Evaluation of the New FecalSwab System for Maintaining Stability of Stool Samples Submitted for Molecular Tests

Silbert, Suzane; Gostnell, Alicia; Kubasek, Carly; Widen, Raymond

doi:10.1128/jcm.00273-17

Cited by 11 publications

(10 citation statements)

References 10 publications

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“…On the other hand, FS is FDA cleared for transport and culture of gastrointestinal (GI) pathogens, but it is not FDA cleared for use with any molecular GI assays. Newer studies conclude that FS with Cary-Blair medium can be used for molecular detection of pathogens without cross-reaction or inhibitory effects (10,17). Nevertheless, a crossreaction of the Cary-Blair medium and the GeneXpert C. difficile test as an explanation for the lower detection rate seen in our study cannot completely be ruled out.…”

Section: Discussionmentioning

confidence: 53%

Evaluation of the Use of Rectal Swabs for Laboratory Diagnosis of Clostridium difficile Infection

et al. 2018

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For the diagnosis of infection (CDI), microbiological testing is almost always accomplished through the analysis of stool specimens. We evaluated the performances of rectal swabs with liquid transport medium (FS) and nylon flocked dry swabs for the detection of Additionally, the impact on the diagnostic yield of storing swabs at -80°C for up to 3 months was evaluated. Sixty clinical stool samples positive for by PCR were used for simulating rectal swabbing. FS and dry swabs were dipped into the stool and tested by PCR directly after swabbing at 1 and 3 months after storage at -80°C. Stool and the liquid medium of FS were additionally tested by a combination of glutamate dehydrogenase antigen (GDH) testing and toxin A/B enzyme immunoassay (EIA), as well as by toxigenic culture (TC). Using dry swabs, the PCR-based detection rate of was equal to the rate using stool samples (30/30 [100%]), whereas the detection rate in FS was significantly lower (25/30 [83.2%]; = 0.019). The sensitivities of FS for detecting by PCR, TC, GDH testing, and toxin A/B EIA were 83.3%, 85.7%, 88%, and 68.9%, respectively. Storage of swabs at -80°C had no impact on the detection rate. FS cannot replace stool samples in the two-step laboratory diagnosis of CDI, as the sensitivities were too low, probably due to diluting effects of the fecal sample in the liquid medium. For simple PCR-based detection of , dry swabs proved to be a suitable alternative to the use of stool samples.

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Section: Discussionmentioning

confidence: 53%

Evaluation of the Use of Rectal Swabs for Laboratory Diagnosis of Clostridium difficile Infection

et al. 2018

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“…Lastly, the current study focuses on the performance of the FecalSwab in its compatibility with the BD Max system. Although our findings and those from others suggest that the FecalSwab can be used for enteric diagnostics with a range of platforms ( 6 , 8 , 9 ), volume standardization and clinical evaluation is required for laboratories using other nucleic acid amplification systems.…”

Section: Discussionmentioning

confidence: 74%

“…Copan FecalSwab collection devices have previously demonstrated equivalent performance to bulk stool for enteric pathogen detection using culture methods ( 7 ) and with the Cepheid Xpert ( 6 ), BioFire FilmArray ( 8 ) and BD Max ( 9 ) molecular platforms. However, this is the first report evaluating the FecalSwab with the BD Max system EVP assay.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the FecalSwab for Stool Specimen Storage and Molecular Detection of Enteropathogens on the BD Max System

et al. 2020

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The FecalSwab™ system (Copan Italia, Brescia, Italy) is a convenient alternative to bulk stool for the diagnosis of enteric pathogens. Although U.S. Food and Drug Administration (FDA) approved for transport and culture of enteric bacterial pathogens, the FecalSwab™ has not been well assessed for its suitability with molecular platforms. In this study, we evaluated the FecalSwab™ as a specimen type for the BD MAX™ System using the viral and bacterial enteric panels (BD Diagnostics, Baltimore, USA). One-hundred eighty-six unpreserved stool specimens were collected and used to prepare matched bulk stool and FecalSwab™ samples. Performance was equivalent (P >0.48) to bulk stool for all targets when 50 μl of FecalSwab™ specimen was loaded onto the BD MAX™ assays. As stool specimens are often collected off-site from the clinical microbiology laboratory and require transport, we assessed the stability of stool specimens stored for up to 14 days at 40C, 220C, or 350C to account for varying transportation conditions. Molecular detection for the majority of viral targets (excluding astrovirus) was unaffected (ΔCT ≤1) by sample storage temperature over the two-week period; however, detection of enteric bacteria was variable if specimens were not refrigerated (220C or 350C). By demonstrating equivalent performance to matched bulk stool and maintaining molecular detection sensitivity when stored at 4°C, we suggest that the FecalSwab™ is a suitable specimen type for enteropathogen diagnostics on the BD MAX™ System.

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“…This may be the main reason for negative results in the RS samples, which collect only a small quantity of fecal matter, especially in cases of watery diarrhea. Another reason that might explain the RS negative samples is the ability of Cary-Blair transport medium used in RS specimens to preserve GE viruses although many reports suggest that the usage of Cary-Blair medium is appropriate for pathogen detection even with a decreased specimen volume [23][24][25]. In addition, negative results may be due to the insufficient amount of fecal matter collected because of technical difficulties during the sampling procedure.…”

Section: Discussionmentioning

confidence: 99%

Rotavirus detection in bulk stool and rectal swab specimens in children with acute gastroenteritis in Norway

Gibory

Haltbakk

Flem

et al. 2017

Journal of Clinical Virology

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Evaluation of the New FecalSwab System for Maintaining Stability of Stool Samples Submitted for Molecular Tests

Cited by 11 publications

References 10 publications

Evaluation of the Use of Rectal Swabs for Laboratory Diagnosis of Clostridium difficile Infection

Evaluation of the Use of Rectal Swabs for Laboratory Diagnosis of Clostridium difficile Infection

Evaluation of the FecalSwab for Stool Specimen Storage and Molecular Detection of Enteropathogens on the BD Max System

Rotavirus detection in bulk stool and rectal swab specimens in children with acute gastroenteritis in Norway

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