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Stool Sample Collection and Contamination

This document discusses guidelines for stool sample collection and analysis for clinical parasitology experiments. It outlines reasons for rejecting stool samples, such as improper transport temperature or container. It also discusses patient preparation, including obtaining patient identifiers and fasting status. Contamination of stool samples after analysis could affect results, such as contamination with urine, which can eliminate motile organisms. Three common chemical preservatives for stool samples are also described: formalin, Schaudinn's fluid, and MIF.

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Kagami Taiga
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66 views2 pages

Stool Sample Collection and Contamination

This document discusses guidelines for stool sample collection and analysis for clinical parasitology experiments. It outlines reasons for rejecting stool samples, such as improper transport temperature or container. It also discusses patient preparation, including obtaining patient identifiers and fasting status. Contamination of stool samples after analysis could affect results, such as contamination with urine, which can eliminate motile organisms. Three common chemical preservatives for stool samples are also described: formalin, Schaudinn's fluid, and MIF.

Uploaded by

Kagami Taiga
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© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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COLLEGE OF MEDICAL LABORATORY SCIENCE

Clinical Parasitology
Experiment #2: Unit Task
MARCOS, LIZ ANDREA E.
BSMLS 3-Y1-5

1. Discuss the grounds for rejection of a stool sample.


a) Improper transport temperature.
b) Improper transport container or medium.
c) Prolonged transport time.
d) Unlabeled or mislabeled specimen.
e) Broken or cracked container.
f) Leaking specimen.
g) Dried-out specimen.
h) Inappropriate specimen for test requested.
i) Inadequate volume.
j) Specimen in fixative (for culture).
k) Duplicate sample in 24-hour period (for urine, sputum, feces culture.
2. Give an example of patient preparation.
It is also useful to understand the patient’s health status, which may have an influence
on test results.
a) Regulations require that at least two patient identifiers be obtained, usually
spelling of their name and their date of birth.
b) In addition, proper labeling of the specimen is also critical (patient’s name,
hospital number or date of birth, time and date of collection, phlebotomist’s
name).
c) Fasting status.
d) Patient diagnosis.
e) Correct test ordered.
3. Discuss the effect if the following contamination of the stool specimen following analysis:
a) Urine
⎯ Stool samples should be collected in a clean, wide-mouthed plastic
container with a secure cover. Water and urine should not be used to
contaminate the specimens since water can include free-living organisms
that might be mistaken for human parasites and urine can eliminate motile
organisms.
b) Soil
⎯ The most important risk factor for various human parasitic illnesses is soil
contamination with parasite eggs, infective larvae, cysts, and oocysts.
Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), Necator
americanus, and Ancylostoma duodenale are the intestinal nematodes
that are spread through soil (hookworms). The soil offers suitable

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COLLEGE OF MEDICAL LABORATORY SCIENCE
Clinical Parasitology
Experiment #2: Unit Task
conditions for the development of infective stages in the life cycle of these
worms. Furthermore, the soil protects the infective stages for a period of
time, during which it may come into touch with a susceptible individual via
the mouth or skin. The eggs or larvae of parasites can survive in the warm
and damp soil of tropical and subtropical areas.
c) Toilet water
⎯ Never take the sample out of the water in the toilet bowl and do not allow
urine to touch it. If your child urinated at the same time, do not collect this
stool. Toilet water and urine will destroy the germs or parasites.
4. Give 3 chemical preservatives utilized preservation of stool specimen and give their
specific uses.
a) Formalin
⎯ Has been used for many years as an all- purpose fixative that is
appropriate for helminth eggs and larvae and for protozoan cysts, oocysts,
and spores. Two concentrations are commonly used: 5%, which is
recommended for preservation of protozoan cysts, and 10%, which is
recommended for helminth eggs and larvae.
⎯ To help maintain organism morphology, the formalin can be buffered with
sodium phosphate buffers.
b) Schaudinn’s Fluid
⎯ Designed to be used with fresh stool specimens or samples from the
intestinal mucosal surface.
⎯ Provides excellent preservation of protozoan trophozoites and cysts.
⎯ Not generally recommended for use inconcentration procedures.
c) MIF / Merthiolate-Iodine-Formaldehyde
⎯ A good stain preservative for most kinds and stages of parasites found in
feces.
⎯ It is used with all common types of stools and aspirates; protozoa, eggs,
and larvae can be diagnosed without further staining in temporary wet
mounts, either made immediately after fixation or prepared several weeks
later.
⎯ Some laboratories maintain that a permanent stained smear can be
prepared from specimens preserved in MIF, most laboratories using such a
fixative examine the material only as a wet preparation.

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Common questions

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Formalin is used because it fixes helminth eggs, larvae, protozoan cysts, oocysts, and spores. In a 5% concentration, it is recommended for preserving protozoan cysts, whereas a 10% concentration is better for helminth eggs and larvae. Sodium phosphate buffers can be added to maintain organism morphology .

Schaudinn’s Fluid provides excellent preservation of protozoan trophozoites and cysts. It is designed for use with fresh stool samples or samples from the intestinal mucosal surface, although it is not recommended for concentration procedures .

Contamination by urine or toilet water should be avoided because it can destroy organisms that need preservation for accurate analysis. These contaminants might also interfere with identifying parasites, leading to erroneous results .

Soil can contain parasite eggs, infective larvae, cysts, and oocysts from intestinal nematodes like Ascaris lumbricoides and hookworms. Contaminated soil offers favorable conditions for these parasites to develop, survive, and potentially infect individuals via ingestion or skin contact .

Duplicate samples submitted within a 24-hour span may result in redundant testing, possibly yielding identical or misleading information without added diagnostic value. This redundancy could lead to resource wastage and unnecessary retesting .

Insufficient specimen volume can compromise the reliability of parasitological analyses by not providing enough sample for confirmatory testing, leading to potentially inaccurate results and interpretations .

MIF is used for preserving stool specimens for parasitology as it acts as a stain preservative suitable for different stages of parasites. It allows diagnosis without additional staining and can be employed with various stool types and aspirates. Wet mounts can be made immediately or weeks later, although permanent stained smears are less common .

Critical patient preparation elements include the use of at least two identifiers (name and birth date), proper specimen labeling (patient’s name, birth date, collection time, phlebotomist’s name), and consideration of fasting status, patient diagnosis, and correct test ordering .

Urine contamination in a stool specimen can eliminate motile organisms and introduce substances that may interfere with analysis. It can destroy potential parasites and affect the specimen's integrity, leading to inaccurate results .

Stool samples can be rejected based on improper transport temperature, incorrect transport container or medium, prolonged transport time, unlabeled or mislabeled specimens, broken containers, leaking or dried-out specimens, inappropriate samples for the test requested, inadequate volume, specimens in a fixative when culture is required, and duplicate samples within a 24-hour period for culture tests .

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