Test Detail

Shiga toxin-producing E. coli (STEC) (O157): Culture Independent Diagnostic Test Panel (PCR or EIA positive stool)

Panel Components
Test Description		Contact: Reference Microbiology (319) 335-4335 Test Request Form: Bacteriology SHL OpenELIS Code: 574, 909
Bacterial culture and identification of Shiga toxin-producing E. coli (STEC) species. Used as a Culture Independent Diagnostic Test on a stool specimen that has been detected positive by PCR or EIA for STEC. It is used for the recovery of isolates to assist epidemiological investigations. This is not a confirmatory test.
E.coli O157 and 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, Shiga toxin - Producing E. coli (STEC) stx DNA Screen by Polymerase Chain Reaction (PCR): results not reported to facility)
Performed	Avg. Turnaround Time	Method
Coralville, 8 a.m. - 5 p.m., M-F	2 - 5 business days	Bacterial Culture, Polymerase Chain Reaction (PCR)
Fee	CPT Code(s)
No charge	87046, 87798
Specimen Requirements
Specimen Type:	Preserved stool, rectal swabs, or Gram Negative (GN) broth that has screened positive for Shiga toxin.
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. Ship to the Coralville location. Any CULTURE (i.e., GN Broth) of Shiga toxin-producing E. coli (STEC) is considered a category A infectious substance under DOT and IATA regulations. Cultures of these organisms require specific packaging, labeling, and documentation before they can be transported to the laboratory for testing. Guidance for the proper packaging and shipping of category A infectious substances can be found at Hazardous Materials Regulations (HMR) 49 CFR 173.196. Specimens for shipment should be packaged following the basic triple packaging system consisting of (1) a primary container (a sealable specimen container) wrapped with absorbent material, (2) a secondary container (watertight, leak-proof), and (3) a rigid outer shipping package. Category A specimens must be packaged according to the Division 6.2 regulations with appropriate documentation.
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