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Entamoeba histolytica, Giardia intestinalis, and Cryptosporidium spp. are not only three of the most important and common diarrhea-causing parasitic protozoa, but they often have similar clinical presentations. Microscopic diagnosis of these parasites is neither sensitive nor specific. Recently, more specific and sensitive alternative molecular methods (polymerase chain reaction [PCR] and antigen detection tests) have been introduced for all three of these parasitic infections. The use of these molecular diagnostic tests in routine diagnostic laboratories is still limited. In this study, we developed a multiplex real-time PCR assay for the simultaneous detection of E. histolytica, G. intestinalis, and Cryptosporidium spp. in one reaction using species-specific probes. This assay was evaluated using clinical specimens and was found to be quite sensitive and specific. The reagents used in this multiplex PCR assay can also be used for detection of these parasites individually. The use of this real-time PCR multiplex assay in developing countries at present will have limited scope for routine diagnosis because the cost will be high for a single test, although in the developed world, the test could see immediate application.
Received July 18, 2006. Accepted for publication December 9, 2006.
Financial support: The study was conducted at the ICDDR,B with the support of NIH Grant U19 AI056872 through the University of Virginia (UVA). ICDDR,B acknowledges with gratitude the commitment of NIH and UVA to the Centers research efforts.
Disclaimer: Dr. Petri received research support from TechLab and royalties from a patent license agreement with TechLab for a diagnostic test for amebiasis. These royalties accrue to the American Society of Tropical Medicine and Hygiene without benefit to Dr. Petri.
* Address correspondence to William Petri Jr, Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, VA 22908. E-mail: wap3g{at}virginia.edu
Authors addresses: Rashidul Haque, Shantanu Roy, Abdullah Siddique, Utpal Mondal, S. M. Mazidur Rahman, and Dinesh Mondal, International Centre for Diarrhoeal Disease Research, Bangladesh, ICDDR,B, Centre for Health and Population Research, Mohakhali, Dhaka 1212, Bangladesh. Eric Houpt and William A. Petri Jr, Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, VA. Present address of Shantanu Roy: Department of Medicine, University of Chicago, Room 615, CLSC, Chicago, IL 60637.
Reprint requests: Rashidul Haque, Laboratory Sciences Division, ICDDR,B, GPO Box 128, Dhaka 1000 Bangladesh. Telephone: 880-2-8860523, Fax: 880-2-8812529, E-mail: rhaque{at}icddrb.org.
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