Enteric Bacteriology / Protozoa PCR

The instruction below is for the collection of a fecal specimen from one patient for the detection of enteric bacteria by culture or protozoa by PCR using a Cary-Blair transport medium vial. Where possible, specify on the test requisition which microbial agent(s) is of interest to investigate.

For further information about enteric bacteriology culture or protozoa PCR specimen collection and testing, refer to PHO’s Enteric Bacteria (including Salmonella, Shigella, STEC, Plesiomonas, Yersinia, Aeromonas, Vibrio, or Campylobacter) – Culture and PCR and Enteric Protozoa (Cryptosporidium, Cyclospora, Dientamoeba, Entamoeba, and Giardia) – PCR webpages.
Note: Do NOT use the transport medium for C. difficile or Clostridium perfringens antigen testing, instead use the Clostridioides Kit.
Instructions:

1. Wash your hands with soap and water and then dry your hands.
2. Obtain the specimen collection vial. NOTE: Do NOT drink any liquid (i.e. transport medium) inside the vial.
3. Check that the vial is not expired based on the expiry date on the vial. If expired, return the vial to the location where it was obtained.
4. If not already done, label the vial with the date of collection, full name, and one other unique identifier such as date of birth or health card number. NOTE: The date of collection, name, date of birth, and/or health card number on each vial label MUST match exactly the information given on the test requisition. Mismatched information may result in specimen cancellation or testing delay.
5. If needed, urinate first and flush (or change diapers if wet) before specimen collection to avoid mixing stool and urine.
6. Defecate into a clean and dry wide-mouthed receptable (e.g. chamber pot) or on a clean disposable surface (e.g., aluminum pie plate, plastic cling wrap, or newspaper placed over the open rim of the toilet bowl). For persons wearing diapers, obtain fecal specimen directly from the feces-soiled diaper. NOTE: Do NOT bring the feces into contact with water or urine in the toilet bowl or in the diaper.
7. Uncap the vial.
8. Using the spatula inside the cap, scoop different sections of the fecal specimen, preferably areas that may have mucus or blood and both the start and the end of the fecal specimen in case organisms are only present in some portions of the feces.
9. Transfer the scooped fecal portions carefully into the vial, adding enough feces to reach the fill line indicated on the vial. NOTE: Do NOT overfill the vial.
10. Replace the cap and screw the cap tightly.
11. Wipe and/or clean your perineum and dispose of the remaining feces as usual.
12. Wash your hands with soap and water and then dry your hands.
13. Shake the vial vigorously for a few seconds to mix the liquid (i.e. transport medium) inside with the feces.
14. Place the vial in the biohazard bag.
15. Peel the adhesive at the bag opening to seal the bag.
16. Fold and insert the filled-out test requisition in the pocket on the outside of the sealed biohazard bag.
17. Give the specimen to the community specimen collection site, hospital laboratory, institution, or local public health unit on the same day that the specimen was collected. NOTE: Do NOT delay submission of the collected specimen, submit it as soon as possible.
18. At the specimen collection site, hospital laboratory, institution, or local public health unit, store the biohazard bag containing the specimen vial in a clean and uncluttered refrigerator until shipped to PHO’s laboratory.

Storage of unused kits: Do NOT use expired kits. Check expiry dates on kits before collecting specimens, Kits may be used until the last day of the month of expiry. Kits can be stored at room temperature until stated expiry date.

Disposal of expired kits: The expired kits may be returned by the community specimen collection site, hospital laboratory, institution, or local public health unit to PHO for disposal if they are not a registered waste generator. Returns of expired kits may be clearly indicated as “Expired Kits” on the shipping container. PHO does not cover shipping costs for returned items. For return authorization and further directions, contact PHOL.Warehouse@oahpp.ca .