Laboratory diagnosis of cryptosporidiosis.

Casemore, D.P.; Armstrong, Martha U.; Sands, R L

doi:10.1136/jcp.38.12.1337

Cited by 236 publications

(161 citation statements)

References 16 publications

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“…Although SMI B 31 states that 'all faecal samples from symptomatic individuals should be stained for Cryptosporidium oocysts', many laboratories in our audit used stool consistency to decide whether to test: 16 (19 %) only tested all non-formed stools (Table 3). Stool consistency has been shown to be an unreliable predictor of Cryptosporidium positivity (Casemore et al, 1985), and oocysts may be shed for many days after symptoms cease (Jokipii & Jokipii, 1986). Symptoms can relapse, and making a diagnosis even after recovery is important so that appropriate advice can be given for prevention of spread, particularly through recreational waters such as swimming pools (Anonymous & PHLS Advisory Committee on Gastrointestinal Infections, 2004).…”

Section: Resultsmentioning

confidence: 99%

An audit of the laboratory diagnosis of cryptosporidiosis in England and Wales

Chalmers

Atchison

Barlow

et al. 2015

Journal of Medical Microbiology

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To assess the level of practice consistent with UK national standards for Cryptosporidium testing, an audit was performed of 156 publicly funded clinical microbiology laboratories in England and Wales between August 2013 and April 2014. Responses were received from 85 (54 %) laboratories. First line diagnostic methods used were mainly microscopy with modified Ziehl-Neelsen (mZN) or auramine phenol (AP) staining (68/85, 80 %), enzyme immunoassays (EIAs) (16/85, 19 %) or in-house PCR (1/85, 1 %). The use of EIAs was more widespread than reported previously. Various methods were used for confirmation of positive EIA reactions and laboratories frequently resorted to sending samples to the national reference laboratory for this purpose, indicating that guidance is required for performance monitoring and confirmation of positive reactions. Laboratory positivity rates were related to the diagnostic test used, with highest median rates reported by those using PCR, EIAs or AP microscopy, and the lowest by those using mZN microscopy. One-third of responding laboratories (28/85, 33 %) routinely tested all stools for Cryptosporidium. However, 16 (19 %) laboratories used stool consistency to decide whether to test for this parasite. Other selection criteria included patient age (n518; 21 % laboratories), history or clinical details (n540; 47 %), duration of hospitalization (n518; 21 %) or clinician requests (n525; 29 %). To encourage laboratories to test all stools submitted for the investigation of diarrhoeal illness for Cryptosporidium, revision of the guidance in the national standards is under way. This will enable improved assessment of the burden of illness and ability to monitor outbreaks, and measure changes in reported cases.

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Section: Resultsmentioning

confidence: 99%

An audit of the laboratory diagnosis of cryptosporidiosis in England and Wales

Chalmers

Atchison

Barlow

et al. 2015

Journal of Medical Microbiology

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“…Each individual in the study was supplied with two containers, one for direct examination by concentration method [16] and for staining with modified Ziehl-Neelsen stain [17]. The second container was preserved for detection of Cryptosporidium coproantigen by ELISA.…”

Section: Collection Of Fecal Samplesmentioning

confidence: 99%

Cryptosporidiosis in patients with diarrhea and chronic liver diseases

Mousa

Abdel‐Razik

El-Nahas

et al. 2014

J Infect Dev Ctries

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Introduction: The aim of this study was to evaluate the epidemiology and clinical significance of Cryptosporidium in patients with diarrhea and chronic liver diseases. Methodology: The study included 150 patients with chronic liver diseases and diarrhea, and 50 subjects with diarrhea as a control group. Stool samples were screened for the presence of Cryptosporidium by microscopic examination after modified Ziehl-Neelsen staining and detection of Cryptosporidium coproantigen by enzyme-linked immunosorbent assay (ELISA). Results: The prevalence of Cryptosporidium infection in patients with chronic liver diseases was 30% (45/150) versus 14% (7/50) in controls. Cryptosporidium infection increased with the progression of chronic liver diseases from Child-Pugh class A to Child-Pugh class C (p< 0.001) and from model for end-stage liver disease (MELD) score ≤ 9 to MELD score > 9 (p< 0.031). Nine patients in Child-Pugh class C with diarrhea associated with Cryptosporidium infection developed hepatic encephalopathy, and only diarrhea was identified as a precipitating factor for hepatic encephalopathy. Conclusions: Cryptosporidium is one of the important causes of diarrhea in patients with chronic liver diseases. The infection significantly increased with the progression of chronic liver diseases. In patients with advanced chronic liver diseases, Cryptosporidium infection may be a precipitating factor of hepatic encephalopathy.

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“…infection in faeces, such as flotation method of oocysts and modified Ziehl Neelsen's staining method (Cole et al 1999), immunofluorescence assay and flow cytometry (Cole et al 1999), ELISA (Werner et al 2004), chromatographic lateral flow immunoassay (Singla et al 2013), PCR and loop-mediated isothermal amplification of DNA (Bakheit et al 2008). The organism is usually identified on the basis of laborious, relatively expensive and time consuming staining, including modified Ziehl Neelsen's and FAT staining of the faecal samples to identify the oocysts of the parasite in people and animals (Casemore et al 1985). However, these are not routinely used protocols in the developing world, including India.…”

Section: Introductionmentioning

confidence: 99%

Validation of Romanowsky staining as a novel screening test for the detection of faecal cryptosporidial oocysts

et al. 2016

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Cryptosporidiosis is an emerging waterborne protozoan disease and one of the major causes of neonatal diarrhea in humans and animals. But the disease remains under diagnosed due to lack of availability of special stains in majority of laboratories at primary health centers. Therefore, it requires a rapid screening test for routine diagnosis in conventional laboratory set up. In this pursuit, the present study was planned. During this study, fecal samples from 100 representative animals randomly selected from 17 out breaks of bovine calf diarrhea, were stained with modified Ziehl Neelsen staining (mZN) and Leishman's stain to demonstrate cryptosporidial oocysts and for routine fecal examination, respectively. By mZN staining, 25 cases confirmed the presence of cryptosporidial oocysts. However, examination of Leishman's stained fecal smears revealed round hollow unstained bodies resembling cryptosporidia in 20 cases. Therefore, a comparative morphometric analysis was made between the two techniques to determine their relative efficacy in demonstrating cryptosporidia in the feces of affected animals. The analyses showed that the Leishman's stain can be effective in making a presumptive diagnosis of cryptosporidiosis with a little experience. Confirmation of cryptosporidiosis was done by histopathological examination of intestinal sections of calves died during these out breaks. The findings appear to have great clinical value for routine laboratory screening of fecal samples for cryptosporidiosis as conventional Romanowsky stains are readily available and used for multipurpose examination in most of the laboratories at grass root level. Perusal of literature proved this to be the first attempt at easy diagnostics for cryptosporidiosis.

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Laboratory diagnosis of cryptosporidiosis.

Cited by 236 publications

References 16 publications

An audit of the laboratory diagnosis of cryptosporidiosis in England and Wales

An audit of the laboratory diagnosis of cryptosporidiosis in England and Wales

Cryptosporidiosis in patients with diarrhea and chronic liver diseases

Validation of Romanowsky staining as a novel screening test for the detection of faecal cryptosporidial oocysts

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