Enteric Viral Panel by PCR




Test Mnemonic

EVPPCR

CPT Codes

  • 87505 - QTY (1)

LOINC ®

79390-1

Aliases

  • GIP
  • adenovirus F40/41
  • astrovirus
  • gastrointestinal
  • norovirus
  • rotavirus
  • sapovirus
  • EVPPCR
  • SQEVPPCR
  • stool

Includes

  • Adenovirus F 40/41 DNA
  • Astrovirus RNA
  • Norovirus GI/GII RNA
  • Rotavirus A RNA
  • Sapovirus (Genogroups I, II, IV, V) RNA

Performing Laboratory

Cleveland Clinic Laboratories


Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
One Cary-Blair kit RefrigeratedThe stool must be passed into a clean, dry, wide mouthed container and not contaminated by urine or water. A bed pan is an ideal initial collection container provided it has been thoroughly cleaned and the patient is cautioned against contaminating the specimen with urine. A plastic bag placed over the toilet seat is also acceptable. Select bloody, slimy, or watery portions of the stool using the collection spoon provided in the cap of the container. Place enough stool (~1g) in the Cary-Blair transport vial (Oracle #1124361, or #1570140 as part of STUL kit) to bring the liquid level up to the “fill to here” line. Mash and mix the stool with the spoon along the sides of the container. Tighten the cap and shake the vial until the mixture appears homogeneous.

Alternate Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
One Sterile container RefrigeratedThe stool must be passed into a clean, dry, wide mouthed container and not contaminated by urine or water. A bed pan is an ideal initial collection container provided it has been thoroughly cleaned and the patient is cautioned against contaminating the specimen with urine. A plastic bag placed over the toilet seat is also acceptable. Select bloody, slimy, or watery portions of the stool using a clean transfer device. Place a minimum of 1g of stool into the sterile container (Oracle #1012787).

Stability

Environmental Condition Description
Refrigerated5 days in Cary-Blair transport media or as unpreserved stool in a sterile container
Ambient2 days in Cary-Blair transport media or as unpreserved stool in a sterile container

Days Performed

7 days a week

Turnaround Time

1 - 3 days

Methodology

Name Description
Qualitative Polymerase Chain Reaction 

Clinical Info

The BD Max Enteric Viral Panel is an FDA-cleared multiplex real-time PCR assay that qualitatively detects nucleic acids from the following targets in stool: Norovirus GI/GII, Rotavirus A, Adenovirus 40/41, Sapovirus (Genogroups I, II, IV, V), and Astrovirus. The Infectious Diseases Society of America recommends stool viral pathogen testing in an outbreak setting and in immunocompromised hosts with diarrhea. Identification of the infectious etiology of diarrheal illness can help guide appropriate therapy, prevent unnecessary or harmful antibiotic exposure, and facilitate further workup. Repeat testing within 14 days of the same episode of diarrhea, or for test of cure, is not recommended. Immunocompromised individuals with persistent diarrhea may additionally benefit from additional testing (ie. SQSTLPCR: Enteric Bacterial by PCR or SQSTLPCR: Expanded Stool Gastrointestinal Panel by PCR, SQOVAP: Stool Ova/Parasite Exam, SQCRYSPO: Cryptosporidium/Cyclospora/Cystoisospora Exam, SQMICSPO: Microsporidia Exam, and gastrointestinal biopsy, among others). Individuals with travel history outside the United States with persistent diarrhea lasting >14 days may benefit from additional parasitic testing (ie. SQOVAP: Stool Ova/Parasite exam, SQCRYSPO: Cryptosporidium/Cyclospora/Cystoisospora exam). Individuals with onset of diarrhea after more than 3 days of hospital admission or with prior antibiotic exposure history may benefit from testing for C. difficile (SQCDPCR).

Clinical Limitation

The BD Max Enteric Viral Panel results are meant to be used in conjunction with clinical presentation, laboratory findings, and epidemiological information. Results of this test should not be used as the sole basis for diagnosis, treatment, or other patient management decisions. Positive results do not rule out co-infection with other organisms that are not detected by this test, and may not be the sole or definitive cause of patient illness. Some targets on this panel have potential for false positives due to non-specific cross reactivity. Negative results in the setting of clinical illness compatible with gastroenteritis may be due to infection by pathogens that are not detected by this test or non-infectious causes such as ulcerative colitis, irritable bowel syndrome, or Crohn’s disease. Refer to the manufacturer package insert for full list of limitations.

Clinical Reference

1. Shane AL, Mody RK, Crump JA, Tarr PI, Steiner TS, Kotloff K, Langley JM, Wanke C, Warren CA, Cheng AC, Cantey J, Pickering LK. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-e80. doi: 10.1093/cid/cix669. PMID: 29053792. 2. Stokes W, Simner PJ, Mortensen J, Oethinger M, Stellrecht K, Lockamy E, Lay T, Bouchy P, Pillai DR. Multicenter Clinical Validation of the Molecular BD Max Enteric Viral Panel for Detection of Enteric Pathogens. J Clin Microbiol. 2019 Aug 26;57(9):e00306-19. doi: 10.1128/JCM.00306-19. PMID: 31270179