Enteric Bacterial Panel by PCR
Test Mnemonic
STLPCR
CPT Codes
- 87505 - QTY (1)
Aliases
- STEC
- STLPCR
- campylobacter
- E. coli
- EIEC
- gastrointestinal
- GIP
- O157
- salmonella
- shiga toxin
- shigella
- SQSTLPCR
- stool
- stx1
- stx2
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| One | Stool | Cary-Blair kit | Refrigerated | The 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 | Stool | Sterile container | Refrigerated | The 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. |
Stability
| Environmental Condition | Description |
|---|---|
| Refrigerated | 5 days in Cary-Blair transport media or as unpreserved stool in a sterile container |
| Ambient | 24 hours 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 |
Reference Range
Clinical Info
The BD Max Enteric Bacterial Panel is an FDA-cleared multiplex real-time PCR assay that qualitatively detects nucleic acids from the following targets: Campylobacter speices (C. jejuni/C. coli), Salmonella species, Shiga-like toxin producing E.coli (STEC), and Shigella/Enteroinvasive E.coli (EIEC). Specimens positive for organisms of public health concern may be reflexed to culture and/or sendout testing at a public health lab as indicated in the result comments. The Infectious Diseases Society of America recommends stool pathogen testing in individuals with diarrhea accompanied by fever, bloody or mucoid stools, severe abdominal cramping or tenderness, or signs of sepsis; 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 benefit from additional testing (ie. 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 Bacterial 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.
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. Harrington SM, Buchan BW, Doern C, Fader R, Ferraro MJ, Pillai DR, Rychert J, Doyle L, Lainesse A, Karchmer T, Mortensen JE. Multicenter evaluation of the BD max enteric bacterial panel PCR assay for rapid detection of Salmonella spp., Shigella spp., Campylobacter spp. (C. jejuni and C. coli), and Shiga toxin 1 and 2 genes. J Clin Microbiol. 2015 May;53(5):1639-47. doi: 10.1128/JCM.03480-14. Epub 2015 Mar 4. PMID: 25740779. 3. Collins JP, Shah HJ, Weller DL, Ray LC, Smith K, McGuire S, Trevejo RT, Jervis RH, Vugia DJ, Rissman T, Garman KN, Lathrop S, LaClair B, Boyle MM, Harris S, Kufel JZ, Tauxe RV, Bruce BB, Rose EB, Griffin PM, Payne DC. Preliminary Incidence and Trends of Infections Caused by Pathogens Transmitted Commonly Through Food - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2016-2021. MMWR Morb Mortal Wkly Rep. 2022 Oct 7;71(40):1260-1264. doi: 10.15585/mmwr.mm7140a2. PMID: 36201372.