Test Catalog

Test Id : OAP

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Ova and Parasite, Concentrate and Permanent Smear, Microscopy, Feces

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detection and identification of parasitic protozoa and the eggs and larvae of parasitic helminths

Highlights

This test includes concentrated wet preparation and permanent (trichrome) stained preparation as well as an exam for fecal leukocytes.

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Name
A short description of the method used to perform the test

Microscopic

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Ova and Parasite, Microscopy, F

Aliases
Lists additional common names for a test, as an aid in searching

O and P (Ova and Parasites)

Trichrome Stain

Egg Cyst

Parasitic Exam

Protozoa

Amoeba, Ameba

Ova

50016-OAP

Helminth

Isospora, Isospora belli, Cystoisospora

Parasites

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Specimen Type
Describes the specimen type validated for testing

Fecal

Ordering Guidance

For non-stool sources for ova and parasitic examination, see OAPNS / Ova and Parasite, Microscopy, Varies.

 

If specific organisms or disease states are suspected, see below:

If Acanthamoeba is suspected, order ACARP / Acanthamoeba species Molecular Detection, PCR, Ocular.

If Cryptosporidium is suspected, order CRYPS / Cryptosporidium Antigen, Feces.

If Cyclospora is suspected, order CYCL / Cyclospora Stain, Feces.

If free-living amebae are suspected, order FLARP / Free-Living Amebae, Molecular Detection, PCR, Varies.

If Giardia is suspected, order GIAR / Giardia Antigen, Feces.

If microsporidia are suspected, order LCMSP / Microsporidia species, Molecular Detection, PCR, Varies.

If pinworm is suspected, order PINW / Pinworm Exam, Perianal.

If scabies is suspected, order PARID / Parasite Identification, Varies.

If Schistosoma is suspected, order SHUR / Schistosoma Exam, Random, Urine.

If Trichomonas vaginalis is suspected, order TVRNA / Trichomonas vaginalis, Nucleic Acid Amplification, Varies.

If worms or worm segments are submitted, order PARID / Parasite Identification, Varies.

Additional Testing Requirements

It is strongly recommended that multiple stool specimens be submitted for ova and parasite analysis. At least 3 specimens should be collected, 1 each day or on alternate days (over a maximum 10-day period).

 

Parasites are shed irregularly in stool and examination of a single specimen does not guarantee detection.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
Q00M0045 Specimen Source

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: Specimen collection should be delayed for 7 to 10 days after administration of barium, bismuth, kaolin, magnesia, castor oil or mineral oil, and 2 to 3 weeks after antibiotics have been given since these may interfere with identification of protozoa.

Specimen Type: Stool, duodenal aspirate, colonic washing

Supplies: ECOFIX Stool Transport Vial (Kit) (T219)

Preferred: ECOFIX preservative

Acceptable: 10% Buffered Formalin Stool Transport plus Zinc Polyvinyl Alcohol (Zn PVA) Stool Transport vials (one of each)

Specimen Volume: Portion of stool or entire collection of intestinal specimen

Collection Instructions:

1. Place specimen into preservative within 30 minutes of passage or collection.

2. Follow instructions on the container as follows:

a. Mix the contents of the tube with the spoon, twist the cap tightly closed, and shake vigorously until the contents are well mixed. Refer to the fill line on the Ecofix vial for stool specimens.

b. Do not fill above the line indicated on the container.

c. Duodenal aspirates, small bowel aspirates, or colonic washings should be placed in Ecofix in a ratio of 1:1

Additional Information: Stool placed in 10% buffered formalin can be accepted if accompanied by Zinc (Zn) PVA-preserved specimen; 10% buffered formalin-preserved specimens submitted without an accompanying Zn PVA-preserved specimen will be canceled. Specimen submitted in Low Viscosity (LV)-PVA, Mercury PVA or Copper (Cu)-PVA will be rejected.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Microbiology Test Request (T244)

-Gastroenterology and Hepatology Client Test Request (T728)

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Fecal Ambient (preferred) 21 days
Refrigerated 21 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Detection and identification of parasitic protozoa and the eggs and larvae of parasitic helminths

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

A variety of different parasites may be found in stool specimens, duodenal aspirates, and other intestinal specimens. These parasites may include protozoa (microscopic unicellular eukaryotes) and helminths (aka worms). Infection is often asymptomatic, but symptoms range from diarrhea and malnutrition, intestinal obstruction, and rarely, death.

 

The most common intestinal reported parasites in stool specimens are Giardia intestinalis (aka Giardia duodenalis, Giardia lamblia) and Cryptosporidium species. Both parasites may cause watery diarrhea and are endemic in the United States. The best tests for these 2 common parasites are parasite-specific fecal antigen tests (GIAR / Giardia Antigen, Feces and CRYPS / Cryptosporidium Antigen, Feces).

 

Other parasites are less commonly seen in the United States, and the stool parasitic exam is the appropriate test for their detection.

For determining which test should be ordered based on the patient's exposure history and risk factors, see Parasitic Investigation of Stool Specimens Algorithm.

 

If evaluating a patient for diarrhea, see Laboratory Testing for Infectious Causes of Diarrhea Algorithm.

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, organism identified

Interpretation
Provides information to assist in interpretation of the test results

A positive result indicates the presence of the parasite but does not necessarily indicate that it is the cause of any symptoms. Some strains of protozoa are nonpathogenic. and some helminths cause little or no illness.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

If possible adult worms or proglottids are identified in stool or the patient's undergarments, they should be placed in 70% alcohol and submitted for PARID / Parasite Identification, Varies.

 

This test is not the optimal method for detecting Giardia, Cryptosporidium, microsporidia, Cyclospora, or pinworm. For optimal results, the specific test should be ordered for detection of these parasites; see Ordering Guidance

 

Parasitic examination of a minimum of 3 stool specimens is indicated for detecting most intestinal protozoa and helminths with maximum sensitivity.

 

Parasitic infections are uncommonly acquired in the hospital setting. This test is not usually useful in patients hospitalized for more than 3 days.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Garcia LS: Diagnostic Medical Parasitology. 6th ed. Wiley; 2016

2. Shane AL, Mody RK, Crump JA, et al: 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-e80. doi: 10.1093/cid/cix669

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Description
Describes how the test is performed and provides a method-specific reference

A portion of the ECOFIX-preserved stool is concentrated and examined. A permanent trichrome-stained slide is prepared from the ECOFIX-preserved feces.(Package inserts: Mini Parasep Faecal Parasite Concentrator. Apacor; 02/2021; Para-Pak ECOSTAIN, Meridian Bioscience Inc; 08/2020;  Para-Pak ULTRA EcoFix. Meridian Bioscience Inc; 04/2022)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

4 to 5 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

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 instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

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 Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

87177-Concentration (any type), for infectious agents

87209-Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hematoxylin) for ova and parasites

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
OAP Ova and Parasite, Microscopy, F 10704-5
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
OAP Ova and Parasite, Microscopy, F 10704-5

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
Test Status - Test Delay 2023-03-16
Test Changes - Specimen Information 2023-01-05
Test Status - Test Resumed 2023-01-05
Test Status - Test Down 2022-08-10
Test Status - Test Down 2022-07-20
Test Status - Test Delay 2022-06-20