Enteric Stool Culture

Testing site      

Alaska State Public Health Laboratory – Anchorage 

Anchorage Lab Request Form 

Diseases 

• Salmonellosis 
• Shigellosis 
• Campylobacteriosis 
• Cholera  
• Foodborne illness 
• Food poisoning 
• Enteric bacterial infection 
• Hemolytic Uremic Syndrome (HUS) 
• Bloody stool 

Organisms 

• Salmonella 
• Shigella 
• Campylobacter 
• Escherichia coli O157:H7 
• Shigatoxin producing Escherichia coli 

Note: Additional testing for Yersinia enterocolitica, Vibrio species, Aeromonas species and Plesiomonas species are performed upon request. 

Test Method 

Culture  

Note: Shigatoxin testing by EIA for Enterohemorrhagic E. coli is performed on all stool cultures. 

Availability

Routine testing   

Specimen type 

• Stool in Enteric Transport Media (ETM)  
• Pure isolate submitted on Cary Blair Swab  
• Bacterial Transport Media 

Specimen collection instructions 

Please read all directions first and follow them carefully. 

The collection set may contain 1 to 4 vials. One of the vials may be empty (contains no liquid). The sample must be placed into the ETM vial within one hour of sample collection. Add enough stool to fill exactly to red fill line.  Do not overfill or underfill.  

• Gather the required supplies
  • Disposable gloves 
  • A clean, dry container (like a margarine tub) or plastic wrap to stretch across the toilet to collect the stool. 
  • Transport container(s): Your provider will give you the appropriate containers. 
    • Ex. Red top vials are for bacteria like Salmonella or Escherichia coli 
  • Pen or marker to label the transport containers 

Supply Request Form 

• Wash your hands before collecting the stool sample. 
  • 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. 
• Put on gloves. Stool may contain pathogens that spread disease. 
• Pass stool into a clean, dry container. You can stretch plastic wrap loosely across the toilet bowl, between the seat and the base to catch the stool. 
  • Either solid or liquid stool can be collected. 
  • Samples from babies and young children may be collected from diapers lined with plastic wrap (if the stool is not contaminated with urine). 
• Carefully open each vial. 
  • Use the spoon attached to the lid and collect small amounts of stool from all areas, capturing areas that are slimy, bloody or watery. If the stool is liquid, carefully pour up to the fill line indicated on the container. 
  • If the stool is solid, use the paddle on the container cap to scoop a walnut size amount into the vial. 
  • If one vial contains no liquid, fill at least 1/3 of the container. 
  • Do not overfill or underfill the vials or mix up the vial lids. 
• Screw the cap tightly onto the transport container it came from. Shake the sample until the samples are well-mixed with the liquid in the vial. 
• Remove your gloves and wash your hands. 
• Label all the containers with the patient’s first and last name, date of birth, and the collection date. 
• Return the transport containers as directed. Make certain that all the vials are tightly capped to avoid leaks. 

Special Conditions 

• Multiple samples must be collected 24-48 hours apart. 
• Specimen should not be contaminated with water, urine, barium, antibiotics or mineral oil. 
• Consult the laboratory if Staphylococcus aureus, Bacillus cereus or Clostridium perfringens are suspected.   

Storage and transport  

• Ambient temperature 
• Package, label, and ship as UN3373 Biological Specimen, Category B 

Ship to Alaska State Public Health Laboratory: Anchorage, ATTN: Clinical Microbiology 

Results  

• Salmonella spp. (includes serotyping): Isolated/Not Isolated  
• Shigella spp. (includes serotyping): Isolated/Not Isolated 
• Campylobacter spp.: Isolated/Not Isolated 
• Escherichia coli O157: Isolated/Not Isolated 
• Non-O157 Shigatoxin producing E.coli: Isolated/Not Isolated 
  • Includes serotyping for O26, O45, O103, O111, O121, and O145 
• Usual gram-negative flora: Present/No Growth 

If additional organisms are requested: 

• Vibrio species: Isolated/Not Isolated 
• Yersinia enterocolitica: Isolated/Not Isolated 
• Aeromonas species: Isolated/Not Isolated 
• Plesiomonas shigelloides: Isolated/Not Isolated 

A normal result is not isolated. 

Turnaround time  

3-7 days

Notes   

A laboratory that isolates Campylobacter, Salmonella, Shigella, E. coli Shigatoxin producing, Vibrio or Yersinia species must submit an isolate or an aliquot of the original specimen to ASPHL. 

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