Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process
Table 2
Expert panel survey, prior to in-person meeting, where attendees rated the degree to which they agreed that if the provided definition was met, in a child with vomiting and/or diarrhea, the pathogen is highly likely to be causative of clinical illness.
Pathogen
Definition
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
Proportion agreement (%)
Bacterial pathogens, (%)
Aeromonas
Isolation of Aeromonas in a stool specimen via culture or PCR
0
0
2/14 (14%)
9/14 (64%)
3/14 (21%)
85
Campylobacter
Isolation of Campylobacter spp. from a stool specimen via culture or PCR
0
0
4/14 (29%)
6/14 (43%)
4/14 (29%)
72
Clostridium difficile
A positive toxin A or B assay for Clostridium difficile from a stool specimen via PCR for toxin A/B
1/14 (7%)
4/14 (29%)
4/14 (29%)
2/14 (14%)
(3/14) (21%)
36
Edwardsiella
Isolation of Edwardsiella in a stool specimen via culture or PCR
1/14 (7%)
0
7/14 (50%)
6/14 (43%)
0
43
Escherichia coli O157 : H7
Isolation of Escherichia coli O157 : H7 from a stool specimen via culture, EIA, or PCR
0
0
0
4/14 (29%)
10/14 (71%)
100
Escherichia coli (non-O157 : H7)
Isolation of Shiga toxin-producing Escherichia coli (non-O157 : H7) from a stool specimen via culture, EIA, or PCR
0
0
1/14 (7%)
8/14 (57%)
5/14 (36%)
93
Salmonella
Isolation of spp. from a stool specimen via culture or PCR
0
0
4/13 (31%)
6/13 (46%)
3/13 (23%)
69
Shigella
Isolation of Shigella spp. from a stool specimen via culture or PCR
0
0
1/13 (8%)
8/13 (62%)
4/13 (31%)
93
Vibrio cholerae serotype O1 or O139
Isolation of cholera toxin-producing Vibrio cholerae serotype O1 or O139 from a stool specimen via culture or PCR
0
0
2/13 (15%)
4/13 (31%)
7/13 (54%)
85
Yersinia enterocolitica
Isolation of Yersinia enterocolitica or Yersinia pseudotuberculosis from a stool specimen via culture or PCR
0
1/14 (7%)
2/14 (14%)
8/14 (57%)
3/14 (21%)
79
Viral pathogens, (%)
Rotavirus
Isolation of rotavirus from stool specimen by EM, EIA, latex agglutination, or PCR
0
0
0
8/14 (57%)
6/14 (43%)
100
Adenovirus (any serotype)
Isolation of adenovirus in a stool specimen via PCR
0
2/14 (14%)
7/14 (50%)
5/14 (36%)
0
36
Adenovirus 40/41
Isolation of adenovirus 40/41 in a stool specimen via PCR
0
0
2/14 (14%)
11/14 (79%)
1/14 (7%)
86
Norovirus
Isolation of norovirus from a stool specimen or ORAL SWAB via PCR
0
0
0
(8/14) (57%)
6/14 (43%)
100
Sapovirus
Isolation of sapovirus in a stool specimen via PCR
0
0
2/14 (14%)
9/14 (64%)
3/14 (21%)
85
Parasitic pathogens, (%)
Cryptosporidium
Isolation of Cryptosporidium from a stool specimen via microscopy, EIA, or PCR
0
1/14 (7%)
2/14 (14%)
7/14 (50%)
4/14 (29%)
79
Entamoeba histolytica
Detection of Entamoeba histolytica from a stool specimen via microscopy
1/14 (7%)
1/14 (7%)
4/14 (29%)
4/14 (29%)
4/14 (29%)
58
Giardia lamblia
Detection of Giardia lamblia in a stool specimen via microscopy or EIA
0
1/14 (7%)
1/14 (7%)
10/14 (71%)
2/14 (14%)
85
EIA, enzyme immunoassay; PCR, polymerase chain reaction. Stool specimen includes bulk stool and/or rectal swab. All definitions are in the context of a single-positive pathogen.
