Beth Israel Deaconess Medical Center Laboratory Manual

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• Submit up to 50 ml (minimum 5 ml) of stool in a clean, non-sterile or sterile container.  The lid should be carefully closed and tightened to prevent leakage during transport.
• If specimen will not be received in the laboratory within a short time of collection (30 minutes if liquid, 1 hour if soft and 24 hours if formed), the Para Pak 2 vial (10% Buffered Neutral Formalin [Pink Label/Cap] and LV-PVA Fixative [Blue Label/Cap]) system should be used for optimal recovery of parasites.
  
  

  Ova & Parasites Para Pak Transport (2 vial) System  10% Buffered Neutral Formalin (Pink Label/Cap]  LV-PVA Fixative (Blue Label/Cap] Caution: Read and follow all instructions for the Para Pak Transport Vials carefully before placing in vials. Liquids are poisonous (do not drink) and if liquid gets on your hands or in your eyes, flush with plenty of water.  If irritation develops, consult a physician. Outpatients should get a completed requisition slip and Para Pak O&P Transport Vials. The patient should pick up the stool with the spatula provided in the lid of each transport medium and place into the medium. Add enough stool to reach the line on the vial label. The date and time collected must be recorded on the specimen label. Place vials back into the "zip-lock" plastic bag provided..

  
  
• Routine Ova and Parasites (O&P):  Three separate stool specimens collected EVERY OTHER DAY are recommended for optimal sensitivity.  Duplicate specimens collected on the same day will not be processed since this does not increase the diagnostic yield.  Make sure to label date and time of collection of each sample submitted to ensure appropriate processing.  Microsporidium will not be detected by this method.  Cyclospora, Giardia and Cryptosporidium may not be reliably detected by this method.  See additional testing information below..
  
• Cryptosporidium/Giardia DFA:  If Cryptosporidium or Giardia are suspected, the Cryptosporidium/Giardia DFA may also be ordered on one or more stool specimens, since this direct immunofluorescence test is more sensitive than the Routine O&P for these agents.
• Microsporidium and Cyclospora Smears: If Microsporidium or Cyclospora are clinically suspected, a Microsporidium Smear and/or Cyclospora Smear should be specifically requested, since special stains need to be performed.  Send up to three stool specimens (as described above in Routine O&P) for optimal detection of these parasites.