The CPP (Culture, PCR + Parasitology) Stool Analysis is an important tool for identifying imbalances in intestinal microflora.

It includes comprehensive bacteriology and yeast cultures to identify the presence of beneficial flora, imbalanced flora including Clostridium species, and dysbiotic flora, as well as detection of infectious pathogenic bacteria, yeast/fungus and parasites by culture, PCR and other gold standard methods.

Antimicrobial susceptibility testing to prescriptive and natural agents is also performed for appropriate cultured bacterial and fungal species to facilitate selection of the most appropriate pharmaceutical or natural ingredients.

Culture (Bacteria & Yeast)

Bacterial and yeast culture of live organisms using advanced techniques to culture out aerobic, anaerobic, and microaerophilic bacteria as well as yeast, the CPP Stool Analysis culture can identify at least 170 species of yeast, 80 species of candida, and over 1400 species of bacteria.  If found, yeast and clinically relevant bacteria are reported.

Antimicrobial susceptibility

Prescription medications and natural agents are tested against select cultured pathogenic bacterial and fungal species to identify their sensitivity to medications and natural ingredients as well as resistance to those agents.

PCR (GI Pathogen Profile)

Using advanced PCR technology for genetic level testing*, this GI pathogen profile detects and identifies 14 of the most common and problematic gastrointestinal viruses, parasites and bacteria in order to expedite clinical options, especially for diarrheal issues.

While bacteria and parasites are the primary cause of food and water-borne diarrheal illness, the vast majority of acute diarrheal illness is caused by viral infections. In fact, Norovirus is the primary gastrointestinal infection occurring the in the US and the leading cause of foodborne illness.¹

The following bacteria, parasites, and viruses are identified using PCR:

Bacteria

• Campylobacter (C. jejuni, C. coli and C. lari)
• Clostridium difficile (toxin A/B)
• Salmonella
• Vibrio cholerae

Viruses

• Adenovirus F 40/41
• Norovirus GI/GII
• Rotavirus A

Diarrheagenic E. coli/Shigella

• E. coli O157
• Enterotoxigenic E. coli (ETEC) lt/st
• Shiga-like toxin-producing E. coli (STEC) stx1/stx2
• Shigella/Enteroinvasive E. coli (EIEC)

Parasites

• Cryptosporidium
• Entamoeba histolytica
• Giardia duodenalis (aka lamblia & intestinalis)

Parasitology (Microscopy)

Parasitic infection may be an underlying factor in several chronic disease processes; however, doctors often do not consider the potential for parasitic involvement because signs and symptoms of parasitic infection often resemble those of other diseases. However, it has been shown that parasite testing is a reasonable approach in evaluating chronic gastrointestinal disorders.

3-Day Collection – The CPP Stool Analysis provides a 3-day collection for microscopic analysis of the presence or absence of parasite adults, larva, eggs or spores. 31 well-characterized parasites are listed on the report; however, any abnormal findings will also be reported.

Charcot Leyden crystals – Charcot Leyden crystals released by eosinophils and basophils (immune cells). Their presence is indirect evidence of parasitic infestation.

Pollen – Pollen can appear microscopically similar to eggs or spores, but does not reflect parasite presence. If pollen is observed, it is reported to emphasize the difference.

Muscle and Vegetable Fibers – Appearance of muscle or vegetable fibers indicates incomplete digestion.

*Currently, validated FDA–cleared probes exist only for pathogenic species.

Sample Report

Collection Instructions

Collection Note

• The CPP provides the option to collect up to a 3-day parasitology.
• The 3-day collection is optional but can enhance the reliability of parasitology microscopy.
• If you wish to only collect on a single day, please discard the “Day 1” and “Day 2” vials, and only collect the two “Day 3” vials in the kit (1x yellow and 1x black capped vials).
• Results take 2-3 weeks from the time the laboratory receives your sample. This test is not available in Pennsylvania and New York. Results for this test are not available online.

Note

The CPP Profile (LC100093) is a good starting point for evaluating microbiome-related gastrointestinal concerns. It represents the best value for identifying the presence of common pathogenic microorganisms, but it does not provide markers of digestive efficiency, GI inflammation or immune function.

For a better assessment of the gut microbiome along with additional markers of digestive health, inflammation & immune function (stool chemistry), consider the Comprehensive Stool Analysis (LC100083). It contains all the tests in the CPP Profile and more.

For the best assessment of microbiome dysbiosis, diversity and digestive health, the GI 360 (LC100088) is the most comprehensive stool test option. It contains all the tests in the both the CPP & CSA and more.

References

1. https://www.cdc.gov/norovirus/trends–outbreaks/burden–US.html