{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T21:08:57Z","timestamp":1774645737659,"version":"3.50.1"},"reference-count":26,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2016,10,24]],"date-time":"2016-10-24T00:00:00Z","timestamp":1477267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T00:00:00Z","timestamp":1477958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Common causes of chronic diarrhea among travelers worldwide include protozoan parasites. The majority of parasitic infections are caused by\n            <jats:named-content content-type=\"genus-species\">Giardia duodenalis<\/jats:named-content>\n            ,\n            <jats:named-content content-type=\"genus-species\">Entamoeba histolytica<\/jats:named-content>\n            ,\n            <jats:named-content content-type=\"genus-species\">Cryptosporidium parvum<\/jats:named-content>\n            , and\n            <jats:named-content content-type=\"genus-species\">Cryptosporidium hominis<\/jats:named-content>\n            . Similarly, these species cause the majority of parasitic diarrhea acquired in the United States. Detection of parasites by gold standard microscopic methods is time-consuming and requires considerable expertise; enzyme immunoassays and direct fluorescent-antibody (DFA) stains have lowered hands-on time for testing, but improvements in sensitivity and technical time may be possible with a PCR assay. We performed a clinical evaluation of a multiplex PCR panel, the enteric parasite panel (EPP), for the detection of these common parasites using the BD Max instrument, which performs automated extraction and amplification. A total of 2,495 compliant specimens were enrolled, including 2,104 (84%) specimens collected prospectively and 391 (16%) specimens collected retrospectively. Approximately equal numbers were received in 10% formalin (1,273 specimens) and unpreserved (1,222 specimens). The results from the EPP were compared to those from alternate PCR and bidirectional sequencing (APCR), as well as DFA (\n            <jats:named-content content-type=\"genus-species\">G. duodenalis<\/jats:named-content>\n            and\n            <jats:named-content content-type=\"genus-species\">C. parvum<\/jats:named-content>\n            or\n            <jats:named-content content-type=\"genus-species\">C. hominis<\/jats:named-content>\n            ) or trichrome stain (\n            <jats:named-content content-type=\"genus-species\">E. histolytica<\/jats:named-content>\n            ). The sensitivity and specificity for prospective and retrospective specimens combined were 98.2% and 99.5% for\n            <jats:named-content content-type=\"genus-species\">G. duodenalis<\/jats:named-content>\n            , 95.5% and 99.6 for\n            <jats:named-content content-type=\"genus-species\">C. parvum<\/jats:named-content>\n            or\n            <jats:named-content content-type=\"genus-species\">C. hominis<\/jats:named-content>\n            , and 100% and 100% for\n            <jats:named-content content-type=\"genus-species\">E. histolytica<\/jats:named-content>\n            , respectively. The performance of the FDA-approved BD Max EPP compared well to the reference methods and may be an appropriate substitute for microscopic examination or immunoassays.\n          <\/jats:p>","DOI":"10.1128\/jcm.00765-16","type":"journal-article","created":{"date-parts":[[2016,8,18]],"date-time":"2016-08-18T02:34:01Z","timestamp":1471487641000},"page":"2681-2688","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":56,"title":["Multicenter Evaluation of BD Max Enteric Parasite Real-Time PCR Assay for Detection of Giardia duodenalis, Cryptosporidium hominis, Cryptosporidium parvum, and Entamoeba histolytica"],"prefix":"10.1128","volume":"54","author":[{"given":"S.","family":"Madison-Antenucci","sequence":"first","affiliation":[{"name":"Parasitology Laboratory, Wadsworth Center, NYSDOH, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. F.","family":"Relich","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Espina","sequence":"additional","affiliation":[{"name":"Parasitology Laboratory, Wadsworth Center, NYSDOH, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Karchmer","sequence":"additional","affiliation":[{"name":"Becton Dickinson and Company, Sparks, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Lainesse","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company, Quebec, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. E.","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Pancholi","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Veros","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. M.","family":"Harrington","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61689-4"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001921"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001920"},{"key":"e_1_3_2_5_2","first-page":"1","article-title":"Summary of notifiable diseases\u2013United States, 2012","volume":"61","author":"Adams DA","year":"2014","unstructured":"Adams DA, Jajosky RA, Ajani U, Kriseman J, Sharp P, Onweh DH, Schley AW, Anderson WJ, Grigoryan A, Aranas AE, Wodajo MS, Abellera JP. 2014. Summary of notifiable diseases\u2013United States, 2012. 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W.","family":"Fenwick","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2016,11]]},"references-count":26,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1128\/JCM.00765-16"],"URL":"https:\/\/doi.org\/10.1128\/jcm.00765-16","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11]]},"assertion":[{"value":"2016-04-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}