Test Code LCMSP Microsporidia species, Molecular Detection, PCR, Varies
Useful For
Detecting Enterocytozoon bieneusi and Encephalitozoon species in fecal and urine specimens to support the clinical diagnosis of microsporidiosis
Testing Algorithm
The following algorithms are available:
Special Instructions
Reporting Name
Microsporidia PCRSpecimen Type
VariesOrdering Guidance
For specimens other than feces or urine, MTBS / Microsporidia Stain, Varies should be ordered since it will detect other microsporidia not targeted by this assay.
Necessary Information
Specimen source is required.
Specimen Required
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Unpreserved feces
Supplies:
-Stool container, Small (Random), 4 oz (T288)
-Stool Collection Kit, Random (T635)
Container/Tube: Fecal container
Specimen Volume: 5 g
Specimen Type: Preserved feces
Supplies:
-ECOFIX Stool Transport Vial (Kit) (T219)
-Stool Collection Kit, Random (T635)
Container/Tube: ECOFIX preservative
Specimen Volume: 5 g
Specimen Type: Urine
Container/Tube: Sterile container
Specimen Volume: 5 mL
Collection Instructions: Mid-stream, clean-catch, suprapubic aspirates and catheterization collections are acceptable. Submit in a clean, sterile container free from preservatives. The first portion of the voided urine (first void) is also acceptable.
Specimen Minimum Volume
Feces: 1 g
Urine: 0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Refrigerated (preferred) | 7 days | |
Ambient | 7 days | ||
Frozen | 7 days |
Reject Due To
Urine containing preservatives Prostate secretions and samples Feces in preservatives other than ECOFIX |
Reject |
Clinical Information
Microsporidia are highly specialized fungi that cause a wide variety of clinical syndromes in humans. The most common microsporidia are Enterocytozoon bieneusi and Encephalitozoon intestinalis, which infect the gastrointestinal tract and cause a diarrheal illness, and Encephalitozoon cuniculi and Encephalitozoon hellem, which can infect the conjunctiva, respiratory tract, and genitourinary system. Human infections have been reported most frequently in patients with AIDS but can also occur in other patients who are immunocompromised, including solid organ allograft recipients and, sporadically, immunocompetent hosts. Less commonly, other microsporidia, such as Vittaforma corneae and Brachiola species, can cause disseminated or organ-specific disease. This assay detects only the most common microsporidia, E bieneusi and Encephalitozoon species, and not microsporidiosis due to other species.
For other diagnostic tests that may be of value in evaluating patients with diarrhea, see Parasitic Investigation of Stool Specimens Algorithm and Laboratory Testing for Infectious Causes of Diarrhea.
Reference Values
Negative
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.
Method Description
Nucleic acid is extracted from feces and urine using the automated MagNA Pure bead-based system (Roche Molecular Systems). The extract is then transferred to individual self-contained capillary cuvettes for amplification. The LightCycler is a self-contained automated instrument that amplifies and monitors the development of target nucleic acid (amplicon) after each cycle of polymerase chain reaction (PCR).
The DNA target for PCR assay is the 18S ribosomal RNA gene of Enterocytozoon bieneusi, Encephalitozoon intestinalis, Encephalitozoon hellem, and Encephalitozoon cuniculi.
This assay utilizes 2 primers and 2 probes, which are specific for E bieneusi and 3 primers and 2 probes specific for Encephalitozoon species. The specific base pair DNA target sequence is first amplified by PCR using the target-specific primers. Amplicon is then detected during melting curve analysis using fluorescence resonance energy transfer probes, which utilizes one hybridization probe with a donor fluorophore, fluorescein, at the 3' end and a second hybridization probe with an acceptor fluorophore, at the 5' end. Fluorescence is produced when the 2 probes anneal to the target sequence in close proximity to one another. The LC-Red 670 emits a measurable and quantifiable light signal at a specific wavelength when E bieneusi is present, and the LC-Red 610 emits a measurable and quantifiable light signal in the presence of Encephalitozoon species.(Bernard PS, Reiser A, Pritham GH: Mutation detection by fluorescent hybridization probe melting curves. In: Meuer S, Wittwer C, Nakagawara K, eds. Rapid Cycle Real-Time PCR: Methods and Applications. Springer; 2012:11-20)
Day(s) Performed
Tuesday through Friday
Report Available
2 to 4 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87798
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
LCMSP | Microsporidia PCR | 94332-4 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
MSPS | Specimen Source | 31208-2 |
36744 | Encephalitozoon species | 94333-2 |
36745 | Enterocytozoon bieneusi | 94334-0 |
Method Name
Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization