Beth Israel Deaconess Medical Center Laboratory Manual

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• Submit a minimum of 10-20 cc of stool in a clean, non-sterile, plastic specimen cup. The lid should be tight.
• Send specimen to the Laboratory to arrive 1 hr. after collection. Enteric pathogens die very quickly during transport. If transport is going to be longer (eg. for outpatients) use the Enteric Pathogen Transport Vial.
  
  

  For the Enteric Bacteria Transport Vial  (Orange Capped Vial) 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 a transport vial. 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 patient or healthcare worker must date, time, and sign each specimen container and place it back into the provided "zip-lock" plastic bag.

  
  

• Routine Culture : Salmonella, Shigella, and Campylobacter species are the only pathogens isolated by the routine enteric culture procedure.
  
• Other Bacterial Pathogens : Please alert the Microbiology Lab if another enteric pathogen such as Yersinia, Vibrio, or enterohemorrhagic E. coli (O157:H7) is suspected.
  
• Formed stool for testing of enteric pathogens and C. difficile toxin is not an optimal specimen.
• Rectal swabs for enteric pathogen culture are accepted from neonates only.
• Since Salmonella, Shigella, Campylobacter and the other enteric pathogens (except C. difficile) are not usually acquired in the hospital, culture requests on inpatients after day 3 of hospitalization will be canceled. If special circumstances exist, call Microbiology resident (pager #30004).
• A single stool culture is very sensitive in detecting those species which cause acute enteritis in normal patients. Thus, only 2 stool specimens for culture of enteric pathogens will be accepted per week.
• In patients with enteric fever, suspected carrier states, or patients who will require therapy (eg. compromised hosts or patients with severe colitis), more frequent culturing can be arranged through the Microbiology resident.
• Fungal cultures of stool have generally not been found to be clinically useful.  Ref:  Hines, J. et al.  Clinical Infectious Diseases.  23:1292, 1996.   Therefore, requests for fungal cultures from this site will not be performed, unless the laboratory is specifically notified by contacting the microbiology resident (pager #30004).