Cystic echinococcosis (CE) is a zoonotic parasitic disease that can result in human and animal health problems globally. Although the disease is known to be endemic in Asia and the Middle East, there are few epidemiological studies on CE in Pakistan. The purpose of the present study was to identify the Echinococcus granulosus sensu lato species and genotypes contributing to human CE cases in the Khyber Pakhtunkhwa (KPK) province of Pakistan. A total of fifty-six formalin fixed paraffin embedded (FFPE) CE cyst samples of human origin were collected from the Pathology Department, Rehman Medical Institute (RMI), KPK for the years 2012-2017. Cyst samples came from the liver (26/56; 46.4%), lungs (3/56; 5.3%), spleen (3/56; 5.3%), pelvis (1/56; 1.8%), breast (1/56; 1.8%), and thigh (1/56; 1.8%). The organ location for 21 of the cysts was not recorded. World Health Organization-Informal Working Group on Echinococcosis (WHO-IWGE) ultrasound-based cyst staging was available for 17 of the 26 (65.4%) hepatic cysts. Five of these cysts (29.4%) were CE3 (transitional), nine (52.9%) were CE4 (inactive), and three (17.6%) were CE5 (inactive). Most of the cysts were obtained from CE patients that were ethnically Afghan Pashtuns (44/56; 78.6%), while 12.5% (7/56) were from patients that were Pakistani Pashtuns. The majority (41/56; 73.2%) of patients reported having close interactions with dogs. Using 12SrRNA primers, 33 cyst samples were identified as being caused by E. granulosus sensu stricto (s.s.). Mitochondrially encoded cytochrome C oxidase 1 (mt-CO1) was evaluated for the remaining 23 samples. PCR product was obtained from six of these 23 samples. Of these six samples, one was identified as Echinococcus canadensis (G6/7). Haplotype analysis showed high haplotype and low nucleotide diversity for the mt-CO1 gene. There were 26 polymorphic sites for the mt-CO1 sequence, of which 65.3% (17/26) were parsimony informative. The E. canadensis mt-CO1 haplotype network consisted of 11 haplotypes, with a main central haplotype. In conclusion, it appears that E. granulosus s.s. and E. canadensis (G6/7) are circulating in the northwestern region of Pakistan. Further molecular epidemiological studies are needed to explore the local genetic diversity of the parasite.

囊性棘球co病（CE）是一种人畜共患寄生虫病，可导致全球人类和动物健康问题。尽管已知该疾病在亚洲和中东是地方病，但巴基斯坦很少有关于CE的流行病学研究。本研究的目的是鉴定细小棘球E巴基斯坦开伯尔-普赫图赫瓦省（KPK）省的人类CE病例的不同种类和基因型。从KPK的Rehman医学研究所（RMI）病理学科收集了2012年至2017年的人类起源的56份福尔马林固定石蜡包埋（FFPE）CE囊肿样品。囊肿样本来自肝脏（26/56; 46.4％），肺（3/56; 5.3％），脾脏（3/56; 5.3％），骨盆（1/56; 1.8％），乳房（1/56 ; 1.8％）和大腿（1/56; 1.8％）。没有记录21个囊肿的器官位置。世界卫生组织基于棘球co病的非正式工作组（WHO-IWGE）基于超声的囊肿分期可用于26个肝囊肿中的17个（占65.4％）。这些囊肿中有五个（29.4％）为CE3（过渡性），九个（52.9％）为CE4（非活动性），三个（17.6％）为CE5（非活动性）。大多数囊肿是从具有种族特征的阿富汗普什图族CE患者中获得的（44/56； 78.6％），而12.5％（7/56）则来自巴基斯坦普什图人的患者。大多数患者（41/56； 73.2％）报告与狗有紧密的互动。使用12SrRNA引物，鉴定出33个囊肿样本是由E. granulosus sensu stricto（ss）。对于其余的23个样品，评估了线粒体编码的细胞色素C氧化酶1（mt-CO1）。从这23个样本中的六个样本中获得了PCR产物。在这六个样本中，一个被鉴定为加拿大棘球chin虫（G6 / 7）。单倍型分析显示mt-CO1基因的高单倍型和低核苷酸多样性。mt-CO1序列有26个多态位点，其中65.3％（17/26）具有简约信息。在E.飞蓬MT-CO1单元型网络包括11个单倍型，有主中央单倍型。总之，似乎是大肠杆菌。和加拿大大肠埃希菌（G6 / 7）在巴基斯坦西北地区流通。需要进一步的分子流行病学研究来探索该寄生虫的局部遗传多样性。