Repeat testing within 7 days is discouraged since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen in APeX.
Contact Pediatric Infectious Disease to obtain approval to do testing on patient's < 1 year old. Testing for NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
Available Stat
No
Performing Lab
Microbiology
Performed
Daily, all shifts
Methodology
PCR, rapid membrane EIA
Reported
Same or next day
Additional Information
Asymptomatic carriage is common, so only symptomatic patients should be tested. Submit stools from patients with diarrhea ONLY (>= 3 unformed stools in <= 24 hours, stool must conform to shape of container). Patients with ileus will also be tested - note this in Apex. Most patients with clinical C. difficile associated diarrhea have had prior antimicrobial therapy.
Repeat testing within 7 days is not recommended since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen.
Due to high rates of colonization in children, C. difficile testing will not be performed on children < 12 months old unless prior approval is obtained from pediatric infectious disease service.
Patients may be colonized with toxigenic C. difficile without having clinical disease. Recent studies indicate that patients who carry C. difficile with toxin gene (identified via PCR), but without detectable toxin protein production (detected by immunoassay) are most likely colonized and may not need treatment directed at the C. difficile (Polage 2015).
Enteric contact isolation will still be necessary for patient with diarrhea who are colonized with toxigenic C. difficile since there can be transmission to other patients.Continue isolation until the patient has formed stool for at least 48 hours, is bathed, and is moved to clean linens in a clean room.
Patients with ileus will also be tested - note this in Apex. If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Testing for the NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
Reflex Testing
Immunoassay for toxin antigen protein will be performed, and billed separately, when the PCR for toxin is positive.
Synonyms
Clostridium difficile Ag
Enterocolitis
Pseudomembranous enterocolitis
Clostridium difficile toxin
enterotoxin
CDI
C.diff
Sample Type
Bristol Stool Chart types 6 and 7 are acceptable.
Patients with ileus may submit a visibly soiled rectal swab in a clean container.
Collect
Sterile container
Amount to Collect
2 ml stool
Preferred Volume
2 mL stool
Minimum Volume
1 mL stool
Remarks
Potentially interfering substances include Vagisil cream and zinc oxide paste.
If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Stability (from collection to initiation)
Room temperature 24 hours, refrigerated 3 days
Unacceptable Conditions
Bristol Stool Chart types 1 - 5.
More than 1 sample in 7 days.
Samples on patients < 1 year old.
Test Code
P328
Test Group
Clostridium difficile
Performing Lab
Microbiology
Specimen Preparation
Repeat testing within 7 days will be accepted if provider has entered a reason for testing in the comment field on the order entry screen in APeX. This will display on the requisition.
Samples from children < 1 year old: TND as CONSUL and add code CDPED C. difficile testing not performed on children < 12 month old unless prior approval obtained from Pediatric ID Service.
Preferred Volume
2 mL stool
Minimum Volume
1 mL stool
Unacceptable Conditions
Bristol Stool Chart types 1 - 5.
More than 1 sample in 7 days.
Samples on patients < 1 year old.
Stability (from collection to initiation)
Room temperature 24 hours, refrigerated 3 days
Reference Interval
Negative for C. difficile
Critical Values
First sample positive for C. difficile toxin on an inpatient or patient currently in ED
Additional Information
Asymptomatic carriage is common, so only symptomatic patients should be tested. Submit stools from patients with diarrhea ONLY (>= 3 unformed stools in <= 24 hours, stool must conform to shape of container). Patients with ileus will also be tested - note this in Apex. Most patients with clinical C. difficile associated diarrhea have had prior antimicrobial therapy.
Repeat testing within 7 days is not recommended since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen.
Due to high rates of colonization in children, C. difficile testing will not be performed on children < 12 months old unless prior approval is obtained from pediatric infectious disease service.
Patients may be colonized with toxigenic C. difficile without having clinical disease. Recent studies indicate that patients who carry C. difficile with toxin gene (identified via PCR), but without detectable toxin protein production (detected by immunoassay) are most likely colonized and may not need treatment directed at the C. difficile (Polage 2015).
Enteric contact isolation will still be necessary for patient with diarrhea who are colonized with toxigenic C. difficile since there can be transmission to other patients.Continue isolation until the patient has formed stool for at least 48 hours, is bathed, and is moved to clean linens in a clean room.
Patients with ileus will also be tested - note this in Apex. If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Testing for the NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
CPT Codes
Rapid membrane EIA: 87324, 87449
PCR: 87493
LOINC Codes
31308-0
Approval Required
Repeat testing within 7 days is discouraged since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen in APeX.
Contact Pediatric Infectious Disease to obtain approval to do testing on patient's < 1 year old. Testing for NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
Available Stat
No
Ordering Recommendations
Testing algorithm:
Test Code
P328
Test Group
Clostridium difficile
Performing Lab
Microbiology
Performed
Daily, all shifts
Methodology
PCR, rapid membrane EIA
Remarks
Potentially interfering substances include Vagisil cream and zinc oxide paste.
If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Collect
Sterile container
Amount to Collect
2 ml stool
Sample Type
Bristol Stool Chart types 6 and 7 are acceptable.
Patients with ileus may submit a visibly soiled rectal swab in a clean container.
Preferred Volume
2 mL stool
Minimum Volume
1 mL stool
Unacceptable Conditions
Bristol Stool Chart types 1 - 5.
More than 1 sample in 7 days.
Samples on patients < 1 year old.
Specimen Preparation
Repeat testing within 7 days will be accepted if provider has entered a reason for testing in the comment field on the order entry screen in APeX. This will display on the requisition.
Samples from children < 1 year old: TND as CONSUL and add code CDPED C. difficile testing not performed on children < 12 month old unless prior approval obtained from Pediatric ID Service.
Reference Interval
Negative for C. difficile
Critical Values
First sample positive for C. difficile toxin on an inpatient or patient currently in ED
Synonyms
Clostridium difficile Ag
Enterocolitis
Pseudomembranous enterocolitis
Clostridium difficile toxin
enterotoxin
CDI
C.diff
Stability (from collection to initiation)
Room temperature 24 hours, refrigerated 3 days
Reported
Same or next day
Reflex Testing
Immunoassay for toxin antigen protein will be performed, and billed separately, when the PCR for toxin is positive.
Additional Information
Asymptomatic carriage is common, so only symptomatic patients should be tested. Submit stools from patients with diarrhea ONLY (>= 3 unformed stools in <= 24 hours, stool must conform to shape of container). Patients with ileus will also be tested - note this in Apex. Most patients with clinical C. difficile associated diarrhea have had prior antimicrobial therapy.
Repeat testing within 7 days is not recommended since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen.
Due to high rates of colonization in children, C. difficile testing will not be performed on children < 12 months old unless prior approval is obtained from pediatric infectious disease service.
Patients may be colonized with toxigenic C. difficile without having clinical disease. Recent studies indicate that patients who carry C. difficile with toxin gene (identified via PCR), but without detectable toxin protein production (detected by immunoassay) are most likely colonized and may not need treatment directed at the C. difficile (Polage 2015).
Enteric contact isolation will still be necessary for patient with diarrhea who are colonized with toxigenic C. difficile since there can be transmission to other patients.Continue isolation until the patient has formed stool for at least 48 hours, is bathed, and is moved to clean linens in a clean room.
Patients with ileus will also be tested - note this in Apex. If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Testing for the NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
CPT Codes
Rapid membrane EIA: 87324, 87449
PCR: 87493
LOINC Codes
31308-0
Ordering
Ordering Recommendations
Testing algorithm:
Approval Required
Repeat testing within 7 days is discouraged since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen in APeX.
Contact Pediatric Infectious Disease to obtain approval to do testing on patient's < 1 year old. Testing for NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
Available Stat
No
Performing Lab
Microbiology
Performed
Daily, all shifts
Methodology
PCR, rapid membrane EIA
Reported
Same or next day
Additional Information
Asymptomatic carriage is common, so only symptomatic patients should be tested. Submit stools from patients with diarrhea ONLY (>= 3 unformed stools in <= 24 hours, stool must conform to shape of container). Patients with ileus will also be tested - note this in Apex. Most patients with clinical C. difficile associated diarrhea have had prior antimicrobial therapy.
Repeat testing within 7 days is not recommended since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen.
Due to high rates of colonization in children, C. difficile testing will not be performed on children < 12 months old unless prior approval is obtained from pediatric infectious disease service.
Patients may be colonized with toxigenic C. difficile without having clinical disease. Recent studies indicate that patients who carry C. difficile with toxin gene (identified via PCR), but without detectable toxin protein production (detected by immunoassay) are most likely colonized and may not need treatment directed at the C. difficile (Polage 2015).
Enteric contact isolation will still be necessary for patient with diarrhea who are colonized with toxigenic C. difficile since there can be transmission to other patients.Continue isolation until the patient has formed stool for at least 48 hours, is bathed, and is moved to clean linens in a clean room.
Patients with ileus will also be tested - note this in Apex. If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Testing for the NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
Reflex Testing
Immunoassay for toxin antigen protein will be performed, and billed separately, when the PCR for toxin is positive.
Synonyms
Clostridium difficile Ag
Enterocolitis
Pseudomembranous enterocolitis
Clostridium difficile toxin
enterotoxin
CDI
C.diff
Collection
Sample Type
Bristol Stool Chart types 6 and 7 are acceptable.
Patients with ileus may submit a visibly soiled rectal swab in a clean container.
Collect
Sterile container
Amount to Collect
2 ml stool
Preferred Volume
2 mL stool
Minimum Volume
1 mL stool
Remarks
Potentially interfering substances include Vagisil cream and zinc oxide paste.
If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Stability (from collection to initiation)
Room temperature 24 hours, refrigerated 3 days
Unacceptable Conditions
Bristol Stool Chart types 1 - 5.
More than 1 sample in 7 days.
Samples on patients < 1 year old.
Processing
Test Code
P328
Test Group
Clostridium difficile
Performing Lab
Microbiology
Specimen Preparation
Repeat testing within 7 days will be accepted if provider has entered a reason for testing in the comment field on the order entry screen in APeX. This will display on the requisition.
Samples from children < 1 year old: TND as CONSUL and add code CDPED C. difficile testing not performed on children < 12 month old unless prior approval obtained from Pediatric ID Service.
Preferred Volume
2 mL stool
Minimum Volume
1 mL stool
Unacceptable Conditions
Bristol Stool Chart types 1 - 5.
More than 1 sample in 7 days.
Samples on patients < 1 year old.
Stability (from collection to initiation)
Room temperature 24 hours, refrigerated 3 days
Result Interpretation
Reference Interval
Negative for C. difficile
Critical Values
First sample positive for C. difficile toxin on an inpatient or patient currently in ED
Additional Information
Asymptomatic carriage is common, so only symptomatic patients should be tested. Submit stools from patients with diarrhea ONLY (>= 3 unformed stools in <= 24 hours, stool must conform to shape of container). Patients with ileus will also be tested - note this in Apex. Most patients with clinical C. difficile associated diarrhea have had prior antimicrobial therapy.
Repeat testing within 7 days is not recommended since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen.
Due to high rates of colonization in children, C. difficile testing will not be performed on children < 12 months old unless prior approval is obtained from pediatric infectious disease service.
Patients may be colonized with toxigenic C. difficile without having clinical disease. Recent studies indicate that patients who carry C. difficile with toxin gene (identified via PCR), but without detectable toxin protein production (detected by immunoassay) are most likely colonized and may not need treatment directed at the C. difficile (Polage 2015).
Enteric contact isolation will still be necessary for patient with diarrhea who are colonized with toxigenic C. difficile since there can be transmission to other patients.Continue isolation until the patient has formed stool for at least 48 hours, is bathed, and is moved to clean linens in a clean room.
Patients with ileus will also be tested - note this in Apex. If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Testing for the NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
Administrative
CPT Codes
Rapid membrane EIA: 87324, 87449
PCR: 87493
LOINC Codes
31308-0
Complete View
Approval Required
Repeat testing within 7 days is discouraged since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen in APeX.
Contact Pediatric Infectious Disease to obtain approval to do testing on patient's < 1 year old. Testing for NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
Available Stat
No
Ordering Recommendations
Testing algorithm:
Test Code
P328
Test Group
Clostridium difficile
Performing Lab
Microbiology
Performed
Daily, all shifts
Methodology
PCR, rapid membrane EIA
Remarks
Potentially interfering substances include Vagisil cream and zinc oxide paste.
If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Collect
Sterile container
Amount to Collect
2 ml stool
Sample Type
Bristol Stool Chart types 6 and 7 are acceptable.
Patients with ileus may submit a visibly soiled rectal swab in a clean container.
Preferred Volume
2 mL stool
Minimum Volume
1 mL stool
Unacceptable Conditions
Bristol Stool Chart types 1 - 5.
More than 1 sample in 7 days.
Samples on patients < 1 year old.
Specimen Preparation
Repeat testing within 7 days will be accepted if provider has entered a reason for testing in the comment field on the order entry screen in APeX. This will display on the requisition.
Samples from children < 1 year old: TND as CONSUL and add code CDPED C. difficile testing not performed on children < 12 month old unless prior approval obtained from Pediatric ID Service.
Reference Interval
Negative for C. difficile
Critical Values
First sample positive for C. difficile toxin on an inpatient or patient currently in ED
Synonyms
Clostridium difficile Ag
Enterocolitis
Pseudomembranous enterocolitis
Clostridium difficile toxin
enterotoxin
CDI
C.diff
Stability (from collection to initiation)
Room temperature 24 hours, refrigerated 3 days
Reported
Same or next day
Reflex Testing
Immunoassay for toxin antigen protein will be performed, and billed separately, when the PCR for toxin is positive.
Additional Information
Asymptomatic carriage is common, so only symptomatic patients should be tested. Submit stools from patients with diarrhea ONLY (>= 3 unformed stools in <= 24 hours, stool must conform to shape of container). Patients with ileus will also be tested - note this in Apex. Most patients with clinical C. difficile associated diarrhea have had prior antimicrobial therapy.
Repeat testing within 7 days is not recommended since infection status rarely changes in this time frame. Enter the reason for testing in the comment field on the order entry screen.
Due to high rates of colonization in children, C. difficile testing will not be performed on children < 12 months old unless prior approval is obtained from pediatric infectious disease service.
Patients may be colonized with toxigenic C. difficile without having clinical disease. Recent studies indicate that patients who carry C. difficile with toxin gene (identified via PCR), but without detectable toxin protein production (detected by immunoassay) are most likely colonized and may not need treatment directed at the C. difficile (Polage 2015).
Enteric contact isolation will still be necessary for patient with diarrhea who are colonized with toxigenic C. difficile since there can be transmission to other patients.Continue isolation until the patient has formed stool for at least 48 hours, is bathed, and is moved to clean linens in a clean room.
Patients with ileus will also be tested - note this in Apex. If C. difficile is clinically suspected in a patient with ileus, a rectal swab may be submitted. The swab should be visibly soiled with stool and submitted in a clean container.
Testing for the NAP1 epidemic strain of C. difficile is available with Infectious Disease approval.
