Bacteriological examination of stool- laboratory analysis, during which the material is inoculated on special nutrient media in order to identify pathogenic, beneficial, opportunistic microorganisms, their qualitative and quantitative assessment. Registers the intensive growth of microorganisms that cause the development of intestinal dysbiosis. The study also establishes the type of infection (salmonella, shigella, fungi, adenoviruses). Allows you to control the dynamics of the treatment, assess the composition of the microflora and its sensitivity to antibacterial and antimycotic agents for the correct selection of medications.
Main indications
Indications for bacteriological analysis of stool include:
- the need to study the qualitative and quantitative composition of intestinal microflora;
- suspicion of the development of an infectious disease (typhoid, dysentery, salmonellosis);
- diagnosis of bacterial carriage;
- treatment control.
How to prepare for the procedure
To obtain reliable results, you must follow some recommendations. Since antibacterial agents have a detrimental effect on microflora, performing an analysis immediately after taking them is not recommended - the picture will be distorted. The examination is carried out 3 weeks after completion of the antibacterial course.
Taking probiotics can also distort the test results, so you should wait 20 days after finishing treatment.
Collection and delivery of material is carried out as follows:
- feces are collected after a bowel movement performed without stimulation by laxatives or an enema;
- the material is collected with a special spatula into a sterile container;
- The material should be delivered to the laboratory within the next 3 hours after collection. If this fails, storage in the refrigerator at a temperature of 4-5 degrees is allowed, but no longer than 9 hours.
Usually, the presence of pathogenic microorganisms (according to the results of bacterial culture) indicates the development of dysbacteriosis, which is expressed in a violation of the normal composition of the microflora.
Features of the analysis
Based on the results of the analysis, a conclusion is made about the state of the microflora, which is assessed by degrees:
1st degree- minor changes in the aerobic part, the presence of pathogenic flora is not noted;
2nd degree- the presence of changes in lacto- and bifidobacteria, an increase in the number of Escherichia;
3rd degree- a sharp reduction in bifido-, lactoflora or its complete absence, an increase in the number of fungi, staphylococci;
4th degree- severe disturbances of microbiocenosis, a large number of opportunistic flora, the presence of fungi.
Stool culture is an informative technique that makes it possible to accurately determine the composition of the microflora and prescribe the correct treatment.
The study of bacteriological analysis of feces makes it possible to identify pathologies in the body. With the help of such testing, a specialist will identify the chemical components in the collection and also determine the properties of feces.
Criteria to be taken into account when performing bacteriological analysis la:
- The collection should contain no more than 80% water. This is the passing rate.
- The quantitative indicator of collection is 100-200 milligrams.
- If a specific odor appears, certain diseases of the body can be identified after testing.
- The color of the material will depend on what food the patient took. It may be different.
- Normal acidity is 6.5-7.0.
Such transcripts should be made only in the clinic with the participation of a specialist. This will help ensure an accurate result of the bacteriological examination of the stool analysis.
Also, bacteriological analysis of stool can be carried out to diagnose possible internal bleeding. There can be blood in the masses for a variety of reasons.
These are:
- Colitis.
- Cirrhosis.
- Haemorrhoids.
- Tuberculosis and other issues.
In most cases, bacteriological examination of stool tests for hidden bleeding is carried out when it is necessary to obtain a result for hemoglobin, to identify helminth eggs or to identify another infection in the body. This will help to quickly diagnose the disease and begin to treat it on time.
Preparing for a tank stool test
To determine the correct results of testing the collection in a child and an adult, a bacteriological analysis must be done correctly. To harvest crops, there are certain rules that must be followed. Doctors give the following recommendations:
- 3 days before the culture is collected, a child or adult should refrain from taking medications. This will help avoid the introduction of foreign substances into the collection and may give a more accurate culture test result.
- Also, before taking the crop, you should adhere to a certain diet. You should avoid eating foods that can change the color of stool, such as smoked meats. Such a diet should be prescribed by the attending physician during a preliminary examination. This will also help to more accurately determine the results of culture testing.
- The crops should be handed over in a clean container, which can be purchased at a pharmacy. You should defecate only in clean dishes. It is also worth trying to prevent urine from getting into the feces. Next, the seed should be placed in a container using a special spoon and sent to the laboratory.
- Before handing over the crop, the child should wash his butt. Then wipe the perineum dry with a clean towel.
During this procedure, the child should collect 6-10 milligrams of material. For an adult, this norm will be higher. The intestines should be emptied on an empty stomach in the morning of the day the doctor prescribed the procedure. Also, before taking the collection, you should refrain from cleaning your mouth with a toothbrush, so as not to cause gum bleeding. For oral hygiene, you can use special solutions to rinse the cavity.
Place the container away from the freezer so that the material does not freeze. In order to test the material as accurately as possible, you should strictly adhere to all the recommendations of your doctor for a certain period.
Standards for stool analysis for dysbacteriosis
| Children under 1 year | Older children | Adults | |
| Bifidobacteria | 10 10 – 10 11 | 10 9 – 10 10 | 10 8 – 10 10 |
| Lactobacilli | 10 6 – 10 7 | 10 7 – 10 8 | 10 6 – 10 8 |
| Escherichia | 10 6 – 10 7 | 10 7 – 10 8 | 10 6 – 10 8 |
| Bacteroides | 10 7 – 10 8 | 10 7 – 10 8 | 10 7 – 10 8 |
| Peptostreptococci | 10 3 – 10 5 | 10 5 – 10 6 | 10 5 – 10 6 |
| Enterococci | 10 5 – 10 7 | 10 5 – 10 8 | 10 5 – 10 8 |
| Saprophytic staphylococci | ≤10 4 | ≤10 4 | ≤10 4 |
| Pathogenic staphylococci | — | — | — |
| Clostridia | ≤10 3 | ≤10 5 | ≤10 5 |
| Candida | ≤10 3 | ≤10 4 | ≤10 4 |
| Pathogenic enterobacteria | — | — | — |
Bifidobacteria
Norm of bifidobacteria
About 95% of all bacteria in the intestines are bifidobacteria. Bifidobacteria are involved in the production of vitamins such as B1, B2, B3, B5, B6, B12, K. They help absorb vitamin D, fight “bad” bacteria with the help of special substances they produce, and also participate in strengthening the immune system.
Reasons for the decrease in the number of bifidobacteria
- Enzymatic diseases (celiac disease, lactase deficiency)
- Immune diseases (immune deficiencies, allergies)
- Change of climate zones
- Stress
Lactobacilli
Norm of lactobacilli
Lactobacilli occupy about 4-6% of the total mass of intestinal bacteria. Lactobacilli are no less useful than bifidobacteria. Their role in the body is as follows: maintaining the pH level in the intestines, producing a large number of substances (lactic acid, acetic acid, hydrogen peroxide, lactocidin, acidophilus) that are actively used to destroy pathogenic microorganisms, and also produce lactase.
Reasons for reducing the number of lactobacilli
- Drug treatment (antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) such as analgin, aspirin, laxatives)
- Poor nutrition (excess fat or protein or carbohydrates, fasting, poor diet, artificial feeding)
- Intestinal infections (dysentery, salmonellosis, viral infections)
- Chronic gastrointestinal diseases (chronic gastritis, pancreatitis, cholecystitis, gastric or duodenal ulcers)
- Stress
Escherichia(E. coli typical)
Escherichia norm
Escherichia appears in the human body from birth and is present throughout life. They perform the following role in the body: they participate in the formation of B vitamins and vitamin K, participate in the processing of sugars, produce antibiotic-like substances (colicins) that fight pathogenic organisms, and strengthen the immune system.
Reasons for the decrease in the number of Escherichia
- Helminthiasis
- Treatment with antibiotics
- Poor nutrition (excess fat or protein or carbohydrates, fasting, poor diet, artificial feeding)
- Intestinal infections (dysentery, salmonellosis, viral infections)
Bacteroides
Norm of bacteroids in feces
Bacteroides are involved in digestion, namely in the processing of fats in the body. In children under 6 months of age, they are not detected in stool tests; they can be detected starting at the age of 8-9 months.
Reasons for increasing the content of bacteroids
- Fat diet (eating a lot of fat)
Reasons for the decrease in bacteroid content
- Treatment with antibiotics
- Intestinal infections (dysentery, salmonellosis, viral infections)
Peptostreptococci
Normal amount in feces
Normally, peptostreptococci live in the large intestine; when their number increases and enters any other area of our body, they cause inflammatory diseases. Participate in the processing of carbohydrates and milk proteins. They produce hydrogen, which turns into hydrogen peroxide in the intestines and helps control the pH in the intestines.
Reasons for the increase in the content of peptostreptococci
- Eating a lot of carbohydrates
- Intestinal infections
- Chronic gastrointestinal diseases
Enterococci
Norm of enterococci
Enterococci are involved in the processing of carbohydrates, in the production of vitamins, and also play a role in creating local immunity (in the intestines). The number of enterococci should not exceed the number of E. coli; if their number increases, they can cause a number of diseases.
Reasons for the increase in the content of enterococci
- Decreased immunity, immune diseases
- Food allergies
- Helminthiasis
- Treatment with antibiotics (in case of resistance of enterococci to the antibiotic used)
- Poor nutrition
- Reducing the amount of Escherichia coli (Escherichia)
Staphylococcus ( saprophytic staphylococci and pathogenic staphylococci )
Norm of saprophytic staphylococci
Norm of pathogenic staphylococci
Staphylococci are divided into pathogenic and non-pathogenic. Pathogenic ones include: golden, hemolytic and plasmacoagulating, golden is the most dangerous. Non-pathogenic staphylococci include non-hemolytic and epidermal.
Staphylococcus does not belong to the normal intestinal microflora; it enters the body from the external environment along with food. Staphylococcus aureus, entering the gastrointestinal tract, usually causes toxic infections.
Causes of staphylococcus Staphylococcus can enter the human body in different ways, starting with dirty hands, along with food, and ending with nosocomial infections.
Clostridia
Normal clostridia
Clostridia are involved in the processing of proteins; the product of their processing is substances such as indole and skatole, which are essentially toxic substances, but in small quantities these substances stimulate intestinal motility, thereby improving the function of fecal evacuation. However, with an increase in the number of clostridia in the intestine, more indole and skatole are produced, which can lead to the development of a disease such as putrefactive dyspepsia.
Reasons for the increase in the number of clostridia
- Large amounts of protein consumed in food
Candida
Candida norm
With an increase in the number of candida in the intestines, fermentative dyspepsia may develop, and a noticeable increase in the number of candida can provoke the development of various types of candidiasis.
Reasons for the increase in the number of candida
- Eating large amounts of carbohydrates
- Treatment with antibiotics (without the use of antifungal drugs in combination)
- Use of hormonal contraceptives
- Pregnancy
- Diabetes
- Stress
Stool analysis for pathogenic flora
Analysis of stool for pathogenic flora is the same analysis of stool for dysbacteriosis.
In the form with test results, it occupies the place - Pathogenic enterobacteria.
The group of pathogenic enterobacteria includes Salmonella and Shigella as the main causative agents of infectious intestinal diseases.
Salmonella
Causes a disease such as salmonellosis, which manifests itself as severe toxic damage to the intestines. The main carriers are waterfowl.
Causes of salmonella
- Eating poorly processed or raw meat
- Eating poorly processed or raw eggs
- Contact with vectors
- Contact with water contaminated with salmonella
- Dirty hands
Shigella
Causes a disease such as dysentery, which also affects the intestines and manifests itself as severe toxic damage to the intestines. The main routes of infection are dairy products, raw vegetables, contaminated water, and people with dysentery.
Causes of Shigella
- Consumption of or contact with contaminated water
- Eating contaminated food
- Contact with people suffering from dysentery
- Dirty hands and contact with contaminated surfaces (dishes, toys)
FAQ
How to properly prepare for the analysis?
The use of certain medications may affect the results of a stool test. Therefore, their use should be suspended or discontinued while preparing for a stool test after consultation with your doctor.
The material for analyzing stool for dysbacteriosis and intestinal infection must be delivered to the laboratory as soon as possible, 30-40 minutes (maximum 1.5-2 hours). The more time has passed from the time of collection of the material and the moment of delivery of the material to the laboratory, the less reliable the analyzes will be. The problem is that most intestinal bacteria are anaerobic, that is, they live in an environment without oxygen and die upon contact with it. This may affect the reliability of the result. Therefore, storing for any period of time beyond the recommended maximum of 2 hours is strictly not recommended.
How to prepare for analysis
Stool analysis is an important test for diagnosing many diseases, so you need to properly prepare for this procedure. First of all, you need to stop using various drugs for a while, because... they can affect the intestinal microflora. You should consult your doctor about these medications. For example, it is recommended to avoid medications that help fight diarrhea.
You need to stop using deworming medications. This applies to laxatives, NSAIDs and antibiotics. In addition, it is better to hold off on enemas.
Before collecting stool, you need to go to the toilet and urinate. Then the urine will not get into the feces. You need to take no more than two teaspoons of material for analysis. It is collected from different areas of the stool. Bacteriological analysis requires a clean container for stool, which will be tightly closed after collecting the material. You also need to remember to sign the jar.
The material for analysis must be delivered as soon as possible - no more than two hours later. The longer the period, the greater the likelihood of data distortion. This is due to the fact that many bacteria that live in the intestines belong to the anaerobic group, so they die in an environment with oxygen.
Bifidobacteria: features
The norm for adults is 10 8 -10 10. For children it is higher. Almost 95% of microbes in the intestines are bifidobacteria, which produce vitamin K and B vitamins. These bacteria are involved in the body's immune defense.
This process can also be affected by poor nutrition, when the diet contains a large amount of fats, proteins and carbohydrates, as well as by fasting, poor diet or artificial feeding of children.
Lactobacilli: nuances
The norm for adults for this indicator is 10 6 -10 8, for children the norm is reduced by an order of magnitude. This type of bacteria accounts for only 5% of all microbes in the intestines. They are also useful, like bifidobacteria. Lactobacilli normalize the level of acidity in the intestines and produce various substances, such as acetic and lactic acid, lactocidin, hydrogen peroxide and acidophilus. All these elements help strengthen the immune system and destroy all pathogenic microbes in the intestines. Lactobacilli can produce lactase.
The lactobacilli content may decrease due to a number of reasons. So, this is affected by medications such as NSAIDs and antibiotics. In addition, with poor nutrition, the content of lactobacilli decreases. This is affected by stressful situations, acute and chronic diseases of the gastrointestinal tract and intestinal infections such as dysentery, salmonellosis and viral diseases.
As for Escherichia, the norm for adults and children is 10 7 -10 8. These bacteria appear in the intestines immediately after a person is born and remain there throughout his life. They are involved in the production of vitamin K and B vitamins and help process sugar. Eschereria produces colicins. These are substances whose properties are similar to antibiotics, so that they eliminate unwanted bacteria in the intestines and strengthen the body's immune defense.
Their number may decrease due to poor nutrition. In addition, this is affected by the presence of intestinal bacterial and viral infections, helminths and the use of antibiotics.
Pathogenic environment in the intestines
Analysis for the pathogenic environment in the intestines is the same analysis as for dysbiosis.
The group of pathogenic microbes includes salmonella and shigella. They are the main culprits of intestinal infections. The analysis should show zero levels of these two bacteria.
Salmonella is carried by waterfowl, so it appears in the human body due to contact with water, contact with vectors, unwashed hands, and also by eating poorly processed meat and fish. Salmonellosis is a toxic intestinal injury.
Shigella causes dysentery and organ toxicity. It can be contracted from untreated water, from people with this disease, through vegetables and dairy products.
Opportunistic intestinal environment
The norm for the content of bacteroids is 10 7 -10 8 for both adults and children. These bacteria help digest food, or more precisely, their effect extends to fats. Children under 6 months should not have them. The number of these bacteria increases if a person begins to consume more fat. Their number can sharply decrease due to antibiotics or intestinal infections.
There should be an order of magnitude less peptostreptococci. They are located in the large intestine, but can also spread to other organs. They process milk proteins and carbohydrates. Their number increases due to the high content of carbohydrates in food and infectious intestinal diseases.
There should be the same number of enterococci as the previous bacteria. They improve human immunity. There should be as many of them as E. coli. Their content increases with food allergies, antibiotics, poor immunity, poor nutrition and due to E. coli.
Staphylococci should be less than 10 4. But they should not turn into a pathogenic form. The number of clostridia and candida should not increase. Candida can lead to various forms of candidiasis, and clostridia can lead to putrefactive dyspepsia. However, all three of these types of microbes, when present in normal numbers, are involved in the digestion of food.
Decoding the stool analysis will give a general picture of the situation in the intestines. Thanks to this, it will be possible to identify all deviations from the norm of various beneficial and pathogenic bacteria, which will lead to the choice of the correct treatment for diseases of the digestive system.
Materials to be examined are collected in sterile containers and accompanied by a label with the name of the person being examined and the name of the material. The accompanying document (referral) must indicate which department is sending the material, full name. and the age of the patient, presumed diagnosis, antibacterial therapy, date and hour of sample collection.
The material is delivered in containers, preventing them from tipping over. During transportation, wetting the cotton plugs and freezing the material are not allowed. The material is delivered within 1-2 hours after collection. If it is impossible to deliver within the specified time frame, the biomaterial is stored in the refrigerator (except for blood and material tested for the presence of meningococcus). When increasing the sample delivery time to 48 hours, it is necessary to use transport media.
Sampling techniques must be described by the microbiologist in special instructions. Laboratory staff provide initial training to all personnel on sample collection compliance.
Samples delivered to the laboratory must be placed in a specially designated place for receiving biomaterial. Upon admission, laboratory workers are responsible for monitoring compliance with the correct delivery of samples. Delivery of material to the laboratory by persons being examined is strictly prohibited.
If the conditions are not met, the samples cannot be processed - this is reported to the attending physician, and the tests are repeated.
General requirements for the sampling and transportation procedure:
Knowledge of the optimal timing for taking material for research;
Taking material taking into account the place of maximum localization of the pathogen by releasing it into the environment;
Selection of material for research in the necessary and sufficient volume, ensuring conditions that exclude sample contamination;
If possible, take material before using antibiotics and other chemotherapy drugs or after stopping antibiotics after 2-3 days.
Microbiological blood test
A procedural nurse or laboratory assistant takes blood from a patient in the treatment room or in the ward, depending on the patient’s condition. It is recommended to take blood for culture before starting antibiotic therapy or 12-24 hours after the last administration of the drug to the patient.
Sowing is carried out when the temperature rises. It is recommended to take blood 2-4 times a day, in case of acute sepsis - 2-3 samples from different places within 10 minutes. If the patient has a permanent subclavian catheter or a system in a vein, you can use them to obtain blood only for 3 days, since the catheter becomes contaminated. A small amount of blood is allowed to flow freely into a tube, and then the blood is drawn into a syringe for culture. Blood cultures are performed over an alcohol lamp.
Blood is taken from adults in the amount of 5-20 ml, and from children - 1-15 ml, from a syringe without a needle over an alcohol lamp and injected into vials with a nutrient medium in a blood to medium ratio of 1:10. Vials of blood are delivered to the laboratory immediately.
Microbiological examination of urine
As a rule, morning urine is examined. Before collection, the external genitalia are toileted. When urinating, the first portion of urine is not used. In the second urination, starting from the middle, urine is collected in a sterile container in the amount of 3-10 ml, tightly closed with a sterile stopper. It is advisable to deliver urine samples to the laboratory immediately. If this is not possible, urine can be stored at room temperature for 1-2 hours, but not more than 24 hours (at a temperature of 4 °C) after collection.
Microbiological examination of stool
For infectious diseases (typhoparatyphoid, acute respiratory infections, dysentery) and nosocomial infections of the gastrointestinal tract, material is taken from the first hours and days of the patient’s admission before the start of antibiotic therapy. Samples are taken at least 2 times.
Stool for culture is taken immediately after defecation. Collection is carried out from a vessel, pot, diaper, which are first thoroughly disinfected and washed repeatedly with hot water. From the dishes, feces are taken with a sterile spatula or stick into sterile jars with lids and test tubes. The samples taken include pathological impurities (pus, mucus, flakes). If it is impossible to obtain stool, material is taken directly from the rectum using rectal swabs. The swab is moistened in saline and inserted 8-10 cm, and then placed in sterile tubes. The feces are delivered to the laboratory no later than 1-2 hours after collection. The material can be stored at a temperature of 2-6 °C for 24 hours.
Microbiological examination of cerebrospinal fluid
It is advisable to take cerebrospinal fluid before starting antibiotic therapy - into a sterile tube with a cap in an amount of 1-3 ml. The material is delivered to the laboratory, where immediately, while the cerebrospinal fluid is warm, it is analyzed. If this is not possible, the liquor can be stored at a temperature of 37 °C in a thermostat for 2-3 hours.
During transportation, the liquor is carefully protected from cooling using heating pads and a thermos.
Microbiological examination of pus, biopsy of abscess walls
The maximum quantity of the material to be tested is taken with a sterile syringe and delivered to the laboratory immediately with a closed needle or can be stored in the refrigerator for 2 hours.
Microbiological examination of sputum
Before coughing, the patient brushes his teeth, rinses his mouth and throat with boiled water. The sputum is collected in a sterile jar or bottle with a lid; if it is poorly separated, it is recommended to prescribe an expectorant the day before, or the patient is allowed to inhale 25 ml of a 3-10% saline solution through a nebulizer.
Sputum can be stored for 2 hours at room temperature and for 24 hours in the refrigerator. When collecting sputum, the patient should not mix mucus and saliva in the mouth. Sputum, consisting of saliva and food particles, is not examined.
Microbiological examination of nasopharyngeal mucus, purulent tonsil discharge, nasal discharge
The material is taken on an empty stomach or no earlier than 2-4 hours after a meal. The root of the tongue is pressed with a spatula. The material is taken with a sterile swab, without touching the tongue, buccal mucosa and teeth.
When examining nasopharyngeal mucus for meningococcus, use a curved sterile cotton swab. It is inserted end up behind the soft palate into the nasopharynx and passed 3 times along the posterior wall. In patients with tonsillitis, if diphtheria is suspected, the material is taken from the tonsils with a dry swab; in the presence of plaque, it should be taken from the border of healthy and affected tissues, lightly pressing on them with a swab. The material on dry swabs is delivered to the laboratory within 2 hours in bags with heating pads.
For whooping cough and parapertussis, nasopharyngeal mucus, nasopharyngeal lavage, and transtracheal aspirates are examined. Fixing the patient's head, insert a tampon into the nostril up to the choanae and leave it there for 15-30 seconds, then remove it and place it in a sterile tube. When collecting material from the mouth, the swab is inserted behind the soft palate, being careful not to touch the tongue and tonsils. Remove mucus from the back wall of the throat, carefully remove the tampon, which is placed in a sterile tube.
Bacteriological culture of stool (tank culture) is a biological study of feces that determines the composition and approximate number of microorganisms living in the human intestines. This is done by introducing feces particles into different nutrient media on which 3 groups of microorganisms grow: normal (necessary for digesting food), opportunistic (change their normal properties) and pathogenic (disease-causing). At the same time, it is possible to establish the sensitivity of pathogenic bacteria to antibiotics and bacteriophages.
Groups of intestinal microorganisms:
Stool culture establishes the composition and quantity. Another name for the study is feces for dysbiosis or feces for intestinal group.
The analysis consists of two stages. At the first stage, a specially prepared smear is examined under a microscope, and bacteria are detected. They are placed in nutrient media that are standardized (in other words, it has long been known which microorganisms develop best in which media).
Laboratory glassware with media and cultures are placed in a thermostat that simulates the temperature and humidity of the human body. The environment is kept in the thermostat for up to 7 days. Time is necessary for all the introduced bacteria to multiply and form colonies (a colony is the descendants of one bacterium). After this period, the number of grown bacteria and colonies is counted.
Some environments natively contain or . By comparing the number of colonies grown on a regular nutrient medium and containing antibiotics, you can find out which drugs can significantly reduce the growth of bacteria. This is how sensitivity to antibiotics is determined.
Based on the result, one can judge which group of bacteria predominates in the intestines of a particular person and how much the normal microflora is changed.
How to take the test correctly?
The reliability of the analysis depends on the quality of material collection, so all points must be carefully followed. The meaning of all actions is sterility, so that bacteria, which are always in the external environment and have nothing to do with humans, do not get into the material.
Preparing for the examination
During preparation, the following conditions must be observed:
- For 2 days, stop taking medications containing bismuth (De-nol, Vikair, Vikalin, Ventrisol, Bismofalk and the like) and iron (Tardiferon, Ferroplekt, Ferrum-lek);
- wait for the natural act of defecation, if necessary, postponing the date of delivery of the material;
- If you need to take any medications daily, inform your doctor and laboratory assistant.
What you should never do:
- use laxatives, their use distorts the result;
- use candles, even glycerin ones;
- give an enema, microenemas (Microlax, Norgalax), including.
Preparing containers
To collect stool, pharmacies have disposable sterile containers with a spoon. The most expensive one costs up to 10 rubles, there are also much cheaper ones. The container should not contain any liquid or preservative (just tell the pharmacist that it is for dysbiosis analysis). Good laboratories provide such containers upon request, adding the cost to the price of the analysis.
It is not advisable to use other containers - baby food jars, etc. - as even boiling does not ensure sterility. At home, it is impossible to achieve the sterility required for laboratory glassware.
Collection of material
- To collect material, use a clean, dry vessel - for bedridden persons. For walkers, place a new plastic bag in the toilet so that the bag covers the entire surface. For children - lay out a clean diaper; you cannot take it from the diaper (the diaper, and especially the diaper, absorbs liquid).
- After defecation, open the container, remove the spoon (attached to the lid), without touching anything inside the container.
- Use a spoon to collect the material from the middle without touching the edges.
- Fill the container no more than one-third full.
- Screw on the lid.
- Place a clear inscription on the container: last name and initials, year of birth, date and time of collection of the material (some laboratories require a referral number).
How long can collected material be stored?
The container with the material must be delivered to the laboratory within 3 hours. If you bring it later, the laboratory simply will not accept it, since the analysis cannot be reliable.
While traveling, it is advisable to avoid direct sunlight and overheating. It is best to place the container, wrapped in a plastic bag, in a bag or briefcase. You cannot place it on the front panel of the car, keep it near the stove or wear it under a fur coat. In winter, the temperature that is in your bag or briefcase is enough; there is no need to wrap it up.
Some laboratories allow the material to be accepted after 8 hours if it has been stored in the refrigerator. This needs to be clarified in the laboratory.
Decoding indicators
The doctor gives a full assessment; the data below is indicative.
The form of each laboratory contains normal average or reference values, and the obtained indicators are compared with them.
Reference values are within:
- typical Escherichia coli - from 10 7 to 10 8;
- lactose-negative rods – less than 10 5;
- - absent;
- Proteus – less than 10 2;
- opportunistic enterobacteria – less than 10 4;
- non-fermenting bacteria – up to 10 4;
- enterococci – up to 10 8;
- hemolytic staphylococcus – absent;
- other staphylococci (saprophytic) – up to 10 4;
- bifidobacteria – up to 10 10;
- lactobacilli – up to 10 7;
- bacteroids (normal inhabitants) – up to 10 7;
- clostridia – no more than 10 5;
- yeast fungi - less than 10 3.
Gastroenterologists distinguish 3 degrees of severity of dysbiosis.
Leads to a decrease in the protective function of the intestines and digestive problems. This condition develops at any age, even newborns can suffer. If the balance of intestinal flora is disturbed, serious complications can occur. Therefore, timely diagnosis and carrying out the necessary tests that will help the doctor prescribe adequate therapy are very important.
What is dysbiosis
Dysbacteriosis is an imbalance of bacteria living in the intestines. under the influence of various factors (taking antibiotics, poor nutrition). Recently, pathology is often observed in very young children.
Features of the disease in newborns and infants
The risk group includes the following categories of children:
In babies who receive breast milk, dysbiosis develops much less frequently. Their intestinal microflora consists of 90% lactobacilli and bifidobacteria.
Signs of impaired intestinal microflora in newborns and infants are as follows:
- bloated stomach;
- bad breath;
- stomach ache;
- formation of gases in the intestines;
- secretion of a large amount of saliva;
- dry and tight skin;
- the appearance of allergic rashes on the skin;
- inflammation of the oral mucosa;
- signs in the mouth;
- difficult stool;
- diarrhea for three or more days;
- vomiting after eating;
- problems gaining weight;
- greenish foamy stool, possibly blood.
According to the World Health Organization, imbalance of intestinal microflora is not a disease. Some foreign experts suggest not interfering with this condition and allowing the body to independently regulate this process. However, most doctors are of the opinion that therapy is still necessary.
To fully evaluate bowel function in a newborn or breastfed infant, the following tests must be performed:
- coprogram (reveals the digestive activity of the intestine, inflammatory processes);
- sowing stool for opportunistic flora (shows how many neutral bacteria are in the intestines);
- tank. stool culture for dysbacteriosis (reveals the percentage of normal and opportunistic intestinal microflora).
According to some experts, it is incorrect to talk about dysbiosis in newborn babies. Children are born with a sterile intestine, which is gradually colonized by bacteria, so it is difficult to judge their normal ratio and quantity.
Causes of imbalance of intestinal microflora in adults and children
Dysbacteriosis can develop in children of preschool and school age, as well as in adults. Most often, the following reasons lead to this condition:
- taking antibiotics;
- eating disorder;
- the presence of a large amount of sweets in food, lack of coarse plant fiber;
- changing your usual food and water when moving to another area;
- infectious intestinal diseases (shigellosis, salmonellosis);
- general decrease in immune system activity;
- operations on the stomach and intestines;
- inflammatory diseases of the stomach and intestines (gastroenterocolitis).
Dysbacteriosis in men and women usually has the same causes. However, the following factors can also contribute to the development of pathology in the fairer sex:
- women's passion for strict diets;
- frequent bowel cleansing using enemas;
- addiction to laxatives for the purpose of losing weight;
- more active treatment with antibiotics.
What signs may indicate the presence of pathology?
Symptoms of dysbiosis in adults and children of preschool and school age:
- bloating and abdominal pain;
- decreased appetite;
- nausea and vomiting;
- undigested pieces of food in stool;
- the appearance of a white coating on the tongue;
- bad breath;
- decreased vitality, fatigue;
- periodic acute abdominal pain;
- dry and brittle hair;
- the appearance of bleeding gums and dark plaque on the teeth.
To confirm objective signs of dysbiosis, it is necessary to do a microbiological examination of stool. This analysis will show the concentration and ratio of beneficial microorganisms (bifidobacteria, lactobacilli, bacteroides) and opportunistic ones, as well as the presence of pathogenic bacteria (shigella, salmonella).
Doctor Komarovsky about dysbiosis - video
Stool analysis for dysbacteriosis: feasibility and reliability of such diagnostics
According to foreign and Russian pediatricians, there is no point in taking a stool test for dysbiosis in children who are breastfed, since mother's milk protects the child from this problem. If the baby is receiving artificial feeding or has already switched to regular food, and he has signs of dysbiosis, a visit to the pediatrician is first necessary.
After the examination, the following tests will be prescribed:
- general clinical analysis of urine and blood;
- coprogram (analysis of intestinal digestive activity);
- stool analysis for the presence of helminthic infestation and enterobiasis (pinworms);
- Ultrasound of the intestines.
And only as a last resort, if other diseases have not been detected, a stool test will be required to study the intestinal microflora, the results of which will be ready in 4-7 days.
To date, the question of the reliability of such a study remains open. In order for the results to be as accurate as possible, you need to collect the material correctly.
When not to get tested
- antibiotics;
- anti-inflammatory non-steroidal drugs;
- other groups of antibacterial drugs;
- vitamins;
- drugs that reduce gas formation in the intestines (Plantex, Espumisan);
- enterosorbents (Smecta, Enterosgel);
- laxatives.
The study should not be performed if the patient is receiving rectal suppositories or enemas.
How to properly collect stool: preparing for the test
You need to collect morning stool for analysis, preferably bring it to the laboratory within an hour. Be sure to place the material in a sterile glass container (not one that contains canned meat or fish or mayonnaise). The best container in this situation is a special plastic container for such analyses. It is necessary to ensure that the urine of a child or adult does not get into the feces. You need to collect it not from a diaper, but from a diaper.
If it is not possible to take the material in the morning, the evening feces will have to be placed on the bottom shelf of the refrigerator until the morning.
Norms for stool analysis for microbiological culture - table
| Microflora | Children under one year old | Older children | Adults |
| Bifidobacteria | 10 10 -10 11 | 10 9 -10 10 | 10 8 -10 10 |
| Lactobacilli | 10 6 -10 7 | 10 7 -10 8 | 10 6 -10 8 |
| Escherichia | 10 6 -10 7 | 10 7 -10 8 | 10 6 -10 8 |
| Bacteroides | 10 7 -10 8 | 10 7 -10 8 | 10 7 -10 8 |
| Peptostreptococci | 10 3 -10 5 | 10 5 -10 6 | 10 5 -10 6 |
| Enterococci | 10 5 -10 7 | 10 8 | 10 5 -10 8 |
| Saprophytic staphylococci | <10 4 | <10 4 | <10 4 |
| Pathogenic staphylococci | - | - | - |
| Clostridia | <10 3 | <10 5 | <10 5 |
| Mushrooms of the genus Candida | <10 3 | <10 4 | <10 4 |
| Salmonella | - | - | - |
| Shigella | - | - | - |
Interpretation of research results: Escherichia, Staphylococcus aureus, Clostridia and other microorganisms in feces
What does the color of stool, mucus or blood in it indicate?
The color of stool in newborns and infants is usually bright yellow; the appearance of a greenish tint indicates an imbalance of microflora or a disease. In adults, the biomaterial should be brown.
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