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Highly sensitive and specific detection of Giardia duodenalis, Entamoeba histolytica, and Cryptosporidium spp. in human stool samples by the BD MAX™ Enteric Parasite Panel

Parčina, Marijo, Reiter-Owona, Ingrid, Mockenhaupt, FrankP., Vojvoda, Valerija, Gahutu, JeanBosco, Hoerauf, Achim, Ignatius, Ralf
Parasitology research 2018 v.117 no.2 pp. 447-451
Cryptosporidium parvum, Entamoeba histolytica, Giardia lamblia, enteritis, false positive results, feces, human resources, laboratory diagnosis, light microscopy, parasites, quantitative polymerase chain reaction
Detection of intestinal protozoan parasites by light microscopy is cumbersome, needs experienced personnel, and may lack sensitivity and/or specificity as compared with molecular-based stool assays. Here, we evaluated the BD MAX™ Enteric Parasite Panel, i.e., a multiplex real-time PCR assay for simultaneous detection of Giardia duodenalis, Entamoeba histolytica, and cryptosporidia (Cryptosporidium parvum and C. hominis), by examining 200 positive human stool samples (138 × G. duodenalis, 27 × E. histolytica, 35 × Cryptosporidium spp.) and 119 controls including 18 samples with E. dispar. The majority of the samples, i.e., 153/200 (76.5%) positive samples and 66/119 (55.5%) controls, were confirmed by multiplex in-house PCR detecting the same parasites as the BD MAX™ Enteric Parasite Panel. The BD MAX™ assay did not yield false-positive results. Sensitivity and specificity were 97.8% (95% CI, 93.3–99.4%) and 100% (95% CI, 97.4–100%) for G. duodenalis, 100% (95% CI, 84.5–100%) and 100% (95% CI, 98.4–100%) for E. histolytica, and 100% (95% CI, 87.7–100%) and 100% (95% CI, 98.3–100%) for cryptosporidia, and similar data were obtained when only the 219 PCR-confirmed samples were analyzed. Thus, the BD MAX™ Enteric Parasite Panel provides a highly sensitive and specific tool for the laboratory diagnosis of three predominant protozoan parasites causing enteritis.