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Assessment of microscopic and molecular tools for the diagnosis and follow-up of cryptosporidiosis in patients at risk
Ist Teil von
European journal of clinical microbiology & infectious diseases, 2016-01, Vol.35 (1), p.137-148
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2016
Quelle
MEDLINE
Beschreibungen/Notizen
Cryptosporidiosis is an important though underreported public health concern. Molecular tools might be helpful in improving its diagnosis. In this study, ZR Fecal DNA MiniPrep™ Kit (ZR) and NucliSens® easyMAG® (EM) were compared using four
Cryptosporidium
-seeded feces and 29
Cryptosporidium
-positive stools. Thereafter, ZR was selected for prospective evaluation of
Cryptosporidium
detection by 18S rDNA and LAXER quantitative PCR (qPCR) in 69 stools from 56 patients after
Cryptosporidium
detection by glycerin, modified Ziehl–Neelsen (ZN) and auramine–phenol (AP) stainings. The combination of any of the two extraction methods with 18S qPCR yielded adequate detection of
Cryptosporidium
in seeded stools, but the ZR kit showed the best performance. All 29
Cryptosporidium
-positive samples were positive with 18S qPCR, after both ZR and EM extraction. However, false-negative results were found with LAXER qPCR or nested PCR. Cryptosporidiosis was diagnosed in 7/56 patients. All the microscopic methods enabled the initial diagnosis, but
Cryptosporidium
was detected in 12, 13, and 14 samples from these seven patients after glycerin, ZN, and AP staining respectively. Among these samples, 14 and 12 were positive with 18S and LAXER qPCR respectively. In two patients,
Cryptosporidium
DNA loads were found to be correlated with clinical evolution. Although little known, glycerin is a sensitive method for the initial detection of
Cryptosporidium
. When combined with 18S qPCR, ZR extraction, which had not been evaluated so far for
Cryptosporidium
, was an accurate tool for detecting
Cryptosporidium
and estimating the oocyst shedding in the course of infection.