Gastroenteritis/enteric pathogens

(Microbiology)

1. Faecal samples submitted for culture to Bacteriology are routinely screened for enteric pathogens according to clinical information.
   
   First line testing is performed on the EntericBio PCR platform, which tests for the following pathogens:
   
   

   Bacteria	Protozoa
   Campylobacter spp.	Cryptosporidium spp.
   Shiga-toxin producing E. coli	Giardia spp.
   Salmonella spp.	Entamoeba histolytica
   Shigella spp. (cross-reacts with enteroinvasive E. coli)
   Vibrio cholerae/parahaemolyticus
   Yersinia spp.

   
   
   Positive PCR results are confirmed by culture and/or reference laboratory testing in certain circumstances
   
   Note 1. It is particularly important to provide full clinical details on patients who are immunocompromised or who have returned from travel abroad, so that a check may be made for all relevant pathogens.
   
   Note 2. But it just as important to supply relevant clinical details on all patients, not just those at 'high risk' - for example, the history of bloody diarrhoea or of renal impairment may prompt special investigations.
   
   
2. If suspected protozoal pathogens other than those listed above, send faeces for ova, cysts and parasites microscopy with full clinical details.
   
   
3. A viral gastroenteritis PCR is available. See Viral Gastroenteritis. This PCR supplements the norovirus service for the additional detection of rotavirus, adenovirus, astrovirus and sapovirus..

Investigations	PCR and Culture for enteric pathogens Requests for parasitological investigation beyond those listed above should be requested separately.
Inform lab before sending	No
Specimen type	Faeces
Ideal time to take specimen	During episode of diarrhoea. . If performing a “test of cure”, this should be clearly stated on the request form
Labelling requirements	click here
How to take the specimen	A blue sterile universal container with spoon, a sterile white capped universal, or a sputum pot. The specimen container should not be filled to the brim. A walnut sized portion of stool or about 10ml of liquid faeces is sufficient.
Transport to the laboratory	As soon as possible. If transport is delayed then refrigerate. Delays of over 48hrs are undesirable.
Test Times	Monday to Friday
Turnround	Up to 72 hrs. May be longer if it is necessary to send the pathogen to a reference laboratory for further work
Additional information	Faecal samples submitted for culture to Bacteriology are routinely screened for enteric pathogens according to clinical information; therefore it is important to provide full clinical details e.g. history of travel abroad, immunocompromised patients, renal impairment or bloody diarrhoea. Faecal testing is performed using the Molecular Enteric Bio platform. This platform has higher sensitivity than conventional culture. The test is not yet accredited by UKAS but the laboratory as a whole is UKAS accredited.
Additional Examination Requests	Please ensure that any requests for additional investigations on the specimen are made within 7 days from the date of the original request.

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