{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:01:37Z","timestamp":1791378097519,"version":"4.3.2"},"reference-count":41,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"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":[[2025,5,14]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Commercial multiplex real-time PCR (qPCR assays) are now widely used for the diagnosis of intestinal protozoan infections, but few prospective studies evaluated their performances on large patient cohorts. We extracted data from our information system from 1 January 2021 to 15 March 2024 and included all stool samples analyzed in routine. Parasites were searched using a multiplex PCR (AllPlex Gastrointestinal Panel assay, Seegene) and microscopic examination with two concentration methods. Acid-fast staining was performed when\n                      <jats:italic toggle=\"yes\">Cryptosporidium<\/jats:italic>\n                      detection was specifically requested. In total, 3,495 stools were analyzed from 2,127 patients.\n                      <jats:italic toggle=\"yes\">Giardia intestinalis<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Cryptosporidium<\/jats:italic>\n                      spp.,\n                      <jats:italic toggle=\"yes\">Entamoeba histolytica<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Dientamoeba fragilis,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Blastocystis<\/jats:italic>\n                      spp. were found by multiplex qPCR in 45 (1.28%), 30 (0.85%), 9 (0.25%), 310 (8.86%), and 673 (19.25%) samples, respectively, alone or in combination (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 909). In the vast majority of cases, PCR detected a protozoan on the first stool sample. Microscopy was positive for\n                      <jats:italic toggle=\"yes\">G. intestinalis<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Cryptosporidium<\/jats:italic>\n                      spp.,\n                      <jats:italic toggle=\"yes\">Entamoeba histolytica\/dispar<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">D. fragilis,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Blastocystis<\/jats:italic>\n                      spp. in 25 (0.7%), 8 (0.23%), 24 (0.68%), 22 (0.63%), and 229 (6.55%), samples, respectively, alone or in combination (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 286 samples). No samples were PCR\u2212\/Microscopy+ for\n                      <jats:italic toggle=\"yes\">G<\/jats:italic>\n                      .\n                      <jats:italic toggle=\"yes\">intestinalis<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Cryptosporidium<\/jats:italic>\n                      spp., and\n                      <jats:italic toggle=\"yes\">E. histolytica<\/jats:italic>\n                      , while\n                      <jats:italic toggle=\"yes\">D. fragilis<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Blastocystis<\/jats:italic>\n                      spp. were detected only with microscopy in 6 and 20 samples, respectively. Microscopy allowed the detection of parasites not targeted by the multiplex panel (5\n                      <jats:italic toggle=\"yes\">Cystoisospora belli,<\/jats:italic>\n                      331 samples with non-pathogenic protozoa, and 68 samples with helminths). Overall, the multiplex PCR proved more efficient to detect protozoan parasites, but a microscopic technique should be performed when infection with\n                      <jats:italic toggle=\"yes\">C. belli<\/jats:italic>\n                      (HIV-infected patients) or helminths is suspected (migrants and travelers).\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        In the era of increasing use of multiplex PCR panels for the diagnosis of intestinal protozoan infections, it is important to form an opinion on the positioning of those assays within a lab workflow. This study analyzes routine results obtained prospectively by microscopy and a commercial multiplex PCR over 3 years, and shows that the assay meets the expectations of a clinical laboratory for the detection of protozoan parasites of medical interest. It is recalled that\n                        <jats:italic toggle=\"yes\">Cystoisospora belli<\/jats:italic>\n                        is not targeted by the multiplex assay, and that microscopy still remains necessary to detect helminths.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.01610-24","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T09:33:36Z","timestamp":1744364016000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":12,"title":["Improvement of the diagnosis of intestinal protozoa using a multiplex qPCR strategy compared to classical microscopy: a prospective study on 3,500 stool samples over 3 years"],"prefix":"10.1128","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4493-596X","authenticated-orcid":true,"given":"Florence","family":"Robert-Gangneux","sequence":"first","affiliation":[{"name":"Laboratoire de parasitologie et mycologie, Centre Hospitalier Universitaire de Rennes","place":["Rennes, France"]},{"name":"Irset (Institut de Recherche en Sant\u00e9 Environnement Travail), Univ Rennes, Centre Hospitalier Universitaire de Rennes, Inserm, EHESP","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Duval","sequence":"additional","affiliation":[{"name":"Laboratoire de parasitologie et mycologie, Centre Hospitalier Universitaire de Rennes","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Cazala","sequence":"additional","affiliation":[{"name":"Laboratoire de parasitologie et mycologie, Centre Hospitalier Universitaire de Rennes","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorya","family":"Belaz","sequence":"additional","affiliation":[{"name":"Laboratoire de parasitologie et mycologie, Centre Hospitalier Universitaire de Rennes","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Dupuis","sequence":"additional","affiliation":[{"name":"Laboratoire de parasitologie et mycologie, Centre Hospitalier Universitaire de Rennes","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6338-3094","authenticated-orcid":true,"given":"H\u00e9l\u00e8ne","family":"Guegan","sequence":"additional","affiliation":[{"name":"Laboratoire de parasitologie et mycologie, Centre Hospitalier Universitaire de Rennes","place":["Rennes, France"]},{"name":"Irset (Institut de Recherche en Sant\u00e9 Environnement Travail), Univ Rennes, Centre Hospitalier Universitaire de Rennes, Inserm, EHESP","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6945-4359","authenticated-orcid":true,"given":"Brice","family":"Autier","sequence":"additional","affiliation":[{"name":"Laboratoire de parasitologie et mycologie, Centre Hospitalier Universitaire de Rennes","place":["Rennes, France"]},{"name":"Irset (Institut de Recherche en Sant\u00e9 Environnement Travail), Univ Rennes, Centre Hospitalier Universitaire de Rennes, Inserm, EHESP","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pierre","family":"Gangneux","sequence":"additional","affiliation":[{"name":"Laboratoire de parasitologie et mycologie, Centre Hospitalier Universitaire de Rennes","place":["Rennes, France"]},{"name":"Irset (Institut de Recherche en Sant\u00e9 Environnement Travail), Univ Rennes, Centre Hospitalier Universitaire de Rennes, Inserm, EHESP","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008505"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.05038-11"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2005.07.008"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijfoodmicro.2004.12.032"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac061"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1051\/parasite\/2021034"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1051\/parasite\/2022026"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1051\/parasite\/2022003"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1051\/parasite\/2018049"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.10.019"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0215068"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9112325"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00531-22"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14181998"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01737-19"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8040569"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001367"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10061237"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01392-10"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01466-18"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-019-3516-6"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12626"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.02.007"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00076-15"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.02.007"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00037-17"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00400-16"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-019-03710-z"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.17.3.553-570.2004"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00436-017-5556-1"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199801000-00003"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2006.09.009"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0031182011000448"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.07.065"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0111868"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-407706-5.00001-0"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1002545"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2017.02.016"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2018.04.006"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-009-0073-8"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pt.2019.12.008"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01610-24","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.01610-24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T09:01:04Z","timestamp":1747213264000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.01610-24"}},"subtitle":[],"editor":[{"given":"Bobbi S.","family":"Pritt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,14]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,14]]}},"alternative-id":["10.1128\/jcm.01610-24"],"URL":"https:\/\/doi.org\/10.1128\/jcm.01610-24","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,14]]},"assertion":[{"value":"2024-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01610-24"}}