Discipline: Biological Sciences
Moses Akintunde - Pennsylvania State University
Co-Author(s): Marc Roger Couturier, University of Utah, Salt Lake City, UT Francisca Abanyie, Centers for Disease Control and Prevention (CDC) Atlanta, GA
Cyclosporiasis is a gastrointestinal illness caused by the protozoan parasite Cyclospora cayetanensis. Over the past twenty-five years, the United States has reported several outbreak-related cases, including recent outbreaks in 2013, 2014, and 2015. A survey conducted in 2000 evaluated U.S. laboratory practices for identifying Cyclospora in stool specimens. The survey found that 36% of laboratories tested for C. cayetanensis on-site; <7% tested fecal specimens for C. cayetanensis as part of routine O&P and 27% tested for the parasite upon request. To assess the current diagnostic capabilities and practices of laboratories examining stool for Cyclospora, American Society for Microbiology (ASM) conducted a nationwide survey of laboratories in the United States and outlying territories over a 1-month period. In total, 125 (87%) of the 143 participants who initiated the survey completed the survey. Of 136 respondents, 62% were microbiologists and 23% were clinical laboratory scientists or medical technologists. Participants of the survey were from 42 of the 56 (75%) states and territories, with the majority of respondents from Southern (32.1%) and Midwestern (29.1%) states. Most respondents described their laboratory as being affiliated with a community hospital (46%) or a university hospital (25%). The majority of respondents’ laboratories (60%) diagnosed cyclosporiasis on-site. Of 119 respondents who reported that their laboratories accepted stool specimens for parasitologic testing, 17% (20 of 115 respondents) stated their laboratory examined Cyclospora oocysts as part of routine ova and parasite analysis; 41% (47 of 115 respondents) performed testing by request only. Microscopy by modified acid-fast staining was the most commonly used diagnostic test (74%; 48 of 65 respondents), followed by Biofire Diagnostic’s FilmArray® Gastrointestinal Panel (FilmArray® GP) (12%; 8 of 65 respondents). Fifty-two percent (34 of 65 respondents) reported that their laboratory has at least two different tests available for identification of Cyclospora. Over the one-year period prior to the survey 33% of respondents (34 of 104 respondents) stated their laboratory reported at least one positive stool specimens for Cyclospora. Of those reporting positive cases, 82% (28 of 34 respondents) had between 1 to 10 positive tests. Compared to the survey conducted in 2000, some progress has been made in incorporating Cyclospora into routine ova and parasite analysis. New clinical laboratory tests such as the FilmArray® GP may help fill the gaps between testing and diagnosis. Overall, the results of this survey emphasize the need for capacity building for Cyclospora in U.S. laboratories. These results will assist ASM and CDC in developing targeted educational and training opportunities for laboratory personnel.
Funder Acknowledgement(s): I would like to thank the IMHOTEP summer program for affording me the wonderful opportunity to work along with Francisca Abanyie, MD, MPH (CGH | DPDM), Marc Roger Couturier, PhD, D(ABMM) (ASM), Rebecca Hall, MPH (CGH| DPDM), and Barbara Herwaldt, MD, MPH (CGH| DPDM).
Faculty Advisor: Francisca Abanyie,