Enteric Panel
Label Mnemonic: ENTPANEL
Epic code: LAB8513
Order form: Microbiology/Molecular Infectious Disease Requisition
Supply order: Supply Order Form
Billing: Billing Policies
CPT code: 87507
Specimen(s):
FecalSwabs, Stool
Collection Medium:
Fecal Copan Collection Transport Swab (Hospital Stores #105117)
Minimum:
The Enteric Panel can only be performed from FecalSwab samples. If test of cure is needed for Salmonella, Shigella or EHEC, order Epic LAB8534, Test of Cure Stool Culture instead.

Please use FecalSwabs [Stores #105117]
1) Obtain a stool specimen in a clean pan or container. Stool specimens should not contain urine or water.
2) Holding FecalSwab shaft above the red breakpoint mark, insert the entire tip of the FecalSwab into the stool sample and rotate. Do not use FecalSwab as a spoon; rather, coat swab with a visible layer.
3) If visible stool is not coating the FecalSwab tip, reinsert until swab is coated.
4) Using swab and aiming tube away, mash and mix the stool sample against the side of the tube to suspend the sample.
5) Invert the tube several times to homogenize the sample and expose the sample to Cary Blair preservative fluid.
Rejection Criteria:
Stool not in FecalSwabs, Rectal swabs, GI aspirates.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
6 hours (upon receipt in laboratory)
Reference Range:
Not Detected
Comments:
The FilmArray gastrointestinal panel is a multiplex PCR test capable of qualitatively detecting DNA or RNA of 22 pathogens (bacteria, parasites, and viruses).

The panel is used to diagnose infection caused by Campylobacter species, Plesiomonas shigelloides, Salmonella species, Vibrio species, V. cholerae, Yersinia species, enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, Shiga toxin producing E. coli, E. coli O157, Shigella/Enteroinvasive E. coli, Cryptosporidium species, Cyclospora cayetanensis, Entamoeba histolytica, Giardia lamblia, Adenovirus F 40/41, Astrovirus, Norovirus, Rotavirus and Sapovirus.
Methodology:
PCR amplification: FilmArray GI Panel
Instructions:
For patients with community-acquired diarrhea of <7 days' duration WITHOUT warning signs (fever, bloody diarrhea, severe abdominal pain, dehydration, hospitalization, or immunocompromise) testing is not generally indicated unless diarrhea persists.

For persistent diarrhea >=7 days' duration, travel-related diarrhea or diarrhea with warning signs or risk factors for severe disease (see above), the gastrointestinal PCR panel should be ordered. If negative, consider additional diagnoses such as a full O&P panel (three samples over 10 days) in patients with an appropriate travel history (Epic LAB8332).

For healthcare-associated diarrhea with onset after the third hospital day, and at least 3 loose stools per day, consider C. difficile testing, which is orderable separately as "C. difficile toxin screen", LAB8239.

Specimen may be stored in Cary Blair transport tube at room temperature up to 48 hours or refirgerated up to 72 hours.
Sample Processing:
Label transport tube with two patient identifiers, date and time of collection.
Specimen should be collected and packaged as close to shipping time as possible.
Transport Instructions:
Place requisition into outside pocket of bag.
Place specimen into zip-lock type bag, seal bag.
DO NOT FREEZE, protect specimen by wrapping in bubble-wrap or toweling.
Ship at room temperature or refrigerate.
CPT Code:
87507
 
See also:
C. difficile Toxin Screen, Stool