• Collect specimen in a clean bed pan or use plastic wrap placed between the toilet seat and the bowl. Do NOT submit feces contaminated with urine, toilet water, or barium.
• Transfer specimen into a clean, dry container.
• Transport unpreserved stool at ambient temperature within 2 hours of collection for bacterial cultures or at 2-8°C for viral cultures.
• If transport delay > 2 hours is unavoidable, place the specimen in an appropriate preservative or transport media immediately after collection; bacterial stool cultures use enteric transport media (Cary-Blair) at ambient or 2-8ºC; for ova and parasite use Protofix at ambient temperature. Do not fill commercial transport vials above indicator line. Overfilling of transport vial results in improper specimen preservation.
• Stool for antigen testing for C. difficile, toxin, H. pylori antigen, and Rotavirus antigen requires 1 gram (1-10 mL) of unpreserved stool to be transported and stored at Ambient: <2 hours; Refrigerated: 72 hours; Frozen: 1 week.

Notes:

• Only loose or diarrheal stools are recommended for routine bacterial cultures and C. difficile toxin testing.
• Bacterial culture orders available include: Culture, Stool (for Salmonella, Shigella, Campylobacter); Culture, Hemorrhagic E. coli stool (E. coli 0157:H7); Culture, Yersinia; Culture, Vibrio.
• Submit 2-3 stools collected at least 24 hours apart for culture.
• Routine stool cultures are not recommended from patients hospitalized for > 3 days, unless the patient is known to be HIV positive or approved by Microbiology Medical Director.
• For parasite testing with no foreign travel in the patient’s history, order: Ova and Parasite Giardia/Cryptosporidim Antigen Screen
  • Submit one stool for antigen testing for Giardia and Cryptosporidium. Specimens will be held for 7 days, and a complete parasite exam may be requested on antigen negative stools.
• For complete parasite exam order: Ova and Parasite Complete, Foreign travel,
  • Collecting 3 specimens over a 10 day period is optimal. Indicate suspected parasites and patient history if applicable. Specimens analyzed to determine efficacy of treatment should be collected 3-4 weeks after treatment.
• For parasite testing of Cyclospora, Isospora and Micorsporidia by modified acid fast stain order: Ova and Parasite stool for Cyclospora and Ispospora Stain.
• Test stool for Clostridium difficile toxin is recommended for all patients over 6 months of age with clinically significant diarrhea and a history of antibiotic exposure. Consider C. difficile testing as an alternative to routine microbiologic studies for inpatients over 6 months of age who have test requests for routine enteric pathogens.