, and ecological factors.</p>
<table-wrap position="float" id="T3">
<label>Table 3</label>
<caption><p><italic>Enterocytozoon bieneusi</italic> occurrence and genotypes identification in pigs in China.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left"><bold>District</bold></th>
<th valign="top" align="center"><bold>No. Positive/Total</bold></th>
<th valign="top" align="center"><bold>Prevalence (%)</bold></th>
<th valign="top" align="left"><bold>Genotypes</bold></th>
<th valign="top" align="center"><bold>Year</bold></th>
<th valign="top" align="center"><bold>References</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Beijing</td>
<td valign="top" align="center">108/257</td>
<td valign="top" align="center">42.02</td>
<td valign="top" align="left"><bold>EbpC</bold>, CAM5, wildboar12, CHS12, CM8, CTS3, Henan-IV, pigEBITS5</td>
<td valign="top" align="center">2020</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B15">15</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Fujian</td>
<td valign="top" align="center">177/725</td>
<td valign="top" align="center">24.41</td>
<td valign="top" align="left"><bold>EbpC</bold>, EbpA, FJF, CHN-RR2, KIN-1, CHG7, CHS5, CM11, FJS, CHG23, G, PigEBITS, D</td>
<td valign="top" align="center">2019</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B11">11</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Guangdong</td>
<td valign="top" align="center">19/72</td>
<td valign="top" align="center">26.39</td>
<td valign="top" align="left"><bold>EbpC</bold>, CHS5, GD1</td>
<td valign="top" align="center">2018</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B14">14</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Hainan</td>
<td valign="top" align="center">88/188</td>
<td valign="top" align="center">46.81</td>
<td valign="top" align="left"><bold>CS-4</bold>, MJ14, CHG19, EbpA, HNP-I, HNP-II, HNP-III, HNP-IV</td>
<td valign="top" align="center">2020</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B17">17</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Heilongjiang</td>
<td valign="top" align="center">267/563</td>
<td valign="top" align="center">47.42</td>
<td valign="top" align="left"><bold>EbpC</bold>, O, CS-4, EbpA, Henan-IV, PigEBITS5, EbpB, CC-1, CS-1, CS-3, CHN7, CS-10</td>
<td valign="top" align="center">2016</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B12">12</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Henan</td>
<td valign="top" align="center">186/246</td>
<td valign="top" align="center">75.61</td>
<td valign="top" align="left"><bold>EbpC</bold>, EbpA, CHC5, CHG19, H, Henan-III</td>
<td valign="top" align="center">2019</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B24">24</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Shaanxi province</td>
<td valign="top" align="center">442/560</td>
<td valign="top" align="center">78.93</td>
<td valign="top" align="left"><bold>SZZD1</bold>, SLTC2, SYLA5, CHG19, CHC5, SLTC3, SZZA2, EbpA, PigEBITS5, SHZA1, SZZC1, H, PigEB4, SYLC1, Henan-IV, SLTC1, SYLA1, SYLA2, CHS5, D, CHN7, CM6, SMXB1, SMXC1, SZZB1, SZZA1, SYLA3, SMXD1, SYLA4, SYLD1, CHG3, SZZD2, SHZC1, SMXD2</td>
<td valign="top" align="center">2018</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B23">23</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Tibet autonomous Region</td>
<td valign="top" align="center">41/345</td>
<td valign="top" align="center">11.88</td>
<td valign="top" align="left"><bold>EbpC</bold>, CHS12, EbpD, PigEBITS5, GB11, GB31</td>
<td valign="top" align="center">2019</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B13">13</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Xinjiang Uygur Autonomous region</td>
<td valign="top" align="center">389/801</td>
<td valign="top" align="center">48.56</td>
<td valign="top" align="left"><bold>EbpC</bold>, CHC5, CS-1, CS-4 CS-7, CS-9, D, EbpA, EbpD, H, PigEb4, PigEBITS5, WildBoar8, XJP-II, XJP-III</td>
<td valign="top" align="center">2019</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B16">16</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Yunnan</td>
<td valign="top" align="center">58/200</td>
<td valign="top" align="center">29.00</td>
<td valign="top" align="left"><bold>EbpC</bold>, EbpA, YN1, Henan-IV, YN3, G, H, PigEBITS5, YN2, D</td>
<td valign="top" align="center">2018</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B14">14</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Zhejiang</td>
<td valign="top" align="center">48/124</td>
<td valign="top" align="center">38.71</td>
<td valign="top" align="left"><bold>EbpC</bold>, EbpA, ZJ1, ZJ2, KIN-1, PigEBITS5</td>
<td valign="top" align="center">2018</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B14">14</xref>)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p><italic>Prevalent genotypes of E. bieneusi in that study are shown in bold</italic>.</p>
</table-wrap-foot>
</table-wrap>
<p>There were significant differences in <italic>E. bieneusi</italic> prevalence between the two age groups, which was consistent with the results of a previous study (<xref ref-type="bibr" rid="B14">14</xref>). Some researchers argue that the probable reason for the higher prevalence of <italic>E. bieneusi</italic> in young pigs (&#x0003C;6 months) might be due to their imperfect immune system (<xref ref-type="bibr" rid="B23">23</xref>). However, a high prevalence of <italic>E. bieneusi</italic> was also found in older pigs in different areas of China (<xref ref-type="bibr" rid="B12">12</xref>, <xref ref-type="bibr" rid="B14">14</xref>). The difference in <italic>E. bieneusi</italic> prevalence among these age groups indicated that geoecology, rearing conditions, and stocking density may be partially responsible for the variations in prevalence.</p>
<p>In this study, 15 known genotypes (PigSpEb2, EbpC, EbpA, EbpB, pigEb4, PigEBITS5, I, Henan-I, G, WildBoar7, SH10, EbpD, CHC5, PigSpEb1, and CHG19) and a novel genotype (PigSX-1) were identified in pigs in Shanxi province. Of which, genotype PigSpEb2 (39.90%, 79/198) was the predominant genotype, followed by EbpC (34.85%, 69/198) (synonyms: E, WL13, WL17, and Peru4) and EbpA (9.60%, 19/198) (synonym: F). This finding was not consistent with the results of previous studies, in which EbpC was detected as the predominate genotype in pigs in Zhejiang province, Guangdong province, Jilin province, and Tibet Autonomous Region in China (<xref ref-type="bibr" rid="B13">13</xref>, <xref ref-type="bibr" rid="B14">14</xref>, <xref ref-type="bibr" rid="B26">26</xref>). So far, the reasons for the difference in predominate genotypes of <italic>E. bieneusi</italic> in pigs from different study regions are still unknown. We reasoned that the geographical locations, pig breeds, and hygiene conditions might be responsible for the variations in predominate genotypes. Hence, more samples from diverse hosts in the study areas should be examined in the future to further clarify the possible patterns of prevalent genotypes of <italic>E. bieneusi</italic>.</p>
<p>Of those 16 identified genotypes, seven known genotypes (EbpC, EbpA, EbpB, PigEBITS5, I, EbpD, and CHG19) were commonly observed in humans (<xref ref-type="bibr" rid="B27">27</xref>), livestock (<xref ref-type="bibr" rid="B7">7</xref>, <xref ref-type="bibr" rid="B28">28</xref>&#x02013;<xref ref-type="bibr" rid="B30">30</xref>), non-human primates (NHPs) (<xref ref-type="bibr" rid="B31">31</xref>), wild animals (<xref ref-type="bibr" rid="B32">32</xref>), and water (<xref ref-type="bibr" rid="B33">33</xref>), posing a great threat to the public health. Particularly, genotypes EbpC and I were also found in squirrels and pet rabbits in China, respectively, which have close contact with humans (<xref ref-type="bibr" rid="B34">34</xref>, <xref ref-type="bibr" rid="B35">35</xref>). Genotypes PigSpEb1 and PigSpEb2 were first identified in pigs in Spain in 2020 and 2021, respectively, but there was no data regarding the age patterns of the two genotypes in pigs (<xref ref-type="bibr" rid="B20">20</xref>, <xref ref-type="bibr" rid="B36">36</xref>). Although our results revealed that younger pigs (&#x0003C;6 months) were more susceptible to PigSpEb1 and PigSpEb2, more investigations are still needed to confirm this in the future. A few studies have reported the presence of PigEb4, Henan-I, CHC5, Wildboar7, and SH10 in pigs, and further studies are warranted to clarify the host specificity and public health implications of these genotypes (<xref ref-type="bibr" rid="B24">24</xref>, <xref ref-type="bibr" rid="B30">30</xref>, <xref ref-type="bibr" rid="B37">37</xref>, <xref ref-type="bibr" rid="B38">38</xref>). Phylogenetic analysis showed that 15 known genotypes were clustered into Group 1 and Group 2 (<xref ref-type="fig" rid="F1">Figure 1</xref>). The novel genotype (PigSX-1) was clustered into Group 1, and was genetically closely related to zoonotic genotype EbpB, suggesting its importance and zoonotic potential.</p>
</sec>
<sec sec-type="conclusions" id="s5">
<title>Conclusion</title>
<p>This study reported, for the first time, the prevalence of <italic>E. bieneusi</italic> (54.70%) in pigs in Shanxi province, north China, and a higher prevalence was observed in young pigs. Fifteen known <italic>E. bieneusi</italic> genotypes and one novel genotype (PigSX-1) were identified. Fifteen genotypes were clustered into Group 1, suggesting that these infections may not only be a veterinary issue but also a public health concern. These findings enriched the global genetic diversity of <italic>E. bieneusi</italic> and provided baseline data for the prevention and control of <italic>E. bieneusi</italic> infection in pigs in the study regions.</p>
</sec>
<sec sec-type="data-availability" id="s6">
<title>Data Availability Statement</title>
<p>The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.</p>
</sec>
<sec id="s7">
<title>Ethics Statement</title>
<p>Ethical review and approval was not required for the animal study because this is not applicable. Written informed consent was obtained from the owners for the participation of their animals in this study.</p>
</sec>
<sec id="s8">
<title>Author Contributions</title>
<p>S-CX, X-QZ, and Y-HR conceived and designed the experiments. Z-HZ performed the experiments, analyzed the data, and wrote the paper. J-JM, R-LQ, and Y-YL participated in the collection of fecal samples. W-WG and Y-HR participated in the implementation of the study. S-CX, QL, YZ, and X-QZ critically revised the manuscript. All authors have read and approved the final version of the manuscript.</p>
</sec>
<sec sec-type="funding-information" id="s9">
<title>Funding</title>
<p>Project support was provided by Fund for Shanxi 1331 Project (Grant No. 20211331-13), the Special Research Fund of Shanxi Agricultural University for High-level Talents (Grant No. 2021XG001), the Yunnan Expert Workstation (Grant No. 202005AF150041), and the Veterinary Public Health Innovation Team of Yunnan Province (Grant No. 202105AE160014).</p>
</sec>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s10">
<title>Publisher&#x00027;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
</body>
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