PROPER COLLECTION AND PRESERVATION OF SPECIMEN

I.

Introduction:

Stool specimen for the laboratory must be collected in any type of clean
disposable container. This can he performed either in the hospital ward or at home. If
the collection is done at home the patient must be clearly instructed not to collect
specimens in waxed paper or paper of any sort, or in small jars or bottles form which the
specimen would be difficult to remove.
Some tests require preparation for the patient before the collection of stool.
The patient should not take iron or other metallic compounds for 4-6 days before the
collection of specimen for the examination of intestinal parasites and patient should not
be under certain medications for at least 2 weeks before specimen collection. It is best
to write these instructions and provide them to the patient prior to the collection of stool.
Specimen collection is usually better in the hospital environment.
Stool specimen in the morning before breakfast is most desirable and should be
processed by the laboratory within 2-3 h after discharge (warm stool). Alternatively,
specimens can be collected at any time and should be processed promptly. If stool is
not discharged by the normal way, a glycerine suppository or an appropriate purgative
can be used: this, however, does not provide the correct picture of the physical
characteristics
Always collect the specimen without the admixture of urine. If possible, have the patient
urinate first. If the specimen is collected in a bedpan, immediately pour off any urine and
transfer the specimen to a suitable container. If the stool is mostly liquid, transfer the
sample to a wide mouth plastic bottle with a tight lid for delivery to the laboratory.
The specimen must be properly labelled with the name of the patient, sex, age,
preliminary diagnosis requesting physician, hospital name, ward and bed number
Deliver specimens to the laboratory immediately, since decomposition proceeds rapidly.
If delay is expected, refrigerate. Addition of a preservative may be necessary in case of
microbiological specimens. Specimens for chemical examination of stool need to be
preserved.
All specimens after examination are disposed off in the sewer. Do not dispose
the specimen in the laboratory sink.

Objectives:

At the end of the exercise, the student should be able to:

II.

Discuss the proper way of collecting stool specimen

Enumerate factors that affect collection and preservation of stool
specimen
Collect, label and apply appropriate preservative measures or agents
on the stool specimen
Identify various ways preserving the stool specimen if they are not to
be examined immediately;
Answer correctly the review questions.

Flowchart:

o
r

URINE
I.

watEr

Collect your fecal specimen in a clean bedpan or wide mouthed

container, avoiding contamination with urine or water as these
adversely affect the parasites that may be present.

II.
With the aid of an applicator stick or
tongue depressor, transfer approximately
teaspoon of a liquid sample or a grapesized amount of soft, semi-formed, or
formed stool sample into a sterile colorless
bottle.

Name:
Sex:
Date and time of
collection:

II.

IV.

III.
Seal with a tight fitting lid into the
bottle, to permit the preservation of
moisture in the specimen.
IV.
The container with specimen
should be labeled clearly with the following
information: Name, age, sex, date and time
of collection.

Obtained results and interpretation

1. Give some reasons when a stool specimen may be rejected or when it is rendered
unacceptable. Discuss each briefly.

A late stool sample or unpreserved sample

- Trophozoites of some amebae or eggs of some helminths may disintegrate
if not examined or preserved within a short time.
Insufficient stool sample
- Because many intestinal organisms are shed into the stool irregularly, a
single stool specimen may be insufficient to detect an intestinal parasite
Stool contaminated with water or urine
Stool specimens should never be collected from toilet bowls; such a practice
might contaminate the specimen with urine or water, resulting in the
destruction of trophozoites or introducing of free-living protozoa,
Stool sample without a label
- The specimen container should be labeled with the patients\s name and
identification number, the physicians name, and the date and time of
sample collection.

2. Identify specimen examined in parasitology, other than stool and give

corresponding parasites that could be detected.
Specimen:
Blood

Tissue biopsies
Vaginal Discharge
Water

Specific Parasite identified/isolated

Some parasites spend most or all of their life
cycle in the bloodstream, such
as Babesia and Plasmodium species.
Parasites, such as Trypanosoma cruzi,
might be found in the blood early in an
infection (the acute phase) and then at much
lower levels later (the chronic phase of
infection).
Leishmania infantum parasites
Trichomonas Vaginalis
Cryptosporidium and Giardia intestinalis

Reference:
Textbook of Diagnostic Microbiology
By Connie R. Mahon, Donald C. Lehman, George

Delmars Manual of Laboratory and Diagnostic Tests

By Rick Daniels

Clinical Parasitology: A Practical Approach

By Elizabeth Zeibig

V. Update

The Fe-Col faecal collection device provides a simple, easy-to-use, efficient and
hygienic stool collection method. For patients they offer a quick, simple solution to a
frustrating and potentially messy problem. For the laboratory testing the faeces, they
prevent the risk of sample contamination, ensuring fewer test errors.

Faeces are tested for a variety of reasons, most commonly for the determination of the
presence of bacteria or parasites, for fat content, for faecal occult blood which can

indicate bowel cancer and for Calprotectin which can help discriminate between
Inflammatory bowel disease (IBD) or Irritable bowel syndrome (IBS).

Unlike most other laboratory tests, stool samples are normally collected by the patient at
home. However, many people find this collection process difficult, unpleasant and
unhygienic to perform. Cling film, paper plates, and copious amounts of toilet paper are
the most commonly used methods, but these are then difficult to dispose of and may
cause plumbing blockages.

More than 50% of patients responding to screening take a stool sample directly from the
toilet bowl. Sampling a stool from the toilet basin is technically difficult, but also creates
potential measurement errors, due to loss of content from the stool into the surrounding
water, or contamination from toilet sanitisers and toilet water additives.
The Fe-Col device has been developed to solve these problems: a unique, disposable
stool collector, which is easily and securely placed on the toilet and can be totally
flushed away after use.