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Chapter 3 : Collection Options

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Collection Options, Page 1 of 2

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Abstract:

This section discusses collection and preservation of the clinical specimens for examination. Although clinical specimens for examination can be obtained from many other body sites, specimens and appropriate diagnostic methods are used for the examination of parasites. Various collection methods are available for specimens suspected of containing parasites or parasitic elements. There are many factors to consider before selecting the approach for your own laboratory. Some of the considerations include client base, physician ordering patterns, number of specimens received per month, cost, presence or absence of appropriate equipment, current and possible methodologies, availability of expert microscopists, collection options, selection of preservative-stain combinations, reimbursement issues, client education, area of the world where the laboratory is located, and emphasis on the most common infections (helminth or protozoa or both) seen in that geographic location. Collection and testing options and their pros and cons can be seen. Several fixatives are available: formalin, sodium acetate-acetic acid-formalin (SAF), Schaudinn's fluid, polyvinyl alcohol (PVA), and single-vial systems. The specimen used for quality control is designed to be used with fixatives from which permanent stained smears will be prepared. The majority of specimens from other body sites would be submitted as fresh specimens for further testing.

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3

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Giardia lamblia
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Entamoeba histolytica
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References

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1. Beaver, P. C.,, R. C. Jung, and, E. W. Cupp. 1984. Clinical Parasitology, 9th ed. Lea & Febiger, Philadelphia, PA.
2. Brooke, M. M.,, and M. Goldman. 1949. Polyvinyl alcohol-fixative as a preservative and adhesive for protozoa in dysenteric stools and other liquid material. J. Lab. Clin. Med. 34:15541560.
3. Code of Federal Regulations. 1991. Occupational exposure to bloodborne pathogens. Fed. Regist. 29CFR1910.1030.
4. Garcia, L. S. 2007. Diagnostic Medical Parasitology, 5th ed. ASM Press, Washington, DC.
5. Garcia, L. S. (coordinating ed.). 2008. Laboratory Procedures for Diagnosis of Blood-Borne Parasitic Diseases. Cumitech 46. ASM Press, Washington, DC.
6. Garcia, L. S. (coordinating ed.). 2003. Selection and Use of Laboratory Procedures for Diagnosis of Parasitic Infections of the Gastrointestinal Tract. Cumitech 30A. ASM Press, Washington, DC.
7. Garcia, L. S.,, R. Y. Shimizu,, T. C. Brewer, and, D. A. Bruckner. 1983. Evaluation of intestinal parasite morphology in polyvinyl alcohol preservative: comparison of copper sulfate and mercuric chloride base for use in Schaudinn’s fixative. J. Clin. Microbiol. 17:10921095.
8. Garcia, L. S.,, R. Y. Shimizu, and, D. A. Bruckner. 1986. Blood parasites: problems in diagnosis using automated differential instrumentation. Diagn. Microbiol. Infect. Dis. 4:173176.
9. Garcia, L. S.,, R. Y. Shimizu,, A. Shum, and, D. A. Bruckner. 1993. Evaluation of intestinal protozoan morphology in polyvinyl alcohol preservative: comparison of zinc sulfate- and mercuric chloride-based compounds for use in Schaudinn’s fixative. J. Clin. Microbiol. 31:307310.
10. Hiatt, R. A.,, E. K. Markell, and, E. Ng. 1995. How many stool examinations are necessary to detect pathogenic intestinal protozoa. Am. J. Trop. Med. Hyg. 53:3639.
11. Horen, W. P. 1981. Modification of Schaudinn fixative. J. Clin. Microbiol. 13:204205.
12. Melvin, D. M.,, and M.M. Brooke. 1982. Laboratory Procedures for the Diagnosis of Intestinal Parasites, 3rd ed. U.S. Department of Health, Education, and Welfare publication no. (CDC) 82-8282. Government Printing Office, Washington, DC.
13. NCCLS/CLSI. 2000. Laboratory Diagnosis of Blood-Borne Parasitic Diseases. Approved guideline M15-A. NCCLS/CLSI, Wayne, PA.
14. NCCLS/CLSI. 2005. Procedures for the Recovery and Identification of Parasites from the Intestinal Tract. Approved guideline M28-2A. NCCLS/CLSI, Wayne, PA.
15. Scholten, T. H.,, and J. Yang. 1974. Evaluation of unpreserved and preserved stools for the detection and identification of intestinal parasites. Am. J. Clin. Pathol. 62:563567.
16. Yang, J.,, and T. Scholten. 1977. A fixative for intestinal parasites permitting the use of concentration and permanent staining procedures. Am. J. Clin. Pathol. 67:300304.
17. Cartwright, C. P. 1999. Utility of multiple stool specimen ova and parasite examinations in a high-prevalence setting, J. Clin. Microbiol. 37:24082411.
18. Hiatt, R. A.,, E. K. Markell, and, E. Ng. 1995. How many stool examinations are necessary to detect pathogenic intestinal protozoa? Am. J. Trop. Med. Hyg. 53:3639.
19. Kehl, K. S. C. 1996. Screening stools for Giardia and Cryptosporidium: are antigen tests enough? Clin. Microbiol. Newsl. 18:133135.
20. Morris, A. J.,, M. L. Wilson, and, L. B. Reller. 1992. Application of rejection criteria for stool ovum and parasite examinations. J. Clin. Microbiol. 30:32133216.
21. Siegel, D. L.,, P. H. Edelstein, and, I. Nachamkin. 1990. Inappropriate testing for diarrheal diseases in the hospital. JAMA 263:979982.

Tables

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Summary: Formalin

Summary: Formalin

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Summary: SAF

Summary: SAF

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Summary: Schaudinn’s Fluid

Summary: Schaudinn’s Fluid

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Summary: PVA

Summary: PVA

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Summary: Modified PVA (Mercury Substitutes)

Summary: Modified PVA (Mercury Substitutes)

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Summary: Single-Vial Collection Systems

Summary: Single-Vial Collection Systems

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Table 3.1

Fecal specimens for parasites: options for collection and processing

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Table 3.2

Approaches to stool parasitology: test ordering

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Table 3.3

Preservatives and procedures commonly used in diagnostic parasitology (stool specimens)

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Table 3.4

Advantages of thin and thick blood films

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Table 3.5

Advantages and disadvantages of buffy coat films

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Table 3.6

Potential problems of using EDTA anticoagulant for the preparation of thin and thick blood films

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3
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Table 3.7

Body sites and possible parasites recovered

Citation: Garcia L. 2009. Collection Options, p 33-60. In Practical Guide to Diagnostic Parasitology, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815967.ch3

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