The Gastrointestinal Microbial Assay Plus (GI-MAP) is an innovative clinical tool that measures gastrointestinal microbiota DNA from a single stool sample with state of the art, quantitative polymerase chain reaction (qPCR) technology.

The GI-MAP was designed to detect microbes that may be disturbing normal microbial balance or contributing to illness as well as indicators of digestion, absorption, inflammation, and immune function. With a culture based test it is not possible to measure strict anaerobes, viruses or virulence factors. 

The GI-MAP's accuracy and reliability allows personalized protocols to address gut dysfunction based on which infections are urgent, which areas of the gut are already optimized, and which areas should be addressed after an infection is resolved. Additionally, the quantification of identified micro-organisms offers a remarkable ability to see how treatment modalities are working because a retest after treatment can show whether a parasite has resolved, dysbiosis has improved, and more.

Indications

• Autoimmune molecular mimicry (if caused by pathogens)

• Diarrhea

• Digestion

• Foodborne illness

• Gastritis

• Gastroenteritis (if it has viral causes)

• Gut dysbiosis

• Immunity

• Inflammation

Analytes measured in GI-MAP:

BACTERIAL PATHOGENS

• Campylobacter
• C. difficile Toxin A
• C. difficile Toxin B
• Enterohemorrhagic E. coli
• E. coli O157
• Enteroinvasive E. coli/Shigella
• Enterotoxigenic E. coli LT/ST
• Shiga-like Toxin E. coli stx1
• Shiga-like Toxin E. coli stx2
• Salmonella
• Vibro cholerae
• Yersinia enterocolitica
• H. pylori
  • Virulence Factor, babA
  • Virulence Factor, cagA
  • Virulence Factor, dupA
  • Virulence Factor, iceA
  • Virulence Factor, oipA
  • Virulence Factor, vacA
  • Virulence Factor, virB
  • Virulence Factor, virD

PARASITIC PATHOGENS

• Cryptosporidium
• Entamoeba histolytica
• Giardia

VIRAL PATHOGENS

• Adrenovirus 40/41
• Norovirus GI
• Norovirus GII

NORMAL/COMMENSAL BACTERIA

• Akkermansia Mucinophilia
• Bacteroides fragilis
• Bifidobacterium spp.
• Clostridia (class)
• Enterobacter spp.
• Enterococcus spp.
• Escherichia spp.
• Faecalbacterium prausnitzii
• Lactobacillus spp.

BACTERIAL PHYLA

• Bacteroidetes
• Firmicutes
• Firmicutes/Bacteroidetes Ratio

ADDITIONAL DYSBIOTIC/OVERGROWTH BACTERIA

• Bacillus spp.
• Enterococcus faecalis
• Enterococcus faecium
• Methanobacteriaceae (family)
• Morganella spp.
• Pseudomonas spp.
• Pseudomonas aeruginosa
• Staphylococcus spp.
• Staphylococcus aureus
• Streptococcus spp.

POTENTIAL AUTOIMMUNE TRIGGERS

• Citrobacter spp.
• Citrobacter freundii
• Fusobacterium spp.
• Klebsiella spp.
• Klebsiella pneumoniae
• Mycobacterium avium
• Prevotella copri
• Proteus spp.
• Proteus mirabilis

FUNGI/YEAST

• Candida albicans
• Candida spp.
• Geotricum spp.
• Microsporidia spp.
• Rhodoturula spp.

OPPORTUNISTIC VIRUSES

• CMV- Cytomegalovirus
• EBV- Epstein Barr Virus

Parasites & worms:

PROTOZOA

• Blastocystis hominis
• Chilomastix mesnelli
• Cyclospora cayetanensis
• Dientamoeba fragilis
• Endolimax nana
• Entamoeba coli
• Pentatrichomonas hominis

WORMS

• Ancyclostroma duodenale
• Ascaris lumbricoides
• Necator americanus
• Trichuris trichiura
• Taenia solium/saginada

Intestinal health markers:

DIGESTION

• Elastase-1
• Steatocrit

IMMUNE RESPONSE

• Secretory IgA
• Anti-gliadin IgA

INFLAMMATION

• Calprotectin

GI MARKERS

• ß-Glucuronidase
• Occult Blood - FIT

Antibiotic resistance genes:

Phenotypes | HELICOBACTER

• Amoxicillin
• Clarithromycin
• Fluoroquinolones
• Tetracycline

Genotypes | UNIVERSAL MICROBIOTA RESISTANCE GENES

• ß-lactamase
• Fluoroquinolones
• Macrolides
• Vancomycin

Practical

Specimen requirements:

Stool

Average processing time:

18 ±4 days

Available add-ons:

Research

• Abubakar I, Irvine L, Aldus CF, et al. A systematic review of the clinical, public health and costeffectiveness of rapid diagnostic tests for the detection and identification of bacterial intestinal pathogens in faeces and food. Health Technol Assess. 2007;11(36):1-216.

• Amar CF, East CL, Gray J, Iturriza-Gomara M, Maclure EA, McLauchlin J. Detection by PCR of Eight groups of enteric pathogens in 4,627 faecal samples: re-examination of the English casecontrol Infectious Intestinal Disease Study (1993-1996). Eur J Clin Microbiol Infect Dis. 2007;26(5):311-323.

• Bischoff SC, Barbara G, Buurman W, et al. Intestinal permeability — a new target for disease prevention and therapy. BMC gastroenterology. 2014;14:189.

• Canny GO, McCormick BA. Bacteria in the intestine, helpful residents or enemies from within? Infection and immunity. 2008;76(8):3360-3373.

• Fasano A, Shea-Donohue T. Mechanisms of disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nature clinical practice. 2005;2(9):416-422.

• Iijima Y, Asako NT, Aihara M, Hayashi K. Improvement in the detection rate of diarrhoeagenic Bacteria in human stool specimens by a rapid real-time PCR assay. Journal of medical microbiology. 2004;53(Pt 7):617-622.

• Kahlau P, Malecki M, Schildgen V, et al. Utility of two novel multiplexing assays for the detection of gastrointestinal pathogens - a first experience. SpringerPlus. 2013;2(1):106.

• Kamada N, Seo SU, Chen GY, Nunez G. Role of the gut microbiota in immunity and inflammatory disease. Nature reviews. Immunology. 2013;13(5):321-335.

• Khanna S, Tosh PK. A clinician's primer on the role of the microbiome in human health and disease. Mayo Clinic proceedings. 2014;89(1):107-114.

• Othman M, Aguero R, Lin HC. Alterations in intestinal microbial flora and human disease. Current opinion in gastroenterology. 2008;24(1):11-16.

• Rashid T, Ebringer A. Autoimmunity in Rheumatic Diseases Is Induced by Microbial Infections via Crossreactivity or Molecular Mimicry. Autoimmune diseases. 2012;2012:539282.
• Schabereiter-Gurtner C, Hirschl AM, Dragosics B, et al. Novel real-time PCR assay for detection of Helicobacter pylori infection and simultaneous clarithromycin susceptibility testing of stool and biopsy specimens. Journal of clinical microbiology. 2004;42(10):4512-4518.

• Stecher B, Hardt WD. The role of microbiota in infectious disease.Trends in microbiology. 2008;16(3):107-114.

• Tiwana H, Wilson C, Walmsley RS, et al. Antibody responses to gut bacteria in ankylosing spondylitis, rheumatoid arthritis, Crohn's disease and ulcerative colitis. Rheumatology international. 1997;17(1):11-16.

See also Brochure under ‘Downloadable files’ for even more research.