Parasites (other) – Microsporidia

Identification of Microsporidia
Microbiology
Bacteriology
○ Biopsy material ○ Bowel aspirates ○ Corneal scrapings ○ Stool

Other Information

○ Collect 1 specimen per day (1 Yellow top and 1 White top container) for 3 days in each vial for a total of six (6) specimens per patient with suspected parasitic infection.

○ Ensure patient avoids anti-diarrheal medications, radiological dye (barium) and antibiotics prior to producing the specimen as they may interfere with parasite detection.

○ Please provide appropriate clinical information on the requisition (e.g. travel history or country of origin if refugee, returned traveller or recent immigrant, consumption of certain food products, eosinophilia, HIV, immunocompromise, critical illness, admitted to ICU or previous parasite infection

○ Biopsy material/corneal scrapings: sterile container with saline (~ 1mL)
○ Stool/bowel aspirates: Parasitology Kit (3 each of SAF yellow top vial, white top sterile vial)


Biopsy material
○ Collect 5-10 mm3 tissue aseptically using surgical technique/punch biopsy. Place in a clean, sterile container with a small amount of sterile saline. Do not wrap tissue in gauze.

Corneal scrapings
○ Corneal surfaces should be rinsed thoroughly with normal saline to remove anaesthetic prior to collecting specimen
○ Use a Kimura scalpel to scrape across the ulcer using short firm strokes in one direction. Obtain 3 to 5 scrapings per cornea. Avoid contact with eyelids/eyelashes. Place scrapings into sterile container.

Stool/bowel aspirates
○ Collect stool immediately after bowel movement in a dry, clean container (e.g. Chamber pot, wide-mouth jar, pie plate, newspaper, or saran wrap on toilet seat). Follow instructions below to add specimen to BOTH yellow and white capped containers. Specimen should not be contaminated with urine or toilet water. Bowel aspirates can be obtained via endoscopic procedure.
Container 1 SAF (Yellow top) vial:
○ Use plastic spork attached to lid to add sample (from beginning, middle and end of stool) to yellow capped bottle so that the preservative fluid level is approximately ¾ full. Mix thoroughly by shaking. Ratio should be 1 part solid stool to 3 parts SAF or 1 part liquid faeces to 1 part SAF.

Container 2 Sterile (White top) vial:
○ Using plastic spork, Add stool directly to sterile white capped container.


Refer to section Sample Processing / Delivery

PHOL

○ Up to 3-5 days from receipt at PHO laboratory

416-586-4800 extension 4603


NO

○ Label specimen container. Place specimens in biohazard bag and seal.. Transport specimen to the laboratory within 72 hours.

○ Specimens should be stored at room temperature (20-25˚C) and transported to the UHN/SH Microbiology Laboratory ASAP following collection. For stool, keep Yellow top tube (SAF vial) at room temperature while the White-top vial should be refrigerated (2-8˚C) prior to transport.

○ The specimen will be referred to the Public Health Ontario Laboratory for testing