Diagnosis of Intestinal Protozoa

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Questions and Answers

What is one of the methods evaluated for diagnosing Giardia intestinalis and Cryptosporidium in stool samples?

Microscopic examination

Culture method

Multiplex PCR assay (correct)

Blood analysis

Which organization provided guidelines for the recovery and identification of intestinal parasites?

World Health Organization

American Society for Microbiology

Clinical and Laboratory Standards Institute (correct)

Centers for Disease Control and Prevention

What type of technology is mentioned as a method for detecting intestinal parasites?

Magnetic resonance imaging

Automated image analysis (correct)

Radiological assessment

Ultrasonic testing

What significant outcome relates to multiple stool examinations in diagnosing parasitic infections?

Higher false-negative results Signup and view all the answers

Which intestinal parasite’s detection remains challenging despite its presence?

Strongyloides stercoralis Signup and view all the answers

What smartphone technology was proposed for parasite detection?

Microscopic method Signup and view all the answers

What is a common limitation of routine parasitological examination mentioned?

It may yield high rates of false-negatives Signup and view all the answers

Which commercial method was assessed for its performance in detecting intestinal protozoa?

Multiplex PCR Signup and view all the answers

What was the total number of fecal samples collected for the study?

197 samples Signup and view all the answers

Which two populations did the fecal samples come from?

Emergency department patients and primary care patients Signup and view all the answers

What method was used to process the fecal samples before microscopic examination?

Dilution with ethyl acetate Signup and view all the answers

What role did the SediMAX2 play in the analysis of the fecal samples?

It obtained high-definition images of the samples Signup and view all the answers

What is one of the main advantages of the Malaysian group's software for parasitological diagnosis?

It counts the number of parasites detected per patient. Signup and view all the answers

How many images were reviewed for each sample using SediMAX2?

60 images Signup and view all the answers

What does the proposed two-step algorithm aim to improve?

The manual workload of parasitologists in high throughput laboratories. Signup and view all the answers

During which days were the stool samples received for processing?

Monday to Friday Signup and view all the answers

What was the centrifugation speed used for separating the sediment from the fixed stools?

500g Signup and view all the answers

How fast does the Malaysian software process images compared to conventional methods?

1-2 images per second Signup and view all the answers

What was the main purpose of microscopic examination in the study?

To check for ova and parasites Signup and view all the answers

Which parasitic infections are mentioned as prevalent for initial detection using the proposed algorithm?

Cryptosporidium spp and Giardia lamblia Signup and view all the answers

What limitation does the software currently face concerning parasite detection?

It lacks options for detecting many other helminths and trophozoites. Signup and view all the answers

What is one of the goals of integrating engineering with medical practice in this study?

To facilitate diagnosis of intestinal parasites for microbiologists. Signup and view all the answers

Which of the following groups could benefit from the two-step algorithm mentioned?

Refugees and travelers from endemic regions. Signup and view all the answers

Which method could be used in the first step of the proposed diagnostic algorithm?

Antigen detection Signup and view all the answers

Study Notes

Study Overview

Analyzed 197 fecal samples from 178 patients suspected of intestinal parasitic infections.
Samples collected between January 2016 and December 2017, fixed in sodium acetate-acetic acid-formalin (SAF).
Sourced from two populations: emergency department or hospitalized patients, and primary care settings.

Sample Processing

Stools processed in a clinical microbiology lab, received Monday to Friday mornings.
Microscopic examination for ova and parasites conducted prior to further processing.
Samples diluted with 3 ml of ethyl acetate, centrifuged at 500g for 5 minutes to concentrate sediments.
Sediments examined under optical microscopy at 20x and 40x magnification.

SediMAX2 Technology

Automated microscopy using SediMAX2 to analyze concentrated samples.
Each sample underwent triple analysis, resulting in 60 high-definition images reviewed by a second reader.
Improvements target reducing debris in samples to enhance image interpretation for diagnosis.

Technological Advances

Malaysian group developing software to count detected parasites per patient, offering user-friendly results.
System's efficiency: processes images in 1–2 seconds each, surpassing traditional methods.

Potential Protocol Enhancements

Proposal for a two-step algorithm integrating antigen detection and digital microscopy.
Initial antigen detection could target prevalent parasites (e.g., Cryptosporidium spp, Giardia lamblia), followed by traditional microscopy for less common infections.
This dual-method approach aims to assist with cases involving refugees, travelers from endemic areas, and adopted children.

Funding and Support

Study partially funded by Menarini, S.A., the distributor of SediMAX2 in Spain.

Challenges and Opportunities

Continuous improvements remain necessary for high throughput laboratories that rely on manual diagnosis.
Emphasis on bridging engineering solutions with medical practice to ease microbiologists' workloads in parasite diagnosis.

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Description

This quiz examines the methods of detecting intestinal protozoa in clinical laboratories, focusing on the performance of real-time PCR compared to traditional parasitological examinations. It reviews findings related to Giardia intestinalis, Cryptosporidium species, and Entamoeba histolytica. Test your knowledge on the latest diagnostic techniques and their effectiveness.