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Bacterial Enteric Pathogen Testing - Stool

Source Stool
Mnemonic M STOOL
Specimen Requirements

Acceptable sample: gross stool, feces, small/large bowel contents.
Rectal swabs are suboptimal specimens and ONLY acceptable on approval of the Microbiologist on Call: 403-770-3757.
Submit gross stool (feces) and/or bowel contents in plain sterile container.

Refer to Laboratory Patient Collection Instructions: Collecting Stool Samples for Bacterial Enteric Pathogen Testing, Rotavirus, Clostridium difficile Toxin, Parasite Screen and/or Ova and Parasites MI6000.

Stool may be collected in a clean, dry disposable container, plastic wrap stretched under the toilet seat, or into a waxed cardboard container.
It MUST be a dry specimen i.e. not contaminated with water or urine.

The patient should be advised to select parts of stool which contain pus, mucous, or blood to transfer to the sterile container.

If an Ova and Parasite examination is also requested, a Stool Collection Kit comprised of a dry sterile container and a container with preservative (SAF) is used for collection.

Specimen Handling

Deliver specimen and requisition to the lab within 8 hours after collecting.
If delivery to laboratory is delayed, refrigerate specimen up to a maximum of 24 hours.

Leaking sample containers will NOT be accepted.

Additional Information

Diarrheal stool specimens are routinely screened using the Bacterial Enteric Panel, a commercial polymerase chain reaction (PCR) assay that tests for the following:
Shiga toxin-Producing Escherichia coli (STEC, including O157 and non-O157), Salmonella, species, Campylobacter species, and Shigella species.

Extended Bacterial Pathogen testing will only be performed if other pathogens (Yersinia, Vibrio and Plesiomonas species) are suspected because of clinical, exposure or travel history and an Extended Bacterial Stool Culture History Form MI6624 is completed.

All PCR-positive results will be confirmed by culture. PCR-positive but culture negative results may represent current infection, past infection, colonization or false-positive PCR and will require clinical correlation.

For positive STEC results, an antigen test for Shiga toxin 1 and 2 will also be used for confirmation. The type of Shiga toxin detected will be reported. STEC may cause hemolytic uremic syndrome (HUS) and isolates producing Shiga toxin 2 are more likely to cause HUS.

Only one stool specimen should be initially submitted regardless of the clinical circumstances of the patient. For hospitalized patients, specimen should be obtained within first four hospital days.

PCR turnaround time: 24 hours
Culture turnaround time: 2-4 days

Testing Location CLS Microbiology
Testing Frequency Daily
Alternate Name(s) Bacterial (Enteric pathogen) culture

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