Abstract
Newly available assays offer alternatives to conventional microscopic examination for Cryptosporidium spp. We compared two enzyme immunoassays, ProSpect Cryptosporidium microtiter assay (Alexon, Inc., Mountain View, Calif.) and Color Vue Cryptosporidium assay (Serady, Indianapolis, Ind.), and a direct immunofluorescent assay, Merifluor Cryptosporidium kit (Meridian Diagnostics, Cincinnati, Ohio), with acid-fast Kinyoun-staining for the detection of Cryptosporidium spp. Examinations were performed on 129 stool specimens received from patients during a recent waterborne outbreak. A specimen was considered positive when organisms could be identified visually by acid-fast and immunofluorescent stains or if organisms could be visualized by either acid-fast or immunofluorescent stain and detected by both enzyme immunoassays. The final number of positive specimens was 55. No single procedure detected all 55 positive specimens. Of these, ProSpect and Color Vue detected 52 (sensitivity, 94.5%), and the Kinyoun stain and Merifluor detected 53 (sensitivity, 96.4%). The final number of negative specimens was 74. One false-positive result was seen with both the Kinyoun stain and the ProSpect assay. The Color Vue and ProSpect assays required the most hands-on technologist time. The ProSpect assay and Merifluor kit were easiest to perform. The acid-fast stain was difficult to interpret. The Merifluor kit was easiest to read and was adaptable to both batch and single testing. Overall, the Kinyoun stain and the Merifluor test were preferable to both of the enzyme immunoassays because of the high reagent cost and hands-on time required for the enzyme immunoassays. The difficult interpretation of the Kinyoun stain smears made the Merifluor a more desirable test despite its higher cost.(ABSTRACT TRUNCATED AT 250 WORDS)
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- Baron E. J., Schenone C., Tanenbaum B. Comparison of three methods for detection of Cryptosporidium oocysts in a low-prevalence population. J Clin Microbiol. 1989 Jan;27(1):223–224. doi: 10.1128/jcm.27.1.223-224.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Baxby D., Hart C. A. The incidence of cryptosporidiosis: a two-year prospective survey in a children's hospital. J Hyg (Lond) 1986 Feb;96(1):107–111. doi: 10.1017/s0022172400062598. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Current W. L., Garcia L. S. Cryptosporidiosis. Clin Microbiol Rev. 1991 Jul;4(3):325–358. doi: 10.1128/cmr.4.3.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Garcia L. S., Brewer T. C., Bruckner D. A. Fluorescence detection of Cryptosporidium oocysts in human fecal specimens by using monoclonal antibodies. J Clin Microbiol. 1987 Jan;25(1):119–121. doi: 10.1128/jcm.25.1.119-121.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Garcia L. S., Bruckner D. A., Brewer T. C., Shimizu R. Y. Techniques for the recovery and identification of Cryptosporidium oocysts from stool specimens. J Clin Microbiol. 1983 Jul;18(1):185–190. doi: 10.1128/jcm.18.1.185-190.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harding S. P., Mallinson H., Roberts C. Ophthalmia neonatorum. J Infect Dis. 1987 Jul;156(1):249–250. doi: 10.1093/infdis/156.1.249-a. [DOI] [PubMed] [Google Scholar]
- Hayes E. B., Matte T. D., O'Brien T. R., McKinley T. W., Logsdon G. S., Rose J. B., Ungar B. L., Word D. M., Pinsky P. F., Cummings M. L. Large community outbreak of cryptosporidiosis due to contamination of a filtered public water supply. N Engl J Med. 1989 May 25;320(21):1372–1376. doi: 10.1056/NEJM198905253202103. [DOI] [PubMed] [Google Scholar]
- Koch K. L., Phillips D. J., Aber R. C., Current W. L. Cryptosporidiosis in hospital personnel. Evidence for person-to-person transmission. Ann Intern Med. 1985 May;102(5):593–596. doi: 10.7326/0003-4819-102-5-593. [DOI] [PubMed] [Google Scholar]
- MacPherson D. W., McQueen R. Cryptosporidiosis: multiattribute evaluation of six diagnostic methods. J Clin Microbiol. 1993 Feb;31(2):198–202. doi: 10.1128/jcm.31.2.198-202.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Martino P., Gentile G., Caprioli A., Baldassarri L., Donelli G., Arcese W., Fenu S., Micozzi A., Venditti M., Mandelli F. Hospital-acquired cryptosporidiosis in a bone marrow transplantation unit. J Infect Dis. 1988 Sep;158(3):647–648. doi: 10.1093/infdis/158.3.647. [DOI] [PubMed] [Google Scholar]
- Nachamkin I., Jones A., Hasyn H. Routine parasitological examination for Cryptosporidium. J Infect Dis. 1986 Aug;154(2):369–370. doi: 10.1093/infdis/154.2.369. [DOI] [PubMed] [Google Scholar]
- Newman R. D., Jaeger K. L., Wuhib T., Lima A. A., Guerrant R. L., Sears C. L. Evaluation of an antigen capture enzyme-linked immunosorbent assay for detection of Cryptosporidium oocysts. J Clin Microbiol. 1993 Aug;31(8):2080–2084. doi: 10.1128/jcm.31.8.2080-2084.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ratnam S., Paddock J., McDonald E., Whitty D., Jong M., Cooper R. Occurrence of Cryptosporidium oocysts in fecal samples submitted for routine microbiological examination. J Clin Microbiol. 1985 Sep;22(3):402–404. doi: 10.1128/jcm.22.3.402-404.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Richardson A. J., Frankenberg R. A., Buck A. C., Selkon J. B., Colbourne J. S., Parsons J. W., Mayon-White R. T. An outbreak of waterborne cryptosporidiosis in Swindon and Oxfordshire. Epidemiol Infect. 1991 Dec;107(3):485–495. doi: 10.1017/s0950268800049189. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rosenblatt J. E., Sloan L. M. Evaluation of an enzyme-linked immunosorbent assay for detection of Cryptosporidium spp. in stool specimens. J Clin Microbiol. 1993 Jun;31(6):1468–1471. doi: 10.1128/jcm.31.6.1468-1471.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rush B. A., Chapman P. A., Ineson R. W. A probable waterborne outbreak of cryptosporidiosis in the Sheffield area. J Med Microbiol. 1990 Aug;32(4):239–242. doi: 10.1099/00222615-32-4-239. [DOI] [PubMed] [Google Scholar]
- Rusnak J., Hadfield T. L., Rhodes M. M., Gaines J. K. Detection of Cryptosporidium oocysts in human fecal specimens by an indirect immunofluorescence assay with monoclonal antibodies. J Clin Microbiol. 1989 May;27(5):1135–1136. doi: 10.1128/jcm.27.5.1135-1136.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith H. V., Patterson W. J., Hardie R., Greene L. A., Benton C., Tulloch W., Gilmour R. A., Girdwood R. W., Sharp J. C., Forbes G. I. An outbreak of waterborne cryptosporidiosis caused by post-treatment contamination. Epidemiol Infect. 1989 Dec;103(3):703–715. doi: 10.1017/s0950268800031101. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Weber R., Bryan R. T., Bishop H. S., Wahlquist S. P., Sullivan J. J., Juranek D. D. Threshold of detection of Cryptosporidium oocysts in human stool specimens: evidence for low sensitivity of current diagnostic methods. J Clin Microbiol. 1991 Jul;29(7):1323–1327. doi: 10.1128/jcm.29.7.1323-1327.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]