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Stool Specimen Collection

Collection Procedure:

LTD-Stool: Specimen Collection  Version 6

Stool Specimen Collection

1. Accept no more than two specimens/patient without prior consultation

with an individual who can explain the limited yield provided by

additional specimens

2. Do not accept specimens from inpatients after the third hospital day,

without prior consultation

3. Test stool for Clostridium difficile toxin for all patients with clinically

significant diarrhea and a history of antibiotic exposure. Consider C.

difficile testing as an alternative to routine microbiologic studies for

inpatients who have test requests for routine enteric pathogens

4. Positive test results for Clostridium difficile do not correlate well with

disease in young children.

Equipment: plastic stool cup or ESwab collection kit

A. Order STOOL Culture for isolation of Campylobacter, Shigella, Salmonella

and Shiga toxin (including E.coli 0157). Note: For orders specific to the

isolation of Yersinia, Vibrio or Aeromonas, write the name of the specific

organism in the comment section of the audit trail, paper requisition, or script,

and notify the Lab that the specimen is being collected. Store at 2-8C if not

cultured within 2 hours. Stool for GI Filmarray can be collected as above or

placed in Cary-Blair Medium.

1. Stool should be passed into a clean dry container. Have the patient

save the stool specimen one of the following ways: Pass stool directly

into a sterile wide-mouth, leak proof container with a tight fitting lid.

Pass stool into a clean, dry bedpan and transfer the stool into a sterile

leak proof container with a tight fitting lid.

NOTE: If using wooden applicator stick to transfer stool, do not leave

wooden stick in container. The stick absorbs moisture and will cause

the stool to become dried and unable to process. Dried stool

specimens will be rejected.

2. Rectal swab: Open ESwab Collection kit. Pass the tip of the sterile

swab beyond the anal sphincter, anywhere from 1cm in infants to 4cm

in larger adolescents. Rotate the swab to sample the anal crypts for 30

seconds. Break the swab at the score line into the transport tube

containing 1.0mL liquid media.

B. C. difficile toxin assay and Rotavirus assay. Refrigerate stool if not

processed within 4 hours for C.difficile and 2 hours for Rotavirus.

Specimen is bulk stool (not rectal swab, specimens on swabs will be

rejected as QNS). Do not place the specimen in Viral Transport Medium

or preservatives (VIRAL TRANSPORT MEDIA- VTM, M4, Cary Blair),.

C. Ova and parasites

Supplies: Clean plastic stool cup

1. The stool should be passed into a clean, dry container. Urine

mixed with the specimen will contaminate results. Specimen

cannot be collected directly out of the toilet.

2. Transfer stool specimen to stool cup and send to the Laboratory

within 2 hours of collection, refrigerate if > than 2 hours.

NOTE: If using wooden applicator stick to transfer stool, do not

leave stick in stool container; specimen will dry out.

D. Occult Blood

Transfer stool specimen to stool cup. Transport to lab.

NOTE: If using wooden applicator stick to transfer stool, do not leave stick

in stool container; specimen will dry out.

E. Pin Worm

Equipment: Pinworm paddle (obtain from lab)

1. Do not turn lights on in the room.

2. The ideal time for obtaining the specimen is early in the morning

before having a bowel movement. Remove the cap which has

an optically clear polystyrene paddle with one side coated with a

nontoxic mildly adhesive material. This side is marked: sticky

side. Press the sticky surface against the perianal skin with

moderate pressure. Replace the cap with paddle into the

container. Label the specimen and deliver the container to the

laboratory.

F. Labeling: Properly label the specimen with at least two patient identifiers,

such as name, medical record number, and date of birth.:

References:

1. Jorgensen, James. Manual of Clinical Microbiology 11th Edition 2015

2. Aries C.difficile Assay Instruction for Use. Luminex Corporation