An audit of inpatient stool ova and parasite (O&P) testing in a multi-hospital health system

ABSTRACT

Background & Objectives

Stool ova and parasite (O&P) examinations are routinely ordered initial tests in patients admitted to the hospital with acute diarrhea, despite low test positivity rates. We examined the diagnostic yield of inpatient stool O&P exams and identified risk factors associated with positive tests.

Methods

A retrospective, case-control analysis of inpatients admitted with diarrhea, who underwent O&P examination, was conducted. Clinical and demographic variables of cases were compared with age-and gender-matched controls via uni- and multivariate conditional logistic regression analyses.

Results

The yield of inpatient O&P exams was 2.15% (37/1723). Blastocystisspp. represented the most common parasites. All patients with positive tests, excluding Blastocystisspp., had at least one of the following risk factors: smoking, prior parasitic disease, HIV-positive status, travel to an endemic area, and institutionalization.

Conclusions

Superfluous inpatient stool O&P exams confer a financial and labor burden to hospital systems. Stool O&P exams should be restricted to individuals admitted to the hospital for <3 days, having diarrhea >7 days and possessing at least one of the following risk factors: smoking, prior parasitic disease, HIV-positive status, travel to an endemic area, and institutionalization. Such selective testing can confer a 51% reduction in testing, costs, and labor.

KEYWORDS:

• Stool ova and parasite
• diarrhea
• parasitic gastroenteritis

Disclosure statement

The authors report no conflicts of interest.

Prior presentations

An abstract of the work was presented as a poster at the ACG 2016 Annual Scientific Meeting in Las Vegas, NV, USA on 17 October 2016.

Additional information

Funding

No funding, grants, or financial support were received for the work represented in the manuscript.