Investigation of the Frequency of Cryptosporidium spp. in Immunosuppressed Patients with Diarrhea.

Objective: We aimed to investigate the frequency of Cryptosporidium spp. in immunosuppressed patients who were admitted with diarrhea by microscopic, serological, and molecular methods and to evaluate the results in comparison with the direct fluorescent antibody (DFA) method.

Methods: We analyzed 90 stool samples from immunosuppressed patients with diarrhea. All stool samples were examined using modified acid-fast staining, polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) tests for the detection of Cryptosporidium spp. samples examined with the DFA method were selected randomly, including samples found positive in other diagnostic tests. Stool samples that were positive in any of these diagnostic tests were evaluated by immunochromatographic card test.

Results: Our study included 90 samples, of which 44 (48.8%) and 46 (51.2%) were from male and female patients, respectively. The mean age of the patients was 37.8±27.5. Thirty-one (34.4%) of the samples were from pediatric patients and their mean age was 5.3±4.34. The methods used did not show a statistically significant difference between the positivity status and patient age and gender (p>0.05). Cryptosporidium spp. positivity was detected in five samples (5.6%), two samples (2.2%), and one sample (1.1%) by using the modified acid-fast staining, PCR, and ELISA methods, respectively. Six of 51 samples to which the DFA method was applied were detected positive. In 4 of the 7 stool samples that were found positive by any of these methods, Cryptosporidium spp. was detected positive by the immunochromatographic card test.

Conclusion: When the DFA method is accepted as the gold standard method in the diagnosis of Cryptosporidium spp., the modified acid-fast method can be used in routine diagnosis with high sensitivity and specificity. Besides, it immunochromatographic diagnostic tests thought to be useful in laboratories with intensive workflow due to their practical use and rapid results.