Comparison of the Mini Parasep SF®, ParaPak SpinCon®, and Paradevice® fecal filtration and concentration devices for microscopic and AI-assisted detection of intestinal parasites
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Effective filtration and concentration of stool specimens is an essential pre-analytical step for reducing fecal debris and improving organism recovery using microscopy-based ova and parasite (O&P) examination. This study evaluated three commercially available fecal sedimentation-based filtration/concentration systems – ParaPak SpinCon® (Meridian Bioscience), Mini Parasep SF® (Apacor), and the newly-available Paradevice® (Reingenuity) – for qualitative parasite detection and workflow logistics using conventional and artificial intelligence (AI)-assisted microscopy. Forty clinical stool specimens (20 parasite-positive and 20 parasite-negative) were processed with the 3 devices, and the resultant 120 wet mount and 120 trichrome-stained smear preparations were examined using conventional microscopy. Trichrome-stained slides were also scanned at 40x magnification using a Hamamatsu® NanoZoomerS360® flatbed digital slide scanner and images were analyzed using the Techcyte® Fusion Human Fecal Trichrome AI algorithm. Positive and indeterminate digital findings were confirmed by conventional glass slide microscopy. Slides and digital images were reviewed in a blinded manner. Concordance was assessed among the 360 initial evaluations (microscopy and AI-assisted), and discrepant parasitology results were resolved through re-review and specimen reprocessing as needed. Final qualitative agreement across slide/image evaluations using all three concentration systems was 100%. Minor discrepancies in protozoan and white/red blood cell detection/identification were noted in 5 and 7 cases, respectively, and likely reflected sampling and observer variability. While the three concentration systems produced equivalent qualitative results, the Paradevice® and Mini Parasep SF® offered the most streamlined workflows. These findings support the Paradevice® and Mini Parasep SF® as efficient, analytically equivalent systems that are compatible with traditional and AI-assisted O&P workflows.
Importance
Microscopy-based examination of stool specimens remains an important diagnostic tool for intestinal parasitic infections. Filtration and concentration methods improve test performance by increasing organism recovery and reducing obscuring fecal debris prior to evaluation. These methods may also facilitate the preparation of thin monolayer trichrome-stained slides for digital scanning and automated parasite detection. Because many clinical laboratories rely on commercial filtration and concentration systems, supply chain disruptions, product shortages, and manufacturer recalls threaten testing continuity, underscoring the need for validated alternatives. This study demonstrates that multiple commercially available concentration systems provide equivalent parasite detection while supporting both conventional microscopy and emerging digital workflows. These findings provide laboratories with evidence-based alternatives that enhance operational resilience without compromising diagnostic performance.
