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Ova and Parasite Examination Stool

This document provides information about a lab test called an ova and parasite examination of stool. It describes what the test is, how to collect and transport stool specimens, limitations of the test, and interpretation of results.

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Nazaqat Farooq
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38 views5 pages

Ova and Parasite Examination Stool

This document provides information about a lab test called an ova and parasite examination of stool. It describes what the test is, how to collect and transport stool specimens, limitations of the test, and interpretation of results.

Uploaded by

Nazaqat Farooq
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Lab Dept: Microbiology

Test Name: OVA AND PARASITE EXAMINATION, STOOL

General Information

Lab Order Codes: OAP

Synonyms: O & P Exam, stool; Stool for Ova and Parasites; Feces for Ova and
Parasites; Parasitology examination

CPT Codes: 87177 – Ova and parasites, direct smears, concentration and
identification
87209 – Smear, primary source with interpretation; complex special
stain for ova and parasites

Test Includes: Examination of stool for intestinal parasites by direct/concentrated


microscopic exam and trichrome stain. This test does not include:
Cryptosporidium, Cyclospora, Microsporidium or Pinworm. If only
Cryptosporidium or Giardia are requested, refer to specific listing for
Cryptosporidium/Giardia FA. If pinworm is requested, refer to Pinworm
Preparation.

Logistics

Lab Testing Sections: Microbiology

Phone Numbers: MIN Lab: 612-813-5866

STP Lab: 651-220-6555

Test Availability: Daily, 24 hours;

Test performed 0700 – 1500. Requests are limited to one specimen per
day.

Turnaround Time: 1 - 2 days

Special Instructions: ● Specimen site and date/time of collection are required for
specimen processing.
● Provide clinical diagnosis and travel history or suspected parasite on
request form. If pinworm is requested, refer to Pinworm Preparation.

Warning: Any stool collected from a patient infected with parasites is


highly infectious. Use extreme caution when Entamoeba histolytica,
Hymenolepis nana, and Taenia sp. are suspected.

Specimen
Specimen Type: Fresh random stool or aspirated stool; early morning sputum; mid-day
urine

Container: Onsite collections: Plastic, leak-proof container

Offsite collections: O&P preservative kit (available from Materials,


Storeroom Item# 14574)

Volume: 5 - 10 mL liquid stool or 5 – 10 grams of formed stool

100 mL urine – entire mid-day urine collection with last voided portion
containing blood and mucous

1-3 mL sputum

Note: If O&P kit is used, make sure to add specimen to “fill” lines.

Collection: Recommendations:

● Maximum of 3 specimens, collected on separate days within a 10-day


time period.
● Do not submit more than one specimen per day. Many organisms
do not appear in stool specimens in consistent numbers on a daily
basis; few or no parasites may be passed on one day, with many
passed the next day.
● Parasite exams on patients hospitalized >3 days are not productive
and should not be ordered unless special circumstances exist.

Fresh Stool:

Onsite collections ONLY:


1. Collect stool in a clean, dry bedpan or on a newspaper over the
toilet. Do not contaminate specimen with urine, residual soap or
disinfectants, which will destroy amoebae.
2. Transfer to a plastic, leak-proof container.
3. If a delay >1 hour in transport is expected, place specimen in O&P
preservative kit. Refer to Special Processing.
4. Those portions of stool containing blood and mucous are especially
significant and should be transferred into the container.
5. Specimens in diapers are not acceptable. Pediatric patients with
severe diarrhea may use a U bag collection system. Place the bag over
the anal area in an attempt to retrieve the specimen before it soaks into
the diaper. The diaper can also be reversed with the plastic side toward
the skin to prevent the specimen from soaking into the diaper. Transfer
specimen into a plastic, leak-proof container.

Offsite collections:
See Special Processing for O&P preservation

Sputum (Expectorate):

Onsite collections ONLY:


1. Collect early morning specimen under the direct supervision of a
nurse or physician.
2. Have patient rinse or gargle with water to remove superficial flora.
3. Instruct patient to cough deeply to produce a lower respiratory
specimen.
4. Exam specimen to make sure it contains thick mucus. Do not submit
saliva.
5. Transport directly to the laboratory (< or =15 min) since specimens
must be examined with one hour of collection.

Urine:

Onsite collections ONLY:


1. Collect mid-day urine specimen in a sterile container. Peak egg
excretion occurs between noon and 3 pm.
2. For patients with hematuria, eggs are associated with the terminal
(last voided) portion of the specimen containing blood and mucus.
3. Transport directly to the laboratory (< or =15 minutes) since
specimens must be examined within one hour of collection.

Special Processing: Instructions for O&P preservative kit: 2 vials, one containing 10%
formalin (pink) and one containing Zn-PVA (gray).

Caution: The liquid preservative in the vials is poisonous.

1. Fill each vial by using the spoon built into the lid of the vial and
transferring small scoopfuls of stool from areas which appear bloody,
slimy or watery until the contents rise to the “Fill Here” red line. Do not
overfill.
2. If the stool is formed, sample small amounts from each end, sides
and the middle.
3. Mix the contents of the vials with the spoon. Screw cap on tightly and
shake the vial vigorously until the contents are well mixed. Make sure
there is no leakage.
4. Label vials with patient’s name, date and time of collection.
5. Store vials at room temperature.
6. Return collection kit to laboratory within 72 hours.

Storage/Transport: Onsite collections: Transport to the laboratory immediately.

Offsite collections: Do not refrigerate, store at room temperature.


Specimens must be promptly transported to the laboratory, with the
next available courier.

Patient Preparation: Do not use antacids, barium, bismuth, antidiarrheal medication,


antibiotics, or oily laxatives for 5-10 days prior to collection.
Sample Rejection: No diapers accepted. Unpreserved specimens (fresh) will be rejected
with a transit time exceeding 1 hour after collection; specimens
containing interfering substances (e.g., antidiarrheal compounds,
antibiotics, antacids, oils, bismuth, or barium); more than one specimen
per day; specimen not submitted in appropriate transport container;
improperly labeled specimen; insufficient volume; specimen
contaminated with toilet water or urine; external contamination. If an
unacceptable specimen is received, the physician or nursing station will
be notified and another specimen will be requested before the
specimen is discarded.

Interpretive

Reference Range: No ova or parasites seen

Limitations: One negative result does not rule out the possibility of parasitic
infestation.

Methodology: Concentrated microscopic exam and trichrome stain

Additional Information: Amebae and other parasites cannot be seen in stool containing barium.
Formed stool are more likely to contain amebic cysts and helminth
eggs. Soft or liquid stools are more likely to contain trophozoites of the
protozoa. Liquid stools must be examined within 30 minutes of
passage, not 30 minutes from the time the specimen arrives in the
laboratory. Soft (semi-formed) specimens should be examined within 1
hour of passage. If these time frames are not possible, the specimen
should be preserved in 10% formalin and Zn-PVA. Formalin will
preserve the protozoan cysts, larvae and eggs of the helminthes. Zn-
PVA will preserve the trophozoite stage of the protozoa. Immediate
examination of formed stools is not as critical as the protozoan cysts will
remain intact generally up to 24 hours.

References: Cook, JH, and M Pezzlo (1992). Specimen receipt and accessioning.
Section 1. Aerobic bacteriology, 1.2.1-4. In HD Isenberg (ed) Clinical
Microbiology Procedures Handbook. American Society for Microbiology,
Washington DC

Miller, J Michael (1999) A Guide To Specimen Management in Clinical


Microbiology, American Society for Microbiology, Washington DC

Miller, J Michael, and HT Holmes (1999) Specimen Collection,


Transport, and Storage In PR Murray et al, (ed), Manual of Clinical
Microbiology, 7th edition, American Society for Microbiology,
Washington DC, pp 33-104

Garcia, LS, RY Shimizu and P Deplazes (2003) Specimen Collection,


Transport, and Processing; Parasitology In PR Murray et al, (ed),
Manual of Clinical Microbiology, 8th edition, American Society for
Microbiology, Washington DC, p 1908
Updates: 1/20/2009: Amended formed stool volume, previously listed as 1 gram.
11/20/2014: Offsite information added.
2/23/2017: CPT update, stain method previously listed s 88312.
2/19/2020: Updated Storage/Transport.

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