Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process

Table 1

Results from initial advisory panel survey reporting respondents who rated “agree” or “strongly agree” that the pathogen/test/collection modality was causative of symptoms in a child with acute gastroenteritis.

Pathogen diagnostic test	Proportion agreement (%)	95% confidence interval
Bacterial pathogens
Aeromonas
Stool culture	43	26, 62
Stool PCR	37	21, 56
Oral swab PCR	13	4, 32
Campylobacter
Stool culture	97	81, 100
Stool PCR	83	65, 94
Oral swab PCR	30	15, 50
Clostridium difficile antigen
Stool EIA	50	32, 68
Stool PCR	47	29, 65
Oral swab PCR	17	6, 35
Edwardsiella
Stool culture	40	23, 59
Stool PCR	30	15, 50
Oral swab PCR	17	6, 35
Escherichia coli O157
Stool culture	97	81, 100
Stool PCR	87	68, 96
Oral swab PCR	37	21, 56
Enterotoxigenic Escherichia coli (ETEC)
Stool culture	90	73, 97
Stool PCR	84	66, 94
Oral swab PCR	29	15, 48
Salmonella spp.
Stool culture	81	62, 92
Stool PCR	77	57, 89
Oral swab PCR	20	8, 39
Shigella spp.
Stool culture	97	81, 100
Stool PCR	90	74, 97
Oral swab PCR	33	18, 53
Shiga toxin-producing Escherichia coli (STEC)
Stool culture	87	68, 96
Stool PCR	80	61, 92
Oral swab PCR	33	18, 53
Vibrio cholera
Stool culture	93	76, 99
Stool PCR	83	65, 94
Oral swab PCR	33	18, 53
Yersinia enterocolitica
Stool culture	93	76, 99
Stool PCR	83	65, 94
Oral swab PCR	33	18, 53
Viral pathogens
Adenovirus (any serotype)
Stool PCR	51	34, 68
Oral swab PCR	31	17, 49
Adenovirus 40/41
Stool PCR	81	63, 91
Oral swab PCR	54	37, 71
Astrovirus
Stool PCR	83	66, 93
Oral swab PCR	47	30, 65
Norovirus GI/GII
Stool PCR	94	80, 99
Oral swab PCR	60	42, 76
Rotavirus
Stool PCR	97	84, 100
Oral swab PCR	43	28, 60
Sapovirus
Stool PCR	75	57, 87
Oral swab PCR	40	24, 58
Parasitic pathogens
Cryptosporidium spp.
Stool ova and parasite	86	66, 95
Stool PCR	68	48, 83
Stool EIA	64	44, 81
Entamoeba histolytica
Stool ova and parasite	57	37, 75
Stool culture	68	48, 83
Stool PCR	61	41, 78
Stool EIA	75	55, 89
Giardia lamblia
Stool ova and parasite	86	66, 95
Stool PCR	68	48, 83
Stool EIA	75	55, 89

EIA, enzyme immunoassay; PCR, polymerase chain reaction. Stool culture, ova and parasite, and EIA: bulk stool and/or rectal swab.