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Detecting Blastocystis using parasitologic and DNA-based methods: a comparative study.

C Rune Stensvold1, Maiken C Arendrup, Cathrine Jespersgaard

  • 1Department of Bacteriology, Mycology and Parasitology, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark. run@ssi.dk

Diagnostic Microbiology and Infectious Disease
|October 5, 2007
PubMed
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Xenic in vitro culture (XIVC) is recommended for cost-effective Blastocystis screening. This method accurately identifies Blastocystis infection and subtypes, outperforming other diagnostic techniques like PCR.

Area of Science:

  • Medical Parasitology
  • Molecular Diagnostics
  • Microbiology

Background:

  • Blastocystis is a common unicellular organism found in human fecal samples.
  • Diagnostic methods for Blastocystis detection vary in performance.
  • Limited studies compare the efficacy of different diagnostic techniques for Blastocystis.

Purpose of the Study:

  • To compare the diagnostic performance of four methods for Blastocystis detection: formol ethyl acetate concentration technique (FECT), permanent trichrome staining (SAF-PST), xenic in vitro culture (XIVC), and polymerase chain reaction (PCR).
  • To evaluate the impact of XIVC on Blastocystis subtype identification.
  • To recommend a cost-effective method for Blastocystis screening and molecular characterization.

Main Methods:

  • A total of 107 fecal samples from 93 patients were analyzed using FECT, SAF-PST, XIVC, and PCR.

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  • Sensitivity and specificity were calculated by comparing each method to PCR.
  • Dideoxy sequencing was used to compare PCR products from direct fecal DNA and DNA from XIVC isolates.

    • Main Results:

    • Compared to PCR, the sensitivity/specificity of XIVC, SAF-PST, and FECT were 89%/100%, 82%/100%, and 50%/100%, respectively.
    • False-negative results with FECT and SAF-PST were associated with Blastocystis sp. subtype 3.
    • XIVC showed minimal impact on Blastocystis subtype distribution or variation.

    Conclusions:

    • Short-term XIVC is recommended for cost-effective screening of fresh fecal specimens for Blastocystis.
    • XIVC enables valid prevalence estimates and identification of isolates for molecular epidemiology studies.
    • XIVC is a reliable method for detecting Blastocystis and characterizing its subtypes.