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

Parasitol Res. 2018 Feb;117(2):447-451. doi: 10.1007/s00436-017-5720-7. Epub 2017 Dec 19.

Abstract

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.

Keywords: Detection; Intestinal protozoa; Real-time PCR; Sensitivity; Specificity.

Publication types

  • Evaluation Study

MeSH terms

  • Animals
  • Biological Assay
  • Child, Preschool
  • Clinical Laboratory Techniques
  • Cryptosporidium parvum / genetics
  • Cryptosporidium parvum / isolation & purification*
  • Entamoeba histolytica / genetics
  • Entamoeba histolytica / isolation & purification*
  • Feces / parasitology
  • Giardia lamblia / genetics
  • Giardia lamblia / isolation & purification*
  • Humans
  • Intestinal Diseases, Parasitic / diagnosis*
  • Intestinal Diseases, Parasitic / parasitology
  • Intestine, Small / parasitology
  • Microscopy
  • Multiplex Polymerase Chain Reaction / methods*
  • Real-Time Polymerase Chain Reaction / methods*
  • Sensitivity and Specificity