McHardy Ian H, Wu Max, Shimizu-Cohen Robyn, Couturier Marc Roger, Humphries Romney M
Pathology and Laboratory Medicine, UCLA, Los Angeles, California, USA.
J Clin Microbiol. 2014 Mar;52(3):712-20. doi: 10.1128/JCM.02877-13. Epub 2013 Nov 6.
Despite recent advances in diagnostic technology, microscopic examination of stool specimens remains central to the diagnosis of most pathogenic intestinal protozoa. Microscopy is, however, labor-intensive and requires a skilled technologist. New, highly sensitive diagnostic methods have been developed for protozoa endemic to developed countries, including Giardia lamblia (syn. G. intestinalis/G. duodenalis) and Cryptosporidium spp., using technologies that, if expanded, could effectively complement or even replace microscopic approaches. To date, the scope of such novel technologies is limited and may not include common protozoa such as Dientamoeba fragilis, Entamoeba histolytica, or Cyclospora cayetanensis. This minireview describes canonical approaches for the detection of pathogenic intestinal protozoa, while highlighting recent developments and FDA-approved tools for clinical diagnosis of common intestinal protozoa.
尽管诊断技术最近取得了进展,但粪便标本的显微镜检查仍然是大多数致病性肠道原生动物诊断的核心。然而,显微镜检查劳动强度大,需要熟练的技术人员。针对发达国家流行的原生动物,包括蓝氏贾第鞭毛虫(同义词:肠贾第虫/十二指肠贾第虫)和隐孢子虫属,已经开发出了新的、高度敏感的诊断方法,所使用的技术若能得到推广,可有效补充甚至取代显微镜检查方法。迄今为止,此类新技术的范围有限,可能不包括脆弱双核阿米巴、溶组织内阿米巴或卡耶塔环孢子球虫等常见原生动物。本综述描述了检测致病性肠道原生动物的经典方法,同时强调了常见肠道原生动物临床诊断的最新进展和美国食品药品监督管理局批准的工具。