Stool Culture, Routine

CPT CODE: 87045
CDM NUMBER: 3421023; 3421001; 3451021; 3421081
TEST INFORMATION: The test includes the isolation and identification of Salmonella species, Shigella species, Aeromonas species, and/or Plesiomonas shigelloides; susceptibility testing, if appropriate. The test also includes an assay for the presence of Campylobacter species.  Yersinia species, Vibrio species, and/or Escherichia coli O157:H7 cultures will be performed ONLY if specifically requested.
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: Campylobacter screening results are available within 1-2 days. Preliminary negative culture reports are available after 48 hours. Culture reports of no enteric pathogens will be issued after 3 days. Isolates presumptively identified as either Salmonella species, Shigella species, or E. coli 0157:H7 must be referred to the Illinois Department of Public Health for confirmation and serogrouping. Isolation of Vibrio species and/or Yersinia species may require an additional 1-2 days for completion.
SPECIAL INSTRUCTIONS: The request for isolation of Vibrio species, Yersinia species, and/or Escherichia coli O157:H7 MUST be specified on the requisition.
CONTAINER TYPE: Sealed plastic feces container, no preservative; sealed sterile or nonsterile clean container; Copan Swab II, Para-Pak Carey-Blair transport vial
COLLECTION: The specimen should be collected directly into the plastic feces specimen container (no preservative) or into a bedpan, avoiding contamination with urine or water. Transfer the feces from the bedpan into the plastic feces container or a sealed container.
SPECIMEN REQUIREMENTS: Fresh stool, rectal swab. However, swabs are unacceptable for Campylobacter screening. A culture for Campylobacter spp. will be performed.
REJECTION CRITERIA: Specimens more than 2 hours old, unless preserved in Carey-Blair transport medium, inappropriate specimen container, insufficient specimen volume, specimen contaminated with urine and/or water, more than one specimen submitted to the laboratory per day, specimen submitted more than 3 days after hospitalization, specimen not submitted in a sealed container. Diapers and specimens on tissue paper are NOT acceptable.
MINIMUM VOLUME: 1-2 gram (for stool) or swab showing fecal material
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature.
REFERENCE RANGE: Negative for Salmonella spp., Shigella spp., Campylobacter spp., Aeromonas spp., and Plesiomonas spp.
LIMITATIONS OF TEST: Specimens will routinely be screened for Salmonella species, Shigella species, Campylobacter species, Aeromonas species, and Plesiomonas species only. A methylene blue stain and Campylobacter screen CANNOT be performed on a rectal swab.
METHODOLOGY: Culture: Conventional culture utilizing media specifically formulated for enteric pathogen isolation.Campylobacter screen: Enzyme immunoassay (EIA). Smear: methylene blue stain.
ADDITIONAL INFORMATION: Organisms other than Salmonella species, Shigella species, and Campylobacter species, Aeromonas spp., and Plesiomonas spp. may not be isolated unless specifically indicated on the requisition that other specific isolates are potential etiologic agents, resulting in inoculation of specific media for isolation of alternative pathogens. In enteric fever caused by Salmonella, blood cultures may be positive before stool cultures; therefore, blood cultures are indicated early. Diagnosis of amebic dysentery requires a test request for ova and parasite examination. Patients who develop diarrhea after more than 3 days of hospitalization rarely are infected with enteric pathogens. A test for Clostridium difficile toxin is most appropriate in those cases.
TEST SYNONYM(S):Enteric Pathogens Culture, Routine; Rectal Swab for Routine Culture; Stool for Routine Culture