Stool SOP
Stool SOP
Stool SOP
Review date:
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Verified by:
Names: Name:
Title: …………………
Names :………… Laboratory Director
Signature :……………
Title::………………. Signature ………………….
Date:……………
Date :…………………
Date:……………..
REVISION HISTORY
Revised by Version Review date Effective date Description of change
NA 001 NA
1. INTRODUCTION
Legacy Pathology Laboratory aims to adhere to the International Standards related to Good Laboratory
Practice and the ISO 15189 accreditation process guidelines. The Laboratory uses Standard Operating
Procedures (SOPs) to facilitate adherence to these regulations.
3. USERS
Only Laboratory staff are authorized to use this procedure upon being trained and competently
ensured. However, the trainees should be allowed to use this SOP and the equipment under supervision.
4. PURPOSE OF THE EXAMINATION
Many parasites cause disease in human. Some of these parasites are excreted in stool; they are called
intestinal parasites. Intestinal parasites can be identified by examination of fresh stool samples. In
stool samples we can find worms (eg. Ascaris lumbricoides) and segments of worms (e.g. Taenia spp)
is visible to the eye. By microscopic examination of fresh stool samples, we can find eggs (e.g.
Hookworm) and larvae of worms (e.g. Strongyloides stercoralis). We also find protozoa trophozoites
(e.g. Amoeba) and cysts (e.g. Cyclospora cayetanensis). In heavy and moderate infection, a direct
smear examination with normal saline (0.9%) and/or iodine to stain cysts, is usually sufficient. For
light infections, a concentration of the stool sample might be required to find helminth (worm) eggs and
protozoa by microscopic examination.
5. PRINCIPLE AND METHODS OF THE PROCEDURE USED FOR EXAMINATION
When stool is emulsified in physiological saline (NaCl 0.9% w/v), parasites are conserved and
separated from fecal debris. Therefore, they can be easily detected, identified and counted using a light
microscope.
6. PERFORMANCE CHARACTERISTICS
(NA)
7. TYPE OF SAMPLES
Fresh stool sample at least 3g collected into a suitable size, clean, dry, leak-proof container.
8. PATIENT PREPARATION
( NA)
9. TYPE OF CONTAINER AND ADDITIVES
Stool container with applictor is required
- Glass slides
- Wooden applicator
- Grease pencil.
- Microscope.
d. Record the macroscopic appearance (presence of blood or mucus, texture (hard, soft, watery), smell,
color)
e. In case of several samples, immediately begin to analyze those that are liquid or show presence of
mucus or blood
g. If stool is watery, place a drop of stool directly on the slide, cover and examine on the microscope.
h. If stool is hard or soft, place a drop of NaCl 0.9% or iodine solution 1% on slide
i. Using a spatula, remove a small portion of sample (about the size of a match head) and mix with the
drop of saline or iodine and cover.
k. Identify any parasites found (mature, eggs, cysts, etc) or any other abnormalities
15. INTERFERENCES
(NA)
16. PRINCIPLE OF PROCEDURES FOR CALCULATING RESULTS
Count and report the number of parasites per High Power Field, Low Power Field or per Preparation
17. BIOLOGICAL REFERENCES INTERVALS
(NA)
(NA)
Many pathogenic parasites are excreted in stool. Often, when a person is infected with intestinal
parasites, other symptom such as anaemia, eosinophilia, diarrhoea and malabsorption are also
present. However diagnosis by physical examination is not sufficient to identify intestinal parasitic
infection. Stool examination is essential to identify parasites that cause the disease.
- Old Specimen or Sample delay; e.g. Amoebic trophozoites begin to degenerate within 1-2 hours
after collection. Always examine watery and blood-stained specimens first.
- High Temperature: Cysts, flagelates and eggs also undergo changes especially if the stool is left at
high temperatures; ambient temperature is sufficient.
- Specimens contaminated with dirt, water or urine. Urine or water may be damaging to trophozoites.
- Never use tincture iodine as it contains alcohol and it would destroy amoeba trophozoites
- Wrong identification: Refer to pictures if you are in doubt about structures that resemble eggs,
cysts or trophozoites.
24. REFERENCES
26.SIGNING PAGE
We, staff members of LEG/PATHLAB, do hereby certify that we have read, discussed and
understood the content of this SOP. We commit ourselves to abide by its spirit and shall strive to
comply and make it complied with.
27.AMENDMENT PAGE