Diagnostic Performance of Toluidine Blue Stain for Direct Wet Mount Detection of <i>Cryptosporidium</i> Oocysts: Qualitative and Quantitative Comparison to the Modified Ziehl–Neelsen Stain

(1) Background: The wet mount staining technique is a simple, economical, and rapid method for detecting parasitic stages. The objective of the current study was to evaluate wet mount diagnostic stains for <i>Cryptosporidium</i> infection in human faecal samples and to compare the sensit...

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Bibliographic Details
Main Authors: Shahira Abdelaziz Ali Ahmed, Annalisa Quattrocchi, Sherine M. Elzagawy, Panagiotis Karanis, Samer Eid Mohamed Gad
Format: Article
Language:English
Published: MDPI AG 2023-08-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/13/15/2557
Description
Summary:(1) Background: The wet mount staining technique is a simple, economical, and rapid method for detecting parasitic stages. The objective of the current study was to evaluate wet mount diagnostic stains for <i>Cryptosporidium</i> infection in human faecal samples and to compare the sensitivity and qualitative performance of toluidine blue (TolB) and modified Ziehl–Neelsen (mZN) stain. (2) Methods: The collection, purification, and molecular amplification of <i>Cryptosporidium</i> oocysts were performed. TolB, malachite green, trypan blue, and crystal violet were evaluated qualitatively to diagnose <i>Cryptosporidium</i> oocysts. The outperforming stain was compared to mZN using a quantitative evaluation and qualitative scoring system. (3) Results: The oocysts of <i>Cryptosporidium parvum</i> were effectively purified and utilized for spiking. TolB was the most effective diagnostic stain among wet mount stains for detecting <i>Cryptosporidium</i> oocysts. TolB outperformed mZN in terms of sensitivity, with 100% versus 79% at a concentration of 10<sup>4</sup> and 49% versus 23% at a concentration of 10<sup>2</sup>. TolB had the most favourable qualitative stain characteristics against mZN; however, sample freshness and being a temporary stain were crucial considerations. (4) Conclusions: This study emphasizes that TolB, as a routine wet mount technique for screening <i>Cryptosporidium</i> infection, will provide a more sensitive and faster method than mZN staining.
ISSN:2075-4418