A stool culture and sensitivity (also called an enteric culture or stool culture) is a laboratory test that looks for disease-causing bacteria in a stool (feces) sample. It helps identify common bacterial pathogens that can cause gastroenteritis, infectious diarrhea, and dysentery, such as Salmonella, Shigella, and Campylobacter (and sometimes other bacteria depending on the lab and your history).

In the “culture” portion of the test, the lab places a small amount of stool on special plates that encourage bacteria to grow. If a suspicious bacterium grows, the lab identifies it. In the “sensitivity” (antibiotic susceptibility) portion, the lab tests which antibiotics are most likely to work against the bacteria found. This is especially helpful when symptoms are severe, prolonged, or when a person is at higher risk of complications.

What results generally mean:

Positive/abnormal culture: A bacterial pathogen was found. This suggests your diarrhea is likely due to that infection. Your clinician uses the result—plus your symptoms and medical history—to decide whether you need treatment (some infections improve without antibiotics, while others may require them). If sensitivity results are provided, they guide the choice of antibiotic and help avoid one that may not work due to resistance.

Negative/normal culture: No targeted bacterial pathogens grew in the culture. This can mean there is no bacterial infection, or that symptoms are due to another cause (such as a virus, parasite, food intolerance, inflammatory bowel disease, or a bacterium/toxin not detected by routine culture). If symptoms continue, your clinician may order additional tests such as stool PCR panels, ova and parasite testing, or tests for C. difficile toxin.

Doctors commonly order a stool culture and sensitivity when diarrhea may be caused by an invasive or contagious bacterial infection, or when the illness is more than “typical stomach flu.” It can help determine whether antibiotics are needed and supports public health measures when foodborne illness is suspected.

This test is often considered when you have:

• Severe or persistent diarrhea (for example, lasting more than a few days, worsening, or causing dehydration)
• Bloody diarrhea or mucus in the stool (symptoms often described as dysentery)
• High fever, severe abdominal cramps, or significant weakness
• Signs of dehydration (dry mouth, dizziness, reduced urination), especially in children or older adults
• Recent travel, especially to areas with higher risk of food- or water-borne infection
• Exposure risks such as outbreaks, undercooked poultry/eggs, unpasteurized dairy, untreated water, or close contact with someone who has infectious diarrhea
• Higher-risk health situations including pregnancy, age extremes (infants/older adults), a weakened immune system, inflammatory bowel disease, or severe underlying medical conditions

It may also be ordered for occupational or outbreak investigations (for example, in food handlers, daycare settings, nursing facilities) when identifying pathogens like Salmonella, Shigella, or Campylobacter is important to prevent spread.

• Salmonellosis (Salmonella foodborne infection)
• Shigellosis (Shigella infection; often causes dysentery)
• Campylobacter enteritis (Campylobacter infection, often linked to poultry)
• Enteropathogenic and other diarrheagenic E. coli infections (depending on culture methods and follow-up testing)
• Yersiniosis (Yersinia enterocolitica infection; sometimes requested based on symptoms/exposures)
• Food poisoning / bacterial gastroenteritis from contaminated food or water
• Traveler’s diarrhea (bacterial causes may be evaluated with stool culture and/or molecular tests)

• Finding the cause of acute diarrhea and guiding the right next steps
• Identifying foodborne illness (e.g., Salmonella) to protect household contacts and the community
• Targeting antibiotic therapy when needed and supporting antibiotic stewardship (choosing an effective drug and avoiding unnecessary antibiotics)
• Reducing complications from severe infectious diarrhea (dehydration, hospitalization risk), especially in vulnerable patients
• Supporting recovery planning for persistent gastrointestinal symptoms after suspected infection
• Outbreak control and return-to-work/school decisions in certain settings (daycare, food handling, healthcare)