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Test Name:
Shiga Toxin Antigen, by EIA, Feces
- SBMF No:
21902 - Performance Lab Name:
Microbiology - Test Mnemonic:
ST SHIGTOX - ABN:
Not required - CPT Code:
87427 - LOINC Code:
64013-6 - Also Known As:
E. coli 0157 Antigen Detection
EHEC Antigen
Enterohemorrhagic Escherichia coli
Enteropathogenic E. Coli
Shiga toxin-producing Escherichia coli (STEC) 0157
Shiga-like Toxin Assay
Shigalike Toxin Assay
STEC 0157
Verotoxin Assay - Also See:
21002 Culture, Feces, Routine, with Campylobacter and Shiga Toxin Antigens, by EIA - Spec Type:
Feces - Spec Container:
Feces Culture Transport Media - Alt Spec Type:
Feces - Alt Spec Container:
Cary-Blair Feces Swab Transport System - Pref Vol:
Fill transport media container to indicated line with feces - Min Vol:
One swab placed in Feces Culture Transport Media - Patient Prep:
Caution the patient against the use of antacids, barium, bismuth, etc. prior to collection of specimen
Fecal specimens should be collected early in the course of the diagnosis process or in the acute phase of diarrheal illness, before antimicrobial therapy has been initiated - Spec Collect:
- Random Feces Specimen:
- – Collect in sterile bedpan (not contaminated with urine, residual soap, or disinfectants)
– Transfer portions of feces, particularly those containing pus, blood, or mucus, to "Feces Culture Transport Media" container
– Do not fill container beyond designated "fill line" - Rectal Swab Specimen:
- – Swabs of rectal wall or sigmoid colon lesions collected during proctoscopy or sigmoidoscopy
- or -
– Pass swab beyond anal sphincter, carefully rotate, and withdraw
– Place swab in container of "Feces Culture Transport Media" and break off a sufficient portion of the swab shaft to allow tightening of the container lid - Duodenal Sigmoid Aspirate Specimens: Collected by physician and placed in "Feces Culture Transport Media"
- Refer to: P-1003 Feces (Stool) Collection and Transport
- Spec Process:
Gently mix specimen and solution several times - Spec Store Transport:
Room temperature
Transport to SBMF within 24 hours of collection (preferred) – Do not exceed 48 hours - Spec Stability:
48 hours room temperature (20-30°C) - Spec Reject:
Transport container filled beyond indicated line
Dry swab
Not received in transport medium
Contains interfering substances
Specimen refrigerated or frozen - Methodology:
Enzyme Immunoassay (EIA) - Use:
Screening stool specimens for Shiga toxin-producing Escherichia coli (STEC) - Clinical Significance:
- Shiga toxin-producing Escherichia coli (STEC) causes gastrointestinal disease, particularly among children and elderly persons. This agent should be suspected in patients with:
- Bloody diarrhea
As well as, patients with right-side abdominal pain with bloody or non-bloody diarrhea
And, when postdiarrheal hemolytic uremic syndrome (HUS) is suspected
The stool sample is inoculated into a selective broth and incubated for 24 hours, followed the next day by ElA. Positive results are considered a reportable disease and the specimen is then sent to the Indiana State Department of Health (ISDH) for serotype confirmation.
In routine feces cultures, 0157 STEC is detected by incorporation of selective culture media, Sorbitol MacConkey agar. However, non-0157 STEC serotypes are indistinguishable from other E. coli and cannot be differentiated by this selective culture media. In order to detect all STEC infections, enzyme immunoassay must be ordered.
- Reference Range:
Negative for Shiga toxin antigen, by EIA - Day Run:
Sun-Sat (daily) - Test Type:
FECES
