title: A retrospective study comparing agar plate culture, indirect immunofluorescence and real-time PCR for the diagnosis of Strongyloides stercoralis infection.
abstract: Strongyloides stercoralis is a parasite that can cause death in immunocompromised people. A proper diagnosis is hence essential. The real-time polymerase-chain reaction (RT-PCR) is a novel, promising diagnostic method, that detects the DNA of the parasite in stool samples. In this retrospective study, we compared the sensitivity of agar plate coproculture (APC), an in-house immunofluorescence test (IFAT) and an in-house RT-PCR for the diagnosis of S. stercoralis infection. The study sample was composed by 223 samples. Samples resulting positive to APC, IFAT and RT-PCR were 20, 140 and 25, respectively. When sensitivity was calculated against a composite reference standard, serology confirmed the best performance (sensitivity 95%), followed by RT-PCR (57%) and APC (45%). In conclusion, in a non-endemic setting, serology is the best screening method, while the combination of APC and RT-PCR does not seem a reasonable approach to increase sensitivity. Both methods can have a role as confirmatory tests for selected cases.
authors.affiliation: Centre for Tropical Diseases,Sacro Cuore Don Calabria Hospital,Via Sempreboni 5,37024 Negrar,Verona,Italy.
authors.forename: Dora
authors.identifier: 0000-0003-0108-6822
authors.initials: D
authors.lastname: Buonfrate
authors.affiliation: Centre for Tropical Diseases,Sacro Cuore Don Calabria Hospital,Via Sempreboni 5,37024 Negrar,Verona,Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Perandin
authors.affiliation: Centre for Tropical Diseases,Sacro Cuore Don Calabria Hospital,Via Sempreboni 5,37024 Negrar,Verona,Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Formenti
authors.affiliation: Centre for Tropical Diseases,Sacro Cuore Don Calabria Hospital,Via Sempreboni 5,37024 Negrar,Verona,Italy.
authors.forename: Zeno
authors.initials: Z
authors.lastname: Bisoffi
mesh_terms: D000362:Agar; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D003470:Culture Media; D018509:DNA, Helminth / Q000737:chemistry / Q000302:isolation & purification; D005243:Feces / Q000469:parasitology; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D018510:RNA, Helminth / Q000235:genetics; D012335:RNA, Ribosomal / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017171:Strongyloides stercoralis / Q000235:genetics / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000175:diagnosis*
chemical_list: D000909:Antibodies, Helminth; D003470:Culture Media; D018509:DNA, Helminth; D018510:RNA, Helminth; D012335:RNA, Ribosomal; D000362:Agar
keywords: 
                 Strongyloides stercoralis
              ; agar plate culture; real-time PCR; serology; strongyloidiasis