Using environmental scanning electron microscopy (ESEM) as a quantitative method to analyse the attachment of Giardia duodenalis to epithelial cells

Giardia duodenalis is a human parasite that colonises the small intestine. In some studies, it may be necessary to estimate the parasite-host adhesion index. When working in vitro, it is very difficult to determine the relative number of parasites adhered to intestinal cells because parasites might be removed from enterocytes during specimen preparation. We have encountered such difficulties with sample analyses when using light and conventional scanning electron microscopy, including the loss of adherent cells during the processing steps. In this study, we showed that environmental scanning electron microscopy (ESEM), which allows the examination of specimens at normal atmospheric pressure or in very low vacuum without any previous treatment, can be used effectively in quantitative studies of the parasite-host relationship.