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Shiga toxin-producing E. coli (STEC) Exclusion Culture Panel (Clearance for Childcare/School/Work)

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Test Description
  • Contact: Reference Microbiology (319) 335-4335
  • Test Request Form: Iowa HHS Epidemiological Investigation Test Request Form. Contact Iowa HHS CADE at (515) 242-5935 (business hours) or (515) 323-4360 (non-business hours) for form.
  • SHL OpenELIS Code: 919, 909
Determine carrier status of affected individual. State of Iowa Department of Health and Human Services (HHS) approval required for submission.
Panel Components
E.coli O157 & Other STEC, Shiga toxin - Producing E. coli (STEC) stx DNA Screen
Reflex Test(s)
Enteric Pathogen Identification/Serotyping by Next Generation Sequencing, (Organism Sequencing by Next Generation Sequencing, EZ1 Extraction by Next Generation Sequencing: results not reported to facility)
Performed Avg. Turnaround Time Method
Coralville, M - F, 8 a.m. - 5 p.m., Sat. 9 a.m. - noon
2 - 5 business days Bacterial Culture for Exclusion, Polymerase Chain Reaction (PCR)
Fee CPT Code(s)
No charge. Prior approval by an Iowa Health and Human Services epidemiologist must be obtained. 87798 x 2, 87798
Specimen Requirements
Specimen Type: Stool specimen or rectal swabs in enteric transport media (Cary-Blair).
Patient Preparation: The patient should be instructed not to take any antacids, oily laxatives, or anti-diarrheal medications unless prescribed by the physician.
Collection Instructions: Use an Enteric Transport Media (Cary-Blair) Vial, clearly labeled with two unique identifiers (patient's name and unique identifier) and the date of collection. ETM is buffered and normally appears red. If the liquid is yellow, an acidic shift has occurred and the vial should not be used. Pass the stool into a clean, dry, plastic disposable container or place a large plastic bag or kitchen wrap over the toilet seat to catch the specimen. DO NOT MIX URINE OR WATER WITH THE STOOL SPECIMEN.

Formed or semi-formed stool: Using the spork built into the lid, add approximately three spoonfuls of firm stool, or five spoonfuls of soft stool to the vial until the liquid reaches the red "fill line". Any blood or mucous should be included.
    Liquid stool: Pour the stool into the vial up to the red fill line.
      Rectal swabs: Insert the swabs into the transport media and break or cut the sticks so that the vial cap may be securely closed.
        Tighten the vial cap completely. A leaking specimen may be unsuitable for testing. Clean the outside of the vial with rubbing alcohol or soap and water if they are soiled. Make sure the patient name and date of collection are still readable. Wrap the specimen in absorbent material and place into a biohazard bag.

        Wash hands thoroughly.

        Shipping:
        Specimens should be stored and shipped under the same conditions. Wrap specimen container in absorbent material and place inside a biohazard bag. Transport specimen at room temperature. Ship to the Coralville location.
        Temperature and Stability: Room Temperature (15-30°C); stable for 3 days. Refrigerated (2-8°C); stable for 4 days.
        Rejection Criteria: Specimens will be rejected if received under these conditions:

        Frozen specimens, unpreserved stool, insufficient or overfilled transport media (ETM or Carey-Blair), Samples received > 3 days from collection if room temperature, Samples received > 4 days from collection if refrigerated, ETM samples that have turned yellow, samples that have leaked.
        Expected Results:
        Organism Identified: Enterohemorrhagic E. coli found, Enterohemorrhagic E. coli not found, Enterohemorrhagic E. coli not found - Normal Fecal Flora Suppressed, Enterohemorrhagic E. coli found - unable to isolate. stx1: Detected, Not Detected, Indeterminate, Equivocal. stx2: Detected, Not Detected, Indeterminate, Equivocal.
        Comments
        Required submission per Iowa Administrative Code {641} Chapter 1
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        State Hygienic Laboratory

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        319-335-4500 or 1-800-421-IOWA (4692)
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