Shiga toxin-producing Escherichia coli (NPHLBK) (HECCU)  

IMPORTANT! Pre-approval needed from state or local health department. Local or State Health Department. Send approval to or call (402) 559-9444.

NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see NUlirt Guide).

Forms Required - Nulirt batch list or NPHL Test Request Form (completed in entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459 for further clarification.


Test: Shiga toxin-producing Escherichia coli
  • No pre-approval needed
  • NUlirt order:
    • Isolate: NPHLBK
    • Stool: HECCU
  • E. coli, O157:H7, Shigatoxin positive, non-O157 E. coli, STEC, hemorragic E. coli, Shiga toxin-positive, E coli
  • Stool: Culture
  • Isolate: Banking and whole genome sequencing (WGS)
  • Test performed Monday - Friday
  • Turnaround time 1 - 7 days
  • Stool or pure isolate
Collection Device:
  • Stool specimens should be collected in Cary Blair or Enteric Plus transport meida according to manufacturer's instructions
    • If fresh stool is received, it should be placed into transport media within 2 hours of collection
    • Ratio of stool to Enteric Plus is 2:15 (0.5 mL stool to 3.75 mL Enteric Plus liquid media)
  • Isolates should be on a plate or slant
  • Seal screw-top tubes with Parafilm™ or tape and place in biohazard bag with absorbent material.
  • Test subject to CLIA regulations and required 2 patient identifiers on specimen container and requisition forms
  • Stool samples minimum: 1 mL
  • Leaking specimen, mixed isolates, or stool contaminated with urine
Specimen Stability:
  • Stool stable at 2-8 °C for up to 4 days
  • Isolates stable at ambient air 15-25 °C
Reference Interval:  
Reportable Disease:  
  • Stool culture performed at Nebraska Medicine
  • Banking and Whole Genome sequencing performed at NPHL
  • Test results are to be used for epidemiological and infection control purposes only
Revised: 7/2/2024 
If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459.