Stool examination for enteropathogenic germs is an examination of the stool that aims to detect bacteria or other pathogens such as viruses, fungi or parasites that are harmful to the intestine.
Different methods of examination can be distinguished, such as culturing in stool cultures or microscopic imaging. Serological methods are also feasible.
The following bacteria, viruses, parasites and fungi are obligate (absolutely) pathogens:
Bacteria
- Aeromonas
- Bacillus cereus
- Campylobacter intestinalis/jejuni
- Clostridium botulinum, -difficile, -perfringens
- Enteropathogenic E. coli (in infancy).
- Enterohemorrhagic E. coli
- Plesiomonas
- Salmonella
- Shigella
- Vibrions
- Yersinia
Viruses
- Adenoviruses
- Noroviruses
- Rotaviruses (in infancy).
Parasites
- Amoebae*
- Ancylostoma
- Ascaria
- Blastocystis hominis
- Cestodes (tapeworms)
- Cryptosporidia*
- Lamblia*
- Oxyurans (pinworms) – are often not reliably detectable in stool samples; by adhesive tape test this succeeds better: For this purpose, a strip is pressed against the anal region several times in the morning and immediately removed again; then the adhesive tape strip is glued to a slide and sent to the laboratory; the eggs adhering to it can be reliably detected under the microscope
- Schistosomes
- Strongyloides
- Trichuris
* After living abroad
Mushrooms
- Candida – disease likely at > 106 fungi/g stool.
Facultative pathogenic bacteria include:
- Citrobacter
- Proteus
- Klebsiae
- Enterobacter
- Edwardsiella
- Pseudomonas
The procedure
Material needed
- Fresh stool sample
Preparation of the patient
- Not necessary
Disruptive factors
- Use only fresh stool samples → immediate processing
- Perform examination in the acute stage of disease
Indications
- Suspected intestinal infection
- Acute/chronic diarrhea (diarrhea)
- Suspected symbiosis disorder – disturbance in the composition of the intestinal flora.
- Suspicion of Candida infection
- Suspicion of parasite infestation
Interpretation
Detection of enteropathogenic pathogens in stool.
Fungi
- Symbiotic disorder – usually manifested by diarrhea (diarrhea), meteorism (flatulence), or constipation (constipation)
Other indications
- In the case of negative failure of the stool samples, but suspicion remains, two more stool samples should be examined
