Microsporidia species, PCR (Sendout)

Useful For: Detecting Enterocytozoon bieneusi and Encephalitozoon species in fecal and urine specimens to support the clinical diagnosis of microsporidiosis.

Test Highlights:

• This test is intended to be used for immunocompromised patients with persistent, watery diarrhea.
• This test is intended to be used for the detection of Enterocytozoon bieneusi and Encephalitozoon species DNA in stool and urine specimens to support the clinical diagnosis of microsporidiosis.
• A negative result indicates the absence of detectable DNA from Enterocytozoon bieneusi and Encephalitozoon species in the specimen, but does not rule out ongoing microsporidiosis.

Interpretation:

A positive result indicates the presence of Enterocytozoon bieneusi and Encephalitozoon species DNA and is consistent with an active or recent infection. Since microsporidia DNA may be present in feces or urine in the absence of clinical symptoms, results should be correlated with clinical presentation.

A negative result indicates absence of detectable DNA from E bieneusi and Encephalitozoon species in the specimen. Still, this does not always rule out ongoing microsporidiosis since the organism may be present at very low levels or may be sporadic.

Other tests to consider in the evaluation of a patient presenting with acute or chronic watery diarrhea include cultures or specific assays for bacterial, viral, and parasitic pathogens.

Cautions:

This test only detects DNA from Enterocytozoon bieneusi and Encephalitozoon species and does not detect the less common microsporidia. These 2 genera are the most common causes of intestinal and renal microsporidiosis.

While this assay is designed to detect symptomatic infection with E bieneusi and Encephalitozoon species, it may detect asymptomatic carriage and should only be used for patients with a clinical history and symptoms consistent with microsporidiosis.

Specimens for this test must be submitted in a separate sample container. Submit one of the following:

• Stool: 5 g unpreserved Stool in a screw-cap stool container or 5 g Stool in ECOFIX preservative
• Urine: 5 mL Urine in a clean, sterile container without preservative. Mid-stream, clean-catch, suprapubic aspirates and catheterization collections are acceptable. The first portion of the voided urine (first void) is also acceptable.

Unacceptable: Urine containing preservatives, Prostate secretions and samples, stool in preservatives other than ECOFIX.

Outside Laboratories:

• Refrigerate specimen. If other tests are requested, submit a separate specimen for each.
• Indicate the specimen source (stool, urine) on the DLMP requisition.

Stability: Refrigerated (preferred): 7 days; Ambient: 7 days; Frozen: 7 days.

Reject Due To: Urine containing preservatives, Prostate secretions and samples, stool in preservatives other than ECOFIX.

Stool: Refrigerate stool in a sterile, screw-capped container.

• If a single unpreserved stool specimen is received for multiple tests, samples may be sent to Micro to be split. Include CID labels and directions for splitting (including minimum volumes). If there is insufficient sample, contact the provider to prioritize testing.

Urine: Transfer 5 mL urine (min 0.5 mL) to a separate aliquot. Refrigerate urine.

SPS Login Note: This test should be ordered on its own accession to prevent multiple stool tests from routing to the same container ID in Sunquest and to ensure proper interface batching. Separate stool specimens or aliquots must be submitted for each sendout test.

Sendouts:

• Order Mayo Test: LCMSP.
• Interfaced: Yes.

Stability: Refrigerated (preferred): 7 days; Ambient: 7 days; Frozen: 7 days.

Reject Due To: Urine containing preservatives, Prostate secretions and samples, stool in preservatives other than ECOFIX.