Appendix 1. Stool specimens for culture


Before collecting stool specimens for culture, make sure that:
– Suspect cases have had diarrhoea for less than 4 days (high bacterial load) and have not received antibiotics;
– Stools have not been disinfected (do not collect stool from buckets as they often contain chlorine solution or other disinfectants).

1.1 Cary-Blair transport medium

– Open the tube, which already contains the swab and Cary-Blair transport medium.
– Soak the swab well in stool.
– Immerse the swab in Cary-Blair transport medium.
– Cut off the top part of the swab stick and reseal the tube tightly.
– Label the tube: code or name and surname, age, date and place of sampling.
– Complete the laboratory request form.

Transport at room temperature after inoculation. Protect the sample from direct light and excessive heat. The sample should reach the reference laboratory within 24 hours.

Note: before use, conserve Cary-Blair transport medium per manufacturer’s recommendations.

1.2 Filter paper method

– Open the tube, which already contains a disc of filter paper.
– Take hold of the paper with clean tweezers (‘sterilize’ the tweezers in a flame before each sample). Single use needles can be used as an alternative (one needle per sample).
– Soak the paper in stool and replace it in the tube.
– Add 2 to 3 drops of 0.9% sodium chloride to prevent the specimen from drying.
– Reseal the tube tightly.
– Label the tube: code or name and surname, age, date and place of sampling.
– Complete the laboratory request form.

Transport at room temperature. If the tube is closed tightly, the sample can be stored for up to 2 weeks from the time of collection. Protect the sample from direct light and excessive heat.


Note: for both methods, create a register to record the date and place of sample collection and date of shipment as well as results as they become available.