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Detection of pathogenic protozoa in the diagnostic laboratory: result reproducibility, specimen pooling, and competency assessment.
J Clin Microbiol. 2008 Jul; 46(7):2200-5.JC

Abstract

Stool microscopy as performed in clinical parasitology laboratories is a complex procedure with subjective interpretation. Quality assurance (QA) programs often emphasize proficiency testing as an assessment tool. We describe a result reproducibility assessment tool, which can form part of a broader QA program, and which is based on the blinded resubmission of selected clinical samples, using concordance between the reports of the initial and resubmitted specimen as an indicator. Specimens preserved in sodium acetate-acetic acid-formalin can be stored for several months for use in such a program. The presence of multiple protozoa in one specimen does not affect concordance. Some dilution of specimens occurs in this process, and this may explain poor concordance when specimens with low protozoal concentrations are resubmitted. Evaluation of this tool in a large parasitology laboratory revealed concordance rates for pathogenic protozoa (Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, and Dientamoeba fragilis) of about 80%, which may be considered for use as a benchmark value. We also used this tool to demonstrate that when pairs of specimens from one patient are pooled to create a single specimen, concordance between the results of the individual and pooled specimens is high.

Authors+Show Affiliations

McGill University Centre for Tropical Diseases, Montreal General Hospital, Room D7-153, 1650 Cedar Avenue, Montréal, Québec, Canada H3G 1A4. michael.libman@mcgill.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18448690

Citation

Libman, M D., et al. "Detection of Pathogenic Protozoa in the Diagnostic Laboratory: Result Reproducibility, Specimen Pooling, and Competency Assessment." Journal of Clinical Microbiology, vol. 46, no. 7, 2008, pp. 2200-5.
Libman MD, Gyorkos TW, Kokoskin E, et al. Detection of pathogenic protozoa in the diagnostic laboratory: result reproducibility, specimen pooling, and competency assessment. J Clin Microbiol. 2008;46(7):2200-5.
Libman, M. D., Gyorkos, T. W., Kokoskin, E., & Maclean, J. D. (2008). Detection of pathogenic protozoa in the diagnostic laboratory: result reproducibility, specimen pooling, and competency assessment. Journal of Clinical Microbiology, 46(7), 2200-5. https://doi.org/10.1128/JCM.01666-07
Libman MD, et al. Detection of Pathogenic Protozoa in the Diagnostic Laboratory: Result Reproducibility, Specimen Pooling, and Competency Assessment. J Clin Microbiol. 2008;46(7):2200-5. PubMed PMID: 18448690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of pathogenic protozoa in the diagnostic laboratory: result reproducibility, specimen pooling, and competency assessment. AU - Libman,M D, AU - Gyorkos,T W, AU - Kokoskin,E, AU - Maclean,J D, Y1 - 2008/04/30/ PY - 2008/5/2/pubmed PY - 2008/8/13/medline PY - 2008/5/2/entrez SP - 2200 EP - 5 JF - Journal of clinical microbiology JO - J Clin Microbiol VL - 46 IS - 7 N2 - Stool microscopy as performed in clinical parasitology laboratories is a complex procedure with subjective interpretation. Quality assurance (QA) programs often emphasize proficiency testing as an assessment tool. We describe a result reproducibility assessment tool, which can form part of a broader QA program, and which is based on the blinded resubmission of selected clinical samples, using concordance between the reports of the initial and resubmitted specimen as an indicator. Specimens preserved in sodium acetate-acetic acid-formalin can be stored for several months for use in such a program. The presence of multiple protozoa in one specimen does not affect concordance. Some dilution of specimens occurs in this process, and this may explain poor concordance when specimens with low protozoal concentrations are resubmitted. Evaluation of this tool in a large parasitology laboratory revealed concordance rates for pathogenic protozoa (Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, and Dientamoeba fragilis) of about 80%, which may be considered for use as a benchmark value. We also used this tool to demonstrate that when pairs of specimens from one patient are pooled to create a single specimen, concordance between the results of the individual and pooled specimens is high. SN - 1098-660X UR - https://www.unboundmedicine.com/medline/citation/18448690/full_citation L2 - http://jcm.asm.org/cgi/pmidlookup?view=long&pmid=18448690 DB - PRIME DP - Unbound Medicine ER -