At a glance
Also known as
Bacterial Culture, stool; Faeces Culture
Why get tested?
To determine whether you have an infection of your digestive tract due to the presence of disease-causing (pathogenic)
When to get tested?
When you have diarrhoea, abdominal cramps, with or without fever, lasting more than a few days
A fresh stool sample or one that has been placed in a transport medium (a collection vial containing a preservative)
Test preparation needed?
What is being tested?
The stool culture is a test that detects and identifies bacteria that cause infections of the lower digestive tract. The test distinguishes between the types of bacteria that cause disease () and the types that are normally found in the digestive tract (). The test helps to determine if pathogenic bacteria are the cause of gastrointestinal symptoms (gastroenteritis). It is important to note that viruses, such as norovirus, cause many cases of diarrhoea in the community and will not be identified on a bacterial stool culture. Viral studies on stool specimens usually need to be requested separately.
The bacteria found in stool are representative of the bacteria that are present in the gastrointestinal tract. Certain bacteria and called normal flora or the inhabit everyone's gastrointestinal tract. They play an important role in the digestion of food, and their presence keeps a check on the growth of disease-causing bacteria. Sometimes, the balance of the normal flora may be affected by the administration of antibiotics; the drugs inhibit the growth of normal flora and allow bacteria resistant to the antibiotic to survive and overgrow the digestive tract. The normal flora may also be affected by anti-cancer drugs and when a person has a weakened , leading to bacterial overgrowth and symptoms such as diarrhoea and abdominal pain.
Pathogenic bacteria can enter and infect the digestive tract when someone eats food or drinks water that is contaminated (food poisoning). Examples of contaminated sources include raw or undercooked eggs, poultry or beef, unpasteurised milk, and untreated water from lakes, streams, and (occasionally) from community water supplies.
People who travel outside Australia, especially to developing nations, may face a greater risk of being exposed to disease-causing bacteria. Some of these bacteria may be true pathogens while others are strains of gastrointestinal bacteria that are normal flora for the local inhabitants but cause gastrointestinal distress to the tourist. Visitors may become infected by eating or drinking anything that has been contaminated with the bacteria, even things as simple as tap water, ice cubes in a drink, a fresh salad, or food from a vendor's stall.
The most common symptoms of a pathogenic bacterial infection include prolonged diarrhoea, bloody diarrhoea, mucus in the stool, abdominal pain and cramping, and nausea. If diarrhoea lasts more than a few days, it may lead to complications such as and electrolyte imbalance - this can be dangerous, especially in children and the elderly. Dehydration can cause symptoms such as dry skin, fatigue, and light-headedness.
Severely affected people may require hospitalisation to replace lost fluids and electrolytes.
Haemolytic uraemic syndrome is a serious complication that may occasionally arise from an infection with a toxin-producing strain of the bacteria Escherichia coli (E.coli). It is characterised by the destruction of red blood cells and kidney failure. The condition is most frequently seen in children, the elderly, and those with weakened immune systems.
Some of the most common pathogenic bacteria that cause infections in Australia and their most frequently encountered sources include:
- Salmonella - found in raw eggs (even sometimes in intact disinfected eggs), raw poultry, uncooked vegetables. Pets, such as lizards and turtles, may carry Salmonella in their intestines without being ill themselves. Some humans may become of Salmonella and can transmit the bacteria to other people.
- Shigella - found in food and water contaminated with stool, and from infected-person to person when careful sanitation is not observed; for instance, it can be a challenge to prevent the spread of Shigella within a family and in a daycare or nursing home setting since even a very few organisms may cause disease.
- Campylobacter - found in raw or undercooked poultry and is a common cause of bacterial diarrhoea in Australia. It may become especially serious if it spreads to the bloodstream, and it occasionally causes long-term complications such as arthritis and Guillain-Barré syndrome.
- Escherichia coli 0157:H7 and other Shiga toxin-producing E. coli (most strains of E. coli are considered normal flora and do not cause disease) - found in raw or undercooked hamburger/beef, and other products such as fresh vegetables contaminated with animal faeces; causes bloody diarrhoea and may lead to haemolytic uraemic syndrome.
- Clostridium difficile - may be present as part of the normal flora, but use of antibiotics can result in an overgrowth of these bacteria. Toxin-producing strains can cause diarrhoea and other serious complications.
A wide variety of other bacteria may sometimes cause diarrhoea. These may include: Aeromonas species, Staphylococcus aureus, Yersinia enterocolitica, Vibrio cholerae and other Vibrio species.
How is the sample collected for testing?
A fresh stool sample is collected in a sterile container. The stool sample should not be contaminated with urine or water. Once it has been collected, the stool should be taken to the laboratory within about an hour after collection or should be transferred into a vial containing a preservative and taken to the lab as soon as possible. For infants, a stool sample is sometimes collected with a swab of the rectum.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed