Clinical consideration is important in the interpretation of results of multiple-pathogen nucleic acid amplification tests because these assays detect DNA and not necessarily viable organisms.
The presence of Salmonella spp., Shigella spp., Campylobacter spp. and Yersinia enterocolitica in a stool culture is at first glance pathological.
However, healthy carriers of Salmonella spp exist, and all Salmonellosis should not lead to antibiotic prescriptions.
Moreover, Yersinia enterocolitica is not always pathogenic, and antibiotic therapy for Yersiniosis should be restricted to symptomatic patients or those at risk of bloodstream infections.
The presence of Escherichia coli, even in large quantities, should not be considered pathological. Only shiga-toxin producing E. coli (STEC) should be considered pathogenic. Enteropathogenic E. coli cause acute diarrhoea only in children.