Community Laboratory Testing for Cryptosporidium: Multicenter Study Retesting Public Health Surveillance Stool Samples Positive for Cryptosporidium by Rapid Cartridge Assay with Direct Fluorescent Antibody Testing
Cryptosporidium is a common cause of sporadic diarrheal disease and outbreaks in the United States. Increasingly, immunochromatography-based rapid cartridge assays (RCAs) are providing community laboratories with a quick cryptosporidiosis diagnostic method. In the current study, the Centers for Dise...
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| Veröffentlicht in: | PloS one 2017-01, Vol.12 (1), p.e0169915-e0169915 |
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| creator | Roellig, Dawn M Yoder, Jonathan S Madison-Antenucci, Susan Robinson, Trisha J Van, Tam T Collier, Sarah A Boxrud, Dave Monson, Timothy Bates, Leigh Ann Blackstock, Anna J Shea, Shari Larson, Kirsten Xiao, Lihua Beach, Michael |
| description | Cryptosporidium is a common cause of sporadic diarrheal disease and outbreaks in the United States. Increasingly, immunochromatography-based rapid cartridge assays (RCAs) are providing community laboratories with a quick cryptosporidiosis diagnostic method. In the current study, the Centers for Disease Control and Prevention (CDC), the Association of Public Health Laboratories (APHL), and four state health departments evaluated RCA-positive samples obtained during routine Cryptosporidium testing. All samples underwent "head to head" re-testing using both RCA and direct fluorescence assay (DFA). Community level results from three sites indicated that 54.4% (166/305) of Meridian ImmunoCard STAT! positives and 87.0% (67/77) of Remel Xpect positives were confirmed by DFA. When samples were retested by RCA at state laboratories and compared with DFA, 83.3% (155/186) of Meridian ImmunoCard STAT! positives and 95.2% (60/63) of Remel Xpect positives were confirmed. The percentage of confirmed community results varied by site: Minnesota, 39.0%; New York, 63.9%; and Wisconsin, 72.1%. The percentage of confirmed community results decreased with patient age; 12.5% of community positive tests could be confirmed by DFA for patients 60 years of age or older. The percentage of confirmed results did not differ significantly by sex, storage temperature, time between sample collection and testing, or season. Findings from this study demonstrate a lower confirmation rate of community RCA positives when compared to RCA positives identified at state laboratories. Elucidating the causes of decreased test performance in order to improve overall community laboratory performance of these tests is critical for understanding the epidemiology of cryptosporidiosis in the United States (US). |
| doi_str_mv | 10.1371/journal.pone.0169915 |
| format | Article |
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Increasingly, immunochromatography-based rapid cartridge assays (RCAs) are providing community laboratories with a quick cryptosporidiosis diagnostic method. In the current study, the Centers for Disease Control and Prevention (CDC), the Association of Public Health Laboratories (APHL), and four state health departments evaluated RCA-positive samples obtained during routine Cryptosporidium testing. All samples underwent "head to head" re-testing using both RCA and direct fluorescence assay (DFA). Community level results from three sites indicated that 54.4% (166/305) of Meridian ImmunoCard STAT! positives and 87.0% (67/77) of Remel Xpect positives were confirmed by DFA. When samples were retested by RCA at state laboratories and compared with DFA, 83.3% (155/186) of Meridian ImmunoCard STAT! positives and 95.2% (60/63) of Remel Xpect positives were confirmed. The percentage of confirmed community results varied by site: Minnesota, 39.0%; New York, 63.9%; and Wisconsin, 72.1%. The percentage of confirmed community results decreased with patient age; 12.5% of community positive tests could be confirmed by DFA for patients 60 years of age or older. The percentage of confirmed results did not differ significantly by sex, storage temperature, time between sample collection and testing, or season. Findings from this study demonstrate a lower confirmation rate of community RCA positives when compared to RCA positives identified at state laboratories. Elucidating the causes of decreased test performance in order to improve overall community laboratory performance of these tests is critical for understanding the epidemiology of cryptosporidiosis in the United States (US).</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0169915</identifier><identifier>PMID: 28085927</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Antigens ; Antigens, Protozoan - analysis ; Assaying ; Biological Assay - methods ; Biology and Life Sciences ; Care and treatment ; Causes of ; Child ; Child, Preschool ; Clinical Laboratory Techniques - methods ; Communities ; Cryptosporidiosis ; Cryptosporidiosis - diagnosis ; Cryptosporidiosis - parasitology ; Cryptosporidium ; Cryptosporidium - isolation & purification ; Cryptosporidium hominis ; Diagnosis ; Diagnostic systems ; Diarrhea ; Disease control ; Disease prevention ; Enzymes ; Epidemiology ; Feces ; Feces - parasitology ; Female ; Fluorescence ; Fluorescent Antibody Technique, Direct - methods ; Giardia ; Giardia lamblia ; Health surveillance ; Humans ; Immunoassay ; Infant ; Infant, Newborn ; Infectious diseases ; Laboratories ; Laboratory tests ; Male ; Medical laboratories ; Medicine and Health Sciences ; Middle Aged ; Outbreaks ; Parasitology ; People and places ; Physical Sciences ; Physiological aspects ; Protozoa ; Public health ; Public Health Surveillance ; Research and Analysis Methods ; Storage temperature ; Studies ; Young Adult ; Zoonoses</subject><ispartof>PloS one, 2017-01, Vol.12 (1), p.e0169915-e0169915</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). 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Increasingly, immunochromatography-based rapid cartridge assays (RCAs) are providing community laboratories with a quick cryptosporidiosis diagnostic method. In the current study, the Centers for Disease Control and Prevention (CDC), the Association of Public Health Laboratories (APHL), and four state health departments evaluated RCA-positive samples obtained during routine Cryptosporidium testing. All samples underwent "head to head" re-testing using both RCA and direct fluorescence assay (DFA). Community level results from three sites indicated that 54.4% (166/305) of Meridian ImmunoCard STAT! positives and 87.0% (67/77) of Remel Xpect positives were confirmed by DFA. When samples were retested by RCA at state laboratories and compared with DFA, 83.3% (155/186) of Meridian ImmunoCard STAT! positives and 95.2% (60/63) of Remel Xpect positives were confirmed. The percentage of confirmed community results varied by site: Minnesota, 39.0%; New York, 63.9%; and Wisconsin, 72.1%. The percentage of confirmed community results decreased with patient age; 12.5% of community positive tests could be confirmed by DFA for patients 60 years of age or older. The percentage of confirmed results did not differ significantly by sex, storage temperature, time between sample collection and testing, or season. Findings from this study demonstrate a lower confirmation rate of community RCA positives when compared to RCA positives identified at state laboratories. Elucidating the causes of decreased test performance in order to improve overall community laboratory performance of these tests is critical for understanding the epidemiology of cryptosporidiosis in the United States (US).</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antigens</subject><subject>Antigens, Protozoan - analysis</subject><subject>Assaying</subject><subject>Biological Assay - methods</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Causes of</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical Laboratory Techniques - methods</subject><subject>Communities</subject><subject>Cryptosporidiosis</subject><subject>Cryptosporidiosis - diagnosis</subject><subject>Cryptosporidiosis - parasitology</subject><subject>Cryptosporidium</subject><subject>Cryptosporidium - isolation & purification</subject><subject>Cryptosporidium 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Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roellig, Dawn M</au><au>Yoder, Jonathan S</au><au>Madison-Antenucci, Susan</au><au>Robinson, Trisha J</au><au>Van, Tam T</au><au>Collier, Sarah A</au><au>Boxrud, Dave</au><au>Monson, Timothy</au><au>Bates, Leigh Ann</au><au>Blackstock, Anna J</au><au>Shea, Shari</au><au>Larson, Kirsten</au><au>Xiao, Lihua</au><au>Beach, Michael</au><au>Adam, Rodney D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Community Laboratory Testing for Cryptosporidium: Multicenter Study Retesting Public Health Surveillance Stool Samples Positive for Cryptosporidium by Rapid Cartridge Assay with Direct Fluorescent Antibody Testing</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-01-13</date><risdate>2017</risdate><volume>12</volume><issue>1</issue><spage>e0169915</spage><epage>e0169915</epage><pages>e0169915-e0169915</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cryptosporidium is a common cause of sporadic diarrheal disease and outbreaks in the United States. Increasingly, immunochromatography-based rapid cartridge assays (RCAs) are providing community laboratories with a quick cryptosporidiosis diagnostic method. In the current study, the Centers for Disease Control and Prevention (CDC), the Association of Public Health Laboratories (APHL), and four state health departments evaluated RCA-positive samples obtained during routine Cryptosporidium testing. All samples underwent "head to head" re-testing using both RCA and direct fluorescence assay (DFA). Community level results from three sites indicated that 54.4% (166/305) of Meridian ImmunoCard STAT! positives and 87.0% (67/77) of Remel Xpect positives were confirmed by DFA. When samples were retested by RCA at state laboratories and compared with DFA, 83.3% (155/186) of Meridian ImmunoCard STAT! positives and 95.2% (60/63) of Remel Xpect positives were confirmed. The percentage of confirmed community results varied by site: Minnesota, 39.0%; New York, 63.9%; and Wisconsin, 72.1%. The percentage of confirmed community results decreased with patient age; 12.5% of community positive tests could be confirmed by DFA for patients 60 years of age or older. The percentage of confirmed results did not differ significantly by sex, storage temperature, time between sample collection and testing, or season. Findings from this study demonstrate a lower confirmation rate of community RCA positives when compared to RCA positives identified at state laboratories. Elucidating the causes of decreased test performance in order to improve overall community laboratory performance of these tests is critical for understanding the epidemiology of cryptosporidiosis in the United States (US).</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28085927</pmid><doi>10.1371/journal.pone.0169915</doi><tpages>e0169915</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-01, Vol.12 (1), p.e0169915-e0169915 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1858297570 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adolescent Adult Antigens Antigens, Protozoan - analysis Assaying Biological Assay - methods Biology and Life Sciences Care and treatment Causes of Child Child, Preschool Clinical Laboratory Techniques - methods Communities Cryptosporidiosis Cryptosporidiosis - diagnosis Cryptosporidiosis - parasitology Cryptosporidium Cryptosporidium - isolation & purification Cryptosporidium hominis Diagnosis Diagnostic systems Diarrhea Disease control Disease prevention Enzymes Epidemiology Feces Feces - parasitology Female Fluorescence Fluorescent Antibody Technique, Direct - methods Giardia Giardia lamblia Health surveillance Humans Immunoassay Infant Infant, Newborn Infectious diseases Laboratories Laboratory tests Male Medical laboratories Medicine and Health Sciences Middle Aged Outbreaks Parasitology People and places Physical Sciences Physiological aspects Protozoa Public health Public Health Surveillance Research and Analysis Methods Storage temperature Studies Young Adult Zoonoses |
| title | Community Laboratory Testing for Cryptosporidium: Multicenter Study Retesting Public Health Surveillance Stool Samples Positive for Cryptosporidium by Rapid Cartridge Assay with Direct Fluorescent Antibody Testing |
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