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Gastrointestinal pathogen, multiplex reverse transcription and multiplex amplified probe technique, multiple types or subtypes, 22 targets (Campylobacter [C. jejuni/C. coli/C. upsaliensis], Clostridium difficile [C. difficile] toxin A/B, Plesiomonas shige

CPT4 code

Name of the Procedure:

Multiplex gastrointestinal pathogen panel using reverse transcription and amplified probe technique, targeting 22 pathogens, including Campylobacter spp. (C. jejuni/C. coli/C. upsaliensis) and Clostridium difficile (toxin A/B), among others.

Summary

In layman's terms, this procedure is a highly advanced test that detects multiple gastrointestinal pathogens at once using specialized molecular techniques and probes. It identifies up to 22 different bacteria, viruses, and parasites that can cause infections in the digestive system.

Purpose

The main aim of this test is to diagnose the cause of symptoms such as diarrhea, abdominal pain, fever, and other gastrointestinal disturbances. By identifying the specific pathogen responsible, healthcare providers can recommend targeted treatments and avoid unnecessary antibiotics.

Indications

This test is indicated for patients experiencing severe or persistent gastrointestinal symptoms including:

  • Diarrhea (acute or chronic)
  • Abdominal pain
  • Fever
  • Nausea and vomiting
  • Dehydration

It is especially useful in cases of suspected bacterial infections such as those caused by Campylobacter spp. and Clostridium difficile.

Preparation

Patients are typically advised to:

  • Collect and submit a stool sample following specific guidelines provided by the healthcare provider.
  • Avoid certain medications that might affect the test results, such as antibiotics or antidiarrheal drugs.

No fasting or special diet is usually required unless instructed otherwise.

Procedure Description

  1. A stool sample is collected from the patient using a sterile container.
  2. The sample is transported to a laboratory where it undergoes preparation.
  3. Laboratory technicians use reverse transcription to convert RNA pathogens to DNA and then amplify these DNA sequences using specialized probes.
  4. The multiplex test detects and identifies the presence of up to 22 different gastrointestinal pathogens simultaneously.
  5. Results are analyzed and reported back to the healthcare provider.

Duration

The entire laboratory process from sample collection to final results typically takes 24 to 48 hours.

Setting

The procedure is usually conducted in an outpatient setting. The stool sample is processed in a clinical laboratory.

Personnel

  • Medical laboratory technicians or technologists who process and analyze the stool sample.
  • Pathologists or microbiologists who interpret the results.
  • Healthcare providers who collect the sample and discuss the results with the patient.

Risks and Complications

  • The stool sample collection process is non-invasive and poses minimal risk.
  • Rarely, sample contamination can occur, which might necessitate recollection.
  • False positives or negatives, although infrequent, can occur and might require additional testing.

Benefits

  • Rapid and accurate identification of gastrointestinal pathogens.
  • Allows for targeted treatment, reducing unnecessary use of broad-spectrum antibiotics.
  • Helps in quick recovery and reduces the risk of complications.

Recovery

  • No recovery period is required for the sample collection itself.
  • Follow-up care depends on the test results and subsequent treatment.
  • Patients may be advised on specific medications or dietary changes based on the identified pathogen.

Alternatives

  • Traditional stool culture, which can take longer and may not detect all pathogens.
  • Serological tests or single-pathogen PCR tests, which are less comprehensive.
  • Pros of the multiplex test include speed and comprehensive detection, while cons might include higher cost compared to simpler tests.

Patient Experience

During the stool sample collection, patients might experience minimal discomfort. Post-procedure, there might be relief from receiving quick and accurate diagnosis. The discomfort, if any, primarily depends on the symptoms of the underlying gastrointestinal condition. Pain management is not typically required for this non-invasive procedure.

Medical Policies and Guidelines for Gastrointestinal pathogen, multiplex reverse transcription and multiplex amplified probe technique, multiple types or subtypes, 22 targets (Campylobacter [C. jejuni/C. coli/C. upsaliensis], Clostridium difficile [C. difficile] toxin A/B, Plesiomonas shige

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