Community Acquired Diarrhoea

  • Routine testing (by PCR +/- culture) is for Salmonella, Shigella, Campylobacter and STEC-producing E coli (includes serotype O157) only

  • Culture for Vibrio, Yersinia and Plesiomonas is available if there is a relevant travel history

  • In addition request Crypto, Giardia, Entamoeba (PCR) if diarrhoea is prolonged (>14d) or there is a history of travel, weight loss or bloating, or immunocompromised. This will be added automatically if the patient is under 5 years old - see Ova, Cysts and Parasites
    • Microscopy for ova, cysts and parasites is indicated where there is a history of tropical travel - see Ova, Cysts and Parasites

  • If amoebic dysentery or suspected, discuss with Microbiology medical staff

  • If patient has received antibiotics in the past month request C.difficile toxin testing - see Clostridium difficile (C.diff)

Hospital Acquired Diarrhoea (more than 4 days into admission)

  • Usually request C.difficile testing only

  • If part of an outbreak / cluster of cases, contact infection control - see Norovirus

  • Request as for community acquired if:

    • age >65 or <16 with significant co-morbidity

    • immunocompromised

    • suspected non-diarrhoeal manifestation of enteric infection

Stool appearance is checked prior to processing of the sample to ensure that formed stools are not processed unless the sample is to check for clearance of a previous pathogen, part of an outbreak or the patient has eosinophilia.

Sample type

Faeces

Specimen requirements

Non-formed stool samples should be sent in a sterilin 30ml universal, with quick-start cap and spoon

Minimum volume

1-2g

Frequency of test

Daily

Turnaround time

Gastroenteritis Bacterial PCR - 1 day

Faeces culture - 5 days

What to request on EPR

Faeces bacterial, PCR & MCS

Clostridium difficile toxin, faeces