Test Id : STL
Enteric Pathogens Culture, Feces
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determining whether a bacterial enteric pathogen is the cause of diarrhea
May be helpful in identifying the source of the infectious agent (eg, dairy products, poultry, water, or meat)
This test is generally not useful for patients hospitalized more than 3 days because the yield from specimens from these patients is very low, as is the likelihood of identifying a pathogen that has not been detected previously.
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| GID | Bacteria Identification | No, (Bill Only) | No |
| ISAE | Aerobe Ident by Sequencing | No, (Bill Only) | No |
| REFID | Additional Identification Procedure | No, (Bill Only) | No |
| SALS | Serologic Agglut Method 1 Ident | No, (Bill Only) | No |
| SHIG | Serologic Agglut Method 3 Ident | No, (Bill Only) | No |
| RMALD | Ident by MALDI-TOF mass spec | No, (Bill Only) | No |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, the reflex tests may be performed at an additional charge. Reportable pathogens include Aeromonas, Campylobacter, Salmonella, Shigella, and Yersinia.
Note: This test does not include culture for Escherichia coli O157:H7. All bacterial isolates worked up, to rule in or out as a pathogen, will be billed for work performed and resources consumed.
For more information see Laboratory Testing for Infectious Causes of Diarrhea.
Method Name
A short description of the method used to perform the test
Conventional Culture
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Aerobic Bacteria Culture, Stool
Aeromonas
Campylobacter
Pathogen-Culture Stool
Pathogens, Aerobic Bacteria Culture, Stool
Salmonella
Shigella
Stool Culture
Vibrio
Yersinia
Culture, Aerobic Bacteria, Stool
50005-STL
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, the reflex tests may be performed at an additional charge. Reportable pathogens include Aeromonas, Campylobacter, Salmonella, Shigella, and Yersinia.
Note: This test does not include culture for Escherichia coli O157:H7. All bacterial isolates worked up, to rule in or out as a pathogen, will be billed for work performed and resources consumed.
For more information see Laboratory Testing for Infectious Causes of Diarrhea.
Specimen Type
Describes the specimen type validated for testing
Fecal
Ordering Guidance
1. If Vibrio is suspected, order VIBC / Vibrio Culture, Feces.
2. If susceptibility testing is needed; also order ZMMLS / Antimicrobial Susceptibility, Aerobic Bacteria, Varies. Pathogens for which susceptibility testing would be pursued are: Shigella species, Yersinia species, Campylobacter species, Arcobacter species, and Vibrio species. If susceptibilities are not appropriate, they will not be performed and ZMMLS will be canceled at report time.
3. Clostridioides (Clostridium) difficile, a major cause of nosocomial diarrhea, is not detected by this test. Order CDPCR / Clostridioides difficile Toxin, PCR, Feces.
4. Escherichia coli O157:H7 is not detected by this test. Order STFRP / Shiga Toxin, Molecular Detection, PCR, Feces.
Additional Testing Requirements
In some cases, local public health requirements may impact Mayo Clinic Laboratories (MCL) clients and require submission of isolates to a public health laboratory. Clients should familiarize themselves with local requirements and will be responsible for submitting isolates to the appropriate public health laboratory. Clients can obtain isolates of Vibrio species by calling 800-533-1710 as soon as possible to ensure viability of the organism.
Shipping Instructions
Specimens must arrive within 72 hours of collection if using fecal swabs or within 4 days of collection if using Culture and Sensitivity stool transport vial.
Necessary Information
Specimen source is required.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| Q00M0057 | Specimen Source |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Patient Preparation: Patient should not use barium or bismuth for 7 to 10 days before specimen collection.
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Fecal Swab
Container/Tube: Culture transport swab (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium)
Specimen Volume: Representative portion of fecal specimen
Collection Instructions:
1. Remove swab from packaging.
2. Collect a small amount of stool by inserting all the tip of the flocked swab into the stool sample and rotate.
3. Transfer swab into the tube with preservative medium within 2 hours of collection and visually check to ensure MAX fill line is not exceeded.
4. Mix stool specimen against side of tube to evenly disperse.
5. Break swab off into the tube.
6. Place screw cap in tube and tighten.
7. Shake vial until sample homogenous.
8. Place vial in a sealed plastic bag.
Specimen Stability Information: Refrigerated 3 days (preferred)/Ambient 2 days
Acceptable:
Specimen Type: Preserved Feces
Container/Tube: Commercially available transport system specific for recovery of enteric pathogens from fecal specimens (15 mL of non-nutritive transport medium containing phenol red as a pH indicator, either Cary-Blair or Para-Pak C and S)
Specimen Volume: Representative portion of fecal specimen
Collection Instructions:
1. Collect fresh feces and submit 1 gram or 5 mL in container with transport medium.
2. Place feces in preservative within 2 hours of collection.
3. Place vial in a sealed plastic bag.
Specimen Stability Information: Ambient 4 days (preferred)/Refrigerated 4 days
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send a Gastroenterology and Hepatology Test Request (T728) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
1 mL
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Unpreserved stool ECOFIX preservative Formalin PVA fixative Enteric Transport Media | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Fecal | Varies | ||
| Ambient | |||
| Refrigerated | |||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determining whether a bacterial enteric pathogen is the cause of diarrhea
May be helpful in identifying the source of the infectious agent (eg, dairy products, poultry, water, or meat)
This test is generally not useful for patients hospitalized more than 3 days because the yield from specimens from these patients is very low, as is the likelihood of identifying a pathogen that has not been detected previously.
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, the reflex tests may be performed at an additional charge. Reportable pathogens include Aeromonas, Campylobacter, Salmonella, Shigella, and Yersinia.
Note: This test does not include culture for Escherichia coli O157:H7. All bacterial isolates worked up, to rule in or out as a pathogen, will be billed for work performed and resources consumed.
For more information see Laboratory Testing for Infectious Causes of Diarrhea.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Diarrhea may be caused by a number of agents (eg, bacteria, viruses, parasites, and chemicals) and these agents may result in similar symptoms. A thorough patient history covering symptoms, severity, duration of illness, age, travel history, food consumption, history of recent antibiotic use, and illnesses in the family or other contacts will help the physician categorize the disease and ensure that any special requests are communicated to the laboratory.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
No growth of pathogens
Interpretation
Provides information to assist in interpretation of the test results
The growth of an enteric pathogen identifies the cause of diarrhea.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. York MK, Rodrigues-Wong P, Church L: Fecal culture for aerobic pathogens of gastroenteritis. In: Clinical Microbiology Procedures Handbook. 3rd ed. ASM Press; 2010:Section 3.8.1
2. Jerris RC, Fields PI, Nicholson MA: Fecal culture for Campylobacter and related organisms. In: Clinical Microbiology Procedures Handbook. 3rd ed. ASM Press; 2010:Section 3.8.2
3. DuPont HL. Persistent diarrhea: A clinical review. JAMA. 2016;315(24):2712-2723. doi:10.1001/jama.2016.7833
Method Description
Describes how the test is performed and provides a method-specific reference
The fecal specimen is inoculated onto selective media designed to inhibit growth of normal bowel microbiota while allowing growth of the enteric pathogens. The following media are used: sheep blood agar, Hektoen enteric agar, eosin-methylene blue agar, Campylobacter agar, cefsulodin-irgasan-novobiocin (CIN) agar, and the enrichment broth, selenite F. After incubation, suspect colonies are identified using 1 or a combination of the following techniques: matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF), conventional biochemical tests, carbon source utilization, serologic methods, or nucleic acid sequencing of the 16S ribosomal RNA gene.(Procop GW, Church DL, Hall GS, et al, eds. Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 7th ed. Lippincott Williams and Wilkins; 2017)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Sunday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
87045-Enteric Pathogens Culture, Stool-with isolation and preliminary examination
87046 x 3-Stool Culture Aerobic Bacteria, each
87077-Ident by MALDI-TOF mass spec (if appropriate)
87077-Bacteria Identification (if appropriate)
87153-Aerobe Ident by Sequencing (if appropriate)
87077-Additional Identification Procedure (if appropriate)
87147 x 3-Serologic Agglut Method 1 Ident (if appropriate)
87147 x 4-Serologic Agglut Method 3 Ident (if appropriate)
87150 Carbapenem resistance genes (if appropriate)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| STL | Enteric Pathogens Culture, Stool | 625-4 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| STL | Enteric Pathogens Culture, Stool | In Process |