Culture, Stool, Comprehensive*

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Turnaround Time: 3-5 days
CPT Code:

87045, 84046, 87427


Use: Detect bacterial pathogenic organisms in the stool; diagnose typhoid fever, enteric fever, bacillary dysentery, and Salmonella infection.

Indications for stool culture include:

  •  Bloody diarrhea
  •  Fever
  •  Tenesmus
  •  Severe or persistent symptoms
  •  Recent travel to a third-world country
  •  Known exposure to a bacterial agent
  •  Presence of fecal leukocytes

Limitations: Yersinia sp and Vibrio parahaemolyticus will not be isolated unless specifically requested; these will each be done with an additional charge. These organisms are fastidious and have 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 not as effective as a stool culture for the detection of the carrier state.

* Stool Culture; possible reflex to 5 different organisms.

Collection Details:

Collection Instructions:

Specimen: Stool or rectal swab

Volume: 1 g, 1 mL, or one swab in stool C&S transport vial (usual bacterial swab transport is not acceptable although the swab may be used)

Container: A stool culture transport vial is required; diapers are not acceptable. A culture collection swab may be used to collect rectal swabs or a swab of fecal material, then the swab should be placed in a stool culture transport vial (Para-Pak® C&S orange).

Collection: A single stool specimen cannot be used to rule out bacteria as a cause of diarrhea. It is recommended that two or three stool specimens, collected on separate days, be submitted to increase the probability of isolating a bacterial pathogen. Hospitalized patients who develop diarrhea while hospitalized and more than 72 hours after admission should be tested for Clostridium difficile by detection of either toxin A and/or toxin B.

Studies have shown that patients who did not have gastroenteritis or other GI symptoms on admission are unlikely to have diarrheal illness due to Salmonella, Shigella, Campylobacter, or enterohemorrhagic E coli.

Stool: Specimen should be collected in a sterile bedpan, not contaminated with urine, residual soap, or disinfectants. Those portions of stool that contain pus, blood, or mucus should be transferred to a sterile specimen container.

Rectal swab: Pass swab beyond anal sphincter, carefully rotate, and withdraw. Swabbing of lesions of the rectal wall or sigmoid colon during proctoscopy or sigmoidoscopy is preferred.

Duodenal or sigmoid aspirate: Specimen should be collected by a physician trained in this procedure.

Stool specimens can be divided for other types of cultures by the laboratory. Miscellaneous tests and ova and parasites tests should be split into appropriate containers and transport devices prior to shipping to the laboratory.

Storage Instructions: Maintain specimen at room temperature.

Causes for Rejection: Specimen received in grossly leaking transport container; diapers; dry specimen; specimen submitted in fixative or additive; specimen received in expired transport media or incorrect transport device; inappropriate specimen transport conditions (not in a C&S vial or in an overfilled C&S vial); specimen received after a prolonged delay in transport (usually more than 72 hours); specimen stored or transported frozen; wooden shaft swab in transport device; unlabeled specimen or name discrepancy between specimen and request label