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Cryposporidium, Cyclospora & Cystoisospora (formerly Isospora), Modified Acid-Fast Stain  

 
IMPORTANT! Pre-approval needed from state or local health department. Local or State Health Department. Send approval to NPHL@unmc.edu or call (402) 559-9444.

NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see NUlirt Guide).

Forms Required - Nulirt batch list or NPHL Test Request Form (completed in entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459 for further clarification.

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Test: Cyposporidium, Cyclospora & Cystoisospora (formerly Isospora), Modified Acid-Fast Stain
Order in NUlirt or complete NPHL Test Order Form  
Synonym: Parasitology Stain by Modified Acid-Fast, Oocyst  
Method: Concentration procedure with modified acid-fast stain or autofluorescence.  
Availability: Monday, Wednesday, Friday if received by 0800 day of testing; results within 24 hours (Frequency may be increased during outbreak testing)   
Specimen: Fresh stool or if transport > 2 h; Proto-fix vial. Add bloody or watery portions of stool if present. Stools fixed in 10% formalin are also acceptable.
   
Collection Device: Use Proto-fix vial for preservation and add stool to fill line marked on Proto-fix vial. Seal and mix well.  
Specimen Labeling:  Test subject to CLIA regulations and requires 2 patient identifiers and specimen source on container.  
Volume: Walnut size stool specimen or 10 ml of stool in preservative  
Storage/Transport:

Prior to shipment & during Transport: Ambient 15-25°C  
Shipping instructions, including specimen-handling requirements during transport:  Seal screw-top tubes with Parafilm™ or tape and place in biohazard bag with absorbent material.


Place specimen inside leak proof secondary container (biohazard bag and if transporting by air, use Tyvek™ Envelope) with adsorbent material. The secondary container must be packed inside an approved Category B shipping container.  Position NUlirt packing list or NPHL Test Order form between secondary container and box lid. Seal with tape.  Label outer box as UN3373 Category B, Biological Substance. Transport by NPHL ground courier. If courier not available, ship by FedEx, UPS, or USPS (1st Class, Priority or Express Mail). Follow appropriate DOT/IATA Regulation Guidelines.  For assistance, call NPHL State Training Coordinator at (402) 559-3590.
See instructions and shipping address: http://nphl.org/

NUlirt packing list or appropriate paperwork (completed in entirety) must accompany specimens.

 
Unacceptable: Dry specimen, leaking container, specimen contaminated with oil, barium or urine, rectal swab, multiple specimens (> 1 in a 24 hour period), and delayed transport.   
Specimen Stability: Preserved specimen stable for up to 9 months at ambient conditions 15-25°C  
Reference Interval: Negative for Cryptosporidium, Cyclospora and Cystoisospora  
Reportable Disease: Report Cryptosporidium & Cyclospora within 7 d to local or state health department.  Refer to Nebraska DHHS Title 173, Communicable Diseases.  All positive Cryptosporidium & Cyclospora stools in transport media should be submitted to the NPHL for molecular sequencing to supplement and epidemiological investigation.  
Comments: Pre-approval needed from state or local health department.  Send approval to NPHL@unmc.edu or call (402) 559-9444.
Proto-fix vials available from Client Services.
If the patient has had foreign travel or continued symptoms, One Proto-fix vial can be used for both modified Acid Fast and O&P tests.
This test is recommended for the examination of stool for the presence of Cyclospora or Isospora (Cystoisospora) by modified acid-fast stain in outbreak settings only. Recommended testing and reporting for Cryptosporidium and Cyclospora is by use of the GI Panel.

NUlirt packing list or NPHL Test Order Form (completed in entirety) must accompany the specimen.  
Revised: 6/11/2021 
If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459.

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