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A retrospective study comparing agar plate culture, indirect immunofluorescence and real-time PCR for the diagnosis of Strongyloides stercoralis infection

Published online by Cambridge University Press:  11 January 2017

DORA BUONFRATE Open the ORCID record for DORA BUONFRATE [Opens in a new window] ,
FRANCESCA PERANDIN ,
FABIO FORMENTI  and
ZENO BISOFFI
DORA BUONFRATE*
Affiliation:
Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar, Verona, Italy
FRANCESCA PERANDIN
Affiliation:
Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar, Verona, Italy
FABIO FORMENTI
Affiliation:
Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar, Verona, Italy
ZENO BISOFFI
Affiliation:
Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar, Verona, Italy
*
*Corresponding author: Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar, Verona, Italy. E-mail: dora.buonfrate@sacrocuore.it
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Summary

Strongyloides stercoralis is a parasite that can cause death in immunocompromised people. A proper diagnosis is hence essential. The real-time polymerase-chain reaction (RT–PCR) is a novel, promising diagnostic method, that detects the DNA of the parasite in stool samples. In this retrospective study, we compared the sensitivity of agar plate coproculture (APC), an in-house immunofluorescence test (IFAT) and an in-house RT–PCR for the diagnosis of S. stercoralis infection. The study sample was composed by 223 samples. Samples resulting positive to APC, IFAT and RT–PCR were 20, 140 and 25, respectively. When sensitivity was calculated against a composite reference standard, serology confirmed the best performance (sensitivity 95%), followed by RT–PCR (57%) and APC (45%). In conclusion, in a non-endemic setting, serology is the best screening method, while the combination of APC and RT–PCR does not seem a reasonable approach to increase sensitivity. Both methods can have a role as confirmatory tests for selected cases.

Keywords

Strongyloides stercoralisstrongyloidiasisreal-time PCRagar plate cultureserology
Type
Research Article
Information
Parasitology , Volume 144 , Issue 6 , May 2017 , pp. 812 - 816
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Copyright
Copyright © Cambridge University Press 2017 

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