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HelpMayo Test ID STL Enteric Pathogens Culture, Feces
Ordering Guidance
1. If Vibrio is suspected, order VIBC / Vibrio Culture, Feces.
2. If susceptibility testing is needed; also order ZMMLS / Antimicrobial Susceptibility, Aerobic Bacteria, Varies. Pathogens for which susceptibility testing would be pursued are: Shigella species, Yersinia species, Campylobacter species, Arcobacter species, and Vibrio species. If susceptibilities are not appropriate, they will not be performed and ZMMLS will be canceled at report time.
3. Clostridioides (Clostridium) difficile, a major cause of nosocomial diarrhea, is not detected by this test. Order CDPCR / Clostridioides difficile Toxin, PCR, Feces.
4. Escherichia coli O157:H7 is not detected by this test. Order STFRP / Shiga Toxin, Molecular Detection, PCR, Feces.
Additional Testing Requirements
In some cases, local public health requirements may impact Mayo Clinic Laboratories (MCL) clients and require submission of isolates to a public health laboratory. Clients should familiarize themselves with local requirements and will be responsible for submitting isolates to the appropriate public health laboratory. Clients can obtain isolates of Vibrio species by calling 800-533-1710 as soon as possible to ensure viability of the organism.
Shipping Instructions
Specimen must arrive within 96 hours of collection.
Necessary Information
Specimen source is required.
Specimen Required
Specimen Type: Preserved Feces
Patient Preparation: Patient should not use barium or bismuth for 7 to 10 days before specimen collection.
Supplies: Culture and Sensitivity Stool Transport Vial (T058)
Container/Tube: Commercially available transport system specific for recovery of enteric pathogens from fecal specimens (15 mL of non-nutritive transport medium containing phenol red as a pH indicator, either Cary-Blair or Para-Pak C and S)
Specimen Volume: Representative portion of fecal specimen
Collection Instructions:
1. Collect fresh feces and submit 1 gram or 5 mL in container with transport medium.
2. Place feces in preservative within 2 hours of collection.
3. Place vial in a sealed plastic bag.
Useful For
Determining whether a bacterial enteric pathogen is the cause of diarrhea
May be helpful in identifying the source of the infectious agent (eg, dairy products, poultry, water, or meat)
This test is generally not useful for patients hospitalized more than 3 days because the yield from specimens from these patients is very low, as is the likelihood of identifying a pathogen that has not been detected previously.
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| GID | Bacteria Identification | No, (Bill Only) | No |
| ISAE | Aerobe Ident by Sequencing | No, (Bill Only) | No |
| REFID | Additional Identification Procedure | No, (Bill Only) | No |
| SALS | Serologic Agglut Method 1 Ident | No, (Bill Only) | No |
| SHIG | Serologic Agglut Method 3 Ident | No, (Bill Only) | No |
| RMALD | Ident by MALDI-TOF mass spec | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, the reflex tests may be performed at an additional charge. Reportable pathogens include Aeromonas, Campylobacter, Salmonella, Shigella, and Yersinia.
Note: This test does not include culture for Escherichia coli O157:H7. All bacterial isolates worked up, to rule in or out as a pathogen, will be billed for work performed and resources consumed.
For more information see Laboratory Testing for Infectious Causes of Diarrhea.
Special Instructions
Method Name
Conventional Culture
Reporting Name
Enteric Pathogens Culture, StoolSpecimen Type
FecalSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Fecal | Ambient (preferred) | 4 days | |
| Refrigerated | 4 days |
Reject Due To
| Unpreserved stool ECOFIX preservative Formalin or PVA fixative |
Reject |
Clinical Information
Diarrhea may be caused by a number of agents (eg, bacteria, viruses, parasites, and chemicals) and these agents may result in similar symptoms. A thorough patient history covering symptoms, severity, duration of illness, age, travel history, food consumption, history of recent antibiotic use, and illnesses in the family or other contacts will help the physician categorize the disease and ensure that any special requests are communicated to the laboratory.
Reference Values
No growth of pathogens
Interpretation
The growth of an enteric pathogen identifies the cause of diarrhea.
Cautions
No significant cautionary statements
Clinical Reference
1. York MK, Rodrigues-Wong P, Church L: Fecal culture for aerobic pathogens of gastroenteritis. In: Clinical Microbiology Procedures Handbook. 3rd ed. ASM Press; 2010:Section 3.8.1
2. Jerris RC, Fields PI, Nicholson MA: Fecal culture for Campylobacter and related organisms. In: Clinical Microbiology Procedures Handbook. 3rd ed. ASM Press; 2010:Section 3.8.2
3. DuPont HL. Persistent diarrhea: A clinical review. JAMA. 2016;315(24):2712-2723. doi:10.1001/jama.2016.7833
Method Description
The fecal specimen is inoculated onto selective media designed to inhibit growth of normal bowel microbiota while allowing growth of the enteric pathogens. The following media are used: sheep blood agar, Hektoen enteric agar, eosin-methylene blue agar, Campylobacter agar, cefsulodin-irgasan-novobiocin (CIN) agar, and the enrichment broth, selenite F. After incubation, suspect colonies are identified using 1 or a combination of the following techniques: matrix-assisted laser desorption/ionization time of flight mass spectrometry, conventional biochemical tests, carbon source utilization, serologic methods, or nucleic acid sequencing of the 16S ribosomal RNA gene.(Procop GW, Church DL, Hall GS, et al, eds. Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 7th ed. Lippincott Williams and Wilkins; 2017)
Day(s) Performed
Monday through Sunday
Report Available
3 to 8 daysSpecimen Retention Time
7 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
87045-Enteric Pathogens Culture, Stool-with isolation and preliminary examination
87046 x 3-Stool Culture Aerobic Bacteria, each
87077-Ident by MALDI-TOF mass spec (if appropriate)
87077-Bacteria Identification (if appropriate)
87153-Aerobe Ident by Sequencing (if appropriate)
87077-Additional Identification Procedure (if appropriate)
87147 x 3-Serologic Agglut Method 1 Ident (if appropriate)
87147 x 4-Serologic Agglut Method 3 Ident (if appropriate)
87150 x 5 Carbapenem resistance genes (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| STL | Enteric Pathogens Culture, Stool | 625-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| STL | Enteric Pathogens Culture, Stool | In Process |