| Shigatoxin EIA (E. coli)
Order in NUlirt or complete NPHL Test Order Form
|Shigatoxin testing, E. coli 0157H7, Shiga-like toxin EIA, Non-E.coli O157)
|Enzyme-linked immunosorbent assay
|Test performed daily; Turnaround time 3d.
|Stool specimen or actively growing culture
| Enteric Plus Para-Pak or Cary Blair Media
Collect stool in a clean dry container or NPHL Stool collection kit (available at Client Services). IMMEDIATELY transfer sufficient stool to Para-Pak Enteric Plus Transport vial or Cary Blair Media to bring the liquid level to the 'Fill' line or approximately 5-10mL of stool sample. Tighten the cap and shake firmly to insure that the specimen is mixed.
Shigatoxin positive stool in pure culture of E.coli sorbitol-negative isolate on MacConkey or MacConkey with sorbitol plate for identification.
Specimen Labeling: Test subject to CLIA regulations and required 2 patient identifiers on specimen container and requisition forms
|10mL in transport media
Prior to and during shipment: Ambient 15-25°C
|Stool received during a colonoscopy. Unpreserved stool will be rejected if greater than 1 hour old. Enteric Plus inoculated with stool greater than 96hr or greater than 4d. Frozen stool. Stool contaminated with urine, barium, bismuth, mineral oil, water or other contaminants are unacceptable. Extremely 'hard' formed stools are unacceptable. Do not use the vial if beyond expiration date or contents of the vial are cloudy or yellow.
|Ambient 15-25°C in transport media for 96h (2d) refrigerated or 4d.
|Shigatoxin negative by EIA
|Report positive Shigatoxin results within 7d to local or state health department. Refer to Nebraska DHHS Title 173, Communicable Diseases. All shigatoxin producing E.coli isolates should be submitted to the NPHL for molecular sequencing to supplement and epidemiological investigation.
| Pre-approval needed from state or local health department. Send approval to NPHL@unmc.edu or call (402) 559-9444.
This test will identify the presence of Shiga-like toxin E. coli in stool; however, it cannot determine the specific strain of E. coli (i.e. O157:H7).
This test can be performed either on a stool sample or on actively growing isolate of E. coli in pure culture.
The Shiga-like toxin EIA can be used as a test for proof-of-=cure testing following a primary diagnosis of enterohemorrhagic E. coli-caused infection. Frequency for shigatoxin proof-of-cure testing can vary according to jurisdictional recommendations. In general, cure is defined as 2 consecutive negative stools taken 24h apart that have been collected no sooner than 48h following discontinuation of antibiotics or 24h after cessation of diarrhea symptoms.
NUlirt packing list or NPHL Test Order Form (completed in entirety) must accompany the specimen.