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Blog


SWABS RULE OVER STOOL: 99 PERCENT VERSUS 76 PERCENT OF PATIENTS COULD PROVIDE
SAMPLE USING FECALSWAB<SUP>®</SUP> IN STUDY

FecalSwab®

September 15, 2017

Convincing a tot to put on their shoes is challenging enough, try asking them to
poop on demand. Thankfully, there’s a better alternative.

A recent study “Enteropathogen Detection in Children with Diarrhoea, or
Vomiting, or Both, Comparing Rectal Flocked Swabs with Stool Specimens: an
Outpatient Cohort Study,” published  in The Lancet Gastroenterology & Hepatology
on July 13, 2017, found that not only are Copan’s rectal swabs a much more
convenient tool for collecting pediatric fecal samples, but they actually
increased the overall yield by 10 percent!

Of the 1,519 study participants, only five were unable to provide a rectal swab
sample compared to 372 who couldn’t provide a stool sample.

Getting Stool Samples from Small Ones
It’s a common dilemma among parents. The baby has a bad case of diarrhea so Mom
schedules an appointment. But exactly how does Mom successfully obtain enough
fecal matter from a baby with liquefied feces that just soak into the diaper?

Since a diaper may contain interfering substances, such as Vaseline®, perfumes,
dyes or other cream contaminants and is also designed to absorb liquids, parents
must find another way to complete the unpleasant task. Lining the diaper with
plastic wrap is one plausible option, but it’s not easy to keep the material in
place, it could cause diaper rashes, and it can yield insufficient sample
volume.

For children out of diapers, figuring out when they’re going to have a bowel
movement and convincing them to go into a toilet hat or Saran® wrap-covered
seat, can pose quite the challenge too. That’s why many parents throw up their
hands in frustration saying “it’s impossible”!

Detecting gastrointestinal pathogens has traditionally depended upon receiving
stool samples from patients, and subsequently testing the specimen for
parasites, virus or bacteria affecting the patient. Due to the preconceived
notion that rectal swabs do not collect enough fecal matter, healthcare
officials have been advised against using them to diagnose GI diseases. Yet,
solely relying on stool specimens for enteric pathogen detection can lead to
delayed diagnosis.

Considering all the difficulties involved collecting pediatric samples,
researchers at The Alberta Provincial Pediatric EnTeric Infection TEam
(APPETITE) decided to conduct a study comparing the two methods: fresh stool
samples, Copan’s FecalSwab® kits and Copan dry flocked swabs. The study, which
spanned from December 12, 2014 through August 31, 2016, involved 1,519 children
under the age of 18 who had suffered at least three episodes of vomiting or
diarrhea in the preceding 24 hours and less than 7 days of symptoms.

Three groups of patients were recruited for the study: “(1) children with
vomiting or diarrhea in Pediatric Emergency Research Canada (PERC) emergency
departments in Calgary and Edmonton (AB, Canada), and children in these
departments with non-infectious illness whose caregivers agreed to submit
specimens if they later developed vomiting or diarrhoea; (2) children receiving
routine vaccinations at a Calgary public health clinic whose caregivers agreed
to submit specimens if vomiting or diarrhoea developed later; and (3)
symptomatic children identified via a provincewide nursing triage telephone
resource called Health Link who met triage criteria for the provision of care at
home instead of seeking medical care.”

Patients were asked to provide three sample types: stool in a sterile container,
two types of swabs: Copan’s FecalSwab® with a regular flocked swab, and a dry
rectal FLOQSwab® with a stopper. Dry swabs and stool samples were transported to
the lab in sterile containers, while the FecalSwab® rectal swabs were
transported in the accompanying 2mL tube of Cary-Blair media.

The rectal swab with a stopper is specifically designed to reach the rectum’s
transition zone, making it much easier to quickly collect rectal samples,
particularly from young children and babies.

Faster Results with Molecular Diagnostics
99 percent of all enrolled patients were able to provide rectal swab samples,
while only 76 percent of the patients were able to produce fresh stool. That
only five of the participants were not able to provide a rectal sample reveals
how effective these swabs are for pediatrics, particularly when rapid detection
is necessary. In addition, overall pathogen yield was 67 percent for swab
samples versus 57 percent for stool showing that rectal swabs are also a more
sensitive device for pathogen detection.

These noteworthy results from the two-year long study, lead the authors to state
“Rectal swabs should be done when enteropathogen identification and rapid
detection are needed, appropriate molecular diagnostic technology is available,
and a stool specimen is not immediately available. In view of their high yield,
we urge the recommendation against the use of rectal swabs as diagnostic
specimens be reconsidered”.

Convincing your kid to poop or trying to “catch” feces with a plastic-lined
diaper doesn’t sound like the best way to spend a day with your sick baby. That
there’s now a device available making fecal collection more convenient for both
mom and baby, should make those scenarios a bygone bad dream.

Advances in technology are continuously improving medicine. The end goal of all
these innovations in healthcare is better patient care. This study demonstrates
that conducting more research on the clinical need for rectal swabs for
pediatric patients is needed.

Ask your doctor about Copan’s FecalSwab® and rectal FLOQSwab® today! Or contact
Copan to see for yourself why this product is a necessity for pediatrics!




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