Spectrum: Local Antimicrobial Stewardship, for Providence Health Care

Persistent Diarrhea

Investigations

Routine bacterial pathogens

  • Salmonella

  • Shigella

  • Campylobacter

  • E.coli O157:H7

  • Yersinia

  • Aeromonas

  • Vibrio

  • Plesiomonas

If suspecting Vibrio cholerae, contact the Medical Microbiology laboratory.

Stool for C.difficile PCR if recent antibiotic exposure or chemotherapy

Stool for ova and parasites X 2 samples 24 hours apart. Giardia, Cryptosporidium, Cystoisospora and Cyclospora are routinely tested

If patient has bloody diarrhea, indicate this on the requisition so that Shiga toxin testing can be performed

If syndrome is compatible with viral gastroenteritis, no testing is required

If Microsporidium testing is indicated (e.g., HIV infected or immunocompromised hosts), please specify this

If amoebic colitis is suspected, request E. histolytica enzyme immunoassay

Management