Laboratory diagnosis of infectious diarrhea

The microbiology laboratory, in conjunction with the medical staff, must determine a reasonable approach to the evaluation of diarrheal stools since the cost to rule out all potential pathogens is prohibitive and control of the use of laboratory services is now a major focus in all institutions. All...

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Bibliographic Details
Published in:Pediatric annals 1994-10, Vol.23 (10), p.570-574
Main Author: Hoshiko, M
Format: Article
Language:English
Subjects:
Bacterial Infections - diagnosis
Child, Preschool
Clinical Laboratory Techniques
Culture Media
Diarrhea - etiology
Etiology
Feces - microbiology
Feces - parasitology
Foodborne Diseases - diagnosis
Gastroenteritis - etiology
Geographic Location
Humans
Individualized Instruction
Infant
Laboratories
Microbiological Techniques
Microbiology
Parasitic Diseases - diagnosis
Patients
Virus Diseases - diagnosis
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Summary:The microbiology laboratory, in conjunction with the medical staff, must determine a reasonable approach to the evaluation of diarrheal stools since the cost to rule out all potential pathogens is prohibitive and control of the use of laboratory services is now a major focus in all institutions. All stool cultures should be examined for Campylobacter, Salmonella, and Shigella, the most common causes of inflammatory bacterial diarrhea in the United States. Special media for other pathogens should be added only if there is high regional endemicity or significant clinical suspicion. If a child has bloody diarrhea, a search for E coli O157:H7 is indicated. For patients with a history of raw seafood ingestion or foreign travel, the laboratory should be asked to screen specimens for Vibrio and Plesiomonas species. The report from the laboratory should specifically state what enteropathogens have been excluded, for example, "No Salmonella, Shigella, or Campylobacter isolated." A report of "negative" or "no enteric pathogens" is not very useful. Diagnosis of viral and parasitic enteritis and antibiotic-associated diarrhea require a variety of additional tests. Clinicians are encouraged to discuss these issues with the pathologist or microbiologist at their local laboratory and be familiar with community microbiology practice, particularly which organisms require a special request for the laboratory to attempt identification.
ISSN:0090-4481
1938-2359
DOI:10.3928/0090-4481-19941001-12