GI-MAP Interpretive Guide by Diagnostic Solutions

Stool

Performed by: Diagnostic Solutions Laboratory

Biomarkers included in this panel:

A2142C

Genes associated with clarithromycin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic

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A2142G

Genes associated with clarithromycin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic

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A2143G

Genes associated with clarithromycin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic

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A926G

Genes associated with tetracycline resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic re

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Adenovirus 40/41

Adenovirus serotypes 40 and 41 cause acute gastroenteritis (inflammation of the stomach and intestines) primarily in children.

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AGA926-928TTC

Genes associated with tetracycline resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic re

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Akkermansia muciniphila

Akkermansia muciniphila may represent 3–5% of the microbial composition in the healthy human intestinal tract, and have a crucial role in the regulation of the gut barrier and other homeostatic and metabolic functions.

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Amoxicillin

The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of re

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Ancylostoma duodenale

The distribution of hookworm (Necator americanus and Ancylostoma duodenale) is worldwide, with particular prevalence in rural areas of the moist tropics where there is inadequate sanitation and people walk barefoot. The two species produce indis

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Anti-gliadin IgA

Antigliadin antibodies (AGAs) are antibodies of the IgA and IgG classes found in the serum of celiac disease patients. These antibodies mainly target gliadin-derived peptides, which are the main proteins of gluten. AGAs are not specific for celiac di

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Ascaris lumbricoides

Ascaris lumbricoides, an intestinal roundworm, is one of the most common helminthic human infections worldwide. Ascaris lumbricoides is the largest intestinal nematode of man. The female worms are larger than the males and can measure 40 cm in len

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b-Glucuronidase

Beta-glucuronidase is an enzyme that breaks the tight bond between glucuronic acid and toxins in the intestines. The liver and intestine bind toxins, steroid hormones and some dietary components to glucuronic acid. That is a protective process that l

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Bacillus spp.

Bacillus spp. are spore forming bacteria, ubiquitous in the environment. B. cereus in particular is a frequently recognized cause of toxin-induced acute gastroenteritis. Other infections caused by this genus include: - sepsis

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Bacteroides fragilis

Gram-negative species of the Bacteroidetes phylum. Immune-modulating normal gut species. Believed to be involved in microbial balance, barrier integrity, and neuroimmune health (Hsiao 2013). High levels may result from reduced digestive capacity or c

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Bacteroidetes

Bacteroidetes are the most prominent gut microbes in much of the world. They are thought to help protect against obesity because they do not digest fat well.

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Bifidobacterium spp.

Gram-positive genus in the Actinobacteria phylum. Present in breast milk. Colonizes the human GI tract at birth. Common in probiotics. Thrives on a wide variety of prebiotic fibers.

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Blastocystis hominis

Blastocystis hominis is found throughout the world in both people with and without symptoms. It is a non-pathogenic parasite. Non-pathogenic parasites are present in the gastrointestinal tract and generally are self-limiting and do not cause illness.

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C. difficile, Toxin A

C. difficile is an opportunistic anaerobic bacterium which causes symptoms ranging from mild diarrhea to pseudomembranous colitis when the normal flora has been altered (as in antibiotic use). C. difficile produces two toxins: - Toxin A is a ti

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C. difficile, Toxin B

C. difficile is an opportunistic anaerobic bacterium which causes symptoms ranging from mild diarrhea to pseudomembranous colitis when the normal flora has been altered (as in antibiotic use). C. difficile produces two toxins: - Toxin A is a ti

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Calprotectin

Calprotectin is a calcium-binding protein with antimicrobial properties. It accounts for 60% of neutrophil cytosolic content and is also found in monocytes and macrophages. Calprotectin is released from the intestinal mucosa into the stool

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Campylobacter

When people worry about eating undercooked chicken, they usually focus on getting sick from salmonella bacteria. But another common type of bacteria called campylobacter can also make you ill if you eat poultry that isn’t fully c

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Candida albicans

Commensal fungi that can be pathogenic to immunocompromised patients. Causes vaginal yeast infections and can be fatal in systemic infections. May cause diarrhea. Has been suggested to cause a cluster of symptoms including GI complaints, fatigue

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Candida spp.

Commensal fungi that can be pathogenic to immunocompromised patients. Causes vaginal yeast infections and can be fatal in systemic infections. May cause diarrhea. Has been suggested to cause a cluster of symptoms including GI complaints, fatigue

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Chilomastix mesnili

Chilomastix mesnili is a nonpathogenic flagellate that is often described as a commensal organism in the human gastrointestinal tract.

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Citrobacter freundii

Gram-negative bacteria in the Proteobacteria phylum.

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Citrobacter spp.

Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity. Autoimmune Association: Rheumatoid arthritis

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Clarithromycin

The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of re

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Clostridia (class)

Markers in this class are important producers of short-chain fatty acids, and have many well-documented roles in promoting a healthy intestinal barrier, immune balance, and protection against pathogens.

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Cryptosporidium

Cryptosporidium is notorious for being spread by swimming pools. A number of Cryptosporidium outbreaks have occurred after contamination of public swimming facilities. Cryptosporidium can cause gas, bloating, diarrhea, and abdominal pain. In a health

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Cyclospora spp.

This parasite causes an intestinal infection called cyclosporiasis.

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Cytomegalovirus

Epidemiology: - Herpes virus that has infected 60% of the US population - One in three children have contracted CMV by five years old - Passed around in child daycare centers

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Desulfovibrio spp.

Desulfovibrio is a genus of gram-negative sulphate-reducing bacteria. This genus has been positively correlated to IBD, colorectal cancer (in animal model), ulcerative colitis, liver disease and autism. Desulfovibrio spp. is predominant member of

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Dientamoeba fragilis

Dientamoeba fragilis is a parasite that lives in the large intestine of people. This protozoan parasite produces trophozoites; cysts have not been identified. The intestinal infection may be either asymptomatic or symptomatic.

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E. coli O157

Elastase-1

Pancreatic elastase is an enzyme that digests protein. It’s only produced by the pancreas and when it is seen in the stool, it’s an excellent biomarker of how well the pancreas is performing.

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Endolimax nana

Epidemiology: - Fecal contamination of food or water Clinical Implications: - Considered non-pathogenic; individuals may be asymptomatic - May be indicative of dysbiosis, conservative treatment may be indicated if clinical presentat

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Entamoeba coli

Entamoeba coli are intestinal amebae that are found in the large intestine. They generally are not considered pathogenic. However, when these amebae are found in stool samples it can indicate the presence of other potentially pathogenic organisms.

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Entamoeba histolytica

Entamoeba histolytica is a disease-causing parasite that can affect anyone, although it is more common in those who lived or travelled in tropical areas with poor sanitary conditions. Diagnosis can be difficult since, under a microscope, it look

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Enterobacter spp.

Gram-negative genus in the Proteobacteria phylum. Closely related to E. coli (in the same taxonomic family). High levels may indicate increased intestinal inflammatory activity. Low levels may indicate reduced mucosal health.

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Enterococcus faecalis

Gram-positive species in the Firmicutes phylum. High levels may result from reduced stomach acid, PPI use, compromised digestive function, SIBO or constipation. High natural resistance to some antibiotics, which may result in overgrowth.

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Enterococcus faecium

Gram-positive species in the Firmicutes phylum. High levels may result from reduced stomach acid, PPI use, compromised digestive function, SIBO or constipation. High natural resistance to some antibiotics, which may result in overgrowth.

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Enterococcus spp.

Gram-positive genus of lactate-producing bacteria in the Firmicutes phylum. High levels may be due to reduced digestive capacity, constipation or small intestinal bacterial overgrowth. Low levels may indicate insufficiency of beneficial bacteria.

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Enterohemorrhagic E. coli (EHEC)

What is enterohemorrhagic E. coli? Escherichia coli (or simply E. coli) is one of the many groups of bacteria that normally live in the intestines of healthy humans and most warm-blooded animals. E. coli bacteria help maintain the balance of norma

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Enteroinvasive E. coli/Shigella

Enterotoxigenic E. coli LT/ST

Eosinophil Activation Protein (EDN/EPX)

Eosinophil Activation Protein (EDN/EPX) is a protein released by activated eosinophils which has strong cytotoxic characteristics.  Cytotoxic means that a substance or process can damage cells or cause them to die. "Cyto"

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Epstein-Barr Virus

- One of the most common viruses worldwide; infects 90–95% of the population - Commonly contracted in childhood and causes mild symptoms

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Escherichia spp.

- Gram-negative genus in the Proteobacteria phylum. - Normal gut flora. - Escherichia coli (E. coli) is the primary species in this genus. - Most E. coli are nonpathogenic (pathogenic E. coli strains are measured separately).

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Faecalibacterium prausnitzii

Faecalibacterium prausnitzii is one of the most important bacteria in the human gut flora and makes up to 5-10% of the total number of bacteria detected in stool samples from healthy humans. Faecalibacterium prausnitzii has a crucial role in maintain

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Firmicutes

Gram-negative Bacteroidetes and grampositive Firmicutes are bacterial phyla that dominate the entire human digestive tract, including the mouth, nose, throat, and colon.2 An abnormal result in one or both of these phylum suggest imbalanced normal mic

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Firmicutes:Bacteroidetes Ratio

An abnormal result in one or both of these phylum suggest imbalanced normal microbes in the GI tract. Gram-negative Bacteroidetes and grampositive Firmicutes are bacterial phyla that dominate the entire human digestive tract, including the mouth,

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Fluoroquinolones

The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of re

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Fusobacterium spp.

Autoimmune Association: Systemic sclerosis or inflammatory bowel disease.

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Geotrichum spp.

May cause disease in immunosuppressed patients. Low levels may be a dietary artefact; certain strains are used to make soft cheeses.

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Giardia

Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States.

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Gluten Peptide

Stool

Fecal gluten monitoring is an important tool to: - Quantitively evaluate amount of gluten peptide in stool for accurate assessment of potential exposure - Monitor adherence to gluten-free diet for anyone aiming to follow a GF lifestyle - Mon

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gyrA D91G

Genes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic

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gyrA D91N

Genes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic

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gyrA N87K

Genes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic

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gyrB R484K

Genes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic

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gyrB S479N

Genes associated with fluoroquinolone resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic

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Helicobacter pylori

Helicobacter pylori (H. pylori) infection occurs when H. pylori bacteria infect your stomach. Helicobacter pylori has been evolving with human beings for well over 50,000 years, since they migrated out of Africa. H. pylori colonization

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Klebsiella pneumoniae

Gram-negative bacteria in the Proteobacteria phylum. Common residents of the oral cavity and respiratory tract. May cause diarrhea, gas, abdominal pain, and bloating; Common after long-term antibiotic use; May release histamine in the gut; High level

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Klebsiella spp.

Klebsiella species are gram-negative bacteria normally found in the intestinal tract that are associated with a wide range of small intestinal disorders including: - alterations of motility, - diarrhea, - gas, - abdominal pain, - and b

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Lactobacillus spp.

Gram-positive genus of lactate-producing bacteria in the Firmicutes phylum. Many strains used as probiotics.

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M. avium subsp. paratuberculosis

Bacterial species in the Actinobacteria phylum. Higher levels have been associated with Crohn’s disease and rheumatoid arthritis.

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Methanobacteriaceae (family)

Family of bacteria-like microbes that produce methane. Facilitates carbohydrate fermentation and short-chain fatty acid production by beneficial bacteria. High levels linked to chronic constipation, as well as some types of SIBO and IBS. Low levels m

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Microsporidium spp.

Morganella spp.

Gram-negative group in the Proteobacteria phylum. May produce histamine. High levels may indicate increased intestinal inflammatory activity. High levels may cause diarrhea, and may also be associated with SIBO.

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Necator americanus

Hookworms are soil-transmitted nematode parasites that can reside for many years in the small intestine of their human hosts; Necator americanus is the predominant infecting species.

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Norovirus GI/II

Norovirus GI & GII, or Norwalk virus, is the most common cause of non-bacterial gastroenteritis in the world. It is widely known for causing the stomach flu on cruise ships. Three genotypes of this diverse virus, GI, GII, and GIV, can infect

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Occult Blood - FIT

The fecal occult blood test (=FOBT) looks for blood in your feces. “Occult” (=hidden) means that the blood amount is so small that it cannot be seen with the naked eye. The bleeding does not change the color of the stool or result in visi

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PBP1A N562Y

Genes associated with amoxicillin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic res

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PBP1A S414R

Genes associated with amoxicillin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic res

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PBP1A T556S

Genes associated with amoxicillin resistance. The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic res

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Pentatrichomonas hominis

Epidemiology: Fecal contamination of food or water Clinical Implications: - Considered harmless, a non-pathogen - Infected individuals are usually asymptomatic - May contribute to dysbiosis - Also colonizes dogs, cats, and other ani

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Prevotella spp.

Prevotella spp. is known for its ability to degrade complex plant polysaccharides (carbohydrates) and fiber.

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Proteus mirabilis

Opportunistic Bacteria associated with Autoimmunity.  Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals c

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Proteus spp.

Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity; May contribute to loose stools or diarrhea; Pets or wild animals can be a source.

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Pseudomonas aeruginosa

- Gram-negative bacteria in the Proteobacteria phylum. - Pseudomonas aeruginosa are normal flora in the human gastrointestinal (GI) tract, which on occasion cause GI tract infection.

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Pseudomonas spp.

Gram-negative bacteria in the Proteobacteria phylum. High levels may indicate increased intestinal inflammatory activity and may cause abdominal cramping and loose stools. Some strains of P. aeroginosa may produce toxins that can damage cells.

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Rhodotorula spp.

- Common in soil, plants, bathrooms, and in beverages like milk, juice, and water.  - May be a commensal (=living in a relationship in which one organism derives food or other benefits from another organism without hurting or helping it). 

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Rodotorula spp.

Roseburia spp.

A genus of Gram-positive anaerobic bacteria in the Clostridia class that inhabit the human colon. The Roseburia genus has five well-characterized species, all of which produce short-chain fatty acids (SCFAs), such as acetate, propionate, and butyrate

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Salmonella

Epidemiology - Fecal contamination of ingested foods (eggs, poultry, meat, unpasteurized milk, raw fruits, and vegetables) - Exposure to pets (reptiles, amphibians, baby chicks) Clinical Implications - May be asymptomatic - Symptoms in

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Secretory IgA

As the most abundant class of antibody found in the human intestinal lumen, secretory IgA (sIgA) is recognized as a first line of defense in protecting the intestinal epithelium from enteric pathogens and toxins. It is used to assess gastrointestinal

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Shiga-like Toxin E. coli stx1

Epidemiology - Fecal contamination of ingested foods (undercooked meat, unpasteurized milk, juice, and water) Clinical Implications - Symptoms may include severe abdominal cramps and diarrhea - Toxins may elicit strong inflammatory respon

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Shiga-like Toxin E. coli stx2

Staphylococcus aureus

Gram-positive bacteria in the Firmicutes phylum. High levels may result from reduced digestive capacity, and intestinal inflammatory activity. Some strains may produce toxins and contribute to loose stools or diarrhea.

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Staphylococcus spp.

Gram-positive bacteria in the Firmicutes phylum. High levels may result from reduced digestive capacity, and intestinal inflammatory activity. Some strains may produce toxins and contribute to loose stools or diarrhea.

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Steatocrit

The steatocrit is a measure of the amount of fat in stool.

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Streptococcus spp.

Streptococcus is a member of Gram-positive lactic acid-producing bacteria (LAB) that belonged to Firmicutes phylum. Many strains of Streptococcus are non-pathogenic and occur as commensal flora on the skin, the oral cavity, n

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Taenia spp.

Taeniasis in humans is a parasitic infection caused by the tapeworm species Taenia saginata (beef tapeworm), Taenia solium (pork tapeworm), and Taenia asiatica (Asian tapeworm). Humans can become infected with these tapeworms by eating raw or unde

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Tetracycline

The GI-MAP includes results for detection of H. pylori antibiotic resistance genes. If an antibiotic resistance gene is present, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of re

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Trichuris trichiura

Epidemiology: - Fecal contamination of produce or person-to-person contact - Prevalent in Asia, Africa, South America, and rural southeastern United States

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Vibrio cholerae

Virulence Factor, babA

Virulence Factor, cagA

Virulence Factor, dupA

Duodenal ulcer promoting gene a (dupA) is a virulence factor of H. pylori that is highly associated with duodenal ulcer development and reduced risk of gastric cancer. 

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Virulence Factor, iceA

The iceA gene is recognized as a significant virulence factor in the genome of Helicobacter pylori, a Gram-negative, spiral-shaped bacterium implicated in the pathogenesis of various gastrointestinal diseases, including gastritis, peptic ulcers, and

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Virulence Factor, oipA

H. pylori virulence factor OipA (Outer Inflammatory Protein A) - associated with gastric cancer and peptic ulcer.

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Virulence Factor, vacA

Virulence Factor, virB

The virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori. These genes code for proteins that will predispose one to more serious H. pylori infections.  Helicobacter pylori (H. pylori): Recent studies have sh

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Virulence Factor, virD

The virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori. These genes code for proteins that will predispose one to more serious H. pylori infections. Recent studies have shown that nearly 50% of the world’s

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Yersinia enterocolitica

Zonulin

Zonulin is a protein that opens intercellular tight junctions in the gut lining (the connections between epithelial cells that make up the gastrointestinal lining). Zonulin increases intestinal permeability in the jejunum and ileum and is considered

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