Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process
Table 3
Definitions that emerged from in-person meeting and subsequently circulated for final evaluation by the definition meeting attendees.
Pathogen
Case definition
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
Proportion agreement (%)
Dropped diagnostics from initial (1) and second survey (2)
Bacterial pathogens, (%)
Aeromonas
Detection of Aeromonas in a stool specimen via culture or NAT (e.g., PCR)
0
0
3/12 (25%)
8/12 (67%)
1/12 (8%)
75
Oral swab PCR (1); none (2)
Campylobacter
Detection of Campylobacter spp. from a stool specimen via culture or NAT (e.g., PCR)
0
0
0
8/12 (67%)
4/12 (33%)
100
Oral swab PCR (1); none (2)
Clostridium difficile
Detection of Clostridium difficile toxin A or B from a stool specimen via NAT (e.g., PCR) for toxin A/B
0
2/12 (17%)
5/12 (42%)
5/12 (42%)
0
42
Stool EIA, oral swab PCR (1); none (2)
Edwardsiella
Detection of Edwardsiella in a stool specimen via culture
0
0
3/12 (25%)
8/12 (67%)
1/12 (8%)
75
Stool PCR, oral swab PCR (1); none (2)
Escherichia coli O157 : H7
Detection of Escherichia coli O157 : H7 from a stool specimen via culture, EIA or NAT (e.g., PCR)
0
0
0
5/12 (42%)
7/12 (58%)
100
Oral swab PCR (1); none (2)
Escherichia coli (non-O157 : H7)
Detection of shiga toxin-producing Escherichia coli (non-O157 : H7) from a stool specimen via culture, EIA or NAT (e.g., PCR)
0
0
0
7/12 (58%)
5/12 (42%)
100
Oral swab PCR (1); none (2)
Salmonella
Detection of Salmonella spp. from a stool specimen via culture or NAT (e.g., PCR)
0
0
0
7/12 (58%)
5/12 (42%)
100
Oral swab PCR (1); none (2)
Shigella
Detection of Shigella spp. from a stool specimen via culture or NAT (e.g., PCR)
0
0
0
6/12 (50%)
6/12 (50%)
100
Oral swab PCR (1); none (2)
Vibrio cholerae serotype O1 or O139
Detection of Vibrio cholerae serotype O1 or O139 from a stool specimen via culture or NAT (e.g., PCR)
0
0
1/12 (8%)
5/12 (42%)
6/12 (50%)
92
Oral swab PCR (1); none (2)
Yersinia enterocolitica
Detection of Yersinia enterocolitica from a stool specimen via culture or NAT (e.g., PCR)
0
0
0
6/12 (50%)
6/12 (50%)
100
Oral swab PCR (1); none (2)
Viral pathogens, (%)
Adenovirus (nontyped)
Detection of adenovirus (nontyped) in a stool specimen by EM, EIA, or NAT (e.g., PCR)
1/12 (8%)
1/12 (8%)
1/12 (8%)
8/12 (67%)
1/12 (8%)
75
Oral swab PCR (1); none (2)
Adenovirus 40/41
Detection of adenovirus 40/41 in a stool specimen via EIA or NAT (e.g., PCR)
0
0
1/12 (8%)
6/12 (50%)
5/12 (42%)
92
Oral swab PCR (1); none (2)
Astrovirus
Detection of astrovirus in a stool specimen via NAT (e.g., PCR)
0
1/12 (8%)
1/12 (8%)
8/12 (67%)
2/12 (17%)
84
Oral swab PCR (1); none (2)
Norovirus
Detection of norovirus from a stool specimen or ORAL SWAB via NAT (e.g., PCR)
0
0
0
8/12 (67%)
4/12 (33%)
100
None (1 and 2)
Rotavirus
Detection of rotavirus from a stool specimen by EM, EIA or NAT (e.g., PCR)
0
0
0
4/12 (33%)
8/12 (67%)
100
Oral swab PCR (1); latex agglutination (2)
Sapovirus
Detection of sapovirus in a stool specimen via NAT (e.g., PCR)
0
0
1/12 (8%)
8/12 (67%)
3/12 (25%)
92
Oral swab PCR (1); none (2)
Parasitic pathogens, (%)
Cryptosporidium
Detection of Cryptosporidium from a stool specimen via microscopy, EIA or NAT (e.g., PCR)
0
0
1/12 (8%)
6/12 (50%)
5/12 (42%)
92
Stool ova and parasite, oral swab PCR (1); none (2)
Entamoeba histolytica/dispar
Detection of Entamoeba histolytica/dispar from a stool specimen via microscopy
0
1/12 (8%)
7/12 (58%)
4/12 (33%)
0
33
Stool ova and parasite, stool culture, PCR, and EIA (1); none (2)
Giardia lamblia
Detection of Giardia lamblia in a stool specimen via microscopy or EIA
0
0
1/12 (8%)
8/12 (67%)
3/12 (25%)
92
Stool ova and parasite, PCR (1); none (2)
EIA, enzyme immunoassay; EM, electron microscopy; NAT, nucleic acid test, PCR, polymerase chain reaction. Stool specimen includes bulk stool and/or rectal swab. All definitions are in the context of a single-positive pathogen.
