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. 2017 Jan-Jun;7(1):41-46.
doi: 10.4103/tp.TP_66_16.

Detection of Cryptosporidium in stool samples of immunocompromised patients

K Vanathy  1 , Subhash Chandra Parija  1 , Jharna Mandal  1 , Abdoul Hamide  2 , Sriram Krishnamurthy  3
Affiliations

Detection of Cryptosporidium in stool samples of immunocompromised patients

K Vanathy et al. Trop Parasitol. 2017 Jan-Jun.

Abstract

Introduction: Cryptosporidium species is the most common opportunistic enteric parasite encountered in the immunocompromised patients. Considering the need to diagnose them early relies mostly on rapid tests such as antigen detection by immunochromatographic test (ICT), ELISA, and microscopy. However, the sensitivity and specificity varies with different methods and different kits used. This study was conducted to determine the intestinal parasitic profile in immunocompromised patients and to assess the diagnostic accuracy of the ICT using ImmunoCard STAT kit in detecting Cryptosporidium spp.

Materials and methods: The patients in this study were divided into two groups: one group was immunocompromised patients (n = 73) and the other was nonimmunocompromised individuals (n = 73). Stool microscopy, ICT, and polymerase chain reaction (PCR) were carried out for all stool samples.

Results: Totally, 4 (5.4%) of 73 patients of the study group were positive for Cryptosporidium. The species detected were Cryptosporidium parvum and Cryptosporidium hominis. PCR was taken as gold standard in the current study. PCR detected Cryptosporidium in four samples while ICT in two samples and microscopy in one sample.

Conclusion: Cryptosporidium was found to be the most common enteric parasite in the immunocompromised patients studied, followed by Cystoisospora, Entamoeba histolytica, and Strongyloides stercoralis. Although the ICT is a rapid test, it was less sensitive and more expensive in comparison to the PCR; hence, its utility appears to be limited in our setting.

Keywords: Cryptosporidium; immunochromatographic test; immunocompromised; polymerase chain reaction.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Clinical profile of immunocompromised patients
Figure 2
Figure 2
Profile of parasites detected by wet mount microscopic examination
Figure 3
Figure 3
Modified acid-fast stain showing oocyst of Cryptosporidium
Figure 4
Figure 4
Profile of intestinal parasites in people living with HIV and AIDS according to their CD4 count
Figure 5
Figure 5
Detection of Cryptosporidium by polymerase chain reaction. Lane 1-100 bp DNA ladder; Lane 2 - Positive control of Cryptosporidium parvum; Lane 3 - Positive control of Cryptosporidium hominis; Lane 4–7 - Samples showing positive band by polymerase chain reaction; Lane 9 - Negative control
Figure 6
Figure 6
Immunochromatography test showing positive for Cryptosporidium
See this image and copyright information in PMC

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