Microbiology, Test Utilization

Enteric Pathogens PCR Panel: New Order Criteria

The Enteric Pathogens PCR test performed by Spectrum Health Laboratory may be used to detect common pathogenic bacteria and viruses in stool collected from individuals with symptoms of gastrointestinal infection. Specifically, this test detects Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Norovirus, Rotavirus, and the Shiga toxin virulence factor. Effective August 17, 2022, Spectrum Health’s Epic EMR will contain new ask-at-order questions to help improve the clinical decision support and appropriate utilization of this testing.

Because acute gastroenteritis is typically self-limited and treated with supportive care, testing may not be indicated for all patients who develop diarrhea and should be reserved for patients with specific exposure or risk factors. The Pharmacy and Infectious Disease Stewardship Committee has endorsed the following order indications for enteric pathogens PCR testing. If any of these indications are met, then the order can be placed.

• Hospitalization less than 72 hours

• Community-acquired diarrhea greater than 7 days duration

• Travel-related diarrhea

• Diarrhea with risk factors for severe disease such as fever, bloody diarrhea, severe abdominal pain, or immunocompromised state

If no indications are met, consider testing if symptoms become more severe or persist for greater than 7 days.

References

  1. Riddle MS, DuPont HL, Connor BA. ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults. Am J Gastroenterol. 2016 May;111(5):602-22.
  2. 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.
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