Gastroenteritis/enteric pathogens

(Microbiology)

1. Faecal samples submitted for culture to Bacteriology are routinely screened for enteric pathogens according to clinical information.
   
   Note 1. It is particularly important to provide full clinical details on patients who are immunocompromised or who have returned from travel abroad, so that a check may be made for all relevant pathogens (which range from CMV to cholera).
   
   Note 2. But it just as important to supply relevant clinical details on all patients, not just those at 'high risk' - for example, the age of the patient or a history of bloody diarrhoea or of renal impairment may prompt special investigations on normally commensal organisms such as E. coli.
   
   
2. Faeces are NOT routinely examined under the microscope for parasites so that if Protozoa (such as Giardia, Entamoeba or Cryptosporidium) or other parasites might be involved (because of age, travel, or immuno-suppression) this should be clearly indicated on the request form sent to Bacteriology. However, a single sample and request form suffice for both bacterial and parasitological studies.
   
   
3. Sellotape slide link microscopic examination is available for Enterobious vermicularis (thread or pin worm) ova
   
   
4. A viral gastroenteritis PCR is available. See Viral Gastroenteritis. This PCR supplements the norovirus service for the additional detection of rotavirus, adenovirus, astrovirus and sapovirus..

Enteric cultures are now performed on the Molecular Enteric Bio platform. This test is not yet accredited by UKAS but the laboratory as a whole is UKAS accredited. This platform has a higher sensitivity and specificity than conventional culture

Investigations	Culture for enteric pathogens Microscopy for enteric parasites, requests for parasitological investigation should be clearly indicated. Faeces are NOT routinely examined under direct microscopy therefor if Protozoa (such as Giardia, Entamoeba or Cryptosporidium) or other parasites might be involved (because of age, travel, or immuno-suppression) this should be clearly indicated on the request form (a single sample and request form suffice for both bacterial and parasitological studies).
Inform lab before sending	No
Specimen type	Faeces
Ideal time to take specimen	During episode of diarrhoea
Labelling requirements	click here
How to take the specimen	A blue sterile universal container with spoon, a sterile white capped universal, or a sputum pot. The specimen container should not be filled to the brim. A walnut sized portion of stool or about 10ml of liquid faeces is sufficient.
Transport to the laboratory	As soon as possible. If transport is delayed then refrigerate. Delays of over 48hrs are undesirable.
Test Times	Monday to Friday
Turnround	Up to 72 hrs. May be longer if it is necessary to send the pathogen to a reference laboratory for further work
Additional information	Faecal samples submitted for culture to Bacteriology are routinely screened for enteric pathogens according to clinical information; therefore it is important to provide full clinical details e.g. history of travel abroad, immunocompromised patients, renal impairment or bloody diarrhoea. (A history of bloody diarrhoea or of renal impairment may prompt special investigations on normally commensal organisms such as E. coli). . It is particularly important to provide full clinical details on patients who are immunocompromised or who have returned from travel abroad, so that a check may be made for all relevant pathogens (which range from CMV to cholera).
Additional Examination Requests	Please ensure that any requests for additional investigations on the specimen are made within 7 days from the date of the original request.

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