Where Can I Get a Stool Culture Test
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Stool Culture
CPT: 87045; 87046; 87427
Synonyms
- Culture, Stool, Comprehensive
- Enteric Pathogens Culture, Routine
- Carrion Civilization, Routine
- Routine Civilisation, Stool
Examination Includes
Culture; isolation and identification (at an additional charge) of Salmonella, Shigella, and Campylobacter, and detection of enterohemorrhagic East coli (EHEC) Shiga toxin by EIA. If culture results warrant, susceptibility testing (additional charges/CPT lawmaking[s] may utilise) may be performed. CPT coding for microbiology and virology procedures frequently cannot be determined earlier the culture is performed. Requests with only a written order and no test number indicated volition be candy according to Default Testing for Routine Microbiology.
Special Instructions
Specify specific pathogen if not Salmonella, Shigella, Campylobacter, or enterohemorrhagic E coli (EHEC). Bank check expiration date of ship; do not use expired devices.
Fecal specimens for dissimilar tests often demand different send containers and different transport weather (eg, frozen, raw stool). Specimens should be portioned out to separate devices of each blazon for each test requested before sending to the laboratory. Stool for bacterial culture and enterohemorrhagic E coli Shiga toxin past EIA should be submitted in the C&South send vial. Merely a thumbnail-size portion of stool, nearly 1 g or 1 mL, should be added to the vial. Overfilling the vial volition reduce recovery of stool pathogens.
Specimens from sources, such as genital, stool, urine, and upper and lower respiratory specimens, cannot be cultured under the aerobic bacterial civilization exam number. If specimens are incorrectly submitted with an lodge for aerobic bacterial civilisation, the laboratory volition procedure the specimen for the test based on the source listed on the asking form. The client will non be telephoned to corroborate this change, simply the modify volition be indicated on the report.
Expected Turnaround Time
3 - 5 days
Turnaround time is defined equally the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or boosted reflex tests. Testing schedules may vary.
Related Documents
Specimen Requirements
Specimen
Volume
1 g, 1 mL, or one swab in stool C&S transport vial (usual bacterial swab send is non adequate although the swab may be used)
Container
Stool culture transport vial is required; diapers are not acceptable. Culture drove swab may be used to collect rectal swabs or a swab of fecal material, so swab should exist placed in stool culture transport vial (Para-Pak® C&Southward orangish).
Collection
A single stool specimen cannot exist used to rule out bacteria every bit a cause of diarrhea. It is recommended that two or three stool specimens, collected on split days, be submitted to increase the probability of isolating a bacterial pathogen. Hospitalized patients who develop diarrhea while hospitalized and more than 72 hours later on admission should be tested for Clostridium difficile by detection of either toxin A and/or toxin B.
Studies accept shown that patients who did non have gastroenteritis or other GI symptoms on admission are unlikely to have diarrheal affliction due to Salmonella, Shigella, Campylobacter, or enterohemorrhagic Eastward coli.
Stool: Specimen should be collected in sterile bedpan, not contaminated with urine, remainder soap, or disinfectants. Those portions of stool that contain pus, claret, or mucus should be transferred to a sterile specimen container.
Rectal swab: Pass swab across anal sphincter, advisedly 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 past a dr. trained in this process.
Stool specimen tin can exist divided for other types of cultures by the laboratory. Miscellaneous tests and ova and parasites tests should be separate into appropriate containers and ship devices prior to aircraft to the laboratory.
Storage Instructions
Maintain specimen at room temperature.
Causes for Rejection
Specimen received in grossly leaking transport container; diapers; dry out specimen; specimen submitted in fixative or additive; specimen received in expired transport media or wrong transport device; inappropriate specimen transport conditions (non in a C&Southward vial or in an overfilled C&South vial); specimen received after prolonged delay in send (usually more than than 72 hours); specimen stored or transported frozen; wooden shaft swab in ship device; unlabeled specimen or proper name discrepancy betwixt specimen and request characterization
Test Details
Apply
Detect bacterial pathogenic organisms in the stool; diagnose typhoid fever, enteric fever, bacillary dysentery, Salmonella infection.
Indications for stool culture include:i
• Bloody diarrhea
• Fever
• Tenesmus
• Severe or persistent symptoms
• Recent travel to a third globe land
• Known exposure to a bacterial amanuensis
• Presence of fecal leukocytes
Limitations
Yersinia sp and Vibrio parahaemolyticus will non be isolated unless specifically requested; these will each be done with an boosted charge. These organisms are fastidious and accept very specific requirements for growth.
Methodology
Aerobic culture on selective media; detection of EHEC Shiga-like toxins by enzyme immunoassay (EIA)
Contraindications
A rectal swab culture is non as effective as a stool culture for detection of the carrier state.
Additional Data
In enteric fever caused by Salmonella typhi, Southward choleraesuis, or S enteritidis, blood culture may be positive before stool cultures, and blood cultures are indicated early; urine cultures may also exist helpful.
Diarrhea is common in patients with the acquired immunodeficiency syndrome (AIDS). It is frequently caused by the classic bacterial pathogens likewise as unusual opportunistic bacterial pathogens and parasitic infestation. (Giardia, Cryptosporidium, and Entamoeba histolytica frequently reported.) Cryptosporidium, Isospora, and Pneumocystis tin occur with AIDS. Rectal swabs are useful for the diagnosis of Neisseria gonorrhoeae and Chlamydia infections. AIDS patients are besides subject field to cytomegalovirus, Salmonella, Campylobacter, Shigella, C difficile, herpes, and Treponema pallidum gastrointestinal tract interest.
| Syndrome (Anatomic Site) | Features | Characteristic Etiologies |
|---|---|---|
| Gastroenteritis (stomach) | Vomiting | Rotavirus Norwalk virus Staphylococcal food poisoning Bacillus cereus food poisoning |
| Enteritis (small bowel) | Watery diarrhea Large-volume stools, few in number | Enterotoxigenic Escherichia coli Vibrio cholerae Any enteric microbe Inflammatory bowel disease |
| Dysentery, colitis (colon) | Small-scale-volume stools containing blood and/or mucus and many leukocytes | Shigella Campylobacter Salmonella Invasive E coli Plesiomonas shigelloides Aeromonas hydrophila Vibrio parahaemolyticus Clostridium difficile Entamoeba histolytica Inflammatory bowel affliction |
In astute or subacute diarrhea, three common syndromes are recognized: gastroenteritis, enteritis, and colitis (dysenteric syndrome). With colitis, patients take fecal urgency and tenesmus. Stools are oft small in book and contain claret, mucus, and leukocytes. External hemorrhoids are common and painful. Diarrhea of small bowel origin is indicated past the passage of few big book stools. This is due to accumulation of fluid in the large bowel before passage. Leukocytes signal colonic inflammation rather than a specific pathogen. Bacterial diarrhea may be present in the absence of fecal leukocytes and fecal leukocytes may exist present in the absence of bacterial or parasitic agents (ie, idiopathic inflammatory bowel disease).2 See table. Although most bacterial diarrhea is transient (1 to 30 days) cases of persistent symptoms (10 months) accept been reported. The etiologic agent in the reported case was Shigella flexneri diagnosed past culture of rectal swab.3 In infants younger than one year of historic period, a history of claret in the stool, more than ten stools in 24 hours, and temperature greater than 39°C accept a high probability of having bacterial diarrhea.4,5 Diarrhea is likewise a common side effect of long-term antibody handling. Although often associated with Clostridium difficile, other bacteria and yeasts have been implicated.6
Footnotes
one. Bishop WP, Ulshen MH. Bacterial gastroenteritis. Pediatr Clin Due north Am. 1988 February; 35(1):69-87 (review). 3277134
2. DuPont HL. Subacute diarrhea. To treat or to look? Hosp Pract. 1989 Mar 30, 24(3A):111-118. 2494199
3. Clements D, Ellis CJ, Allan RN. Persistent shigellosis. Gut. 1988 Sep; 29(9):1277-1278. 3058558
4. Finkelstein JA, Schwartz JS, Torrey S, Fleisher GR. Common clinical features every bit predictors of bacterial diarrhea in infants.Am J Emerg Med. 1989 Sep; seven(5):469-473. 2757712
5. Cohen MB. Etiology and mechanisms of acute infectious diarrhea in infants in the United states of america. J Pediatr. 1991 Apr; 118(4 Pt ii):S34-S39. 2007955
6. Bartlett JG. Antibiotic-associated diarrhea. Clin Infect Dis. 1992 Oct; 15(4):573-581. 1420669
References
DeWitt TG. Acute diarrhea in children. Pediatr Rev. 1989 Jul; 11(one):6-12. 2664748
Farmer RG. Infectious causes of diarrhea in the differential diagnosis of inflammatory bowel disease. Med Clin North Am. 1990 Jan; 74(1):29-38. 2404179
Gavin PJ, Thomson RB. Diagnosis of enterohemorrhagic Escherichia coli infection by detection of Shiga toxins. Clin Microbiol Newslet. 2004; 26:49-54.
Guerrant RL. Nausea, airsickness, and noninflammatory diarrhea. In: Mandell GL, Douglas RG Jr, Bennett JE, eds. Principles and Practice of Infectious Diseases. 3rd ed. New York, NY: Churchill Livingstone;1990: 851-863.
Guerrant RL, Hughes JM, Lima NL, Crane j. Diarrhea in developed and developing countries: Magnitude, special settings, and etiologies. Rev Infect Dis. 1990 Jan-Feb; 12(Suppl 1):541-550. 2406855
Pickering LK. Therapy for astute infectious diarrhea in children. J Pediatr. 1991 Apr; 118(iv Pt two):S118-S128. 2007952
LOINC® Map
| Club Lawmaking | Order Lawmaking Proper noun | Order Loinc | Result Code | Consequence Lawmaking Proper name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 008144 | Stool Culture | 82305-four | 008722 | Salmonella/Shigella Screen | 43371-4 | |
| 008144 | Stool Culture | 82305-iv | 180141 | Campylobacter Civilisation | 6331-3 | |
| 008144 | Stool Civilization | 82305-iv | 180935 | E coli Shiga Toxin Environmental impact assessment | 21262-i |
| Reflex Tabular array for Salmonella/Shigella Screen | ||||||
|---|---|---|---|---|---|---|
| Social club Lawmaking | Club Name | Result Code | Result Name | UofM | Result LOINC | |
| Reflex 1 | 997871 | Issue | 997141 | Result ane | 6463-4 | |
| Reflex Table for Salmonella/Shigella Screen | ||||||
|---|---|---|---|---|---|---|
| Social club Code | Gild Name | Consequence Code | Issue Name | UofM | Result LOINC | |
| Reflex 1 | 997871 | Result | 997142 | Result 2 | 6463-four | |
| Reflex Table for Salmonella/Shigella Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Gild Name | Effect Code | Upshot Name | UofM | Result LOINC | |
| Reflex 1 | 997871 | Consequence | 997143 | Upshot 3 | 6463-4 | |
| Reflex Tabular array for Salmonella/Shigella Screen | ||||||
|---|---|---|---|---|---|---|
| Order Code | Social club Name | Result Code | Consequence Name | UofM | Outcome LOINC | |
| Reflex ane | 997871 | Result | 997144 | Upshot four | 6463-4 | |
| Reflex Table for Salmonella/Shigella Screen | ||||||
|---|---|---|---|---|---|---|
| Lodge Code | Guild Name | Result Lawmaking | Event Name | UofM | Result LOINC | |
| Reflex i | 997871 | Event | 997145 | Antimicrobial Susceptibility | 23658-viii | |
| Reflex Table for Campylobacter Civilization | ||||||
|---|---|---|---|---|---|---|
| Order Lawmaking | Order Proper name | Result Code | Result Proper name | UofM | Result LOINC | |
| Reflex 1 | 080172 | Issue | 080173 | Effect one | 6463-4 | |
| Reflex Tabular array for Campylobacter Civilisation | ||||||
|---|---|---|---|---|---|---|
| Order Lawmaking | Guild Proper name | Outcome Code | Upshot Proper name | UofM | Result LOINC | |
| Reflex i | 080172 | Upshot | 080174 | Event 2 | 6463-4 | |
| Reflex Table for Campylobacter Culture | ||||||
|---|---|---|---|---|---|---|
| Guild Lawmaking | Order Proper name | Result Code | Result Proper noun | UofM | Result LOINC | |
| Reflex one | 080172 | Consequence | 080175 | Result 3 | 6463-four | |
| Reflex Tabular array for Campylobacter Culture | ||||||
|---|---|---|---|---|---|---|
| Club Code | Order Name | Result Code | Event Name | UofM | Result LOINC | |
| Reflex 1 | 080172 | Result | 080177 | Result 4 | 6463-four | |
| Reflex Table for Campylobacter Culture | ||||||
|---|---|---|---|---|---|---|
| Guild Code | Social club Proper noun | Outcome Code | Effect Proper noun | UofM | Result LOINC | |
| Reflex 1 | 080172 | Result | 080178 | Antimicrobial Susceptibility | 23658-eight | |
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