Specimen Requirements

Optimal times for specimen collection must be based upon both the type of infectious disease process and ability of laboratory to expertly process specimens. The Microbiology Laboratory is not as well staffed during evening and late night hours. Specimens collected late in the evening often do not produce adequate growth by next morning. STAT testing is available at all times for critical tests including blood cultures, body fluid Gram stains, etc.

Specimen must arrive within 30 minutes of collection if not added to a collection vial.

Submit only 1 of the following specimens:

Feces

1. Lift toilet seat, and cover toilet bowl with a large sheet of plastic wrap. Make a depression in plastic wrap. With toilet seat lowered, pass stool specimen directly onto plastic wrap. Do not contaminate with urine. 

2. Place 1 g of diarrheal (liquid or loose) stool in a screw-capped, sterile container/stool cup.

3. Alternatively, collect stool specimen in a sterile, dry, wide-mouth container. Do not use toilet paper to collect specimen. Do not remove specimen from toilet water.

4. Stool specimen may also be collected in a stool culture collection vial(s). Follow instructions accompanying vial(s) for collection procedure.
5. Label container/stool cup/vial(s) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

6. Place container/stool cup/vial(s) in biohazard transport bag.

7. Maintain sterility and forward promptly. Do not refrigerate.
Note:  1. Specimen source is required on request form for processing.

2. Contamination of stool specimen with urine or barium is not acceptable.

3. Fresh stool specimens will not be processed for culture if received more than 2 hours after collection. Stool culture vials are not acceptable for culture if received more than 24 hours after collection. Routinely, only 1 stool specimen per day should be collected for routine culture. After the third hospital day, it is generally recommended that Clostridium difficile toxin testing be performed on patients with diarrhea, not routine culture.

Swab

If a stool specimen cannot be obtained on pediatric patients, collect specimen as follows:

1. Insert a sterile swab approximately 1 inch (2.5 cm) beyond anal sphincter.

2. Gently rotate swab to sample anal crypts.

3. Collect 3 swabs (feces should be evident on swabs).

Note:  When using sterile swabs, follow instructions on swab packaging.

4. Label tube (not packaging) with patient’s name, physician’s name, date and time collected, initials of collector, and specimen source.

5. Place tube in biohazard transport bag.

6. Maintain sterility and forward promptly. Do not refrigerate.
Note:  1. Specimen source is required on request form for processing.

2. Contamination of stool specimen with urine or barium is not acceptable.

3. Fresh stool specimens will not be processed for culture if received more than 2 hours after collection. Stool culture vials are not acceptable for culture if received more than 24 hours after collection. Routinely, only 1 stool specimen per day should be collected for routine culture. After the third hospital day, it is generally recommended that Clostridium difficile toxin testing be performed on patients with diarrhea, not routine culture.