Advice for clinicians; Faecal PCR testing recommendations

NSW Health Pathology’s John Hunter Laboratory performs PCR on faeces for the detection of enteric pathogens. This assay is performed on the BD MAX system (BD Diagnostics, Baltimore, MD, USA) and comprises testing for bacteria, parasites, and viruses using separate panels.

This PCR assay supersedes the conventional tests namely bacterial culture, enzyme immunoassay for parasites, and viruses. Please refer to the ordering matrix for specific test requests. Clostridium difficile testing is not included in this faecal PCR assay and will continue to be performed at request using the Xpert C difficle assay (Xpert CD assay; Cepheid, Sunnyvale, CA, USA).

Please refer to the table below for the list of pathogens covered by various panels and consult the John Hunter Laboratory on (02) 4921 3000 for cases outside these criteria.

Note: Only unformed/liquid stools will be accepted for testing.

Pathogens covered by Faecal PCR

• Faecal Enteric Bacterial Panel- Salmonella spp. Campylobacter spp. (jejuni and coli) Shigella spp./Enteroinvasive E. coli (EIEC) Shiga toxin 1&2 (E. coli [STEC]).
• Faecal Extended Enteric Bacterial panel- Plesiomonas shigelloides, Vibrio (V.vulnificus, V.parahaemolyticus and V cholera), Enterotoxigenic E coli (ETEC), Yersinia enterocolitica.
• Faecal Enteric Parasite Panel- Giardia lamblia,Cryptosporidium (C.hominis and C.parvum), Entamoeba histolytica.
• Faecal Enteric Viral Panel- Norovirus G I & GII, Rotavirus A, Adenovirus F 40/41, Sapovirus (genogroups I, II, IV, V), Human Astrovirus (hAstro).

This advice is being sent to clinicians in Hunter New England Health and Mid North Coast Local Health District, as well as GPs, to ensure clinicians are aware of the correct ordering protocol for Faecal PCR test assays.

Questions, can be directed to:

Dr Hema Varadhan, Director, Microbiology
NSW Health Pathology, John Hunter Hospital
Phone: 02 4921 4423
Email: Hemalatha.Varadhan@health.nsw.gov.au