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25384 Fecal Bacteria-only Pathogen Panel, NAT

Fecal Bacteria-only Pathogen Panel, NAT
Test Code: SSCSNAT
Synonyms/Keywords
​​Salmonella, Shigella, Campylobacter, Escherichia coli, O157, H7, STEC, EHEC Shiga Toxin, Stool, Feces, Nucleic Acid Test, Enteric Pathogen
Test Components
​DNA isolation, multiplex real-time polymerase chain reaction amplification and detection.
Useful For

Detection of Salmonella, Shigella, Campylobacter (C. jejuni and C. coli species only) and Shiga Toxin-producing Escherichia coli (STEC, otherwise known as enterohemorrhagic E. coli or EHEC) are routinely reported.  Acute diarrhea occurring after 3 days of hospitalization is unlikely to be due to bacterial enteropathogens.  Consider a Clostridium difficile toxin nucleic acid assay for C. difficile-associated nosocomial diarrhea instead of stool nucleic acid test.  (See Clostridium difficile Toxin Nucleic Acid).

All positive stool samples are forwarded to the Wisconsin State Lab of Hygiene (WSLH) for surveillance testing. STEC positive samples are subtyped against that most common serogroups in the US including O157:H7.  Salmonella serotyping is also performed. Surveillance data are generated for public health purposes and are not reported to the medical record unless otherwise requested by Provider.

Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No ​Feces Leak-proof container
​Cary Blair,
ParaPak C & S
 ​1 gram ​1 gram ​1 gram
Collection Processing Instructions

NOTE - the preferred specimen container is raw stool in a leak-proof container.

If submitting in Cary-Blair, remove cap and place approximately 1 gram of the raw stool into the transport medium or a sufficient amount to bring the liquid level up to the "fill to here" line.

No more than two specimens per patient are acceptable without prior consultation.

For more information on Specimen Collection Media/Swab, see Specimen Transport Pictorial.

Acceptable Specimen Types

​Feces, Liquid or Soft Raw Stool 

Specimen Stability Information
Specimen Type Temperature Time
​Feces ​ ​Room Temperature ​ 24 hours
​Refrigerated 1​20 hours​
​ParaPak C & S (Cary Blair) filled to the fill line ​Refrigerated 
 ​120 hours
Rejection Criteria
Rectal Swabs
Feces at room temperature equal to or greater than 24 hours old
Feces refrigerated equal to or greater than 120 hours old
ParaPak C & S equal to or greater than 120 hours old​
​Frozen feces
Duplicate specimen within 24 hours​
Interference
​Any inhibition of amplification will be detected through the use of an internal amplification control.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Sunday through Friday
6-8 hours*
 ​Nucleic Acid Test
*Testing performed once/day.
​ ​Sample must be re​ceived in the lab by 0400 to be tested same day.​ ​ ​ ​ ​ ​
Reference Range Information
Performing Location Reference Range
​Marshfield ​Negative for Salmonella, Shigella, Campylobacter (C. jejuni and C. coli),
and Shiga Toxin-producing E. coli (Shiga Toxin 1 & 2)
Interpretation
​Antibiotic susceptibility testing is not normally performed, but may be requested on Salmonella and Shigella isolates through the Wisconsin State Laboratory of Hygiene at an additional charge.  Antimicrobial therapy is not recommended for E. coli STEC infections, as it may enhance Shiga toxin release and increase the risk of hemolytic uremic syndrome (HUS).
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
87505 ​ ​ ​
Synonyms/Keywords
​​Salmonella, Shigella, Campylobacter, Escherichia coli, O157, H7, STEC, EHEC Shiga Toxin, Stool, Feces, Nucleic Acid Test, Enteric Pathogen
Test Components
​DNA isolation, multiplex real-time polymerase chain reaction amplification and detection.
Ordering Applications
Ordering Application Description
​​COM ​Fecal Bacterial Pathogens, NAT
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No ​Feces Leak-proof container
​Cary Blair,
ParaPak C & S
 ​1 gram ​1 gram ​1 gram
Collection Processing

NOTE - the preferred specimen container is raw stool in a leak-proof container.

If submitting in Cary-Blair, remove cap and place approximately 1 gram of the raw stool into the transport medium or a sufficient amount to bring the liquid level up to the "fill to here" line.

No more than two specimens per patient are acceptable without prior consultation.

For more information on Specimen Collection Media/Swab, see Specimen Transport Pictorial.

Acceptable Specimen Types

​Feces, Liquid or Soft Raw Stool 

Specimen Stability Information
Specimen Type Temperature Time
​Feces ​ ​Room Temperature ​ 24 hours
​Refrigerated 1​20 hours​
​ParaPak C & S (Cary Blair) filled to the fill line ​Refrigerated 
 ​120 hours
Rejection Criteria
Rectal Swabs
Feces at room temperature equal to or greater than 24 hours old
Feces refrigerated equal to or greater than 120 hours old
ParaPak C & S equal to or greater than 120 hours old​
​Frozen feces
Duplicate specimen within 24 hours​
Interference
​Any inhibition of amplification will be detected through the use of an internal amplification control.
Useful For

Detection of Salmonella, Shigella, Campylobacter (C. jejuni and C. coli species only) and Shiga Toxin-producing Escherichia coli (STEC, otherwise known as enterohemorrhagic E. coli or EHEC) are routinely reported.  Acute diarrhea occurring after 3 days of hospitalization is unlikely to be due to bacterial enteropathogens.  Consider a Clostridium difficile toxin nucleic acid assay for C. difficile-associated nosocomial diarrhea instead of stool nucleic acid test.  (See Clostridium difficile Toxin Nucleic Acid).

All positive stool samples are forwarded to the Wisconsin State Lab of Hygiene (WSLH) for surveillance testing. STEC positive samples are subtyped against that most common serogroups in the US including O157:H7.  Salmonella serotyping is also performed. Surveillance data are generated for public health purposes and are not reported to the medical record unless otherwise requested by Provider.

Test Components
​DNA isolation, multiplex real-time polymerase chain reaction amplification and detection.
Reference Range Information
Performing Location Reference Range
​Marshfield ​Negative for Salmonella, Shigella, Campylobacter (C. jejuni and C. coli),
and Shiga Toxin-producing E. coli (Shiga Toxin 1 & 2)
Interpretation
​Antibiotic susceptibility testing is not normally performed, but may be requested on Salmonella and Shigella isolates through the Wisconsin State Laboratory of Hygiene at an additional charge.  Antimicrobial therapy is not recommended for E. coli STEC infections, as it may enhance Shiga toxin release and increase the risk of hemolytic uremic syndrome (HUS).
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Sunday through Friday
6-8 hours*
 ​Nucleic Acid Test
*Testing performed once/day.
​ ​Sample must be re​ceived in the lab by 0400 to be tested same day.​ ​ ​ ​ ​ ​
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
87505 ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.