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Journal of Clinical Microbiology, April 1998, p. 995-998, Vol. 36, No. 4
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Comparison of PCR and Microscopy for Detection of Cryptosporidium parvum in Human Fecal Specimens: Clinical Trial

U. M. Morgan,1,* L. Pallant,1 B. W. Dwyer,2 D. A. Forbes,3 G. Rich,2 and R. C. A. Thompson1

World Health Organisation Collaborating Center for the Molecular Epidemiology of Infectious Diseases and State Agricultural Biotechnology Centre, Division of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA, 6150,1 Western Diagnostic Pathology, Myaree, WA, 6154,2 and Department of Paediatrics, University of Western Australia, Princess Margaret Hospital, WA, 6001,3 Australia

Received 4 August 1997/Returned for modification 21 October 1997/Accepted 14 January 1998

PCR technology offers alternatives to conventional diagnosis of Cryptosporidium for both clinical and environmental samples. We compared microscopic examination by a conventional acid-fast staining procedure with a recently developed PCR test that can not only detect Cryptosporidium but is also able to differentiate between what appear to be host-adapted genotypes of the parasite. Examinations were performed on 511 stool specimens referred for screening on the basis of diarrhea. PCR detected a total of 36 positives out of the 511 samples, while routine microscopy detected 29 positives. Additional positives detected by PCR were eventually confirmed to be positive by microscopy. A total of five samples that were positive by routine microscopy at Western Diagnostic Pathology but negative by PCR and by microscopy in our laboratory were treated as false positives. Microscopy therefore exhibited 83.7% sensitivity and 98.9% specificity compared to PCR. PCR was more sensitive and easier to interpret but required more hands-on time to perform and was more expensive than microscopy. PCR, however, was very adaptable to batch analysis, reducing the costs considerably. Bulk buying of reagents and modifications to the procedure would decrease the cost of the PCR test even more. An important advantage of the PCR test, its ability to directly differentiate between different Cryptosporidium genotypes, will assist in determining the source of cryptosporidial outbreaks. Sensitivity, specificity, ability to genotype, ease of use, and adaptability to batch testing make PCR a useful tool for future diagnosis and studies on the molecular epidemiology of Cryptosporidium infections.

* Corresponding author. Mailing address: Division of Veterinary and Biomedical Sciences, Murdoch University, South St., Murdoch, WA 6150, Australia. Phone: (08) 9360 2457. Fax: (08) 9310 4144. E-mail: morgan{at}numbat.murdoch.edu.au.

Journal of Clinical Microbiology, April 1998, p. 995-998, Vol. 36, No. 4
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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