Culturing Stool Specimens for Campylobacter spp., Pennsylvania, USA

Nkuchia M. M’ikanatha, Lisa A. Dettinger, Amanda Perry, Paul Rogers, Stanley M. Reynolds, and Irving Nachamkin

Author affiliations: Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA (N.M. M’ikanatha, A. Perry); Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (N.M. M’ikanatha, I. Nachamkin); Pennsylvania Department of Health, Exton, Pennsylvania, USA (L.A. Dettinger, P. Rogers, S.M. Reynolds)

Abstract

In 2010, we surveyed 176 clinical laboratories in Pennsylvania regarding stool specimen testing practices for enteropathogens, including Campylobacter spp. Most (96.3%) routinely test for Campylobacter spp. In 17 (15.7%), a stool antigen test is the sole method for diagnosis. We recommend that laboratory practice guidelines for Campylobacter spp. testing be developed.

Clinical microbiology laboratories play a critical role in surveillance for infectious diseases, including recognition of outbreaks and clarification of disease trends over time (1). Few studies have examined laboratory testing practices for common enteric pathogens, particularly Campylobacter spp., fastidious organisms that can be difficult to detect because of specimen transport and specific culture requirements (2–4). With the exception of geographic locations included in the Centers for Disease Control and Prevention’s (CDC’s) Foodborne Diseases Active Surveillance Network (5), surveillance for Campylobacter spp. is largely based on passive reporting without additional confirmation by public health laboratories.
Surveillance for Campylobacter spp. in Pennsylvania is limited, and only a fraction of isolates are submitted to the state public health laboratory because there is no regulatory requirement to do so. Because testing practices for enteric infections are not standardized (and largely unknown in Pennsylvania), understanding the methods used to diagnose enteric diseases in clinical laboratories is essential if surveillance programs are to be strengthened. We describe the results obtained from a survey conducted among clinical microbiology laboratories in Pennsylvania to assess laboratory testing practices for enteric pathogens, with an emphasis on Campylobacter diagnostics.