Geisinger Medical Laboratories Microbiology Specimen Collection Instructions

Stool Specimen Collection

For Culture and/or Ova & Parasite Giardi and Cryptosporidium Testing

NOTE: The patient should be instructed not to take antacids, oily laxatives, or antidiarrheal medication unless prescribed by a physician, prior to the collection of the sample(s). Radiological examinations utilizing contrast chemicals (e.g., bismuth, barium) should be avoided prior to collection of the fecal specimen for parasite analysis.

The collection set may contain 1, 2, or 3 vials. If multiple specimens must be collected, collect on consecutive days, not on the same day. The vials will contain liquid. NOTE: The liquids are poisonous. Do not drink or pour out liquid. Keep out of the reach of children or pets.

IMPORTANT:
Please wash hands before beginning the procedure.  DO NOT pass the specimen into the toilet. DO NOT pass the specimen directly into the collection vial. DO NOT urinate on the specimen or into the collection vial. DO NOT allow any water to mix with the specimen.

1. Collect the stool specimen (bowel movement) in any clean, dry wide-mouth container, bedpan, or on a plastic plate or clean newspaper, plastic bag, or clean diaper. This prevents the fecal specimen from falling into the toilet bowl. Collection device (e.g. diaper, newspaper, bedpan) must not be sent to the laboratory. The stool sample must be transferred to the appripriate transport device(s) before being sent to the laboratory.
2. Carefully open the TotalFix vial (ova and parasite testing only) and/or C&S Medium (Cryptosporidium, Giardia and culture) 
   
3. Using the spoon attached to cap, add approximately three spoonfuls of firm stool, or five spoonfuls of soft stool, to each vial. It is important to sample areas of the specimen which appear bloody, slimy, or watery. If the stool is firm, sample small amounts from each end and the middle of the specimen. Fill each vial with enough specimen so that the liquid reaches the “fill line” located on the label.
   NOTE: Hard stools are not acceptable for routine culture.
   
4. Thoroughly mix the specimen and the liquid in the vial using the spatula. Fill only one vial at a time and replace the spoon/cap onto the same vial it came from. Do not mix spoons/caps with other vials.
5. Replace the spoon/cap and close tightly.
6. Shake each vial until the specimen is well mixed with the liquid in the vial.
7. Label the vials with:
   1. Patient name, medical record number and/or date of birth.
   2. Date and time specimen was collected.
   3. Specimen number if more than one specimen was taken, for example #1, #2, and #3.
   4. Check the box that best describes your stool sample.
   5. Please note on the label if specimen is bloody.
8. Place the vial(s) in the original package and seal securely. Store and transport specimens at 2-8°C (refrigerated). Return specimen(s) to the laboratory as soon as possible.
   
9. Wash hands thoroughly with soap and water.
   
10. IMPORTANT: If any liquid from the vial or stool specimen gets into your eyes or on your skin, rinse the area with plenty of water. If any discomfort or irritation develops, contact a physician.
    ANTIDOTE IF SWALLOWED: Give plenty of milk or water. Follow with a tablespoon of salt in a glass of warm water and repeat until the vomit is clear. Contact a physician or local poison control center IMMEDIATELY.

Reference:
Alpha-Tec Product Insert. Directions for Stool Specimen Collection Set. 2005.

Stool Specimen Collection For Rotavirus, Clostridium, And Lactoferrin Eia (Fecal Leukocyte) Testing

Pseudomembranous colitis (PMC) related to antimicrobial therapy is caused primarily by Clostridium difficile toxin. C. difficile may also be involved in a similar disease not related to antimicrobial therapy but following the use of methotrexate and other cytotoxic agents, in exacerbations of inflammatory bowel disease, and in complications of strangulation obstruction of the bowel. The C. difficile PCR assay is a rapid method for the detection of C. difficile toxin B gene DNA in human fecal samples, to be used as an aid in the detection of C. difficile associated disease.

Rotavirus is a major cause of acute gastroenteritis, especially in children 6 to 24 months of age. In addition, rotavirus infections can produce severe illness as well as asymptomatic infection in adults. The incubation period of rotavirus infection is usually 1-3 days followed by gastroenteritis with an average duration of 5-8 days. Virus titers are highest shortly after the onset of illness. Rotavirus EIA is a rapid method for detecting rotavirus in stools.

A positive test result for lactoferrin indicates an increased level of fecal lactoferrin and warrants additional testing. Inflammatory diarrheas are caused by pathogens such as Shigella, Salmonella, Capylobacter jejnuii and Clostridium difficile. In inflammatory diarrheas, fecal leukocytes are found in feces in large numbers. This test may not be appropriate for immunocompromised patients.

Rotavirus - Collect a minimum of 2 mL of stool sample in an appropriately labeled sterile container. Store and transport to the laboratory at 2-8°C.

C. difficile - Collect a minimum of 2 mL of stool sample in an appropriately labeled sterile container. Specimens should be liquid or soft. (Formed, hardened stool specimens are not acceptable for Clostridium difficile testing.) Store and transport to the laboratory at 2-8°C.

Lactoferrin EIA - Collect a minimum of 1-2 mL of stool sample in an appropriately labeled sterile container. Store and transport to the laboratory at 2-8°C.

Revised: 8/29/2023