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- E coli O157
- EHEC, Stool Culture
- Shiga Toxin
Expected Turnaround Time
2 - 3 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
For more information, please view the literature below.
Specimen Requirements
Specimen
Stool or rectal swab placed in stool culture transport vial
Volume
1 to 2 g, 1 to 2 mL, or one swab
Minimum Volume
Rectal swab with obvious stool
Container
Stool culture transport vial; culture collection swab may be used to collect rectal swabs or a swab of fecal material, then swab should be placed in stool culture transport vial (Para-Pak® orange).
Storage Instructions
Maintain specimen at room temperature.
Causes for Rejection
Specimen received in grossly leaking transport container; diapers; dry specimen; specimen submitted in fixative or additive; specimen received in expired transport media or incorrect transport device; inappropriate specimen transport conditions (not in a C&S vial or in an overfilled C&S vial); specimen received after prolonged delay in transport (usually more than 72 hours); specimen stored or transported frozen; wooden shaft swab in transport device; unlabeled specimen or name discrepancy between specimen and request label
Test Details
Use
Detect the presence of Shiga-toxin-producing enterohemorrhagic E coli
Limitations
There are four types of pathogenic E coli (see table). This test detects only enterohemorrhagic E coli; tests are not available for the other pathogenic E coli.
Category | Clinic Manifestation |
|---|---|
Enterotoxigenic (ETEC) | Travelers' diarrhea and infant diarrhea in less developed countries |
Enteropathogenic (EPEC) | Infant diarrhea |
Enterohemorrhagic (EHEC) | Hemorrhagic colitis Hemolytic uremic syndrome Thrombotic thrombocytopenia purpura |
Enteroinvasive (EIEC) | Dysentery |
Methodology
Detection of enterohemorrhagic E coli Shiga toxins by enzyme immunoassay (EIA)
Reference Interval
No enterohemorrhagic E coli Shiga toxin detected
Additional Information
Treatment of patients infected with Enterohemorrhagic E coli (EHEC) with antibiotics is contraindicated. Hemorrhagic colitis can be differentiated from other causes of diarrhea by its progression from watery to bloody diarrhea during a few days' time. Fecal leukocytes are markedly increased. Fever is usually absent. The disease is mediated by the production of a Shiga-like toxin that interferes with colonic brush border cells, protein synthesis, and ultimately causes cell death. Enterohemorrhagic E coli (EHEC) differ from other strains of bacteria in the large amount of toxin they produce. Virtually all O157:H7 organisms and other EHEC strains have been shown to produce Shiga toxin.
References
Gavin PJ, Thompson RJ. Diagnosis of enterohemorrhagic Escherichia coli infection by detection of Shiga toxins. Clin Microbiol Newslet. 2004; 26:49-54.
Griffin PM, Ostroff SM, Tauxe RV, et al, Illnesses associated with Escherichia coli O157:H7 infections. A broad clinical spectrum. Ann Intern Med. 1988 Nov 1; 109(9):705-712.3056169
Park CH, Kim HJ, Hixon DL et al. Importance of testing stool specimens for Shiga toxins. J Clin Microbiol. 2002 Sep; 40(9):3542-3543. Erratum: J Clin Microbiol. 2003 Jan; 41(1):526.. 12202617
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 180935 | E coli Shiga Toxin EIA | 21262-1 | 180935 | E coli Shiga Toxin EIA | 21262-1 |
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