Test ID: MTBS
Microsporidia Stain
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Diagnosis of intestinal microsporidiosis in patients with AIDS and others with unexplained diarrhea, especially after overseas travel
See Parasitic Investigation of Stool Specimens Algorithm in Special Instructions for other diagnostic tests that may be of value in evaluating patients with diarrhea.
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
See Parasitic Investigation of Stool Specimens Algorithm in Special Instructions.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
Trichrome-Blue Stain (Ryan Modification)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Entercytozoon
Nosema
Pleistophora
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Forms: If not ordering electronically, submit a Microbiology Request Form (Supply T244) with the specimen.
Patient should avoid use of anti-diarrheal medication (ie, loperamide or Pepto-Bismol).
The presence of barium will interfere with this test.
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Preserved stool
Container/Tube:
Preferred: ECOFIX preservative (Supply T219)
Acceptable: Container with 10% formalin
Specimen Volume: 5 g
Collection Instructions: See Stool Collection Information Sheet in Special Instructions.
Specimen Stability Information: Ambient (preferred)/Refrigerated/Frozen
Additional Information: Formed stool specimens seldomly yield microsporidial organisms.
Specimen Type: Unpreserved stool
Container/Tube: Stool container (Supply T288)
Specimen Volume: 5 g
Collection Instructions: See Stool Collection Information Sheet in Special Instructions.
Specimen Stability Information: Refrigerated <3 days (preferred)/Frozen
Additional Information: Formed stool specimens seldomly yield microsporidial organisms.
Acceptable:
Specimen Type: Duodenal aspirate
Container/Tube: Sterile container
Specimen Volume: 0.5 mL
Specimen Stability Information: Refrigerated <3 days (preferred)/Frozen
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Varies | |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Microsporidia are obligate protozoan parasites which have been documented to infect invertebrates and vertebrates. They are very small organisms (1-2 microns, about the size of bacteria) and are classified in a phylum, microspora, characterized by the structure of their spores which contain polar tubules which are extruded to inject infective material into host cells.
The microsporidia known to infect humans include Enterocytozoon bieneusi (intestinal microsporidiosis), Encephalitozoon hellem (eye infections), and Enterocytozoon (Septata) intestinalis (intestinal and disseminated infections, especially to the biliary tree).
Human infections have been reported most frequently in patients with AIDS, but also can occur sporadically in immunocompetent patients. The primary clinical findings are chronic diarrhea, weight loss, and malabsorption.
Enterocytozoon bieneusi is found in the duodenal mucosa and infection is accompanied by a wide spectrum of histopathologic changes ranging from normal architecture to almost complete effacement of the villi and virtual obliteration of the lamina propria by inflammatory cells.
The anti-helmintic drug, albendazole has been found effective in some infections due to Enterocytozoon bieneusi and Encephalitozoon (Septata) intestinalis.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Negative
If positive, reported as microsporidia
Interpretation Provides information to assist in interpretation of the test results
Presence of microsporidia in stool may or may not be associated with symptoms in infected persons and may or may not be the cause of any symptoms since patients with AIDS may be infected with more than 1 intestinal pathogen at the same time.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
These organisms are very difficult to identify among the multitude of organisms and artifactual debris present in the stool.
The sensitivity and specificity of the stain have not been determined.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Weber R, Bryan RT, Schwartz DA, Owen RL: Human microsporidial infections. Clin Microbiol Rev 1994;7:426-461
2. Goodgame RW: Understanding intestinal spore-forming protozoa: cryptosporidia, microsporidia, isospora, and cyclospora. Ann Intern Med 1996;124:429-441
3. Wanke CA, DeGirolami P, Federman M: Enterocytozoon bieneusi infection and diarrheal disease in patients who were not infected with human immunodefeciency virus: case report and review. Clin Infect Dis 1996;23:816-818
Method Description Describes how the test is performed and provides a method-specific reference
Stool concentrates (or duodenal aspirates) are stained by the trichrome-blue method. (DeGirolami PC, Ezratty CR, Desai G, et al: Diagnosis of intestinal microsporidiosis by examination of stool and duodenal aspirate with Weber's modified trichrome and Uvitex 2B stains. J Clin Microbiol 1995;33:805-810)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; 12 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
87015-Concentration
87207-Stain
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| MTBS | Microsporidia Stain | In Process |
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