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Test Code SSCSNAT Fecal Bacteria-only Pathogen Panel, NAT

Useful For

Detection of Salmonella, Shigella, Campylobacter (C. jejuni and C. coli species only) and Shiga Toxin-producing Escherichia coli (STEC, otherwise known as enterohemorrhagic E. coli or EHEC) are routinely reported.  Acute diarrhea occurring after 3 days of hospitalization is unlikely to be due to bacterial enteropathogens.  Consider a Clostridium difficile toxin nucleic acid assay for C. difficile-associated nosocomial diarrhea instead of stool nucleic acid test.  (See Clostridium difficile Toxin Nucleic Acid).

 

All positive stool samples are forwarded to the Wisconsin State Lab of Hygiene (WSLH) for surveillance testing. STEC positive samples are subtyped against that most common serogroups in the US including O157:H7.  Salmonella serotyping is also performed. Surveillance data are generated for public health purposes and are not reported to the medical record unless otherwise requested by Provider.

Synonyms/Keywords

Salmonella, Shigella, Campylobacter, Escherichia coli, O157, H7, STEC, EHEC Shiga Toxin, Stool, Feces, Nucleic Acid Test, Enteric Pathogen

Specimen Requirements

Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No Feces Sterile, Leak-proof container Cary Blair 1 gram 1 gram 1 gram

Acceptable Specimen Types

Feces, Liquid or Soft Raw Stool 

Collection/Processing Instructions

The preferred specimen is fresh stool in a leak-proof container. Transfer approximately 1 gram of stool specimen to a dry, clean container. Avoid contamination with water or urine. 

 

If submitting in Cary-Blair, remove cap and place approximately 1 gram of the raw stool into the transport medium or a sufficient amount to bring the liquid level up to the "fill to here" line.

 

For more information on Specimen Collection Media/Swab, see Specimen Transport Pictorial.

Specimen Stability Information

Specimen Type Temperature Time
Feces Room Temperature 24 hours
Refrigerated 120 hours
Feces in Cary Blair filled to the fill line Refrigerated  120 hours

Rejection Criteria

Feces outside of stability ranges
Feces received in unapproved preserative
Frozen feces
Duplicate specimen within 24 hours

 

If test is ordered in conjuction with the Enteric Parasite Panel and the Enteric Viral Panel, all tests will be canceled, and the Extended Gastrointestinal Panel will be ordered instead. 

Test Components

DNA isolation, multiplex real-time polymerase chain reaction amplification and detection.

Interferences

Any inhibition of amplification will be detected through the use of an internal amplification control.

Interpretations

Antibiotic susceptibility testing is not normally performed, but may be requested on Salmonella and Shigella isolates through the Wisconsin State Laboratory of Hygiene at an additional charge.  Antimicrobial therapy is not recommended for E. coli STEC infections, as it may enhance Shiga toxin release and increase the risk of hemolytic uremic syndrome (HUS).

Reference Range Information

Performing Location Reference Range
Marshfield Negative for Salmonella, Shigella, Campylobacter (C. jejuni and C. coli),
and Shiga Toxin-producing E. coli (Shiga Toxin 1 & 2)

Marshfield Labs Performing Department

Marshfield Labs Molecular Pathology

Performing Information

Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield Sunday through Friday 6-8 hours* Nucleic Acid Test

*Testing performed once/day.

Sample must be received in the lab by 0600 to be tested same day.

CPT Codes

CPT Modifier
(if needed)		 Quantity Description Comments
87505        

Outreach CPT Codes

CPT Modifier
(if needed)		 Quantity Description Comments
87505        

Ordering Applications

Ordering Application Description
COM Fecal Bacterial Pathogens, NAT