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Test Name: Stool Culture
Test Code: 008144
Other Names: N/A
Test Includes: Salmonella/Shigella Screen
Specimen Requirements: Stool or rectal swab placed in a stool culture transport vial (ParaPak C&S - Orange), 1 g, 1 mL, or one swab in stool C&S transport vial (the usual bacterial swab transport is NOT acceptable although the swab may be used).
Container: Stool culture transport vial is required; diapers are not acceptable. Culture collection swab may be used to collect rectal swabs or a swab of fecal material, then swab should be placed in C&S vial (fecal transport system).
Collection Instructions: A single stool specimen cannot be used to rule out bacteria as a cause of diarrhea. It is recommended that two or three stool specimens, collected on separate days, be submitted to increase the probability of isolating a bacterial pathogen. Hospitalized patients who develop diarrhea while hospitalized and more than 72 hours after admission should be tested for Clostridium difficile by detection of toxin A and/or toxin B. Studies have shown that patients who did not have gastroenteritis or other GI symptoms on admission are unlikely to have diarrheal illness due to Salmonella, Shigella, Campylobacter, or enterohemorrhagic E coli. STOOL: Specimen should be collected in sterile bedpan, not contaminated with urine, residual soap, or disinfectants. Those portions of stool which contain pus, blood, or mucus should be transferred to sterile specimen container. RECTAL SWAB: Pass swab beyond anal sphincter, carefully rotate, and withdraw. Swabbing of lesions of rectal wall or sigmoid colon during proctoscopy or sigmoidoscopy is preferred. DUODENAL or SIGMOID ASPIRATE: Specimen should be collected by a physician trained in this procedure. Stool specimen can be divided for other types of cultures by laboratory. Miscellaneous tests and ova and parasites tests should be split into appropriate containers and transport devices prior to shipping to the laboratory.
Stability: Maintain specimen at room temperature.
Rejection Criteria / Special Instructions: Specify specific pathogen if not Salmonella, Shigella, Campylobacter, or enterohemorrhagic E coli (EHEC). Check expiration date of transport; do NOT use expired devices. Fecal specimens for different tests often need different transport containers and dif
Methodology: Aerobic culture on selective media; detection of EHEC Shiga-like toxins by enzyme immunoassay (EIA)