Cystoisospora belli (syn. Isospora belli) – Faeces
|Test Requested||Required Requisition(s)||Specimen Type||Minimum Volume||Collection Kit|
Ova and parasites1
As per Kit instructions
Ova and parasites1
Duodenal contents and Tissue/biopsy materials6
Submission and Collection Notes
The suspected organism may be included under the ‘Test Description’.
Please note on the requisition (under other): If the patient has Eosinophilia, HIV, is immunocompromised, has a critical illness or was admitted to ICU, or had a previous parasitic infection.
Indicate Country/Region and if the patient is a new immigrant or refugee or returned traveler under ‘Travel’ section of the requisition. It is imperative that the foreign country be identified.
Collect a sample in each white top and yellow top (SAF) vial of the Parasitology Kit. Follow the collection instructions on the instruction sheet provided with the Parasitology Kit.
Collect one specimen per day for 3 days in each vial for a total of six (6) specimens.
Duodenal contents and tissue/biopsy materials are accepted only if result of faeces examination is negative.
Anti-diarrhoeal medication, radiological dyes (barium) and antibiotics interfere with the identification of intestinal protozoa as well as helminths and coccidians.
Preparation Prior to Transport
Label the specimen container with the patient’s full name, date of collection and one other unique identifier such as the patient’s date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.
Place specimen container in a biohazard bag and seal. Reminder: Store the yellow capped container at room temperature at all times. The white capped container must be refrigerated before submission or frozen if there is a delay of more than 72 hours.
Follow the instruction found in the updated Para Kit Instruction Sheet.
Collect faeces in clean dry container and immediately transfer a portion of the sample to the:
- White Cap sterile container and then emulsify another portion in the
- SAF preservative in the Yellow top container (Mix 1 part faeces with 3 parts SAF or 1 part liquid faeces with 1 part SAF).
The submission of the white top container will allow for method development of newer and more sensitive methods such as polymerase chain reaction (PCR) to obtain improved species identification.
Test Frequency and Turnaround Time (TAT)
Cystoisospora (syn. Isospora) - faeces testing is performed Monday to Friday.
Turnaround time is up to 5 days from receipt by the PHO laboratory.
Results are reported to the ordering physician or health care provider as indicated on the requisition.
Cystoisospora (syn. Isospora) specimens are examined by microscopy by preparing a smear and concentrate following a centrifugation procedure using the Formalin/Ethyl-acetate method. The concentration method allows for detection of small numbers of organisms.
A permanent stained smear is used for the identification of trophozoites, occasionally cysts and to confirm species. It is prepared and read from the concentrate. Iron Hematoxylin stain is used to identify and confirm non-coccidial intestinal protozoa.
Cystoisospora (syn. Isospora) will not be identified using the Iron Hematoxylin stain. They are concentrated using floatation method. Oocysts of Cryptosporidium, Cystoisospora (syn. Isospora) and Cyclospora are stained with a modified Auramine Rhodamine fluorescent stain and confirmed with a Safranin stain.
Alternately some labs use a combined stain instead to detect both trophozoites, cysts and coccidians. Specimens are stained with the sequential Kinyoun-haematoxylin stain.