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HelpTest ID: GIP Gastrointestinal Pathogen Panel, PCR, Feces
Useful For
Rapid detection of gastrointestinal infections caused by:
-Campylobacter species (Campylobacter jejuni/Campylobacter coli/Campylobacter upsaliensis)
-Clostridioides difficile toxin A/B
-Plesiomonas shigelloides
-Salmonella species
-Vibrio species (Vibrio parahaemolyticus, Vibrio vulnificus, Vibrio cholerae)
-Vibrio cholerae
-Yersinia species
-Enteroaggregative Escherichia coli (EAEC)
-Enteropathogenic E coli (EPEC)
-Enterotoxigenic E coli (ETEC)
-Shiga toxin
-E coli O157
-Shigella/Enteroinvasive E coli (EIEC)
-Cryptosporidium species
-Cyclospora cayetanensis
-Entamoeba histolytica
-Giardia
-Adenovirus F 40/41
-Astrovirus
-Norovirus GI/GII
-Rotavirus A
-Sapovirus
This test is not recommended as a test of cure.
Special Instructions
Method Name
Multiplex Polymerase Chain Reaction (PCR)
Reporting Name
GI Pathogen Panel, PCR, FSpecimen Type
FecalOrdering Guidance
It is not recommended that the following tests be concomitantly ordered if this test is ordered:
-VIBC / Vibrio Culture, Feces
-ROTA / Rotavirus Antigen, Feces
-LADV / Adenovirus, Molecular Detection, PCR, Varies
-GIAR / Giardia Antigen, Feces
-CRYPS / Cryptosporidium Antigen, Feces
-CYCL / Cyclospora Stain, Feces
-STL / Enteric Pathogens Culture, Feces
-CAMPC / Campylobacter Culture, Feces
-SHIGC / Shigella Culture, Feces
-SALMC / Salmonella Culture, Feces
-YERSC / Yersinia Culture, Feces
-E157C / Escherichia coli O157:H7 Culture, Feces
-STFRP / Shiga Toxin, Molecular Detection, PCR, Feces
-CDPCR / Clostridioides difficile Toxin, PCR, Feces
-LNORO / Norovirus PCR, Molecular Detection, Feces
Additional Testing Requirements
In some cases, there may be local public health requirements that impact Mayo Clinic Laboratories (MCL) clients and require additional testing on specimens with positive results from this panel. Clients should familiarize themselves with local requirements. MCL recommends clients retain an aliquot of each specimen submitted for this test to perform additional testing themselves, as needed. If necessary, see Interpretation for detailed information about how to obtain this testing.
Shipping Instructions
Specimen must arrive within 4 days of collection.
Do not freeze. Testing will be canceled on specimens received frozen.
Specimen Required
Supplies: Culture and Sensitivity Stool Transport Vial (T058)
Container/Tube:
Preferred: Specific modified Cary Blair transport system; see Additional Information for acceptable collection media
Acceptable: Approved Cary Blair transport system (15 mL of non-nutritive transport medium containing phenol red as a pH indicator)
Specimen Volume: Representative portion of feces
Collection Instructions:
1. Collect fresh fecal specimen and submit 1 gram or 5 mL in container with transport medium.
2. Place feces in preservative within 2 hours of collection.
3. Submit preserved feces in original container. Do not aliquot.
4. If unpreserved specimens received, testing will be canceled.
Additional Information:
If collection media other than those listed is utilized, testing may be canceled. Media listed have been verified for use by Mayo Clinic Laboratories.
Modified Cary Blair media:
Preferred: Culture and Sensitivity Stool Transport Vial (T058)
Acceptable: Meridian Para-Pak C and S, Cardinal Health Culture and Sensitivity Stool transport Vial
Cary Blair media: Remel Cary Blair, Remel; Protocol Cary Blair
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Fecal | Ambient (preferred) | 4 days | |
| Refrigerated | 4 days |
Clinical Information
Acute diarrheal syndromes are usually self-limiting but may be complicated by dehydration, vomiting, and fever. Diagnostic testing and treatment may be required in some instances. Many bacterial enteric infections in the United States originate within the food supply chain. According to the CDC, in 2012 there were 19,531 laboratory-confirmed cases of infection with pathogens potentially transmitted through food in the United States. The numbers of infections, by pathogen, were as follows: Salmonella species (7800), Campylobacter species (6793), Shigella species (2138), Cryptosporidium species (1234), Shiga toxin-producing Escherichia coli non-O157 (551), Shiga toxin-producing E coli O157 (531), Vibrio species (193), Yersinia species (155), and Cyclospora cayetanensis (15). Giardia may also be transmitted through ingestion of contaminated food and water. There were 15,178 cases of giardiasis reported to the CDC in 2012. Since the clinical presentation may be very similar to many of these bacterial, viral, and parasitic pathogens, laboratory testing is required for definitive identification of the causative agent.
Rapid multiplex panel detection of the most common agents of bacterial, viral, and parasitic enteric infections directly from stool specimens is sensitive, specific, and provides same-day results, obviating the need for culture, antigen testing, microscopy, or individual nucleic acid amplification tests.
For other diagnostic tests that may be of value in evaluating patients with diarrhea the following are available:
Reference Values
Negative (for all targets)
Interpretation
A negative result should not rule-out infection in patients with a high pretest probability for gastrointestinal infection. The assay does not test for all potential infectious agents of diarrheal disease.
Positive results do not distinguish between a viable or replicating organism and the presence of a nonviable organism or nucleic acid, nor do they exclude the potential for coinfection by organisms not contained within the panel.
Results of the panel are intended to aid in the diagnosis of illness and are meant to be used in conjunction with other clinical and epidemiological findings.
In some cases, there may be local public health requirements that impact Mayo Clinic Laboratories (MCL) clients and require additional testing on specimens with positive results from this panel. Clients should familiarize themselves with local requirements. MCL recommends clients retain an aliquot of each specimen submitted for this test to perform additional testing themselves, as needed. If necessary, selected add-on tests can be performed by MCL at an additional charge, as detailed below. Call 800-533-1710 within 4 days of specimen collection to request supplemental testing for positive test results:
|
Gastrointestinal pathogen panel positive for |
Client action |
|
Campylobacter species |
Request add on test: CAMPC / Campylobacter Culture, Feces |
|
Salmonella species |
Request add on test: SALMC / Salmonella Culture, Feces |
|
Shigella/Enteroinvasive E coli |
Request add on test: SHIGC / Shigella Culture, Feces (for the Shigella/Enteroinvasive E coli target, the culture will assess for Shigella species only) |
|
Yersinia species |
Request add on test: YERSC / Yersinia Culture, Feces |
|
Shiga toxin-producing E coli E coli O157 |
Request add on test: E157C / Escherichia coli O157:H7 Culture, Feces |
MCL will report results to the client for additional cultures when ordered. If cultures are positive and the client needs the isolated organism (eg, Campylobacter, Salmonella, Shigella, Yersinia or Vibrio species, or E coli O157:H7) for submission to a public health laboratory, the client needs to call MCL and request that the isolates be returned to them (the client). The client will be responsible for submitting the isolates to the appropriate public health department. Positive culture results will also be reported via the Electronic Clinical Laboratory Reporting System.
Alternatively (not preferred), clients who want a patient specimen returned from MCL should call 800-533-1710 as soon as possible, at the latest within 96 hours of specimen collection, to request that MCL return an aliquot of the submitted specimen to them. Clients will be responsible for submitting specimens to appropriate public health departments.
Clinical Reference
1. Khare R, Espy MJ, Cebelinski E, et al. Comparative evaluation of two commercial multiplex panels for detection of gastrointestinal pathogens by use of clinical stool specimens. J Clin Microbiol. 2014;52(10):3667-3673
2. Centers for Disease Control and Prevention. Incidence and trends of infection with pathogens transmitted commonly through food-foodborne diseases active surveillance network, 10 U.S. sites, 1996-2012. MMWR Morb Mortal Wkly Rep. 2013;62(15):283-287
3. Centers for Disease Control and Prevention. Summary of notifiable diseases-United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;61(53):1-121
4. DuPont HL. Persistent diarrhea: A clinical review. JAMA. 2016;315(24):2712-2723. doi:10.1001/jama.2016.7833
5. Lawson PA, Citron DM, Tyrrell KL, Finegold SM. Reclassification of Clostridium difficile as Clostridioides difficile (Hall and O'Toole 1935) Prevot 1938. Anaerobe. 2016;40:95-99. doi:10.1016/j.anaerobe.2016.06.008
6. Oren A, Garrity GM. Validation List No. 169. List of new names and new combinations previously effectively, but not validly, published. Int J Syst Evol Microbiol. 2016;66(6):2456-2458. doi:10.1099/ijsem.0.001181
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
87507
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| GIP | GI Pathogen Panel, PCR, F | 82195-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| SRCGI | Specimen Source | 31208-2 |
| 37081 | Campylobacter species | 82196-7 |
| 37082 | C. difficile toxin | 82197-5 |
| 37083 | Plesiomonas shigelloides | 82198-3 |
| 37084 | Salmonella species | 82199-1 |
| 37085 | Vibrio species | 82200-7 |
| 37086 | Vibrio cholerae | 82201-5 |
| 37087 | Yersinia species | 82202-3 |
| 37088 | Enteroaggregative E. coli (EAEC) | 80349-4 |
| 37089 | Enteropathogenic E. coli (EPEC) | 80348-6 |
| 37090 | Enterotoxigenic E. coli (ETEC) | 80351-0 |
| 37091 | Shiga toxin producing E. coli | 82203-1 |
| 37092 | Escherichia coli O157 serotype | 82204-9 |
| 37093 | Shigella/Enteroinvasive E. coli | 80350-2 |
| 37094 | Cryptosporidium species | 82205-6 |
| 37095 | Cyclospora cayetanensis | 82206-4 |
| 37096 | Entamoeba histolytica | 82207-2 |
| 37097 | Giardia | 82208-0 |
| 37098 | Adenovirus F40/41 | 82209-8 |
| 37099 | Astrovirus | 82210-6 |
| 37100 | Norovirus GI/GII | 82211-4 |
| 37101 | Rotavirus | 82212-2 |
| 37103 | Sapovirus | 82213-0 |
| 37262 | Interpretation | 59464-8 |
Testing Algorithm
If positive for Vibrio species or Vibrio cholerae, a Vibrio culture will be performed at an additional charge.
The following algorithms are available:
Day(s) Performed
Monday through Sunday
Report Available
1 to 2 daysForms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Gastroenterology and Hepatology Test Request (T728)
-Microbiology Test Request (T244)
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| VIBC | Vibrio Culture, Stool | Yes | No |
mml-giinfections