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Jan 7, 2022Print this page

Fecal Swabs: What to Look for in a Fecal Swab Test Kit

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A wide range of factors can contribute to gastrointestinal problems, including foodborne illnesses and other diarrhea-causing infections. Fecal swabs are a critical sample collection tool for gathering information about the bacterial source of the problem to aid in diagnosis. However, getting the best diagnostic information depends first upon using the right materials for sample collection and transport. 

What is a fecal swab?

A fecal swab sample may either be a rectal swab sample or a stool swab sample. Both sample types are preserved in a vial of medium and transported to a laboratory for testing that will help clinicians in the diagnosis of a range of gastrointestinal bacterial infections. 

Fecal stool swab vs fecal rectal swab

A fecal stool swab is typically collected by a patient at home and transferred to a healthcare setting, where a qualified professional inserts and rotates the provided collection swab into the sample before adding the sample swab into the vial of medium. A fecal rectal swab, however, is used by clinicians to collect samples directly from the rectum in a healthcare setting, and processed immediately by inserting and rotating the sample swab into the vial of medium. This diagnostic tool can be used to identify specific bacteria in the rectum that may be the cause of a range of gastrointestinal symptoms and illnesses.

Either sample can be added to the vial of medium using a flocked swab. The vial of medium is specially designed to preserve the viability of bacteria during transport from the collection site to the testing laboratory. It is important to ensure that the swab uses compatible transport media for accurate lab results. 

What’s included in a fecal swab kit?

A fecal swab kit includes everything that is needed to collect and preserve a rectal or stool sample for laboratory analysis. This includes:

  • A sterile pouch that contains a swab applicator for fecal rectal specimen collection or fecal stool specimen processing. It is critical that swabs not be used if the sterile peel has been damaged in any way.
  • A vial containing a transport medium. The vial should contain a secure lid, typically a screw-cap.
  • Directions for use. Since fecal stool samples can be collected at home by patients, it is important to provide clear directions for proper collection and handling of samples. Careful handling prevents changes in the microbiological conditions of the sample. 

The transport medium is specifically designed to preserve microorganisms during transport. This medium is made up of a salt solution containing phosphates and chloride salts that provide a buffering capability. Other included ingredients may ensure an oxygen-reduced environment that helps maintain the viability of pathogens during transport.

Best results occur when the specimen is stored according to the manufacturer’s instructions and processed rapidly after collection. 

What to look for in a fecal swab

The accuracy of diagnosis depends upon the use of the appropriate tools and techniques for collecting fecal rectal and fecal stool samples. While cotton swabs have been used for this task in the past, flocked swabs offer a significant advantage in diagnostic accuracy.

Flocked swabs feature synthetic fibers of varying lengths specially formulated to provide the highest possible collection and elution capacity. This unique microstructure of the individual fibers allow for higher rates of bacteria recovery than other materials. 

Fecal swab products

Swabs specially designed for stool sample collection should carry proof of testing for bacteria recovery performance. No chemicals should be added to the swab tip fibers, as this may impact diagnosis. The use of medical grade plastics for fecal swab handles and transport vials ensures the safe transport of potentially infectious materials. 

Get the Guide to Stool Sample Collection

How to collect stool & fecal samples

The accuracy of your test results depends upon close attention to proper test procedure. To use a fecal swab appropriately, follow the directions below.

How to use a rectal swab:

  1. Peel open sterile pouch and remove the vial of medium and the swab. Do not touch the swab tip.
  2. Collect rectal specimen by inserting the swab through the rectal sphincter 2 to 3 cm and gently rotate.
  3. Withdraw and examine to make sure there is fecal material visible on the swab tip.
  4. Using appropriate aseptic technique, remove the vial cap and insert the swab into the vial. Visually confirm the “Max Fill” line is not exceeded. If the sample exceeds the “Max Fill” line, the sample should be discarded and a second sample should be collected.
  5. Holding the swab shaft between thumb and finger, mash and mix the stool specimen against the side of the vial to evenly disperse and suspend the specimen in the medium.
  6. Place the swab shaft with the breakpoint against the rim of the vial. Bend and break the swab shaft at the breakpoint.
  7. Replace the vial cap, securing tightly. Record patient information in the space provided on the vial label and transport the specimen to the laboratory.

How to use a fecal swab:

  1. Have the patient pass stool into a clean, dry pan or a special container mounted on the toilet.
  2. Peel open sterile pouch and remove the vial of medium and swab. Do not touch the swab tip.
  3. Collect a small amount of stool by inserting the entire tip of the swab into the stool sample and rotate it. Select bloody, slimy or watery area of stools as possible. Make sure there is fecal material visible on the swab tip.
  4. Remove the vial cap and insert the swab into the vial. Ensure the “Max Fill” line is not exceeded. If the sample exceeds the “Max Fill” line, the sample should be discarded and a second sample collected.
  5. Holding the swab shaft between thumb and finger, mash and mix the stool specimen against the side of the vial to evenly disperse and suspend the specimen in the medium.
  6. Place the swab shaft with the breakpoint against the rim of the vial. Bend and break the swab shaft at the breakpoint.
  7. Replace and secure the vial cap. Shake secured vial to assure sample is uniformly diluted.

For complete directions and guidance on how to collect and transport a stool sample, download our guide.

Still have questions? We can help. Puritan provides specially formulated fecal swabs designed for the most accurate diagnosis. Contact us with questions and we can guide you to the right solution for your clinical needs.

Collect a Fecal Sample

Topics: Media Transport Systems, Medical, Diagnostics, Specimen Collection Procedure

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