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Background  This study compared diagnostic methods for identifying  Blastocystis  in stool samples, and evaluated the frequency of detection of  Blastocystis  in patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).    Results and Discussion  From a set of 105 stool specimens submitted for routine parasitological analysis, 30 were identified as positive for  Blastocystis  by the culture method. From that group of 30 positives, Lugol's stain, trichrome staining, and an immunofluorescence assay identified 11, 15, and 26 samples as positive respectively. Using culture as a standard, the sensitivity of Lugol's stain was 36.7%, trichrome staining was 50%, and the IFA stain was 86.7%. The specificity of Lugol's stain was 91%, trichrome staining was 100%, and the IFA stain was 97.3%. In the group of 27 IBS and IBD patients, using all methods combined, we detected  Blastocystis  in 67% (18/27) of the patients.  Blastocystis  was detected in 33% (2/6) of IBD patients and 76% (16/21) of IBS patients. For comparison, trichrome staining alone, the method most frequently used in many countries, would have only identified  Blastocystis  infection in 29% (6/21) of the IBS patients. No parasitic co-infections were identified in the IBS/IBD patients. Most  Blastocystis- positive IBS/IBD patients were over 36 with an average length of illness of 4.9 years.    Conclusions  Most IBS patients in this study were infected with  Blastocystis . IFA staining may be a useful alternative to stool culture, especially if stool specimens have been chemically preserved.

Comparison of Methods for Detection of Blastocystis Infection in Routinely Submitted Stool Samples, and also in IBS/IBD Patients in Ankara, Turkey