CLSI M28 A2 : 2ED 2005

Abstract
Committee Membership
Foreword
1 Scope
2 Equipment for Fecal Specimen Examination
   2.1 Microscope
   2.2 Calibration (Ocular Micrometer)
   2.3 Centrifuge
   2.4 Fume Hood
   2.5 Biological Safety Cabinet
   2.6 Miscellaneous Equipment
   2.7 Basic Supplies
3 Standard Precautions
4 Definitions
5 Collection, Preservation, and Shipment of Specimens
   5.1 Fresh Specimen Collection
   5.2 Preservation of Specimens
   5.3 Collection Kits
   5.4 Shipment of Specimens
6 Macroscopic Examination
   6.1 Age
   6.2 Consistency
   6.3 Abnormalities
   6.4 Clinical Relevance of Fresh Specimens and Organism
        Recovery
7 Microscopic Examination (Wet Preparation)
   7.1 Direct Smear of Fresh Specimen (Unfixed)
   7.2 Concentration Procedures
8 Microscopic Examination (Permanent Stained Smears/Other
   Methods)
   8.1 General Considerations
   8.2 Trichrome Stain
   8.3 Iron-Hematoxylin Stain
   8.4 Modified Iron-Hematoxylin Stain Incorporating the
        Carbol Fuchsin Step
   8.5 Modified Kinyoun's Acid-Fast Stain (Cold) for
        Cryptosporidium spp., Cyclospora cayetanensis,
        and Isospora belli Oocysts
   8.6 Modified Ziehl-Neelsen Acid-Fast Stain (Hot) for
        Cryptosporidium spp., Cyclospora cayetanensis, and
        Isospora belli Oocysts
   8.7 Modified Hot Safranin Technique for Cryptosporidium
        spp., Cyclospora cayetanensis, and Isospora belli
        Oocysts
   8.8 Modified Trichrome Stain (Chromotrope 2R) for
        Microsporidia (Weber-Green and Ryan-Blue)
   8.9 Chemofluorescence Agents
9 Fecal Immunoassays and Gene Probes
   9.1 Giardia lamblia
   9.2 Cryptosporidium spp
   9.3 Entamoeba histolytica/E. dispar Group
   9.4 Entamoeba histolytica
10 Special Techniques for Organisms Found in Fecal Specimens
   10.1 Larval Nematodes: Concentration and Culture Techniques
   10.2 Helminth Eggs
   10.3 Adult Helminths
11 Other Specimens From the Intestinal Tract
   11.1 Sigmoidoscopy Specimen: Direct Wet Smear
   11.2 Sigmoidoscopy Specimen: Permanent Stained Smear
   11.3 Duodenal Aspirate
   11.4 String Test (Gelatin-Capsule Method)
12 Culture Technique for Amoebae
   12.1 Entamoeba histolytica
   12.2 Specimen
   12.3 Tys Gm-9 Medium
   12.4 Quality Control/Assurance
   12.5 Media Examination
   12.6 Reporting Results
   12.7 Limitations of the Procedure
13 Identification Aids: Stool Artifacts
   13.1 Sources
   13.2 Corrective Action
   13.3 Reporting of Stool Artifacts
References
Additional Reference
Helpful Websites
Appendix A. How to Use the Relative Centrifugal Force
            Nomograph
Appendix B. OSHA Regulations on the Use of Formaldehyde
Appendix C. Stool Specimen Collection and Testing Options:
            Fecal Specimens for Parasites - Options for
            Collection
Appendix D. Ordering Recommendations for Routine O&P
            Examination and Fecal Immunoassays
Appendix E. Permanent Stained Smears From MIF-Preserved
            Material
Appendix F. Reporting Recommendations
Summary of Comments and Working Group Responses
Summary of Delegate Comments and Working Group Responses
The Quality System Approach
Related CLSI/NCCLS Publications

This guideline is intended to provide the readers with standardized procedures used for the recovery and identification of parasites from the intestinal tract.