87505 Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe tech

Name of the Procedure:

Infectious Agent Detection by Nucleic Acid (DNA or RNA); Gastrointestinal Pathogen

• Common Name: GI Pathogen Panel, DNA/RNA Test for GI Infections
• Technical Terms: Multiplex PCR, Reverse Transcription, Amplified Probe Technology

Summary

This procedure involves testing a stool sample to detect the presence of various gastrointestinal pathogens such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, and Giardia. The test uses advanced molecular techniques to identify the DNA or RNA of these pathogens, providing a rapid and accurate diagnosis.

Purpose

The procedure aims to pinpoint the specific cause of gastrointestinal infections, facilitating appropriate treatment. It is used to diagnose infections that cause symptoms like diarrhea, abdominal pain, and vomiting.

Indications

• Persistent or severe diarrhea
• Abdominal pain and cramping
• Fever, nausea, or vomiting
• Recent travel history to areas with endemic gastrointestinal diseases
• Potential exposure to contaminated food or water

Preparation

• No fasting required
• Avoid taking antibiotics for 24-48 hours prior to the test, if possible
• Collect stool sample in a sterile container provided by the healthcare provider

Procedure Description

1. Sample Collection: A stool sample is collected by the patient and submitted to the clinic or lab.
2. Sample Processing: In the lab, the sample undergoes nucleic acid extraction to isolate DNA/RNA of potential pathogens.
3. Amplification: Using multiplex polymerase chain reaction (PCR) and reverse transcription (if RNA pathogens are targeted), the DNA/RNA of multiple pathogens is amplified.
4. Detection: Amplified probe technology is used to identify the specific pathogens present in the sample.

No anesthesia or sedation is required as this is a non-invasive diagnostic test.

Duration

The entire testing process may take a few hours to a couple of days, depending on the lab's workload and protocols.

Setting

The sample is collected at home or in a clinical setting and processed in a specialized laboratory.

Personnel

• Medical Laboratory Technicians
• Clinical Microbiologists
• Ordering Physician/Nurse Practitioner

Risks and Complications

• Common: No direct risks as it is a non-invasive test.
• Rare: Potential for sample contamination or insufficient sample leading to inconclusive results; these scenarios may require repeat testing.

Benefits

• Rapid and accurate identification of gastrointestinal pathogens
• Helps in selecting appropriate treatment and avoiding unnecessary antibiotics
• Potentially reduces the severity and duration of symptoms by enabling timely intervention

Recovery

• No recovery time needed
• Normal activities can be resumed immediately after sample collection
• Follow-up visit may be scheduled to discuss results and treatment

Alternatives

• Stool culture: Takes longer to yield results and may miss some pathogens.
• Antigen tests: Less comprehensive, may require multiple tests to cover all possible pathogens.

Patient Experience

• During the Procedure: Minimal discomfort, primarily involving the collection of a stool sample.
• After the Procedure: No pain or discomfort; results are typically communicated by the healthcare provider, who will also discuss next steps based on findings.

Pain management and comfort measures are not applicable as this is a diagnostic procedure involving stool analysis only.